UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 10-Q

(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended JuneSeptember 30, 2019
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from ______ to ______
Commission File Number 000-55039
logo1a11.jpg
BIOTELEMETRY, INC.
(Exact Name of Registrant as Specified in its Charter)
Delaware 46-2568498
(State or other jurisdiction of incorporation or organization) (I.R.S. Employer Identification No.)
1000 Cedar Hollow Road  
Malvern,Pennsylvania 19355
(Address of principal executive offices) (Zip Code)
(610) 729-7000
(Registrant’s Telephone Number, including Area Code)
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $0.001 par valueBEATNASDAQ Global Select Market
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.  Yes    No 
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).  Yes    No 
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company.  See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act.  (Check one):
Large accelerated filerAccelerated filerEmerging growth company
Non-accelerated filerSmaller reporting company  
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).  Yes    No  
As of July 22,October 28, 2019, 33,889,43033,991,107 shares of the registrant’s common stock $0.001 par value per share, were outstanding.
 




BIOTELEMETRY, INC.
QUARTERLY REPORT ON FORM 10-Q
FOR THE PERIOD ENDED JUNESEPTEMBER 30, 2019

TABLE OF CONTENTS
  Page
PART I
 
Financial Statements (unaudited)
Management'sManagement’s Discussion and Analysis of Financial Condition and Results of Operations
   
PART II
 
   
Unless the context otherwise indicates or requires, the terms “we,” “our,” “us,” “BioTelemetry” and the “Company,” as used in this Quarterly Report on Form 10-Q, refer to BioTelemetry, Inc. and its directly and indirectly owned subsidiaries as a combined entity, except where otherwise stated or where it is clear that the terms mean only BioTelemetry, Inc. exclusive of its subsidiaries. We do not use the ® or ™ symbol in each instance in which one of our registered or common law trademarks appears in this Quarterly Report on Form 10-Q, but this should not be construed as any indication that we will not assert our rights thereto to the fullest extent permissible under applicable law.


CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS
This document includes certain forward-looking statements within the meaning of the “Safe Harbor” provisions of the Private Securities Litigation Reform Act of 1995 regarding, among other things, our growth prospects, the prospects for our products and our confidence in our future. These statements may be identified by words such as “expect,” “anticipate,” “estimate,” “intend,” “plan,” “believe,” “promises” and other words and terms of similar meaning. Examples of forward-looking statements include statements we make regarding our ability to increase demand for our products and services, to leverage our Mobile Cardiac Outpatient Telemetry platform, to expand into new markets, to grow our market share, our expectations regarding revenue trends in our segments and the achievement of cost efficiencies through process improvement. Such forward-looking statements are based on current expectations and involve inherent risks and uncertainties, including important factors that could delay, divert or change any of these expectations, and could cause actual outcomes and results to differ materially from current expectations. These factors include, among other things:
our ability to identify acquisition candidates, acquire them on attractive terms and integrate their operations into our business;
our ability to educate physicians and continue to obtain prescriptions for our products and services;
changes to insurance coverage and reimbursement levels by Medicare and commercial payors for our products and services;
our ability to attract and retain talented executive management and sales personnel;
the commercialization of new competitive products;
acceptance of our new products and services, such as our mobile cardiac telemetry (“MCT”) patch;
the outcome of our pending and ongoing incident investigation (as detailed in “Part I; Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations” of this report), including our discovery of additional information relating to the incident and our customers’ and other stakeholders’ reactions to that additional information;
costs related the incident investigation and resulting liabilities;
our ability to obtain and maintain required regulatory approvals for our products, services and manufacturing facilities;
changes in governmental regulations and legislation;
adverse regulatory action;
our ability to obtain and maintain adequate protection of our intellectual property;
interruptions or delays in the telecommunications systems that we use;
our ability to successfully resolve outstanding legal proceedings; and
the other factors that are described in “Part I; Item 1A. Risk Factors” of our Annual Report on Form 10-K for the year ended December 31, 2018.2018, as well as the factors that are described


in “Part II; Item 1A. Risk Factors” of this Quarterly Report on Form 10-Q.
We undertake no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise, except as may be required by law.

PART I — FINANCIAL INFORMATION


Item 1.  Financial Statements
BIOTELEMETRY, INC.
CONSOLIDATED BALANCE SHEETS
(in thousands, except share and par value amounts)
(Unaudited)
June 30,
2019
 December 31,
2018
(in thousands, except share and par value data)
(Unaudited)
September 30,
2019
 December 31,
2018
ASSETS      
Current assets:      
Cash and cash equivalents$51,712
 $80,889
$61,573
 $80,889
Healthcare accounts receivable, net of allowance for doubtful accounts of $27,458 and $25,345, at June 30, 2019 and December 31, 2018, respectively48,307
 37,754
Other accounts receivable, net of allowance for doubtful accounts of $187 and $268, at June 30, 2019 and December 31, 2018, respectively15,026
 14,874
Healthcare accounts receivable, net of allowance for doubtful accounts of $26,504 and $25,345, at September 30, 2019 and December 31, 2018, respectively56,832
 37,754
Other accounts receivable, net of allowance for doubtful accounts of $92 and $268, at September 30, 2019 and December 31, 2018, respectively15,637
 14,874
Inventory6,037
 7,323
6,389
 7,323
Prepaid expenses and other current assets8,925
 5,820
9,712
 5,820
Total current assets130,007
 146,660
150,143
 146,660
Property and equipment, net of accumulated depreciation of $70,679 and $67,202, at June 30, 2019 and December 31, 2018, respectively54,289
 48,377
Property and equipment, net of accumulated depreciation of $74,241 and $67,202, at September 30, 2019 and December 31, 2018, respectively55,608
 48,377
Intangible assets, net137,530
 129,653
133,593
 129,653
Goodwill303,981
 238,814
304,101
 238,814
Deferred tax assets16,116
 19,975
12,828
 19,975
Other assets22,238
 3,322
19,891
 3,322
Total assets$664,161
 $586,801
$676,164
 $586,801
LIABILITIES AND EQUITY      
Current liabilities:      
Accounts payable$22,484
 $18,157
$19,287
 $18,157
Accrued liabilities25,927
 24,689
28,487
 24,689
Current portion of finance lease obligations590
 1,652
490
 1,652
Current portion of long-term debt10,250
 5,125
12,813
 5,125
Total current liabilities59,251
 49,623
61,077
 49,623
Long-term portion of finance lease obligations419
 117
348
 117
Long-term debt186,358
 193,424
182,825
 193,424
Other long-term liabilities71,294
 33,152
71,007
 33,152
Total liabilities317,322
 276,316
315,257
 276,316
Stockholders’ equity: 
  
