Carasent ASA

OSE:CARA

Earnings Call Analysis

Carasent Q3 2024: Solid Growth and Strategic Changes Ahead

In Q3 2024, Carasent demonstrated robust performance with a 23% year-over-year growth in contracted ARR, reaching NOK 277 million. They reported a 17% increase in recurring revenue and expect further growth from significant contracts like Volvat. Despite some delays anticipated in contract implementations and high one-time costs, the company maintains its strong revenue and EBITDAC growth outlook. They aim for a 20% ARR growth target for 2025, supported by an active sales strategy and cost control measures. Gross margins improved to 85%, indicating better operational efficiency as they prepare for a NASDAQ Stockholm listing in December.

A Promising Quarter

In the third quarter, Carasent experienced solid improvements across various metrics. With an impressive 17% organic growth in recurring revenue, the company has shown resilience and responsiveness to market conditions. The contracted Annual Recurring Revenue (ARR) base now stands at NOK 277 million, reflecting a 23% organic growth over the past year, comfortably surpassing the target of 20% for the upcoming year.

Future Contracts and Delays

The company has signed not yet implemented ARR totaling NOK 70 million, which indicates good momentum for future revenue. However, concerns have arisen about potential delays in implementing the contract with Volvat, projected to contribute NOK 9 million to EBITDAC once operational. While the management remains optimistic, they acknowledged that these delays may affect their operational headroom and overall goals in the near term.

Profitability Trends

Carasent’s profitability metrics reveal a growing trend. The EBITDA reached NOK 12 million, while EBITDAC was reported at NOK 8 million, marking a robust improvement from last year. These figures suggest that most of the organic growth translates directly into higher margins, although they admit that the margins remain modest and are set to rapidly improve.

Cost Control Efforts

Efficient cost control is a core focus area for Carasent. The company has successfully renegotiated costs with suppliers and is transitioning from consultants to full-time employees, demonstrating a commitment to reduce operational expenses. This strategic shift is expected to maintain cost levels despite planning for expansion, indicating a well-thought-out approach to growth.

Significant Backlog and Customer Growth

The company's revenue backlog has seen a remarkable increase, jumping from NOK 2 million last year to NOK 17 million this quarter, fueled primarily by large contracts from key clients like Volvat and Medrave. This backlog positions Carasent well not only for the immediate future but also for sustained growth in the coming years.

Market Position and Competitive Landscape

Carasent continues to enhance its market position through focused product development and customer engagement. The launch of the Webdoc X module is a pivotal point, with expectations of launching it for the German market in the first half of 2025. This could open new revenue streams, particularly given the anticipated SEK 150 million market potential for the surgery module in Sweden.

Customer Retention and New Sales Strategy

With a net retention rate of 113%, Carasent highlights its ability to retain existing customers while also capturing new ones. The company has ramped up its sales and marketing efforts, showing promising results in recent months. Their proactive engagement strategy has led to quicker conversions, further underlining the operational strengths of the management team.

Looking Ahead

While anticipating growth, management has shared insights into the challenges posed by the regional shift towards the Millennium EHR system, which could impede sales in certain areas. However, they remain confident in their market approach and see numerous opportunities ahead, including potential large tenders for Medrave and broader activities with Webdoc and Ad Opus.

Earnings Call Transcript 2024-Q3

[Operator]

Welcome to Carasent Q3 Report for 2024. [Operator Instructions] Now I will hand the conference over to CEO, Daniel Ohman; and CFO, Svein Martin Bjornstad. Please go ahead.

[Daniel Ohman, executive]

Good morning, and welcome to our presentation of the third quarter. My name is Daniel Ohman, I'm CEO. And with me, I have Svein Martin Bjornstad, our CFO. We will start with the company update, and then Svein Martin will continue with the financial update.

