Medpace (MEDP) 10-Q 23 Jul 24 2024 Q2 Quarterly report Financial data

Cover Page

Cover Page - shares	6 Months Ended
	Jun. 30, 2024	Jul. 19, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2024
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 Central Index Key	0001668397
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q2
Amendment Flag	false
Entity Common Stock, Shares Outstanding		31,001,761

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 510,894	$ 245,449
Accounts receivable and unbilled, net (includes $2.7 million and $2.4 million with related parties at June 30, 2024 and December 31, 2023, respectively)	301,108	298,400
Prepaid expenses and other current assets (includes $0.3 million with related parties at June 30, 2024 and December 31, 2023)	60,521	49,979
Total current assets	872,523	593,828
Property and equipment, net	122,394	120,589
Operating lease right-of-use assets	134,001	144,801
Goodwill	662,396	662,396
Intangible assets, net	35,087	35,809
Deferred income taxes	75,196	74,435
Other assets	18,451	24,970
Total assets	1,920,048	1,656,828
Current liabilities:
Accounts payable (includes $0.4 million and $3.1 million with related parties at June 30, 2024 and December 31, 2023, respectively)	27,388	31,869
Accrued expenses	292,659	292,961
Advanced billings (includes $10.8 million and $10.1 million with related parties at June 30, 2024 and December 31, 2023, respectively)	638,417	559,860
Other current liabilities	34,624	40,441
Total current liabilities	993,088	925,131
Operating lease liabilities	131,796	142,122
Deferred income tax liability	2,294	2,404
Other long-term liabilities	29,271	28,221
Total liabilities	1,156,449	1,097,878
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, 2024 and December 31, 2023	0	0
Common stock - $0.01 par-value; 250,000,000 shares authorized at June 30, 2024 and December 31, 2023; 31,001,549 and 30,752,292 shares issued and outstanding at June 30, 2024 and December 31, 2023, respectively	310	308
Treasury stock - 70,073 and 70,573 shares at June 30, 2024 and December 31, 2023, respectively	(12,235)	(12,322)
Additional paid-in capital	818,903	802,681
Accumulated deficit	(30,790)	(221,645)
Accumulated other comprehensive loss	(12,589)	(10,072)
Total shareholders’ equity	763,599	558,950
Total liabilities and shareholders’ equity	$ 1,920,048	$ 1,656,828

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED)(Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Accounts receivable and unbilled, net	$ 301,108	$ 298,400
Prepaid expenses and other current assets	60,521	49,979
Accounts payable	27,388	31,869
Advanced billings	$ 638,417	$ 559,860
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)	31,001,549	30,752,292
Common stock shares outstanding (in shares)	31,001,549	30,752,292
Treasury stock (in shares)	70,073	70,573
Related Party
Accounts receivable and unbilled, net	$ 2,700	$ 2,400
Prepaid expenses and other current assets	300	300
Accounts payable	400	3,100
Advanced billings	$ 10,800	$ 10,100

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Revenue, net (includes $11.2 million and $13.3 million with related parties for the three months ended June 30, 2024 and 2023, respectively, and $24.0 million and $29.1 million with related parties for the six months ended June 30, 2024 and 2023, respectively)	$ 528,104	$ 460,868	$ 1,039,148	$ 894,942
Operating expenses:
Total direct costs	374,266	336,551	730,168	640,436
Selling, general and administrative	41,453	39,404	85,534	77,431
Depreciation	6,874	5,970	13,505	11,378
Amortization	361	550	722	1,100
Total operating expenses	422,954	382,475	829,929	730,345
Income from operations	105,150	78,393	209,219	164,597
Other income (expense), net:
Miscellaneous (expense) income, net	(133)	(1,283)	4,460	(596)
Interest income (expense), net	5,465	(1,366)	9,585	(2,227)
Total other income (expense), net	5,332	(2,649)	14,045	(2,823)
Income before income taxes	110,482	75,744	223,264	161,774
Income tax provision	22,131	14,676	32,322	27,812
Net income	$ 88,351	$ 61,068	$ 190,942	$ 133,962
Net income per share attributable to common shareholders:
Basic (in dollars per share)	$ 2.85	$ 2	$ 6.17	$ 4.35
Diluted (in dollars per share)	$ 2.75	$ 1.93	$ 5.96	$ 4.20
Weighted average common shares outstanding:
Basic (in shares)	30,990	30,537	30,917	30,771
Diluted (in shares)	32,086	31,575	32,046	31,864
Direct Costs
Operating expenses:
Total direct costs	$ 171,541	$ 158,526	$ 343,033	$ 309,594
Reimbursable Out of Pocket Costs
Operating expenses:
Total direct costs	$ 202,725	$ 178,025	$ 387,135	$ 330,842

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Total revenue	$ 528,104	$ 460,868	$ 1,039,148	$ 894,942
Related Party
Total revenue	$ 11,200	$ 13,300	$ 24,000	$ 29,100

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (UNAUDITED) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Statement of Comprehensive Income [Abstract]
Net income	$ 88,351	$ 61,068	$ 190,942	$ 133,962
Other comprehensive (loss) income
Foreign currency translation adjustments, net of taxes	(548)	120	(2,517)	1,198
Comprehensive income	$ 87,803	$ 61,188	$ 188,425	$ 135,160