   
Common stock—$0.001 par value as of June 30, 2019 and December 31, 2018; 200,000,000 shares authorized as of June 30, 2019 and December 31, 2018; 33,888,920 and 33,406,364 shares issued and outstanding at June 30, 2019 and December 31, 2018, respectively34
 33
Common stock—$0.001 par value as of September 30, 2019 and December 31, 2018; 200,000,000 shares authorized as of September 30, 2019 and December 31, 2018; 33,991,107 and 33,406,364 shares issued and outstanding at September 30, 2019 and December 31, 2018, respectively34
 33
Paid-in capital443,135
 426,054
449,087
 426,054
Accumulated other comprehensive (loss)/income(457) 256
(624) 256
Accumulated deficit(95,873) (115,858)(87,590) (115,858)
Total equity346,839
 310,485
360,907
 310,485
Total liabilities and equity$664,161
 $586,801
$676,164
 $586,801
See accompanying Notes to Consolidated Financial Statements.
BIOTELEMETRY, INC.
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)

Three Months Ended Nine Months Ended
Three Months Ended Six Months EndedSeptember 30, September 30,
(in thousands, except per share data)June 30,
2019
 June 30,
2018
 June 30,
2019
 June 30,
2018
2019 2018 2019 2018
Revenue$111,803

$101,360
 $215,782
 $195,856
$111,291

$100,013
 $327,073
 $295,869
Cost of revenue41,563
 35,605
 80,764
 72,053
41,952
 37,276
 122,716
 109,329
Gross profit70,240
 65,755
 135,018
 123,803
69,339
 62,737
 204,357
 186,540
Operating expenses:              
General and administrative30,587
 28,741
 58,194
 55,460
29,651
 26,325
 87,845
 81,785
Sales and marketing12,795
 11,075
 25,235
 22,415
12,572
 10,120
 37,807
 32,535
Bad debt expense5,379
 6,875
 10,527
 11,754
5,858
 5,157
 16,385
 16,911
Research and development3,532
 2,733
 6,865
 6,022
3,661
 2,429
 10,526
 8,451
Other charges2,234
 5,208
 5,304
 10,293
2,598
 1,330
 7,902
 11,623
Total operating expenses54,527
 54,632
 106,125
 105,944
54,340
 45,361
 160,465
 151,305
Income from operations15,713
 11,123
 28,893
 17,859
14,999
 17,376
 43,892
 35,235
Other expense:              
Interest expense(2,538) (2,684) (5,020) (4,574)(2,338) (2,408) (7,358) (6,982)
Loss on equity method investments(154) (45) (186) (184)(65) (54) (251) (238)
Other non-operating income/(expense), net86
 550
 (968) 737
Other non-operating (expense)/income, net(845) (194) (1,813) 543
Total other expense, net(2,606) (2,179) (6,174) (4,021)(3,248) (2,656) (9,422) (6,677)
Income before income taxes13,107
 8,944
 22,719
 13,838
11,751
 14,720
 34,470
 28,558
(Provision for)/benefit from income taxes(4,807) 1,500
 (2,734) 1,642
(3,468) 1,281
 (6,202) 2,923
Net income8,300
 10,444
 19,985
 15,480
8,283
 16,001
 28,268
 31,481
Net loss attributable to noncontrolling interest
 
 
 (946)
 
 
 (946)
Net income attributable to BioTelemetry, Inc.$8,300
 $10,444
 $19,985
 $16,426
$8,283
 $16,001
 $28,268
 $32,427
              
Net income per common share attributable to BioTelemetry, Inc.:              
Basic$0.25
 $0.32
 $0.59
 $0.51
$0.24
 $0.48
 $0.83
 $1.00
Diluted$0.23
 $0.29
 $0.55
 $0.46
$0.23
 $0.45
 $0.78
 $0.91
Weighted average number of common shares outstanding:              
Basic33,825
 32,435
 33,806
 32,227
33,908
 33,003
 33,885
 32,488
Dilutive common stock equivalents2,493
 3,143
 2,638
 3,187
2,360
 2,915
 2,560
 3,078
Diluted36,318
 35,578
 36,444
 35,414
36,268
 35,918
 36,445
 35,566
See accompanying Notes to Consolidated Financial Statements.
BIOTELEMETRY, INC.
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(Unaudited)

 Three Months Ended Six Months Ended
(in thousands)June 30,
2019
 June 30,
2018
 June 30,
2019
 June 30,
2018
Net income attributable to BioTelemetry, Inc.$8,300
 $10,444
 $19,985
 $16,426
Other comprehensive income/(loss):       
Foreign currency translation (loss)/gain(711) 30
 (713) (167)
Comprehensive income attributable to BioTelemetry, Inc.$7,589
 $10,474
 $19,272
 $16,259



 Three Months Ended Nine Months Ended
 September 30, September 30,
(in thousands)2019 2018 2019 2018
Net income attributable to BioTelemetry, Inc.$8,283
 $16,001
 $28,268
 $32,427
Other comprehensive loss:       
Foreign currency translation loss(167) (27) (880) (194)
Comprehensive income attributable to BioTelemetry, Inc.$8,116
 $15,974
 $27,388
 $32,233
See accompanying Notes to Consolidated Financial Statements.