Looking at the quarter, we have a quarter of solid improvements in all areas, a trend which we see will continue each quarter going forward. We have a good organic growth, and almost all that growth translates into higher EBITDAC, which we are very pleased with. And as I say, that's a trend we see continuing forward.

We are now on the home stretch of listing on the NASDAQ Stockholm. We aim to have the first day of trading in December, and we believe that we are now past all major obstacles, even though there are some final approvals still awaiting. In the quarter, we have high onetime cost, and this is related to this relisting, but also from the EG process and the acquisition project in Germany. So quite high onetime cost in the quarter, which we see going -- becoming lower going forward.

In the report, I also highlight I see a risk that the Volvat implementation might be a bit delayed. And to explain a bit why that's costly, I think it's worth going a little bit again. That contract has an ARR of NOK 6 million, and all that will translate to EBITDAC once the contract is up and running. Furthermore, we're doing quite a lot of development work for them. And if this year, 2024, it's around NOK 3 million. That's half the price would normally take for that development work. So that would typically have been NOK 6 million of turnover this year. So in total, we have an EBITDAC swing of NOK 9 million once that contract is up and running.

Now we never calculated for a majority of that to be active next year, and it won't be because as we come on clinic by clinic, and we start with some [Technical Difficulty] to make sure everything goes well. So we might see a small delay in that contract. It may take away some of the headrooms we had in our goals, but we still believe strongly in our goals. But you always want to have some headrooms in your external goals. But also at the same time, we see sales picking up. We have really good discussions with new customers. So I saw we did another, close another big sale this morning actually. So we still believe that the goals are very much realistic.

If looking at the growth, we have signed not implemented ARR of NOK 70 million and that -- and a 17% organic growth. And in total, we're now at 23% contracted ARR growth above our target of 20% for next year.

Looking at the profitability, we see that EBITDAC is also improving considerably. It's, however, worth noting that in the third quarter, we always have improving the quarter as such, but we have big improvements from last year.

In total, we have an organic growth of NOK 11 million in the quarter. If we add signed not implemented ARR or quarterly recurring revenue in this case, we are at NOK 50 million. As you also can see here, we had last quarter -- last year, the same quarter, we had NOK 2 million of [ churn of ] Confrere company, we now have divested.

Looking at EBITDAC, which is the financial metric we follow most closely internally, so growth and EBITDAC is what we're looking at. We see that almost all of those NOK 11 million becomes improved EBITDAC with an improvement of NOK 10 million.

And looking at this chart, here, we have made some changes. So now we moved HPI and Ad Opus into operations. They were previously in a separate lane together with Confrere, as you saw that there where we had to do a lot of improvements. So Confrere has now been divested and HPI and Ad Opus are not losing a large amount of money anymore. So we're now looking at operations as such. It does not mean that we still need to continue to improve in that area, but we need to improve in all areas. So it doesn't make them unique in any sense anymore. You see the growth of 17%. You see that operations have improved their EBITDA from NOK 11 million to NOK 18 million in the quarter and EBITDAC from NOK 5 million to NOK 13 million.

Webdoc X is now at a cost -- running cost of NOK 4 million each quarter. That's roughly where it will be. We're not aiming to go lower. This is where the running rate will be. We have a really efficient team, doing good improvements in the development. We see that's been very stable now. We have done a lot of changes to that part of organization, got rid of a lot of consultants. So we're quite happy with where that project is at the moment. We also lower costs somewhat at the HQ level.

I get a lot -- quite a lot of questions about the situation in VGR and Millennium. So I thought it was worth talking a bit about the potential consequence of that situation at this call. So the background is that Vastra Gotalands Regionen and VGR has decided many, many years ago that when they change to Millennium, as their EHR system in the public care, all private providers providing public care should also change and work in the same system. And they do that in order to make sure that the information can flow between systems. That can be accomplished in many other ways, too. You can use the APIs, you can use robots, you can use their national services that are to exchange information in Sweden called [ PAEHR ], most users know it as [indiscernible]. So there are many other ways of accomplishing most of what they want to accomplish.