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	Accumulated Other Comprehensive Loss
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)
Balance, beginning of period at Dec. 31, 2023	558,950	308	(12,322)	802,681	(221,645)	(10,072)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	102,591				102,591
Foreign currency translation	(1,969)					(1,969)
Stock-based compensation expense	4,310			4,310
Stock options exercised	7,660	2		7,658
Re-issuance of treasury stock	0		87		(87)
Balance, end of period at Mar. 31, 2024	671,542	310	(12,235)	814,649	(119,141)	(12,041)
Balance, beginning of period at Dec. 31, 2023	558,950	308	(12,322)	802,681	(221,645)	(10,072)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	190,942
Foreign currency translation	(2,517)
Balance, end of period at Jun. 30, 2024	763,599	310	(12,235)	818,903	(30,790)	(12,589)
Balance, beginning of period at Mar. 31, 2024	671,542	310	(12,235)	814,649	(119,141)	(12,041)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	88,351				88,351
Foreign currency translation	(548)					(548)
Stock-based compensation expense	3,588			3,588
Stock options exercised	666			666
Balance, end of period at Jun. 30, 2024	$ 763,599	$ 310	$ (12,235)	$ 818,903	$ (30,790)	$ (12,589)

CONDENSED CONSOLIDATED STATEM_5

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 190,942	$ 133,962
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	13,505	11,378
Amortization	722	1,100
Stock-based compensation expense	7,898	10,344
Noncash lease expense	11,461	9,659
Deferred income tax benefit	(919)	(3,709)
Other	(3,903)	(899)
Changes in assets and liabilities:
Accounts receivable and unbilled, net	(2,714)	(21,734)
Prepaid expenses and other current assets	(11,251)	(11,831)
Accounts payable	(2,453)	2,341
Accrued expenses	915	21,259
Advanced billings	78,557	27,828
Lease liabilities	(11,025)	(9,379)
Other assets and liabilities, net	(2,661)	(7,725)
Net cash provided by operating activities	269,074	162,594
CASH FLOWS FROM INVESTING ACTIVITIES:
Property and equipment expenditures	(18,368)	(17,959)
Other	8,108	(11)
Net cash used in investing activities	(10,260)	(17,970)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from stock option exercises	8,326	4,127
Repurchases of common stock	0	(144,020)
Proceeds from revolving loan	0	105,000
Payments on revolving loan	0	(100,000)
Net cash provided by (used in) financing activities	8,326	(134,893)
EFFECT OF EXCHANGE RATES ON CASH, CASH EQUIVALENTS, AND RESTRICTED CASH	(1,695)	1,142
INCREASE IN CASH, CASH EQUIVALENTS, AND RESTRICTED CASH	265,445	10,873
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — Beginning of period	245,449	28,265
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — End of period	510,894	39,138
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION —
Acquisition of property and equipment—non-cash	$ 3,536	$ 5,848

Basis of Presentation

Basis of Presentation	6 Months Ended
	Jun. 30, 2024
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, 2023. Share Repurchases In the fourth quarter of 2022, the Board approved a stock repurchase program of up to $500.0 million. The Company did not execute any share repurchases during the three and six months ended June 30, 2024. 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, 2024, the Company has remaining authorization of $308.8 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, 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. Recently Issued Accounting Pronouncements In November 2023, the FASB issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures" which requires entities to enhance disclosures around segment reporting. The guidance is effective for annual periods beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures. In December 2023, the FASB issued ASU 2023-09, "Income Taxes (Topic 740): Improvements to Income Tax Disclosures" which requires entities to enhance disclosures around income taxes. The guidance is effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures.

Net Income Per Share

Net Income Per Share	6 Months Ended
	Jun. 30, 2024
Earnings Per Share [Abstract]
Net Income Per Share	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 six months ended June 30, 2024 and 2023 (in thousands, except for earnings per share): Three Months Ended Six Months Ended 2024 2023 2024 2023 Weighted-average shares: Common shares outstanding 30,990 30,537 30,917 30,771 RSAs — 21 7 21 Total weighted-average shares 30,990 30,558 30,924 30,792 Earnings per common share—Basic Net income $ 88,351 $ 61,068 $ 190,942 $ 133,962 Less: Undistributed earnings allocated to RSAs — (41) (41) (90) Net income available to common shareholders—Basic $ 88,351 $ 61,027 $ 190,901 $ 133,872 Net income per common share—Basic $ 2.85 $ 2.00 $ 6.17 $ 4.35 Basic weighted-average common shares outstanding 30,990 30,537 30,917 30,771 Effect of diluted shares 1,096 1,038 1,129 1,093 Diluted weighted-average shares outstanding 32,086 31,575 32,046 31,864 Net income per common share—Diluted $ 2.75 $ 1.93 $ 5.96 $ 4.20 During the six months ended June 30, 2024, the Company had (in thousands) 4.8 stock options 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, 2023, the Company had (in thousands) 16.7 stock options 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, 2024
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, 2024. There were no material transfers between Level 1, Level 2 or Level 3 during the three and six months ended June 30, 2024 or June 30, 2023.

Contract Assets and Contract Li

Contract Assets and Contract Liabilities	6 Months Ended
	Jun. 30, 2024
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 $ 292,189 $ 275,932 Unbilled receivables 8,919 22,475 Less: allowance for doubtful accounts — (7) Total accounts receivable and unbilled, net $ 301,108 $ 298,400 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 $ 638,417 $ 559,860 As of June 30, 2024 and December 31, 2023, the Company had approximately $3.2 billion and $2.9 billion of performance obligations remaining to be performed for active projects.