BIOTELEMETRY, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)


Nine Months Ended
Six Months EndedSeptember 30,
(in thousands)June 30,
2019
 June 30,
2018
2019 2018
OPERATING ACTIVITIES      
Net income$19,985
 $15,480
$28,268
 $31,481
Adjustments to reconcile net income to net cash provided by operating activities:      
Bad debt expense10,527
 11,754
16,385
 16,911
Depreciation11,012
 11,236
Amortization9,201
 8,646
Depreciation and amortization30,508
 30,231
Stock-based compensation6,026
 4,923
9,662
 6,278
Accretion of debt discount621
 621
932
 932
Deferred income taxes1,980
 (3,258)5,021
 (4,149)
Change in fair value of acquisition-related contingent consideration(1,810) (700)(1,720) (700)
Other non-cash items(398) 120
(105) 279
Changes in operating assets and liabilities:      
Healthcare and other accounts receivable(19,643) (22,579)(34,637) (28,826)
Inventory1,286
 (2,376)934
 (3,454)
Prepaid expenses and other assets(3,366) 1,700
(3,493) 1,932
Accounts payable3,837
 (582)640
 1,105
Accrued and other liabilities(3,128) (8,849)207
 (7,733)
Net cash provided by operating activities36,130
 16,136
52,602
 44,287
INVESTING ACTIVITIES      
Acquisition of businesses, net of cash acquired(44,766) 
(44,766) 
Purchases of property and equipment and investment in internally developed software(16,092) (9,937)(23,686) (17,498)
Net cash used in investing activities(60,858) (9,937)(68,452) (17,498)
FINANCING ACTIVITIES      
Proceeds related to the exercising of stock options and employee stock purchase plan4,729
 6,152
7,045
 10,818
Payments of tax withholdings related to vesting of share-based awards

(4,955) (2,890)(4,955) (2,890)
Principal payments on long-term debt(2,563) (1,025)(3,844) (1,538)
Principal payments on finance lease obligations(1,659) (1,973)(1,735) (3,005)
Acquisition of noncontrolling interests
 (2,885)
 (2,885)
Net cash used in financing activities(4,448) (2,621)
Net cash (used in)/provided by financing activities(3,489) 500
Effect of exchange rate changes on cash(1) (166)23
 (193)
Net (decrease)/increase in cash and cash equivalents(29,177) 3,412
(19,316) 27,096
Cash and cash equivalents - beginning of period80,889
 36,022
80,889
 36,022
Cash and cash equivalents - end of period$51,712
 $39,434
$61,573
 $63,118
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION      
Non-cash purchases of property and equipment$1,645
 $1,131
$1,721
 $1,056
Non-cash fair value of equity issued for acquisition of business2,142
 
2,142
 
Non-cash acquisitions of noncontrolling interests
 3,972
Non-cash fair value of equity issued for acquisition of noncontrolling interests
 3,972
Cash paid for interest4,327
 3,675
6,301
 5,830
Cash paid for taxes$312
 $1,107
$617
 $1,120
See accompanying Notes to Consolidated Financial Statements.
BIOTELEMETRY, INC.
CONSOLIDATED STATEMENTS OF EQUITY
(Unaudited)




BioTelemetry, Inc. Equity  BioTelemetry, Inc. Equity
Common Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Income/(Loss)
 Accumulated Deficit Total EquityCommon Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Loss
 Accumulated Deficit Total Equity
(in thousands, except shares)Shares Amount Shares Amount 
Balance at March 31, 201933,803,736
 $34
 $436,892
 $254
 $(104,173) $333,007
Balance at June 30, 201933,888,920
 $34
 $443,135
 $(457) $(95,873) $346,839
Share issuances related to stock compensation plans36,022
 
 418
 
 
 418
102,187
 
 2,316
 
 
 2,316
Stock-based compensation
 
 3,477
 
 
 3,477

 
 3,636
 
 
 3,636
Shares withheld to cover taxes on vesting of share based awards(838) 
 (44) 
 
 (44)
Issuance of stock related to business combination50,000
 
 2,142
 
 
 2,142
Deferred purchase price consideration - equity portion
 
 250
 
 
 250
Currency translation adjustment
 
 
 (711) 
 (711)
 
 
 (167) 
 (167)
Net income
 
 
 
 8,300
 8,300

 
 
 
 8,283
 8,283
Balance at June 30, 201933,888,920
 $34
 $443,135
 $(457) $(95,873) $346,839
Balance at September 30, 201933,991,107
 $34
 $449,087
 $(624) $(87,590) $360,907


BioTelemetry, Inc. Equity    BioTelemetry, Inc. Equity
Common Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Income/(Loss)
 Accumulated Deficit Noncontrolling Interest Total EquityCommon Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Loss
 Accumulated Deficit Total Equity
(in thousands, except shares)Shares Amount Shares Amount 
Balance at March 31, 201832,239,656
 $33
 $411,328
 $(311) $(152,696) $(2,000) $256,354
Balance at June 30, 201832,715,190
 $33
 $415,701
 $(281) $(142,252) $273,201
Share issuances related to stock compensation plans480,766
 
 3,666
 
 
 
 3,666
496,868
 
 4,985
 
 
 4,985
Stock-based compensation
 
 2,858
 
 
 
 2,858

 
 1,355
 
 
 1,355
Shares withheld to cover taxes on vesting of share based awards(5,232) 
 (151) 
 
 
 (151)
Acquisition of noncontrolling interest
 
 (2,000) 
 
 2,000
 
Currency translation adjustment
 
 
 30
 
 
 30

 
 
 (27) 
 (27)
Net income
 
 
 
 10,444
 
 10,444

 
 
 
 16,001
 16,001
Balance at June 30, 201832,715,190
 $33
 $415,701
 $(281) $(142,252) $
 $273,201
Balance at September 30, 201833,212,058
 $33
 $422,041
 $(308) $(126,251) $295,515



See accompanying Notes to Consolidated Financial Statements.
BIOTELEMETRY, INC.
CONSOLIDATED STATEMENTS OF EQUITY
(Unaudited)




BioTelemetry, Inc. Equity  BioTelemetry, Inc. Equity
Common Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Income/(Loss)
 Accumulated Deficit Total EquityCommon Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Income/(Loss)
 Accumulated Deficit Total Equity
(in thousands, except shares)Shares Amount Shares Amount 
Balance at December 31, 201833,406,364
 $33
 $426,054
 $256
 $(115,858) $310,485
33,406,364
 $33
 $426,054
 $256
 $(115,858) $310,485
Share issuances related to stock compensation plans496,974
 1
 4,728
 