All the caregivers really, really want to avoid going into Millennium. It's a very old system. It fits them really badly, and it's much more expensive than their present system. The price is not a major hurdle. The major hurdle is that it would really, really hurt them financially in their operations that they will become much less efficient.

Where we are at is that according to the region, the first private primary care clinics should move into Millennium by the end of next year. That will most likely be delayed again, but that's where they are at the moment, and that will just be a few clinics. And looking at the potential outcomes when now the private providers are trying not to get in, and we are supporting them heavily. There will be legal processes. They have quite a good case, a really good case.

I think it's more likely than not that they will succeed, but you never know with those type of cases. It also might become obvious or quite likely that will become obvious for the region, this is not a good idea. It's really difficult for them to be a good provider to the private providers of electronic and health record systems. So -- but the potential and the range of outcomes is what I wanted to show you.

So if the region would succeed and actually manage to get rid of the legal cases, managed to squash the -- all the complaints from private providers and actually managed to roll it out, then it would be a onetime churn of SEK 15 million to SEK 25 million and in the late 2026. Why it's a range is that we cannot see what our customers are using Webdoc for. We're not allowed to go in and see what type of patients they have. And they are only allowed to use Millennium for the patients provided -- they take care of for the public.

So not occupational health, not insurance, not private pay patients and so on, not vaccinations. So most or many might have to use double systems. So that's why we have a range of the worst case. And new states would be unaffected. We are not able to sell to customers at this moment that are expected that they might have to go into Millennium. They are not buying a new EHR system at the moment. Then if the providers succeed and stop this, then we would have 0 churn, and we would see a big increase in new sales because at the moment, we cannot sell to the region, where we are the largest and most well-known. So we would, in this scenario, a big increase in new sales.

And then there's the middle ground. As I said previously, many might have to use double systems. Millennium is a really bad systems for our customers. So they might want to stay in Webdoc and then we'll transfer data into Millennium, as we do in Stockholm, where we now have [ Ad Opus ] going back and forth between the public system there without the region actually opening up anything for us. We are solid in our -- at our end. And then users would likely increase in this middle ground because then they know that they can use Webdoc for certain patients.

So this is the scenarios that we could end up in. I think it's more likely not that we will succeed. And then, we have a big positive scenario. And then in worst case, we have roughly 1 year of growth that in worst, worst case, we would lose. Last update is from June, which was very positive that private specialists will be excluded. They do not have to go into Millennium anymore.

So looking ahead, going forward, we see a really big interest in surgery. We have been developing that for quite some time now, and it will go live early next year, and we can therefore start selling it now, and we're aiming to sign multiple contracts in the coming months. We believe that we have a very strong offering and have a very good positive response from the potential customers.

We will continue to work with efficiency. If we every month get a couple of percentage points more efficient in all parts over a year, that translates to big improvements, and over 2 years, it's even bigger improvements. And we can do a lot to become more efficient. I mean, most of the organization is new, either from a structure point of view or from the people or both. So that means that there's still a lot to get in place and to become really, really efficient in all parts. That's something we're working hard at.

An important area for us is cost control in this line [Technical Difficulty]. I think the connection dropped there. I hope that was an efficient use of resources.

And the most important part for us now is continued cost control. There are so many things we can develop for our customers that create value. And there's no end in the number of projects we could start. So that's -- and all of them would have a positive return on investment, but we cannot let costs grow in that sense. So that's why we have chosen that we have quite a large developed organization, but this is the level it should be at. And then we prioritize projects and choose the ones, which create the best return on investment at a reasonable risk. So we'll continue to work hard on the financial follow-up and have a very clear understanding of where we're heading.