Intangible Assets, Net

Intangible Assets, Net	6 Months Ended
	Jun. 30, 2024
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 (141,610) (140,888) Total finite-lived intangible assets, net 3,441 4,163 Trade name (indefinite-lived) 31,646 31,646 Total intangible assets, net $ 35,087 $ 35,809 As of June 30, 2024, estimated amortization expense of the Company’s intangible assets for each of the next five years is as follows (in thousands): Amortization Remainder of 2024 $ 721 2025 946 2026 620 2027 577 2028 577 $ 3,441

Accrued Expenses

Accrued Expenses	6 Months Ended
	Jun. 30, 2024
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 $ 64,238 $ 75,822 Project related reimbursable expenses 219,126 205,864 Other 9,295 11,275 Total accrued expenses $ 292,659 $ 292,961

Short-Term Debt

Short-Term Debt	6 Months Ended
	Jun. 30, 2024
Debt Disclosure [Abstract]
Short-Term Debt	Short-term Debt 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 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. On March 28, 2024, the Company entered into Amendment No. 6 to the Loan Agreement, which changed the aggregate principal amount that may be borrowed under the facility’s line of credit to up to $10.0 million and extended the expiration date of revolving credit note to March 31, 2025. 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%). 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, 2024 and December 31, 2023, there were less than $0.1 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, 2024
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 16 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, 2024 2023 2024 2023 Operating lease cost $ 7,903 $ 6,954 $ 15,768 $ 13,635 Variable lease cost 2,735 1,835 5,401 4,172 Supplemental cash flow information related to the leases was as follows (in thousands): Six Months Ended June 30, 2024 2023 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 11,565 $ 9,599 Right-of-use assets obtained in exchange for lease obligations: Operating leases 2,222 10,061 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 $ 78,999 $ 83,065 Operating lease right-of-use assets - non-related parties 55,002 61,736 Operating lease right-of-use assets $ 134,001 $ 144,801 Other current liabilities - related parties 6,021 5,730 Other current liabilities - non-related parties 15,908 16,635 Other current liabilities $ 21,929 $ 22,365 Operating lease liabilities - related parties 87,462 90,568 Operating lease liabilities - non-related parties 44,334 51,554 Operating lease liabilities 131,796 142,122 Total operating lease liabilities $ 153,725 $ 164,487 Weighted Average Remaining Lease Term (years) Operating leases 9.9 10.0 Weighted Average Discount Rate Operating leases 5.7 % 5.6 % Lease payments due related to lease liabilities as of June 30, 2024 were as follows (in thousands): Related Party Operating Leases Non-Related Parties Operating Leases Total Operating Leases Remainder of 2024 $ 5,728 $ 8,882 $ 14,610 2025 11,607 17,231 28,838 2026 11,807 14,207 26,014 2027 10,839 11,108 21,947 2028 8,609 6,320 14,929 Later years 91,669 9,599 101,268 Total lease payments 140,259 67,347 207,606 Less: imputed interest (46,776) (7,105) (53,881) Total $ 93,483 $ 60,242 $ 153,725

Shareholder's Equity and Stock-

Shareholder's Equity and Stock-Based Compensation	6 Months Ended
	Jun. 30, 2024
Equity [Abstract]
Shareholder's Equity and Stock-Based Compensation	Shareholder’s Equity and Stock-Based Compensation The Company granted 2,991 awards to employees under the 2016 Incentive Award Plan during the six months ended June 30, 2024, consisting of 2,491 RSU having five year vesting schedules and 500 RSU having four year vesting schedules. The Company granted an additional 5,718 stock option awards to non-employee directors under the 2016 Incentive Award Plan during the six months ended June 30, 2024. 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, 2024 Stock Options Weighted Average Outstanding - beginning of period 1,343,287 $ 100.75 Granted 5,718 $ 393.30 Exercised (164,822) $ 50.52 Cancelled/Forfeited/Expired (2,953) $ 223.78 Outstanding - end of period 1,181,230 $ 108.87 Exercisable - end of period 874,891 $ 90.34 The following table sets forth the Company’s RSA/RSU activity: Six Months Ended Shares/Units Outstanding and unvested - beginning of period 390,998 Granted 2,991 Vested (84,435) Forfeited (13,053) Outstanding and unvested - end of period 296,501 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, 2024 2023 2024 2023 Total direct costs $ 2,308 $ 2,558 $ 4,778 $ 5,498 Selling, general and administrative 1,280 2,348 3,120 4,846 Total stock-based compensation expense $ 3,588 $ 4,906 $ 7,898 $ 10,344

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company’s effective income tax rate was 20.0% and 19.4% for the three months ended June 30, 2024 and 2023, respectively. The Company's effective income tax rate was 14.5% and 17.2% for the six months ended June 30, 2024 and 2023, respectively. The Company’s effective income tax rate for the three months ended June 30, 2024 and the six months ended June 30, 2024 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, 2024
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, 2024 and December 31, 2023. 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, 2024. Purchase Commitments