 
 4,729
599,161
 1
 7,044
 
 
 7,045
Stock-based compensation
 
 6,026
 
 
 6,026

 
 9,662
 
 
 9,662
Shares withheld to cover taxes on vesting of share based awards(64,418) 
 (4,955) 
 
 (4,955)
Shares withheld to cover taxes on vesting of share-based awards(64,418) 
 (4,955) 
 
 (4,955)
Issuance of stock related to business combination50,000
 
 2,142
 
 
 2,142
50,000
 
 2,142
 
 
 2,142
Deferred purchase price consideration - equity portion
 
 9,140
 
 
 9,140

 
 9,140
 
 
 9,140
Currency translation adjustment
 
 
 (713) 
 (713)
 
 
 (880) 
 (880)
Net income
 
 
 
 19,985
 19,985

 
 
 
 28,268
 28,268
Balance at June 30, 201933,888,920
 $34
 $443,135
 $(457) $(95,873) $346,839
Balance at September 30, 201933,991,107
 $34
 $449,087
 $(624) $(87,590) $360,907


BioTelemetry, Inc. Equity    BioTelemetry, Inc. Equity    
Common Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Loss
 Accumulated Deficit Noncontrolling Interest Total EquityCommon Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Loss
 Accumulated Deficit Noncontrolling Interest Total Equity
(in thousands, except shares)Shares Amount Shares Amount 
Balance at December 31, 201731,906,195
 $32
 $409,517
 $(114) $(158,678) $(1,054) $249,703
31,906,195
 $32
 $409,517
 $(114) $(158,678) $(1,054) $249,703
Share issuances related to stock compensation plans835,386
 1
 6,151
 
 
 
 6,152
1,332,254
 1
 11,136
 
 
 
 11,137
Stock-based compensation
 
 4,923
 
 
 
 4,923

 
 6,278
 
 
 
 6,278
Shares withheld to cover taxes on vesting of share based awards(85,177) 
 (2,890) 
 
 
 (2,890)
Shares withheld to cover taxes on vesting of share-based awards(85,177) 
 (2,890) 
 
 
 (2,890)
Acquisition of noncontrolling interest58,786
 
 (2,000) 
 
 2,000
 
58,786
 
 (2,000) 
 
 2,000
 
Currency translation adjustment
 
 
 (167) 
 
 (167)
 
 
 (194) 
 
 (194)
Net income/(loss)
 
 
 
 16,426
 (946) 15,480

 
 
 
 32,427
 (946) 31,481
Balance at June 30, 201832,715,190
 $33
 $415,701
 $(281) $(142,252) $
 $273,201
Balance at September 30, 201833,212,058
 $33
 $422,041
 $(308) $(126,251) $
 $295,515



See accompanying Notes to Consolidated Financial Statements.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)



