HealthStream, Inc. (HSTM) 10-Year Financial Performance & Capital Metrics

HSTM • • Industrial / General

HealthcareHealthcare ITClinical Software & EHR SystemsProvider Management Solutions

AboutHealthStream, Inc. provides workforce and provider solutions for healthcare organizations in the United States. It operates through two segments, Workforce Solutions and Provider Solutions. The company offers workforce solutions, including software-as-a-service (SaaS) based services and subscription-based solutions to meet the range of its clinical development, talent management, training, education, certification, scheduling, competency assessment, performance appraisal, and other needs, as well as implementation and account management services. It also provides applications for learning, performance appraisal, competency management, disclosure management, clinical assessment and development, simulation-based education, quality management, and industry training. In addition, the company offers VerityStream that delivers enterprise-class solutions to transform the healthcare provider experience for ambulatory surgery centers, urgent care facilities, clinics, medical groups, and other healthcare organizations; EchoCredentialing and MSOW platforms that manage medical staff credentialing, enrollment, and privileging processes for hospitals; and EchoOneApp, a provider enrollment platform for medical groups. Further, it provides CredentialMyDoc, a credentialing and enrollment SaaS solution for medical groups and surgery centers; CredentialStream, a SaaS-based provider credentialing, privileging, and enrollment solution; and NurseGrid Mobile for nurse managers. The company offers its solutions in healthcare industry companies that include private, not-for-profit, and government entities, as well as pharmaceutical and medical device companies through direct sales teams. HealthStream, Inc. was incorporated in 1990 and is headquartered in Nashville, Tennessee.Show more

Revenue $292M +4.5%
EBITDA $63M +9.5%
Net Income $20M +31.5%
EPS (Diluted) 0.66 +32.0%
Gross Margin 66.42% +0.7%
EBITDA Margin 21.44% +4.8%
Operating Margin 7.3% +27.2%
Net Margin 6.86% +25.8%
ROE 5.72% +26.8%
ROIC 4.98% +31.1%
Debt/Equity 0.06 -5.5%
Interest Coverage -

Technical Analysis

Key Insights

Based on financial data analysis

✓Strengths

✓Company is almost debt free
✓Strong Piotroski F-Score: 9/9
✓High quality earnings: Operating CF exceeds net income

✗Weaknesses

✗Weak 3Y average ROE of 4.6%
✗Weak momentum: RS Rating 19 (bottom 19%)
✗Trading more than 30% below 52-week high

Price & Volume

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Growth Metrics

Revenue CAGR

10Y5.5%

5Y2.79%

3Y4.34%

TTM3.68%

Profit (Net Income) CAGR

10Y6.77%

5Y4.87%

3Y50.71%

TTM5%

EPS CAGR

10Y5.96%

5Y8.45%

3Y54.2%

TTM4.62%

ROCE

10Y Avg3.89%

5Y Avg3.83%

3Y Avg4.31%

Latest5.48%

Peer Comparison

Provider Management Solutions

Name	Market Cap	Current Price	P/E Ratio	Revenue Growth 1Y	Net Margin	ROE	FCF Yield	Debt/Equity
PRVAPrivia Health Group, Inc.	2.93B	23.86	216.91	4.74%	0.89%	2.38%	3.55%	0.01
PGNYProgyny, Inc.	2.1B	24.31	42.65	7.22%	4.46%	10.1%	8.29%	0.05
DOCSDoximity, Inc.	5.64B	41.05	36.98	19.98%	40.72%	23.1%	4.73%	0.01
HSTMHealthStream, Inc.	653.89M	22.04	33.39	4.51%	6.93%	5.93%	4.51%	0.06
SPOKSpok Holdings, Inc.	272.51M	13.23	18.12	-0.99%	11.88%	11.16%	9.44%	0.06
BTSGBrightSpring Health Services, Inc. Common Stock	7.14B	39.60	-423.08	27.65%	1.04%	7.12%		1.76