The third area for us is the launch of Webdoc X. The focus is still on certifying Webdoc X for Germany. It has taken a little bit longer than expected, but should be there in the first half of 2025. We have the first German pilots going live now. So physical clinics actually using Webdoc X. They're not using it for all circumstances. They aren't allowed to do that yet. But they are using it for part of their processes. And we're still working hard on the acquisition of a strong German position. I think we are in a good place when it comes to that, but I cannot say much more about that at this point in time.

With those words, I will hand over to Svein Martin.

[Svein Bjornstad, executive]

Thank you. So looking at the financials for Q3, we saw good improvement across all our metrics in the quarter. We now have a contracted ARR base of NOK 277 million, and that has grown with 23% organically over the last year. And that is, of course, boosted by these 3 large contracts that we have signed that is still in the backlog, but not yet in the reported figures.

The reported recurring growth was 17%, and that is also a step-up compared to what we have posted in the last few years. I would say the main driver of this is Webdoc, where we continue to have a good pace on the sales side, and we have seen an increase in both signing new customers, new clinics and also selling to existing customer functionality.

HPI is also growing fast and Medrave as well had a good quarter with growth. We had net retention of 113%. I think it's worthwhile just recapping how we calculate that figure because these customer groups, where we have such as, for example, Cambio, there we have many clinics, but they are counted as one customer in this figure. So for Webdoc, we have signed a lot of clinics for Cambio and other existing customers, and that is also a main driver of the net retention. Margins is also improving. We are still at quite modest levels, but it's improving rapidly, as we see.

In terms of contracted ARR growth, we see that the net upsell was 14%, churn is stable at 2% and new customer growth was 4%. And then we have this big jump in the revenue backlog from NOK 2 million in same quarter last year to NOK 17 million now, and that is driven by the contract with Volvat for Metodika, VGR for Medrave, and Frelsesarmeen for Ad Curis. And these contracts will be gradually implemented next year. And that is a key contributor to our growth next year.

Looking at the profitability, we see that we are improving every quarter. And we are now at EBITDA of NOK 12 million and EBITDAC of NOK 8 million, excluding the investments into Webdoc X or 11% margin.

And in addition to the revenue growth, we maintain a very high focus on cost efficiencies. We have done several measures on this year, including, for example, renegotiating prices with suppliers. We have changed from consultants to employees, reducing costs, and we have also removed several roles during this year. And I think it's a promising signal, as well for the future that we have capacity to grow further. And when we do a budget now for next year, it's very limited roles that is even being requested by the organization. So the organization is fully on board with the strategy and the plan to keep costs flat for a long time.

If we look at this slide, it shows our P&L for the quarter and year-to-date. I think I would like to highlight a few different figures here. Firstly, you see the gross margins improved from 80% to 85%, which is quite a big increase. That is driven by 2 factors. Firstly, that we sold Confrere, which was dilutive. And secondly, that we renegotiated costs with the hosting supplier in Norway. So it's a big increase, and it's sustainable as well.

Secondly, the non-recurring expenses is high in this quarter for the cost for the EG process and also for the relisting. And we will have additional costs for the relisting in Q4, as it concludes in December.

We also -- thirdly, the third figure I would like to highlight is the EBITDA minus CapEx for the group, including all costs for Webdoc X, it's also positive now at around NOK 4 million or 6%. But it's worth noting that it's some holiday effects in there as well in Q3, as we have lower personnel expenses, as people go on annual leave.

Finally, the cash flow has improved a lot year-over-year, but it was negative in Q3, the free cash flow, and that is basically mainly driven by this working capital effects, where we pay out holiday to the employees and also holiday payments to employees and also these one-off costs, as well. But in general, a good financial quarter with solid improvements in line with our targets and our plan.

So with that, we can take the questions.

[Operator]

[Operator Instructions] The next question comes from Fredrik Nilsson from Redeye.

[Fredrik Nilsson, analyst]

Can you hear me?

[Daniel Ohman, executive]

Yes. Good morning.