1. Summary of Significant Accounting Policies
a) Principles of Consolidation & Reclassifications
The accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information, the instructions to Form 10-Q, and Rule 10-01 of Regulation S-X and include the accounts of BioTelemetry, Inc. and its controlled subsidiaries (“BioTelemetry,” the “Company,” “we,” “our” or “us”). In the opinion of management, all adjustments (which are of a normal and recurring nature) considered necessary to present fairly the financial position, the results of operations, and statements of comprehensive income, cash flows, and equity for the interim periods ended JuneSeptember 30, 2019 and 2018 have been included. All intercompany transactions and balances have been eliminated in consolidation. The results of operations for any interim period are not indicative of the results of the full year. Certain information and footnote disclosures normally included in consolidated financial statements presented in accordance with U.S. GAAP, but which are not required for interim reporting purposes, have been omitted. The accompanying unaudited consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2018.
Certain reclassifications have been made to prior period statements to conform to the current period presentation. These consist of combining our contract liabilitiesnon-cash depreciation and amortization expenses into accrued liabilitiesone line on our consolidated balance sheetstatements of cash flows and combiningseparating the non-cash operating itemsitem of equity method investment loss and lease income/(expense) intochange in fair value of acquistion-related contingent consideration from other non-cash items a component of our net cash provided by operating activities on our consolidated statements of cash flows. TheThese reclassifications had no impact on previously reported current liabilities, working capital, consolidated results of operations, cash flows or accumulated deficit.
b) Use of Estimates
The preparation of consolidated financial statements in conformity with U.S. GAAP requires that we make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results may differ from those estimates.
c) Fair Value of Financial Instruments
Fair value is defined as the exit price, the price that would be received to sell an asset or transfer a liability in an orderly transaction between market participants at the measurement date. The fair value hierarchy prioritizes the inputs to valuation techniques used to measure fair value into three broad levels, as defined below. Observable inputs are inputs a market participant would use in valuing an asset or liability based on market data obtained from sources independent of us. Unobservable inputs are inputs that reflect our own assumptions about the factors a market participant would use in valuing an asset or liability developed using the best information available in the circumstances. The classification of an asset’s or liability’s level within the fair value hierarchy is determined based on the lowest level input that is significant to the fair value measurement.
Level 1 -Quoted prices in active markets for an identical asset or liability.
Level 2 -Inputs that are observable for the asset or liability, either directly or indirectly through market corroboration, for substantially the full term of the asset or liability.
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Level 3 -Inputs that are unobservable for the asset or liability, based on our own assumptions about the assumptions a market participant would use in pricing the asset or liability.
Our financial instruments consist primarily of cash and cash equivalents, Healthcare accounts receivable, other accounts receivable, accounts payable, acquisition-related contingent consideration, short-term debt and long-term debt. With the exception of acquisition-related contingent consideration and long-term debt, the carrying value of these financial instruments approximates their fair value because of their short-term nature (classified as Level 1).
Our long-term debt (classified as Level 2) is measured using market prices for similar instruments, inputs such as the borrowing rates currently available, benchmark yields, actual trade data, broker/dealer quotes and other similar data obtained from quoted market prices or independent pricing vendors.
The fair value of acquisition-related contingent consideration (classified as Level 3) is measured on a recurring basis using a Monte Carlo simulation. This model uses assumptions, including estimated projected revenues, estimated stock price volatility in future periods, estimated discount rates and discounts for the lack of marketability of common stock. In addition to the recurring fair value measurements, the fair value of certain assets acquired and liabilities assumed in connection with a business combination are recorded at fair value, primarily using a discounted cash flow model (classified as Level 3). This valuation technique requires us to make certain assumptions, including future operating performance, and cash flows and revenue growth rates, royalty rates and other such variables, which are discounted to present value using a discount rate that reflects the risk factors associated with future cash flow, the characteristics of the assets acquired and liabilities assumed and the experience of the acquired business. Non-financial assets such as goodwill, intangible assets, and property and equipment are subsequently measured at fair value when there is an indicator of impairment and recorded at fair value only when an impairment is recognized. We assess the impairment of goodwill and intangible assets annually or whenever events or changes in circumstances indicate that the carrying amount of an intangible asset may not be recoverable.
d) Accounts Receivable and Allowance for Doubtful Accounts
Healthcare accounts receivable is recorded at the time Healthcare segment revenue is recognized and is presented on the consolidated balance sheet net of an allowance for doubtful accounts. For our contracted payors, we determine revenue based on negotiated prices for the services provided. Based on our history, we have experience collecting substantially all of the negotiated contracted rates and are therefore not providing an implicit price concession. As a result, an allowance for doubtful accounts is recorded based on historical collection trends to account for the risk of patient default. Because of continuing changes in the health care industry and third-party reimbursement, it is possible that our estimates of collectability could change, which could have a material impact on our operations and cash flows.
Other accounts receivable is related to the Research segment and Corporate and Other category and is recorded at the time revenue is recognized, when products are shipped or services are performed. We estimate an allowance for doubtful accounts on a specific account basis and consider several factors in our analysis, including customer specific information.
We write off receivables when the likelihood for collection is remote, we believe collection efforts have been fully exhausted and we do not intend to devote additional resources in attempting to collect. We perform write-offs on a monthly basis.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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e) Acquisition-Related Contingent Consideration
Acquisition-related contingent consideration is our obligation, arising from a business combination, to transfer additional assets and/or equity interests to the seller if certain future events occur or conditions are met. The fair value of the contingency is estimated as of the acquisition date using certain unobservable inputs (and therefore classified as Level 3 in the fair value hierarchy) and is recorded as a liability and/or equity depending on the terms of the acquisition agreement.liability. We re-measure the estimated fair value of acquisition-related contingent consideration classified as a liability at each reporting date. Adjustments subsequent to the acquisition measurement period are recorded in other charges in the consolidated statements of operations. Changes to the inputs used in the measurement of acquisition-related contingent consideration include, but are not limited to: changes in the assumptions regarding probabilities of successful achievement of future events or conditions; the estimated timing in which the future events or conditions are achieved; estimated revenue projections; discounts for lack of marketability of our common stock; estimated stock price volatility; and the discount rate used to estimate the fair value of the liability. Acquisition-related contingent consideration may change significantly as our inputs and assumptions noted above evolve and additional data is obtained. The inputs and assumptions used in estimating fair value require significant judgment. The use of different assumptions and judgments could result in different fair value estimates that may have a material impact on our results from operations and financial position.
f) Concentrations of Credit Risk
Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash, cash equivalents, Healthcare accounts receivable and other accounts receivable. We maintain our cash and cash equivalents with high quality financial institutions to mitigate this risk. We perform ongoing credit evaluations of our customers and generally do not require collateral. We record an allowance for doubtful accounts in accordance with the procedures described above. Past-due amounts are written off against the allowance for doubtful accounts when collections are believed to be unlikely and all collection efforts have ceased.
At JuneSeptember 30, 2019 and December 31, 2018, one1 payor, Medicare, accounted for 13%21% and 15%, respectively, of our gross accounts receivable.
g) Noncontrolling Interest
The consolidated financial statements reflect the application of Accounting Standards Codification (“ASC”) 810 - Consolidations, which establishes accounting and reporting standards that require: (i) the ownership interest in subsidiaries held by parties other than the parent to be clearly identified and presented in the consolidated balance sheet within stockholders’ equity but separate from the parent’s equity; (ii) the amount of consolidated net income/(loss) attributable to the parent and the noncontrolling interest to be clearly identified and presented in the consolidated statements of operations; and (iii) changes in a parent’s ownership interest while the parent retains its controlling financial interest in its subsidiary to be accounted for consistently.
h) Leases
We lease our administrative and service facilities, as well as certain office equipment, monitoring devices and information technology equipment under arrangements classified as leases under ASC 842 - Leases (“ASC 842”). We adopted ASC 842 using the optional modified retrospective transition method as of January 1, 2019, therefore prior period amounts are not restated.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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We recognize right-of-use (“ROU”) assets at the inception of the arrangement as the present value of the lease payments plus our initial direct costs (if any), less any lease incentives. The corresponding liability is computed as the present value of the lease payments at inception. Assets are classified as either operating or finance ROU assets according to the classification criteria in ASC 842. Upon the adoption of ASC 842, we elected the transition practical expedients to not reassess lease identification, lease classification and initial indirect costs related to those leases entered into prior to adoption of ASC 842 and to not separate lease and non-lease components where we are the lessor when the requisite criteria is met to be treated as such. The present value of the lease payments is computed using the rate implicit in the lease (if known) or our incremental borrowing rate.
Operating lease costs are charged to operations on a straight-line basis over the lease term. Interest charged on the finance lease liabilities is charged to interest expense, while the amortization of the finance lease ROU assetassets is also charged to operations on a straight-line basis.
Under our policy, we do not record an ROU asset or corresponding liability for arrangements where the initial lease term is one year or less, or when the ROU asset at inception is deemed immaterial. Those leases are expensed on a straight-line basis over the term of the lease.
Effective January 1, 2019, for our operating leases, we record the ROU assets as a component of other assets, the current lease liability as a component of accrued liabilities, and the long-term lease liability as a component of other long-term liabilities on our consolidated balance sheet. For our finance leases, we record the ROU asset and the accumulated amortization for the finance ROU asset as a component of property and equipment, net, with the current and long-term portions of the finance lease obligations as separate lines within our consolidated balance sheet. We amortize the finance ROU assets over the shorter of the remaining lease term or the estimated life of the asset.
i) Stock-Based Compensation