Profit & Loss

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Sales/Revenue+	209M	225.97M	247.66M	231.62M	254.11M	244.83M	256.71M	266.83M	279.06M	291.65M
Revenue Growth %	0.22%	0.08%	0.1%	-0.06%	0.1%	-0.04%	0.05%	0.04%	0.05%	0.05%
Cost of Goods Sold+	89.39M	96.63M	106M	96.01M	103.89M	89.33M	91.03M	91.14M	95.02M	97.94M
COGS % of Revenue	0.43%	0.43%	0.43%	0.41%	0.41%	0.36%	0.35%	0.34%	0.34%	0.34%
Gross Profit+	119.62M	129.34M	141.66M	135.6M	150.22M	155.49M	165.68M	175.68M	184.04M	193.71M
Gross Margin %	0.57%	0.57%	0.57%	0.59%	0.59%	0.64%	0.65%	0.66%	0.66%	0.66%
Gross Profit Growth %	0.24%	0.08%	0.1%	-0.04%	0.11%	0.04%	0.07%	0.06%	0.05%	0.05%
Operating Expenses+	106.06M	123.77M	131.86M	120.11M	135.5M	139.68M	157.62M	163.23M	168.02M	172.42M
OpEx % of Revenue	0.51%	0.55%	0.53%	0.52%	0.53%	0.57%	0.61%	0.61%	0.6%	0.59%
Selling, General & Admin	64.85M	72.67M	77.68M	70.14M	78.52M	77.18M	79.15M	81.01M	81.41M	82.29M
SG&A % of Revenue	0.31%	0.32%	0.31%	0.3%	0.31%	0.32%	0.31%	0.3%	0.29%	0.28%
Research & Development	24.21M	28.9M	27.9M	25.73M	29.11M	32.3M	41.66M	44.28M	45.54M	48.89M
R&D % of Revenue	0.12%	0.13%	0.11%	0.11%	0.11%	0.13%	0.16%	0.17%	0.16%	0.17%
Other Operating Expenses	162K	581K	733K	1.08M	27.87M	30.19M	36.81M	37.95M	41.08M	41.24M
Operating Income+	13.56M	5.57M	9.8M	15.49M	14.72M	15.82M	8.05M	12.45M	16.02M	21.29M
Operating Margin %	0.06%	0.02%	0.04%	0.07%	0.06%	0.06%	0.03%	0.05%	0.06%	0.07%
Operating Income Growth %	-0.17%	-0.59%	0.76%	0.58%	-0.05%	0.07%	-0.49%	0.55%	0.29%	0.33%
EBITDA+	30.55M	27.77M	33.85M	39.72M	42.59M	46.01M	44.87M	50.39M	57.09M	62.53M
EBITDA Margin %	0.15%	0.12%	0.14%	0.17%	0.17%	0.19%	0.17%	0.19%	0.2%	0.21%
EBITDA Growth %	0.12%	-0.09%	0.22%	0.17%	0.07%	0.08%	-0.02%	0.12%	0.13%	0.1%
D&A (Non-Cash Add-back)	17M	22.21M	24.05M	24.23M	27.87M	30.19M	36.81M	37.95M	41.08M	41.24M
EBIT	13.56M	6.15M	9.41M	15.49M	14.72M	15.82M	8.05M	12.45M	16.02M	21.29M
Net Interest Income+	0	0	0	0	0	0	0	444K	2.36M	3.83M
Interest Income	0	0	0	0	0	0	0	444K	2.36M	3.83M
Interest Expense	0	0	0	0	0	0	0	0	0	0
Other Income/Expense	162K	-372K	733K	1.08M	3.21M	2M	-289K	3.14M	2.49M	3.52M
Pretax Income+	13.72M	6.15M	10.53M	16.57M	17.93M	17.82M	7.77M	15.59M	18.51M	24.8M
Pretax Margin %	0.07%	0.03%	0.04%	0.07%	0.07%	0.07%	0.03%	0.06%	0.07%	0.09%
Income Tax+	5.1M	2.39M	529K	3.32M	3.73M	3.73M	1.92M	3.49M	3.3M	4.8M
Effective Tax Rate %	0.63%	0.61%	0.95%	1.94%	0.88%	0.79%	0.75%	0.78%	0.82%	0.81%
Net Income+	8.62M	3.75M	10M	32.22M	15.77M	14.09M	5.84M	12.09M	15.21M	20.01M
Net Margin %	0.04%	0.02%	0.04%	0.14%	0.06%	0.06%	0.02%	0.05%	0.05%	0.07%
Net Income Growth %	-0.17%	-0.56%	1.66%	2.22%	-0.51%	-0.11%	-0.59%	1.07%	0.26%	0.32%
Net Income (Continuing)	8.62M	4.79M	8.84M	13.25M	14.2M	14.09M	5.84M	12.09M	15.21M	20.01M
Discontinued Operations	0	0	1.17M	18.97M	1.57M	0	0	0	0	0
Minority Interest	0	0	0	0	0	0	0	0	0	0
EPS (Diluted)+	0.28	0.12	0.31	1.00	0.44	0.44	0.18	0.39	0.50	0.66
EPS Growth %	-0.24%	-0.57%	1.58%	2.23%	-0.56%	0%	-0.59%	1.17%	0.28%	0.32%
EPS (Basic)	0.29	0.12	0.31	1.00	0.44	0.44	0.19	0.39	0.50	0.66
Diluted Shares Outstanding	30.44M	32.07M	32.2M	32.34M	32.43M	31.99M	31.62M	30.72M	30.67M	30.54M
Basic Shares Outstanding	30.06M	31.72M	31.86M	32.26M	32.37M	31.96M	31.53M	30.65M	30.57M	30.39M
Dividend Payout Ratio	-	-	-	1%	0%	0%	0%	-	0.2%	0.17%