Related Party Transactions

Related Party Transactions	6 Months Ended
	Jun. 30, 2024
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 at June 30, 2024 and December 31, 2023 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 $3.9 million and $9.7 million during the three months ended June 30, 2024 and 2023, respectively, and $10.4 million and $23.0 million during the six months ended June 30, 2024 and 2023, respectively, in the Company’s condensed consolidated statements of operations. As of June 30, 2024 and December 31, 2023, respectively, the Company had Advanced billings from LIB of $6.4 million and $7.6 million in the condensed consolidated balance sheets. In addition, as of June 30, 2024 and December 31, 2023, respectively, the Company had Accounts receivable and unbilled, net from LIB of $0.4 million and $0.5 million in the condensed consolidated balance sheets. 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 $7.3 million and $3.6 million during the three months ended June 30, 2024 and 2023, respectively, and $13.6 million and $6.1 million during the six months ended June 30, 2024 and 2023, respectively, in the Company’s condensed consolidated statements of operations. As of June 30, 2024 and December 31, 2023, respectively, the Company had Advanced billings from CinRx of $4.4 million and $2.5 million in the condensed consolidated balance sheets. As of June 30, 2024 and December 31, 2023 the Company had Accounts receivable and unbilled, net from CinRx of $2.3 million and $1.9 million, respectively, in the condensed consolidated balance sheets. In addition, as of June 30, 2024 and December 31, 2023 the Company had Prepaid expenses and other current assets with CinRx of $0.3 million and $0.2 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 $0.1 million during the three months ended June 30, 2024 and 2023, and $0.2 million during the six months ended June 30, 2024 and 2023 at The Summit. 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. The Company has determined that the lease is an operating lease. Operating lease cost recognized for the three months ended June 30, 2024 and 2023 was $0.7 million. Operating lease cost recognized for the six months ended June 30, 2024 and 2023 was $1.4 million and $1.3 million, 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, 2024 and December 31, 2023 were $18.5 million and $19.3 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at June 30, 2024 were $1.6 million and $17.3 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, 2023 were $1.5 million and $18.1 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, 2024 and 2023 was $1.4 million. Operating lease cost recognized for the six months ended June 30, 2024 and 2023 was $2.8 million. 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, 2024 and December 31, 2023 were $51.0 million and $51.9 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at June 30, 2024 were $1.4 million and $62.8 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, 2023 were $1.3 million and $63.5 million, respectively and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The Company entered into a multi-year lease agreement governing the occupancy of office space in a building 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 lease expires 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 lease is an operating lease. Operating lease cost recognized for the three months ended June 30, 2024 and 2023 was $0.7 million. Operating lease cost recognized for the six months ended June 30, 2024 and 2023 was $1.3 million. 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, 2024 and December 31, 2023 were $7.5 million and $8.5 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at June 30, 2024 were $2.1 million and $5.3 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, 2023 were $2.1 million and $6.4 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The Company entered into a multi-year lease agreement governing the occupancy of office space in a building 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 lease expires in 2027 with the Company having one 10-year option to extend the lease term. In the first quarter of 2024, the Company reduced the lease term in connection with a plan to replace the leased office beginning in early 2025. 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, 2024 and 2023 was $0.8 million and $0.2 million. Operating lease cost recognized for the six months ended June 30, 2024 and 2023 was $1.5 million and $0.5 million. 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, 2024 and December 31, 2023 were $2.0 million and $3.4 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at June 30, 2024 were $0.9 million and $2.0 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, 2023 were $0.9 million and $2.5 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. The Aircraft Management Company also makes the private aviation charter aircraft available to third parties. The Company incurred travel expenses of $0.7 million and $0.4 million during the three months ended June 30, 2024 and 2023, respectively, and $1.0 million and $0.8 million during the six months ended June 30, 2024 and 2023, 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 June 30, 2024 and December 31, 2023, the Company had Accounts payable to the Aircraft Management Company of $0.3 million and $0.4 million, respectively, in the condensed consolidated balance sheets.

Entity Wide Disclosures

Entity Wide Disclosures	6 Months Ended
	Jun. 30, 2024
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 2024 2023 2024 2023 Therapeutic Area Oncology $ 162,952 $ 147,089 $ 318,150 $ 289,040 Other 112,432 101,055 220,832 188,159 Metabolic 106,302 87,860 209,941 174,700 Cardiology 60,699 51,130 116,336 97,747 Central Nervous System 46,519 37,726 90,655 76,423 AVAI 39,200 36,008 83,234 68,873 Total revenue $ 528,104 $ 460,868 $ 1,039,148 $ 894,942

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Pay vs Performance Disclosure
Net income	$ 88,351	$ 102,591	$ 61,068	$ 72,894	$ 190,942	$ 133,962

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended	6 Months Ended
	Jun. 30, 2024 shares	Jun. 30, 2024 shares
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		During the three months ended June 30, 2024, 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, except as described in the table below: Action Date Trading Arrangement Total Shares to be Purchased or Sold Duration/Expiration Date Rule 10b5-1* Non-Rule 10b5-1** August J. Troendle , Chief Executive Officer and Chairman of the Board Adopt April 25, 2024 [1] X Up to 190,000 shares to be sold Good until cancelled August J. Troendle , Chief Executive Officer and Chairman of the Board Modify May 22, 2024 [2] X Up to 190,000 shares to be sold Good until cancelled August J. Troendle , Chief Executive Officer and Chairman of the Board Terminate May 30, 2024 [3] X Up to 190,000 shares to be sold Good until cancelled Susan E. Burwig , Executive Vice President, Operations Adopt June 5, 2024 [4] X Up to 7,681 shares to be sold The earlier of until cancelled or 180 days from the placement of the limit order * Intended to satisfy the affirmative defense of Rule 10b5-1(c). ** Not intended to satisfy the affirmative defense of Rule 10b5-1(c). [1] On April 25, 2024, August J. Troendle placed a limit order to sell up to 190,000 shares that were previously acquired through various stock option exercises. Between April 25, 2024 and May 21, 2024, Mr. Troendle sold 142,250 shares pursuant to the limit order. [2] On May 22, 2024, August J. Troendle changed the price limit for sales under the limit order originally adopted on April 25, 2024. [3] On May 30, 2024, August J. Troendle terminated the limit order originally adopted on April 25, 2024. [4] On June 5, 2024, Ms. Burwig placed a limit order to sell up to 7,681 shares that were acquired upon the vesting of restricted shares.
Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Susan E. Burwig [Member]
Trading Arrangements, by Individual
Name	Susan E. Burwig
Title	Executive Vice President, Operations
Non-Rule 10b5-1 Arrangement Adopted	true
Adoption Date	June 5, 2024
Arrangement Duration	180 days
Aggregate Available	7,681	7,681
Trading Arrangement with August J. Troendle Adopted on April 25th, 2024 [Member] | August J. Troendle [Member]
Trading Arrangements, by Individual
Name	August J. Troendle
Title	Chief Executive Officer and Chairman of the Board
Non-Rule 10b5-1 Arrangement Adopted	true
Adoption Date	April 25, 2024
Non-Rule 10b5-1 Arrangement Terminated	true
Termination Date	May 22, 2024
Aggregate Available	190,000	190,000
Trading Arrangement with August J. Troendle Modified on May 22, 2024 [Member] | August J. Troendle [Member]
Trading Arrangements, by Individual
Name	August J. Troendle
Title	Chief Executive Officer and Chairman of the Board
Non-Rule 10b5-1 Arrangement Adopted	true
Adoption Date	May 22, 2024
Non-Rule 10b5-1 Arrangement Terminated	true
Termination Date	May 30, 2024
Aggregate Available	190,000	190,000