ASC 718 - Compensation - Stock Compensation (“ASC 718”), addresses the accounting for share-based payment transactions in which an enterprise receives employee services in exchange for: (i) equity instruments of the enterprise or (ii) liabilities that are based on the fair value of the enterprise’s equity instruments or that may be settled by the issuance of such equity instruments. ASC 718 requires that an entity measure the cost of equity-based service awards issued to employees, such as stock options and restricted stock units (“RSUs”), based on the grant-date fair value of the award and recognize the cost of such awards over the requisite service period (generally, the vesting period of the award). The compensation expense associated with performance stock units (“PSUs”) is recognized ratably over the period between when the performance conditions are deemed probable of achievement and when the awards are vested. Performance stock options (“PSOs”) are valued and stock-based compensation expense is recorded once the performance conditions of the outstanding PSOs have achieved probability. Prior to July 1, 2018, we accounted for equity awards issued to non-employees in accordance with ASC 505-50, Equity-Based Payments to Non-Employees; see “m) Recent Accounting Pronouncements; Accounting Pronouncements Recently Adopted” for further details related to our adoption of Accounting Standards Update (“ASU”) 2018-07, Compensation - Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting, during the three months ended June 30, 2018 and our current accounting for equity awards issued to non-employees.
We have historically recorded stock-based compensation expense based on the number of stock options or RSUs we expect to vest using our historical forfeiture experience and we periodically update
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those forfeiture rates to apply to new grants. While we early adopted ASU 2016-09, Improvements to Employee Share-Based Payment Accounting during the year ended December 31, 2016, we have elected to continue to estimate forfeitures under the true-up provision of ASC 718. We record additional expense if the actual forfeiture rate is lower than estimated and record a recovery of prior expense if the actual forfeiture rate is higher than estimated.
We estimate the fair value of our stock options using the Black‑Scholes option valuation model. The Black‑Scholes option valuation model requires the use of certain subjective assumptions. The most significant of these assumptions are the estimates of the expected volatility of the market price of our stock and the expected term of the award. We base our estimates of expected volatility on the historical average of our stock price. The expected term represents the period of time that share‑based awards granted are expected to be outstanding. Other assumptions used in the Black‑Scholes option valuation model include the risk‑free interest rate and expected dividend yield. The risk‑free interest rate for periods pertaining to the expected term of each option is based on the U.S. Treasury yield of a similar duration in effect at the time of grant. We have never paid, and do not expect to pay, dividends in the foreseeable future.
We estimate the fair value of our PSUs using a Monte Carlo simulation. This model uses assumptions, including the risk free interest rate, expected volatility of our stock price and those of the performance group, dividends of the performance group members and expected life of the awards. As noted above, we continue to estimate forfeitures under the true-up provision of ASC 718. If it is deemed probable that the PSU performance targets will be met, compensation expense is recorded for these awards ratably over the requisite service period. The PSUs are forfeited to the extent the performance criteria are not met within the service period.
j) Income Taxes
We account for income taxes under the liability method, as described in ASC 740 - Income Taxes (“ASC 740”). Deferred income taxes are recognized for the tax consequences of temporary differences between the tax and consolidated financial statement reporting bases of assets and liabilities. When we determine that we will not be able to realize our deferred tax assets, we adjust the carrying value of the deferred tax asset through the valuation allowance.
Under ASC 740, the effects of changes in tax rates and tax laws on deferred tax balances are recognized in the period in which the new legislation is enacted. The total effect of tax law changes on deferred tax balances is recorded as a component of income tax expense.
We record unrecognized tax benefits in accordance with ASC 740 on the basis of a two-step process in which (i) we determine whether it is more likely than not that the tax positions will be sustained on the basis of the technical merits of the position and (ii) for those tax positions that meet the more-likely-than-not recognition threshold, we recognize the largest amount of tax benefit that is more than 50 percent likely to be realized upon ultimate settlement with the related tax authority.
k) Net Income/(Loss) Per Share
We compute net income/(loss) per share in accordance with ASC 260 - Earnings Per Share. Basic net income/(loss) per share is computed by dividing net income/(loss) by the weighted average number of common shares outstanding during the period. Diluted net income per share is computed by giving effect to all potential dilutive common stock equivalents, including stock options, RSUs, PSOs and PSUs, using
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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the treasury stock method and shares expected to be issued in connection with acquisition-related contingent consideration arrangements when dilutive.
Certain stock options, which are priced higher than the average market price of our shares for the quartersperiods ended JuneSeptember 30, 2019 and JuneSeptember 30, 2018 would be anti-dilutive and therefore have been excluded from the weighted average shares used in computing diluted net income per share. These options could become dilutive in future periods. Similarly, certain recently granted RSUs and PSUs are also excluded using the treasury stock method as their impact would be anti-dilutive. The dilutive effect of weighted average shares outstanding excludes approximately 0.61.0 million and 0.4 million shares for the three and sixnine month periods ended JuneSeptember 30, 2019, respectively, and excludes approximately 0.60.1 million and 0.70.5 million shares for the three and sixnine month periods ended JuneSeptember 30, 2018, respectively, as their effect would have been anti-dilutive on our net income per share.
l) Segment Information
ASC 280 - Segment Reporting, establishes standards for reporting information regarding operating segments in annual financial statements. Operating segments are identified as components of an enterprise for which separate discrete financial information is available for evaluation by the chief operating decision maker, or decision-making group, in making decisions on how to allocate resources and assess performance.
We report our business under two2 segments: Healthcare and Research. The Healthcare segment is focused on remote cardiac monitoring to identify cardiac arrhythmias or heart rhythm disorders and to monitor the functionality of implantable cardiac devices. We offer cardiologists, electrophysiologists, neurologists and primary care physicians a full spectrum of solutions, which provides them with a single source of cardiac monitoring services. The Research segment is engaged in centralized core laboratory services providing cardiac monitoring, imaging services, scientific consulting and data management services for drug and medical device trials. Included in the Corporate and Other category is the manufacturing, testing and marketing of cardiac and blood glucose monitoring devices to medical companies, clinics and hospitals and corporate overhead and other items not allocated to any of our reportable segments.
m) Recent Accounting Pronouncements
Accounting Pronouncements Recently Adopted
In August 2018, the FASB issued ASU 2018-15, Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract, to align the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The updated guidance also requires an entity to expense the capitalized implementation costs of a hosting arrangement that is a service contract over the term of the hosting arrangement. Historically, our implementation costs incurred in hosting service contracts have not been material. We early adopted this standard effective April 1, 2019 on a prospective basis. Upon adoption, our cloud computing implementation costs are deferred and recorded as a component of technology within intangible assets in our consolidated balance sheet and amortized to selling, general and administrative costs over the life of the service arrangement on our statement of operations. This update did not have a material impact on our financial position, results of operations or disclosures.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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In August 2018, the U.S. Securities and Exchange Commission (“SEC”) adopted the final rule under SEC Release No. 33-10532, Disclosure Update and Simplification, amending certain disclosure requirements that were redundant, duplicative, overlapping, outdated or superseded. Additionally, the amendments expanded the disclosure requirements on the consolidated statements of equity for interim consolidated financial statements. Under the amendments, a summary of changes in each caption of stockholders’ equity presented in the consolidated balance sheets must be provided in a note or separate statement. The consolidated statements of equity should present a reconciliation of the beginning balance to the ending balance of each period for which the consolidated statement of comprehensive income is required to be filed. This final rule was effective in the fourth quarter of 2018. The SEC provided relief on the effective date until the first quarter of 2019, and we adopted this rule in the first quarter of 2019.
In June 2018, the Financial Accounting Standards Board (“FASB”) issued ASU 2018-07, Compensation - Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting (“ASU 2018-07”). This update expands the scope of Topic 718 to include share-based payment transactions for acquiring goods and services from nonemployees. The amendments specify that Topic 718 applies to all share-based payment transactions in which a grantor acquires goods or services to be used or consumed in a grantor’s own operations by issuing share-based payment awards. The amendments also clarify that Topic 718 does not apply to share-based payments used to effectively provide (1) financing to the issuer or (2) awards granted in conjunction with selling goods or services to customers as part of a contract accounted for under ASC 606 - Revenue from Contracts with Customers (“ASC 606”). The amendments in ASU 2018-07 are effective for public business entities for fiscal years beginning after December 15, 2018, including interim periods within that fiscal year. Early adoption iswas permitted. We adopted this standard on July 1, 2018, effective January 1, 2018, and this standard did not have a material impact on our financial position, results of operations or disclosures.
In February 2016, the FASB issued ASU 2016-02, Leases. This standard, along with several subsequent updates, requires lessees to recognize most leases on their balance sheet, make selected changes to lessor accounting and disclose additional key information about leases. We adopted these updates on January 1, 2019, using the optional modified retrospective transition method and utilizing practical expedients available. The adoption of the new standard resulted in the recording, as of January 1, 2019, of additional ROU assets of $22.7 million as a component of other assets, current ROU liabilities of $6.2 million as a component of accrued liabilities and long-term ROU liabilities of $16.5 million, all of which relate to our operating leases. The adoption of the new standard did not materially impact our consolidated results of operations and had no impact on our cash flows.
Accounting Pronouncements Not Yet Adopted
In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework-Changes to the Disclosure Requirements for Fair Value Measurement (“ASU 2018-13”). This update eliminates certain disclosures related to transfers and valuation processes, clarifies the requirement for measurement uncertainty disclosures, and requires additional disclosures for Level 3 fair value measurements, including the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements. ASU 2018-13 is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, with early adoption permitted. We are in the process of evaluating the impact of this update on our consolidated financial statements and related disclosures.
In June 2016, the FASB issued ASU 2016-13, Financial Instruments - Credit Losses. This update, along with subsequent amendments, introduces the current expected credit loss model, which will require
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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an entity to measure credit losses for certain financial instruments and financial assets, including trade receivables. Under this update, onupon initial recognition and at each reporting period, an entity will be required to recognize an allowance that reflects the entity’s current estimate of credit losses expected to be incurred over the life of the financial instrument. This update will be effective for fiscal years beginning after December 15, 2019 and interim periods within those fiscal years, with early adoption permitted. We are in the process of evaluating the impact of this update on our consolidated financial statements and related disclosures.