Balance Sheet

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Total Current Assets+	209.54M	177.44M	199.73M	241.43M	224.57M	114.72M	106.84M	114.38M	130.21M	153.12M
Cash & Short-Term Investments	148.99M	103.17M	131.12M	168.82M	172.87M	46.49M	51.95M	53.91M	71.13M	97.22M
Cash Only	82.01M	49.63M	84.77M	134.32M	131.54M	36.57M	46.91M	46.02M	40.33M	59.47M
Short-Term Investments	66.98M	53.54M	46.35M	34.5M	41.33M	9.93M	5.04M	7.88M	30.8M	37.75M
Accounts Receivable	38.35M	47.39M	38.02M	41M	30.38M	46.1M	34.92M	42.71M	38.45M	35.32M
Days Sales Outstanding	66.97	76.54	56.03	64.62	43.63	68.73	49.65	58.42	50.29	44.21
Inventory	0	0	0	0	0	0	0	0	0	0
Days Inventory Outstanding	-	-	-	-	-	-	-	-	-	-
Other Current Assets	14.04M	18.18M	22.26M	13.6M	11.9M	9.57M	9.15M	9.07M	3.03M	9.55M
Total Non-Current Assets+	170.03M	218.56M	211.35M	198.73M	264.97M	385.59M	379.91M	383.36M	369.73M	357.64M
Property, Plant & Equipment	12.47M	10.24M	8.99M	14.08M	55.68M	50.3M	43.12M	38.24M	33.12M	28.19M
Fixed Asset Turnover	16.76x	22.06x	27.54x	16.45x	4.56x	4.87x	5.95x	6.98x	8.43x	10.34x
Goodwill	139.04M	188.13M	179.11M	145.52M	162.28M	178.44M	182.5M	192.4M	191.38M	191.22M
Intangible Assets	13.96M	16.31M	18.7M	18.35M	21.45M	127.35M	121.62M	118.67M	108.67M	98.92M
Long-Term Investments	3.64M	3.28M	3.77M	3.38M	6.78M	6.84M	7.04M	4.52M	4.13M	1.5M
Other Non-Current Assets	4.57M	3.88M	4.54M	17.25M	18.52M	22.66M	25.63M	29.15M	32.43M	37.81M
Total Assets+	379.57M	396M	411.07M	440.17M	489.54M	500.31M	486.75M	497.74M	499.94M	510.77M
Asset Turnover	0.55x	0.57x	0.60x	0.53x	0.52x	0.49x	0.53x	0.54x	0.56x	0.57x
Asset Growth %	0.48%	0.04%	0.04%	0.07%	0.11%	0.02%	-0.03%	0.02%	0%	0.02%
Total Current Liabilities+	89.08M	94.97M	101.07M	105.07M	105.19M	119.44M	100.35M	117.21M	118.36M	115.69M
Accounts Payable	4.62M	3.13M	4.18M	8.5M	4.81M	9.33M	5.13M	7.29M	7.46M	6.63M
Days Payables Outstanding	18.85	11.81	14.39	32.3	16.9	38.13	20.55	29.18	28.68	24.7