[Fredrik Nilsson, analyst]

I want to start with the situation in VGR. I mean, as you mentioned, the specialists will be excluded. Does that eliminate the region succeed scenario? Or is that included in those numbers that you presented?

[Daniel Ohman, executive]

No, that's included in the numbers we present. So I mean, we've been growing with customers all along and also the specialists were never being able to fully go into Millennium, as they have so much insurance patients, private pay and patients from other regions. So they would always stay within Webdoc to a very large percentage.

[Fredrik Nilsson, analyst]

Okay. And now that the surgery module is more or less finished, could you remind us of the market potential for that functionality?

[Daniel Ohman, executive]

The surgery module, yes, we have calculated it to be around SEK 150 million in Sweden. It's typically bigger clinics than what we normally sign. And yes, that's been our calculation.

[Fredrik Nilsson, analyst]

Okay. And given that you sound quite optimistic regarding the prospects, the customers or potential customers being quite interested already. I mean, could you elaborate a bit on your expectations? I mean, should we expect, I mean, a meaningful increase in new sales? Or what's your expectations?

[Daniel Ohman, executive]

Yes, yes, that's my expectation. And that's what's also included for numbers next year. I would say it's a meaningful increase in new sales. So surgery is a part of that, even though these are large clinics typically, so they take a bit longer to sell to and it take a bit longer to implement that. Normally, a small clinic, we can sell to and implement sometimes [ within the ] same day, a large thing like this, you have a lot of staff to educate, you have to do it in -- they have to take terms because they don't want to lose production and so on. So we will see the actually payments come from new clinics. That will take some time before they start coming in. But signing contracts, I would see that accelerating in the coming months.

[Fredrik Nilsson, analyst]

Okay. And lastly, could you elaborate a bit on why you are more successful with the [ semi-cold cases ], as you mentioned? What's the new thing you do there?

[Daniel Ohman, executive]

Yes. So I think that our sales and marketing team has done a great job. It used to be the last couple of years, Webdoc sold mostly through or almost only through potential customer e-mailing us saying that they want to have Webdoc and then we have contacted them. Now we have done so much actually. But we're very active when it comes to marketing, social media, directed marketing to create [ leads ], and we are very visible for our customers. I think that's important to be visible that they think about you, and they have you on top of mind.

And I think there are many customers -- potential customers going around thinking that system I have is quite bad, but it's a lot of work to change. Let's do that later. And those you can push, I think, to change systems earlier. So -- and for the sales department, we have moved from almost only fixed salaries to 30% variable pay based on your own performance the last month. So some of our sellers now have been like almost twice the normal seller settlements. So it creates very strong incentives.

We have also divided all present or potential customers between the sellers, so everyone knows, who are their customers. Otherwise, it's difficult to start working them. And we have introduced a CRM system, so that we have a better understanding of the customers, what they're using today and that we can also do additional sales to present customers.

So far this year, we've been selling to new customers a bit faster than planned. We have been a bit below plan when it comes to additional payments, additional sales to existing customers. That has really increased the last couple of months. And I think that, that we are learning. It's a process both for the individuals as such, but also for the organization to learn how to do this type of sales. And that I think is the key. Thank you, Fredrik.

[Svein Bjornstad, executive]

Thank you, Fredrik. We also have some questions in the chat. So first one from [indiscernible]. Congratulations on a strong quarter. Could you clarify what you mean by scope regarding the Volvat contract? Are they increasing the functionality, number of clinics? Or what are you referring to? Also, is it possible that it will lead to larger ARR from that customer?

[Daniel Ohman, executive]

Yes. So what I think is there are a couple of different things that has increased the scope. For example, they were planning to use their own billing system or an external billing system. There is a billing functionality in Metodika, which they did not have planned to use from the beginning. But now when they've seen how well it works together, they are planning to use our billing system instead, but then they want some additional features in that. They have also asked for a patient portal, so patients can rebook their appointments and chat with the clinics and so on.