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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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2. Revenue Recognition
We adopted ASC 606 on January 1, 2018, which requires revenue recognized to represent the transfer of promised goods or services to customers at an amount that reflects the consideration that a company expects to receive in exchange for those goods or services.
We utilized the modified retrospective method for adoption, allowing us to not retrospectively adjust prior periods. We applied the modified retrospective method only to contracts that were not complete at January 1, 2018 and accounted for the aggregate effect of any contract modifications upon adoption. No cumulative adjustment to retained earnings was recorded.
Disaggregation of Revenue
We disaggregate revenue from contracts with customers by payor type and major service line. We determined that disaggregating revenue into these categories achieves the disclosure objective of illustrating the differences in the nature, amount, timing and uncertainty of our revenue streams. Disaggregated revenue by payor type and major service line for the three and sixnine months ended JuneSeptember 30, 2019 and 2018 were as follows:
 Three Months Ended June 30, 2019
(in thousands)Healthcare Research Other Total Consolidated
Payor/Service Line       
Remote cardiac monitoring services - Medicare$36,096
 $
 $
 $36,096
Remote cardiac monitoring services - commercial payors58,908
 
 
 58,908
Clinical trial support and related services
 13,879
 
 13,879
Technology devices, consumables and related services
 
 2,920
 2,920
Total$95,004
 $13,879
 $2,920
 $111,803

Three Months Ended September 30, 2019
Three Months Ended June 30, 2018Reporting Segment   Total Consolidated
(in thousands)Healthcare Research Other Total ConsolidatedHealthcare Research Other 
Payor/Service Line              
Remote cardiac monitoring services - Medicare$36,599
 $
 $
 $36,599
$39,537
 $
 $
 $39,537
Remote cardiac monitoring services - commercial payors50,124
 