Basis of Presentation (Policies

Basis of Presentation (Policies)	6 Months Ended
	Jun. 30, 2024
Accounting Policies [Abstract]
Unaudited Interim Financial Information	Unaudited Interim Financial Information
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.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements In November 2023, the FASB issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures" which requires entities to enhance disclosures around segment reporting. The guidance is effective for annual periods beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures.

Net Income Per Share (Tables)

Net Income Per Share (Tables)	6 Months Ended
	Jun. 30, 2024
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, 2024 and 2023 (in thousands, except for earnings per share): Three Months Ended Six Months Ended 2024 2023 2024 2023 Weighted-average shares: Common shares outstanding 30,990 30,537 30,917 30,771 RSAs — 21 7 21 Total weighted-average shares 30,990 30,558 30,924 30,792 Earnings per common share—Basic Net income $ 88,351 $ 61,068 $ 190,942 $ 133,962 Less: Undistributed earnings allocated to RSAs — (41) (41) (90) Net income available to common shareholders—Basic $ 88,351 $ 61,027 $ 190,901 $ 133,872 Net income per common share—Basic $ 2.85 $ 2.00 $ 6.17 $ 4.35 Basic weighted-average common shares outstanding 30,990 30,537 30,917 30,771 Effect of diluted shares 1,096 1,038 1,129 1,093 Diluted weighted-average shares outstanding 32,086 31,575 32,046 31,864 Net income per common share—Diluted $ 2.75 $ 1.93 $ 5.96 $ 4.20

Contract Assets and Contract _2

Contract Assets and Contract Liabilities (Tables)	6 Months Ended
	Jun. 30, 2024
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 $ 292,189 $ 275,932 Unbilled receivables 8,919 22,475 Less: allowance for doubtful accounts — (7) Total accounts receivable and unbilled, net $ 301,108 $ 298,400 Advanced billings consisted of the following (in thousands): As of June 30, December 31, Advanced billings $ 638,417 $ 559,860

Intangible Assets, Net (Tables)

Intangible Assets, Net (Tables)	6 Months Ended
	Jun. 30, 2024
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 (141,610) (140,888) Total finite-lived intangible assets, net 3,441 4,163 Trade name (indefinite-lived) 31,646 31,646 Total intangible assets, net $ 35,087 $ 35,809
Schedule of Estimated Amortization Expense of Intangible Assets	As of June 30, 2024, estimated amortization expense of the Company’s intangible assets for each of the next five years is as follows (in thousands): Amortization Remainder of 2024 $ 721 2025 946 2026 620 2027 577 2028 577 $ 3,441

Accrued Expenses (Tables)

Accrued Expenses (Tables)	6 Months Ended
	Jun. 30, 2024
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 $ 64,238 $ 75,822 Project related reimbursable expenses 219,126 205,864 Other 9,295 11,275 Total accrued expenses $ 292,659 $ 292,961

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2024
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, 2024 2023 2024 2023 Operating lease cost $ 7,903 $ 6,954 $ 15,768 $ 13,635 Variable lease cost 2,735 1,835 5,401 4,172
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, 2024 2023 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 11,565 $ 9,599 Right-of-use assets obtained in exchange for lease obligations: Operating leases 2,222 10,061
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 $ 78,999 $ 83,065 Operating lease right-of-use assets - non-related parties 55,002 61,736 Operating lease right-of-use assets $ 134,001 $ 144,801 Other current liabilities - related parties 6,021 5,730 Other current liabilities - non-related parties 15,908 16,635 Other current liabilities $ 21,929 $ 22,365 Operating lease liabilities - related parties 87,462 90,568 Operating lease liabilities - non-related parties 44,334 51,554 Operating lease liabilities 131,796 142,122 Total operating lease liabilities $ 153,725 $ 164,487 Weighted Average Remaining Lease Term (years) Operating leases 9.9 10.0 Weighted Average Discount Rate Operating leases 5.7 % 5.6 %
Schedule of Lease Payments Due Related To Lease Liabilities	Lease payments due related to lease liabilities as of June 30, 2024 were as follows (in thousands): Related Party Operating Leases Non-Related Parties Operating Leases Total Operating Leases Remainder of 2024 $ 5,728 $ 8,882 $ 14,610 2025 11,607 17,231 28,838 2026 11,807 14,207 26,014 2027 10,839 11,108 21,947 2028 8,609 6,320 14,929 Later years 91,669 9,599 101,268 Total lease payments 140,259 67,347 207,606 Less: imputed interest (46,776) (7,105) (53,881) Total $ 93,483 $ 60,242 $ 153,725