Short-Term Debt	0	0	0	0	0	0	0	0	0	0
Deferred Revenue (Current)	1000K	1000K	1000K	1000K	1000K	0	0	1000K	1000K	0
Other Current Liabilities	16.06M	21.31M	71.71M	29.21M	2.8M	81.18M	73.82M	2.84M	2.97M	84.23M
Current Ratio	2.35x	1.87x	1.98x	2.30x	2.14x	0.96x	1.06x	0.98x	1.10x	1.32x
Quick Ratio	2.35x	1.87x	1.98x	2.30x	2.14x	0.96x	1.06x	0.98x	1.10x	1.32x
Cash Conversion Cycle	-	-	-	-	-	-	-	-	-	-
Total Non-Current Liabilities+	10.17M	14.92M	9.84M	16.15M	46.19M	46.81M	47.38M	46.46M	40.83M	35.72M
Long-Term Debt	0	0	0	0	0	0	0	0	0	0
Capital Lease Obligations	0	0	0	0	30.73M	28.48M	26.18M	23.32M	20.25M	17.37M
Deferred Tax Liabilities	4.76M	5.97M	1.93M	11.07M	13.18M	0	0	18M	16.13M	0
Other Non-Current Liabilities	1.06M	1.09M	7.91M	2.21M	357K	18.33M	21.21M	2.21M	2.28M	18.35M
Total Liabilities	99.25M	109.89M	110.9M	121.22M	151.38M	166.25M	147.73M	163.68M	159.19M	151.41M
Total Debt+	0	0	0	0	30.73M	31.87M	29.11M	23.32M	20.25M	20.17M
Net Debt	-82.01M	-49.63M	-84.77M	-134.32M	-100.81M	-4.7M	-17.8M	-22.7M	-20.09M	-39.3M
Debt / Equity	-	-	-	-	0.09x	0.10x	0.09x	0.07x	0.06x	0.06x
Debt / EBITDA	-	-	-	-	0.72x	0.69x	0.65x	0.46x	0.35x	0.32x
Net Debt / EBITDA	-2.68x	-1.79x	-2.50x	-3.38x	-2.37x	-0.10x	-0.40x	-0.45x	-0.35x	-0.63x
Interest Coverage	-	-	-	-	-	-	-	-	-	-
Total Equity+	280.32M	286.11M	300.17M	318.95M	338.17M	334.06M	339.02M	334.06M	340.75M	359.36M
Equity Growth %	0.67%	0.02%	0.05%	0.06%	0.06%	-0.01%	0.01%	-0.01%	0.02%	0.05%
Book Value per Share	9.21	8.92	9.32	9.86	10.43	10.44	10.72	10.88	11.11	11.77
Total Shareholders' Equity	280.32M	286.11M	300.17M	318.95M	338.17M	334.06M	339.02M	334.06M	340.75M	359.36M
Common Stock	278.8M	280.81M	282.67M	286.6M	290.02M	271.78M	270.79M	254.83M	249.07M	252.43M
Retained Earnings	1.59M	5.35M	17.54M	32.37M	48.14M	62.28M	68.12M	80.21M	92.37M	108.97M
Treasury Stock	0	0	0	0	0	0	0	0	0	0
Accumulated OCI	-70K	-51K	-38K	-23K	4K	1K	106K	-981K	-691K	-2.05M
Minority Interest	0	0	0	0	0	0	0	0	0	0