We already have that in Webdoc, but we do not have that in Metodika at this moment. So we're also developing that. So that's the type of things that goes into increased scope. It will give us some extra income from consultancy, but that's not what we look for. But that will be full priced -- full price development. So that's better at least than what we're doing at the moment.

And also, some of this functionality, we can hopefully sell to other providers, for example, the patient portal. So it will lead to better income going forward. It also will lead to a more satisfied customer. So I think there are many positives in it. And it's -- I mean, we're talking about a couple of months delay. So it's no major thing and the contract is still really good. But being on the stock exchange, a couple of months delay is not very fun, and it hurts.

[Svein Bjornstad, executive]

Next one, are there any large tenders in the market in the coming 15 months, such as the one you took with Medrave?

[Daniel Ohman, executive]

Yes. I think it's quite likely that we'll see -- we have signals that there might be tenders for Medrave, for example. I also think that it's possible for us to take larger contracts with both Webdoc and Ad Opus in the coming 6 months. That's not a promise, but there are quite a lot of opportunities out there. So I'm hopeful.

[Svein Bjornstad, executive]

Yes. And final one here. [ The SSI Group ] went live in September. Will the changes to these regions affect your ability to sell into those markets in any way?

[Daniel Ohman, executive]

So [ The SSI Group ] is a couple of regions using Cambio, and they went live in -- it's not a real cloud solution, but one of those client server -- cloud solutions of Cambio, [ the same system they had ] most of them. It does not change anything for us. These regions have very little private care, and we are not focusing on them.

[Svein Bjornstad, executive]

Great. Next one from [ Niclas ]. Can you tell us a bit more on the development for HPI? It seems like you are investing in new staff. What's your view on the product going forward?

[Daniel Ohman, executive]

We're changing staff from consultants to employees. So it's not new staff. We're not increasing costs at HPI. But my view of the product is that it's a really good product. It has a strong position within occupational health with almost all occupational health in Sweden using them. We have interest from Norway also on that platform, and to take that platform to Norway is not a big thing. You just need [indiscernible], and you need the language. So it's very easy to take it to a new market. It's not like an HR system.

But the challenge for the platform for HPI is that occupational health compared to health care is quite dependent on how the industries are doing. Occupational health is the first place you can try to save money on before getting rid of staff. So it's quite sensitive to downturns in the economy. So that makes it a bit harder to grow that compared to our products for the health care market. But still, it's a really good product. It can really improve how occupational health can work with both the customers, so the employer, but also with the employees. So I think it's a great product. We have big interest from both small and large occupational health care providers.

The downside with that product is that they need to change somewhat how they work. And typically, I don't think we should develop solutions that require that our customers change how they work. We should allow for changes in how to work and improvement in workflows, but we also need our products to support existing workflows because otherwise, the barriers to sell are too high. So we're trying to never end up in that scenario. But sometimes you have to, and this is a big improvement, but it requires more from the customers than our new products typically do. And I would say that's why it takes a bit longer. But that being said, they're growing very rapidly in a market, which is quite challenging at the moment.

[Svein Bjornstad, executive]

Yes. Next one from Emilie, DNB. Any updates on guidance for 2024, but also 2025, given what you are currently seeing?

[Daniel Ohman, executive]

So no changes. As I mentioned earlier on the call, we -- I'm a bit worried about the delays in Volvat, which removes some of the headroom we had in the goals. I mean, you really want to have headroom in external goals, so that you can beat the external goals. And that's why we want to give heads up because we have a really good overview, where we're going. We have good cost control. We know what we're selling. We see the pace of what we're selling. So -- but we still believe in our goals. We should be able to fulfill them, so they stay as they are.

[Svein Bjornstad, executive]

Okay. There are no more questions in the chat.

[Daniel Ohman, executive]

Okay. Then I would just like to thank you all for listening in, and hope you all have a good day. Thank you.