Shareholder's Equity and Stoc_2

Shareholder's Equity and Stock-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2024
Equity [Abstract]
Schedule of Stock Option Activity	The following table sets forth the Company’s stock option activity: Six Months Ended June 30, 2024 Stock Options Weighted Average Outstanding - beginning of period 1,343,287 $ 100.75 Granted 5,718 $ 393.30 Exercised (164,822) $ 50.52 Cancelled/Forfeited/Expired (2,953) $ 223.78 Outstanding - end of period 1,181,230 $ 108.87 Exercisable - end of period 874,891 $ 90.34
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 390,998 Granted 2,991 Vested (84,435) Forfeited (13,053) Outstanding and unvested - end of period 296,501
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, 2024 2023 2024 2023 Total direct costs $ 2,308 $ 2,558 $ 4,778 $ 5,498 Selling, general and administrative 1,280 2,348 3,120 4,846 Total stock-based compensation expense $ 3,588 $ 4,906 $ 7,898 $ 10,344

Entity Wide Disclosures (Tables

Entity Wide Disclosures (Tables)	6 Months Ended
	Jun. 30, 2024
Entity Wide Disclosures [Abstract]
Summary of Revenue by Major Source	The following table disaggregates our revenue by major source (in thousands): Three Months Ended Six Months Ended 2024 2023 2024 2023 Therapeutic Area Oncology $ 162,952 $ 147,089 $ 318,150 $ 289,040 Other 112,432 101,055 220,832 188,159 Metabolic 106,302 87,860 209,941 174,700 Cardiology 60,699 51,130 116,336 97,747 Central Nervous System 46,519 37,726 90,655 76,423 AVAI 39,200 36,008 83,234 68,873 Total revenue $ 528,104 $ 460,868 $ 1,039,148 $ 894,942

Basis of Presentation - Narrati

Basis of Presentation - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2022
Basis Of Presentation [Line Items]
Payments for repurchase of common stock			$ 0	$ 144,020
2022 Share Repurchase Program
Basis Of Presentation [Line Items]
Repurchases of common stock (in shares)	0	126,281	0	781,068
Payments for repurchase of common stock		$ 23,900		$ 144,000
Remaining amount of repurchase program	$ 308,800		$ 308,800
2022 Share Repurchase Program | Maximum
Basis Of Presentation [Line Items]
Stock repurchase program, authorized amount					$ 500,000

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				6 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Weighted-average shares:
Weighted average number of shares outstanding, basic (in shares)	30,990		30,537		30,917	30,771
Total weighted average shares outstanding, basic (in shares)	30,990		30,558		30,924	30,792
Earnings per common share—Basic
Net income	$ 88,351	$ 102,591	$ 61,068	$ 72,894	$ 190,942	$ 133,962
Net income available to common shareholders—Basic	$ 88,351		$ 61,027		$ 190,901	$ 133,872
Net income per common share, Basic (in dollars per share)	$ 2.85		$ 2		$ 6.17	$ 4.35
Basic weighted-average common shares outstanding (in shares)	30,990		30,537		30,917	30,771
Effect of diluted shares (in shares)	1,096		1,038		1,129	1,093
Diluted weighted-average shares outstanding (in shares)	32,086		31,575		32,046	31,864
Net income per common share, Diluted (in dollars per share)	$ 2.75		$ 1.93		$ 5.96	$ 4.20
RSAs
Weighted-average shares:
Weighted average number of shares outstanding, basic (in shares)	0		21		7	21
Earnings per common share—Basic
Less: Undistributed earnings allocated to RSAs	$ 0		$ (41)		$ (41)	$ (90)
Basic weighted-average common shares outstanding (in shares)	0		21		7	21
Common Stock
Weighted-average shares:
Weighted average number of shares outstanding, basic (in shares)	30,990		30,537		30,917	30,771
Earnings per common share—Basic
Basic weighted-average common shares outstanding (in shares)	30,990		30,537		30,917	30,771

Net Income Per Share - Narrativ

Net Income Per Share - Narrative (Details) - shares	3 Months Ended	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Stock Options
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of diluted EPS (in shares)	16,700	4,800	16,700

Contract Assets and Contract _3

Contract Assets and Contract Liabilities - Summary of Accounts Receivable and Unbilled, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Revenue from Contract with Customer [Abstract]
Accounts receivable	$ 292,189	$ 275,932
Unbilled receivables	8,919	22,475
Less: allowance for doubtful accounts	0	(7)
Total accounts receivable and unbilled, net	$ 301,108	$ 298,400

Contract Assets and Contract _4

Contract Assets and Contract Liabilities - Summary of Advanced Billings (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Revenue from Contract with Customer [Abstract]
Advanced billings	$ 638,417	$ 559,860

Contract Assets and Contract _5

Contract Assets and Contract Liabilities - Narrative (Details) - USD ($) $ in Billions	Jun. 30, 2024	Dec. 31, 2023
Revenue from Contract with Customer [Abstract]
Performance obligations remaining to be performed	$ 3.2	$ 2.9