Cash Flow

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Cash from Operations+	34.92M	24.23M	46.71M	43.25M	65.66M	35.87M	42.38M	51.19M	63.97M	57.66M
Operating CF Margin %	0.17%	0.11%	0.19%	0.19%	0.26%	0.15%	0.17%	0.19%	0.23%	0.2%
Operating CF Growth %	0.02%	-0.31%	0.93%	-0.07%	0.52%	-0.45%	0.18%	0.21%	0.25%	-0.1%
Net Income	8.62M	3.75M	10M	32.22M	15.77M	14.09M	5.84M	12.09M	15.21M	20.01M
Depreciation & Amortization	17M	22.21M	26.28M	24.23M	36.17M	38.96M	45.98M	48.54M	52.57M	41.24M
Stock-Based Compensation	3.28M	1.97M	1.85M	1.78M	4.24M	2.22M	5.3M	3.55M	4.15M	4.47M
Deferred Taxes	392K	1.79M	-2.04M	3.02M	0	0	0	0	0	-1.11M
Other Non-Cash Items	-1.28M	1.33M	2.32M	-10.06M	-154K	3K	-10.28M	6.67M	6.58M	13.67M
Working Capital Changes	6.91M	-6.81M	8.29M	-7.94M	9.62M	-19.39M	-4.46M	-19.67M	-14.54M	-20.61M
Change in Receivables	-736K	-736K	-6.08M	-4.05M	11.61M	-2.99M	10.34M	-7.77M	3.24M	537K
Change in Inventory	-1.27M	-10.51M	8.82M	-2.33M	0	0	0	0	0	0
Change in Payables	2.74M	1.49M	6.36M	4.92M	0	0	0	0	0	-5.03M
Cash from Investing+	-134.86M	-56.66M	-11.58M	36.56M	-67.52M	-110.41M	-25.72M	-28.39M	-56.6M	-33.97M
Capital Expenditures	-15.36M	-14.81M	-17.87M	-18.45M	-22M	-1.99M	-3.42M	-1.77M	-2.2M	-1.4M
CapEx % of Revenue	0.07%	0.07%	0.07%	0.08%	0.09%	0.01%	0.01%	0.01%	0.01%	0%
Acquisitions	-	-	-	-	-	-	-	-	-	-
Investments	-	-	-	-	-	-	-	-	-	-
Other Investing	-54.8M	107.94M	55.26M	-115K	-18.51M	12.92M	-17.6M	-22.66M	-47.78M	14.11M
Cash from Financing+	99.96M	46K	1K	-30.25M	-916K	-20.49M	-6.21M	-23.7M	-13.04M	-4.52M
Debt Issued (Net)	-	-	-	-	-	-	-	-	-	-
Equity Issued (Net)	-	-	-	-	-	-	-	-	-	-
Dividends Paid	0	0	0	-32.36M	-58K	-40K	-19K	0	-3.06M	-3.4M
Share Repurchases	-	-	-	-	-	-	-	-	-	-
Other Financing	1.95M	46K	1K	2.11M	176K	0	0	0	-118K	0
Net Change in Cash	-	-	-	-	-	-	-	-	-	-
Free Cash Flow+	19.56M	9.43M	28.84M	24.8M	43.66M	33.89M	38.97M	49.42M	61.77M	29.52M
FCF Margin %	0.09%	0.04%	0.12%	0.11%	0.17%	0.14%	0.15%	0.19%	0.22%	0.1%
FCF Growth %	-0.19%	-0.52%	2.06%	-0.14%	0.76%	-0.22%	0.15%	0.27%	0.25%	-0.52%
FCF per Share	0.64	0.29	0.90	0.77	1.35	1.06	1.23	1.61	2.01	0.97
FCF Conversion (FCF/Net Income)	4.05x	6.45x	4.67x	1.34x	4.16x	2.55x	7.25x	4.23x	4.20x	2.88x
Interest Paid	190K	76K	101K	117K	101K	96K	132K	99K	132K	101K
Taxes Paid	2.65M	2.5M	638K	16.51M	0	0	0	0	0	8.7M