Intangible Assets, Net - Schedu

Intangible Assets, Net - Schedule of Intangible Assets, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Accumulated amortization:
Total finite-lived intangible assets, net	$ 3,441	$ 4,163
Trade name (indefinite-lived)	31,646	31,646
Total intangible assets, net	35,087	35,809
Customer Relationships
Finite-lived intangible assets:
Finite-lived intangible assets, gross	145,051	145,051
Accumulated amortization:
Total accumulated amortization	$ (141,610)	$ (140,888)

Intangible Assets, Net - Sche_2

Intangible Assets, Net - Schedule of Estimated Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Remainder of 2024	$ 721
2025	946
2026	620
2027	577
2028	577
Total finite-lived intangible assets, net	$ 3,441	$ 4,163

Accrued Expenses - Schedule of

Accrued Expenses - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Employee compensation and benefits	$ 64,238	$ 75,822
Project related reimbursable expenses	219,126	205,864
Other	9,295	11,275
Total accrued expenses	$ 292,659	$ 292,961

Short-Term Debt (Details)

Short-Term Debt (Details) - USD ($) $ in Millions	Mar. 28, 2024	Jun. 30, 2024	Dec. 31, 2023	Mar. 31, 2023	Sep. 30, 2019
Debt Instrument [Line Items]
Outstanding letters of credit (less than)		$ 0.1	$ 0.1
Credit facility
Debt Instrument [Line Items]
Aggregate principal amount borrowed under line of credit facility	$ 10			$ 150
Credit facility | Secured Overnight Financing Rate (SOFR)
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)	6 Months Ended
	Jun. 30, 2024
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	16 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, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Leases [Abstract]
Operating lease cost	$ 7,903	$ 6,954	$ 15,768	$ 13,635
Variable lease cost	$ 2,735	$ 1,835	$ 5,401	$ 4,172

Leases - Summary of Supplementa

Leases - Summary of Supplemental Cash Flow Information Related to Leases (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 11,565	$ 9,599
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 2,222	$ 10,061

Leases - Summary of Supplemen_2

Leases - Summary of Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Leases, Supplemental Balance Sheet Information [Line Items]
Operating lease right-of-use assets	$ 134,001	$ 144,801
Other current liabilities	$ 21,929	$ 22,365
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other current liabilities	Other current liabilities
Operating lease liabilities	$ 131,796	$ 142,122
Total operating lease liabilities	$ 153,725	$ 164,487
Weighted Average Remaining Lease Term (years)
Operating leases	9 years 10 months 24 days	10 years
Weighted Average Discount Rate
Operating leases	5.70%	5.60%
Related Party
Leases, Supplemental Balance Sheet Information [Line Items]
Operating lease right-of-use assets	$ 78,999	$ 83,065
Other current liabilities	6,021	5,730
Operating lease liabilities	87,462	90,568
Total operating lease liabilities	93,483
Nonrelated Party
Leases, Supplemental Balance Sheet Information [Line Items]
Operating lease right-of-use assets	55,002	61,736
Other current liabilities	15,908	16,635
Operating lease liabilities	44,334	$ 51,554
Total operating lease liabilities	$ 60,242

Leases - Schedule of Lease Paym

Leases - Schedule of Lease Payments Due Related To Lease Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2024	$ 14,610
2025	28,838
2026	26,014
2027	21,947
2028	14,929
Later years	101,268
Total lease payments	207,606
Less: imputed interest	(53,881)
Total	153,725	$ 164,487
Related Party
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2024	5,728
2025	11,607
2026	11,807
2027	10,839
2028	8,609
Later years	91,669
Total lease payments	140,259
Less: imputed interest	(46,776)
Total	93,483
Nonrelated Party
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2024	8,882
2025	17,231
2026	14,207
2027	11,108
2028	6,320
Later years	9,599
Total lease payments	67,347
Less: imputed interest	(7,105)
Total	$ 60,242

Shareholder's Equity and Stoc_3

Shareholder's Equity and Stock-Based Compensation - Narrative (Details)	6 Months Ended
	Jun. 30, 2024 shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted (in shares)	5,718
2016 Incentive Award Plan | Non Employee Directors
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted (in shares)	5,718
2016 Incentive Award Plan | Granted to Employees
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Awards granted to employees (in shares)	2,991
2016 Incentive Award Plan | Restricted Stock Units (RSU) | Vesting After Five Years
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares granted (in shares)	2,491
Award vesting period	5 years
2016 Incentive Award Plan | Restricted Stock Units (RSU) | Vesting After Four Years
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares granted (in shares)	500
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, 2024 $ / shares shares
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Outstanding [Roll Forward]
Options outstanding, beginning of period (in shares) | shares	1,343,287
Options granted (in shares) | shares	5,718
Options exercised (in shares) | shares	(164,822)
Options cancelled/forfeited/expired (in shares) | shares	(2,953)
Options outstanding, end of period (in shares) | shares	1,181,230
Options exercisable, end of period (in shares) | shares	874,891
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Options outstanding, beginning of period (in dollars per share) | $ / shares	$ 100.75
Options granted (in dollars per share) | $ / shares	393.30
Options exercised (in dollars per share) | $ / shares	50.52
Options cancelled/forfeited/expired (in dollars per share) | $ / shares	223.78
Options outstanding, end of period (in dollars per share) | $ / shares	108.87
Options exercisable, end of period (in dollars per share) | $ / shares	$ 90.34

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, 2024 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)	390,998
Granted (in shares)	2,991
Vested (in shares)	(84,435)
Forfeited (in shares)	(13,053)
Outstanding and unvested - end of period (in shares)	296,501

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, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 3,588	$ 4,906	$ 7,898	$ 10,344
Total direct costs
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	2,308	2,558	4,778	5,498
Selling, general and administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 1,280	$ 2,348	$ 3,120	$ 4,846

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Income Tax Disclosure [Abstract]
Effective income tax rate	20%	19.40%	14.50%	17.20%
U.S. statutory rate	21%		21%

Commitments and Contingencies -

Commitments and Contingencies - Narrative (Details) $ in Millions	6 Months Ended
	Jun. 30, 2024 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Minimum purchase commitments for project related supplies	$ 14.9

Related Party Transactions (Det

Related Party Transactions (Details) $ in Thousands	3 Months Ended			6 Months Ended
	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Mar. 31, 2023 renewal_option	Jun. 30, 2024 USD ($) renewal_option	Jun. 30, 2023 USD ($)	Dec. 31, 2023 USD ($)
Related Party Transaction [Line Items]
Total revenue	$ 528,104	$ 460,868		$ 1,039,148	$ 894,942
Advanced billings	638,417			638,417		$ 559,860
Accounts receivable and unbilled, net	301,108			301,108		298,400
Prepaid expenses and other current assets	60,521			60,521		49,979
Operating lease cost	7,903	6,954		15,768	13,635
Operating lease right-of-use assets	134,001			134,001		144,801
Other current liabilities	21,929			21,929		22,365
Operating lease liabilities	131,796			131,796		142,122
Accounts payable	27,388			27,388		31,869
Related Party
Related Party Transaction [Line Items]
Total revenue	11,200	13,300		24,000	29,100
Advanced billings	10,800			10,800		10,100
Accounts receivable and unbilled, net	2,700			2,700		2,400
Prepaid expenses and other current assets	300			300		300
Operating lease right-of-use assets	78,999			78,999		83,065
Other current liabilities	6,021			6,021		5,730
Operating lease liabilities	87,462			87,462		90,568
Accounts payable	400			400		3,100
Employee Loans | Related Party
Related Party Transaction [Line Items]
Prepaid expense and other assets	300			300		300
Service Agreement | Related Party | LIB
Related Party Transaction [Line Items]
Total revenue	3,900	9,700		10,400	23,000
Advanced billings	6,400			6,400		7,600
Accounts receivable and unbilled, net	400			400		500
Service Agreement | Related Party | CinRx Pharma and Subsidiaries
Related Party Transaction [Line Items]
Total revenue	7,300	3,600		13,600	6,100
Advanced billings	4,400			4,400		2,500
Accounts receivable and unbilled, net	2,300			2,300		1,900
Prepaid expenses and other current assets	300			300		200
Service Agreement | Related Party | The Summit
Related Party Transaction [Line Items]
Operating expenses	100	100		200	200
Leased Real Estate | Chief Executive Officer
Related Party Transaction [Line Items]
Term of lease			10 years
Number of lease renewal options | renewal_option			1
Lease term upon renewal			10 years
Operating lease cost	700	700		1,400	1,300
Operating lease right-of-use assets	18,500			18,500		19,300
Other current liabilities	1,600			1,600		1,500
Operating lease liabilities	$ 17,300			$ 17,300		18,100
Leased Real Estate | Related Party | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Number of lease renewal options | renewal_option				2
Lease term upon renewal	10 years			10 years
Operating lease cost	$ 1,400	1,400		$ 2,800	2,800
Operating lease right-of-use assets	51,000			51,000		51,900
Other current liabilities	1,400			1,400		1,300
Operating lease liabilities	$ 62,800			$ 62,800		63,500
First Leased Office Space | Related Party | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Number of lease renewal options | renewal_option				1
Lease term upon renewal	10 years			10 years
Operating lease cost	$ 700	700		$ 1,300	1,300
Operating lease right-of-use assets	7,500			7,500		8,500
Other current liabilities	2,100			2,100		2,100
Operating lease liabilities	$ 5,300			$ 5,300		6,400
Second Leased Office Space | Related Party | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Number of lease renewal options | renewal_option				1
Lease term upon renewal	10 years			10 years
Operating lease cost	$ 800	200		$ 1,500	500
Operating lease right-of-use assets	2,000			2,000		3,400
Other current liabilities	900			900		900
Operating lease liabilities	2,000			2,000		2,500
Travel Services | Chief Executive Officer
Related Party Transaction [Line Items]
Travel expenses with related party	700	$ 400		1,000	$ 800
Travel Services | Related Party
Related Party Transaction [Line Items]
Accounts payable	$ 300			$ 300		$ 400

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, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Disaggregation Of Revenue [Line Items]
Total revenue	$ 528,104	$ 460,868	$ 1,039,148	$ 894,942
Oncology
Disaggregation Of Revenue [Line Items]
Total revenue	162,952	147,089	318,150	289,040
Other
Disaggregation Of Revenue [Line Items]
Total revenue	112,432	101,055	220,832	188,159
Metabolic
Disaggregation Of Revenue [Line Items]
Total revenue	106,302	87,860	209,941	174,700
Cardiology
Disaggregation Of Revenue [Line Items]
Total revenue	60,699	51,130	116,336	97,747
Central Nervous System
Disaggregation Of Revenue [Line Items]
Total revenue	46,519	37,726	90,655	76,423
AVAI
Disaggregation Of Revenue [Line Items]
Total revenue	$ 39,200	$ 36,008	$ 83,234	$ 68,873