Key Ratios

Metric	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Return on Equity (ROE)	3.85%	1.33%	3.41%	10.41%	4.8%	4.19%	1.74%	3.59%	4.51%	5.72%
Return on Invested Capital (ROIC)	7.16%	1.92%	3.25%	5.81%	5.23%	4.19%	1.86%	2.95%	3.8%	4.98%
Gross Margin	57.23%	57.24%	57.2%	58.55%	59.12%	63.51%	64.54%	65.84%	65.95%	66.42%
Net Margin	4.12%	1.66%	4.04%	13.91%	6.21%	5.76%	2.28%	4.53%	5.45%	6.86%
Debt / Equity	-	-	-	-	0.09x	0.10x	0.09x	0.07x	0.06x	0.06x
FCF Conversion	4.05x	6.45x	4.67x	1.34x	4.16x	2.55x	7.25x	4.23x	4.20x	2.88x
Revenue Growth	22.45%	8.12%	9.6%	-6.48%	9.71%	-3.65%	4.85%	3.94%	4.59%	4.51%

Revenue by Segment

	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Subscription Services	-	-	-	-	-	-	-	-	267.94M	280.32M
Subscription Services Growth	-	-	-	-	-	-	-	-	-	4.62%
Professional Services	-	-	-	-	-	-	-	-	11.13M	11.33M
Professional Services Growth	-	-	-	-	-	-	-	-	-	1.82%
Healthstream Workforce Solutions	161.29M	-	-	190.14M	208.6M	197.59M	205.44M	213.59M	-	-
Healthstream Workforce Solutions Growth	-	-	-	-	9.71%	-5.28%	3.98%	3.97%	-	-
Healthstream Provider Solutions	13.52M	-	-	41.48M	45.51M	47.24M	51.27M	53.24M	-	-
Healthstream Provider Solutions Growth	-	-	-	-	9.73%	3.79%	8.53%	3.84%	-	-
HealthStream Workforce Solutions	-	168.04M	178.06M	-	-	-	-	-	-	-
HealthStream Workforce Solutions Growth	-	-	5.96%	-	-	-	-	-	-	-
HealthStream Provider Solutions	-	24.08M	36.84M	-	-	-	-	-	-	-
HealthStream Provider Solutions Growth	-	-	52.96%	-	-	-	-	-	-	-
Patient Experience Solutions	34.19M	33.85M	32.76M	-	-	-	-	-	-	-
Patient Experience Solutions Growth	-	-1.00%	-3.21%	-	-	-	-	-	-	-

Frequently Asked Questions

Valuation & Price

HealthStream, Inc. (HSTM) has a price-to-earnings (P/E) ratio of 33.4x. This suggests investors expect higher future growth.

Growth & Financials

HealthStream, Inc. (HSTM) reported $298.6M in revenue for fiscal year 2024. This represents a 264% increase from $82.1M in 2011.

HealthStream, Inc. (HSTM) grew revenue by 4.5% over the past year. Growth has been modest.

Yes, HealthStream, Inc. (HSTM) is profitable, generating $20.7M in net income for fiscal year 2024 (6.9% net margin).

Dividend & Returns

Yes, HealthStream, Inc. (HSTM) pays a dividend with a yield of 0.51%. This makes it attractive for income-focused investors.

HealthStream, Inc. (HSTM) has a return on equity (ROE) of 5.7%. This is below average, suggesting room for improvement.

HealthStream, Inc. (HSTM) generated $57.6M in free cash flow for fiscal year 2024. Positive FCF indicates the company can fund dividends, buybacks, or reinvestment.

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