 
 50,124
54,336
 
 
 54,336
Clinical trial support and related services
 12,546
 
 12,546

 14,236
 
 14,236
Technology devices, consumables and related services
 
 2,091
 2,091

 
 3,182
 3,182
Total$86,723
 $12,546
 $2,091
 $101,360
$93,873
 $14,236
 $3,182
 $111,291

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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 Three Months Ended September 30, 2018
 Reporting Segment   Total Consolidated
(in thousands)Healthcare Research Other 
Payor/Service Line       
Remote cardiac monitoring services - Medicare$34,638
 $
 $
 $34,638
Remote cardiac monitoring services - commercial payors49,558
 
 
 49,558
Clinical trial support and related services
 13,464
 
 13,464
Technology devices, consumables and related services
 
 2,353
 2,353
Total$84,196
 $13,464
 $2,353
 $100,013

Nine Months Ended September 30, 2019
Six Months Ended June 30, 2019Reporting Segment   Total Consolidated
(in thousands)Healthcare Research Other Total ConsolidatedHealthcare Research Other 
Payor/Service Line              
Remote cardiac monitoring services - Medicare$70,031
 $
 $
 $70,031
$114,573
 $
 $
 $114,573
Remote cardiac monitoring services - commercial payors112,982
 
 
 112,982
162,313
 
 
 162,313
Clinical trial support and related services
 26,843
 
 26,843

 41,079
 
 41,079
Technology devices, consumables and related services
 
 5,926
 5,926

 
 9,108
 9,108
Total$183,013
 $26,843
 $5,926
 $215,782
$276,886
 $41,079
 $9,108
 $327,073
Nine Months Ended September 30, 2018
Six Months Ended June 30, 2018Reporting Segment   Total Consolidated
(in thousands)Healthcare Research Other Total ConsolidatedHealthcare Research Other 
Payor/Service Line              
Remote cardiac monitoring services - Medicare$66,814
 $
 $
 $66,814
$101,452
 $
 $
 $101,452
Remote cardiac monitoring services - commercial payors100,460
 
 
 100,460
150,018
 
 
 150,018
Clinical trial support and related services
 23,790
 
 23,790

 37,254
 
 37,254
Technology devices, consumables and related services
 
 4,792
 4,792

 
 7,145
 7,145
Total$167,274
 $23,790
 $4,792
 $195,856
$251,470
 $37,254
 $7,145
 $295,869

Remote Cardiac Monitoring Services Revenue (Healthcare segment)
Healthcare segment revenue is generated by remote cardiac monitoring to identify cardiac arrhythmias or heart rhythm disorders and to monitor the functionality of implantable cardiac devices. We offer cardiologists, electrophysiologists, neurologists and primary care physicians a full spectrum of solutions, which provides them with a single source of cardiac monitoring services.
Performance obligations are determined based on the nature of the services provided. With our remote cardiac monitoring services, the patient receives the benefits of the service over time, resulting in revenue recognition over time based on the output method. We believe that this method provides an accurate depiction of the transfer of value over the term of the performance obligation because the level of effort in providing these services is consistent during the service period.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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A summary of the payment arrangements with payors is as follows:
Contracted payors (including Medicare): We determine the transaction price based on negotiated prices for services provided, on a case rate basis, as provided for under the relevant Current Procedural Terminology (“CPT”) codes.
Non-contracted payors: Non-contracted commercial and government insurance carriers often reimburse out-of-network rates provided for under the relevant CPT codes on a case rate basis. Our transaction price includes implicit price concessions based on our historical collection experience for our non-contracted patients.
We are utilizing the portfolio approach practical expedient in ASC 606 for our patient contracts in the Healthcare segment. We account for the contracts within each portfolio as a collective group, rather than individual contracts. Based on our history with these portfolios and the similar nature and
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characteristics of the patients within each portfolio, we have concluded that the financial statement effects are not materially different than if accounting for revenue on a contract-by-contract basis.
For the contracted portfolio, we have historical experience of collecting substantially all of the negotiated contractual rates and determined at contract inception that these customers have the intention and ability to pay the promised consideration. As such, we are not providing an implicit price concession but, rather, have chosen to accept the risk of default, and adjustments to the transaction price are recorded as bad debt expense.
For our non-contracted portfolio, we are providing an implicit price concession because we do not have a contract with the underlying payor, the result of which requires us to estimate our transaction price based on historical cash collections utilizing the expected value method. Subsequent adjustments to the transaction price are recorded as an adjustment to Healthcare segment revenue and not as bad debt expense.
We have not made any significant changes to judgments in applying ASC 606 to the Healthcare segment during the three and sixnine months ended JuneSeptember 30, 2019.
Clinical Trial Support and Related Services Revenue (Research segment)
Research segment revenue is generated by providing centralized core laboratory services, including cardiac monitoring, imaging services, scientific consulting and data management services for drug and medical device trials. These amounts are due from pharmaceutical companies and contract research organizations. We bill our customers on a fee for service basis. Under a typical contract, some customers pay us a portion of our fee upon contract execution as an upfront refundable deposit. Upfront deposits are deferred and then recognized as the services are performed. If a contract is canceled prior to service being provided, the upfront deposit is refunded.
Performance obligations are determined based on the nature of the services provided by us. Our core laboratory services are provided over time as the customer receives benefits resulting in revenue recognition over the term of the contract. Our research customer contracts have legally enforceable terms that are predominately thirty days due to termination for convenience clauses, which are held by the customer with no significant penalty. Given the short-term nature of these contracts and the structure of our billing practices, our billing practices approximate our performance if measured by an output method, where each output is an individual occurrence of each performance obligation. Accordingly, we utilize the invoice
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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practical expedient as defined in ASC 606, resulting in recognition of revenue in the amount that we have the right to invoice.
We have not made any significant changes to judgments in applying ASC 606 to the Research segment during the three and sixnine months ended JuneSeptember 30, 2019.
Other Revenue (Other category)
Our Other category revenue is primarily derived from the sale of non-invasive cardiac monitors to healthcare companies, wireless blood glucose meters and test strips to wholesale distributors of diabetes supplies and diabetic patients, as well as product repairs. Performance obligations are primarily the sale of devices, related goods and repairs provided by us. These contracts transfer control to a customer at a point in time based on the transfer of title for the underlying good or service. We provide standard warranty provisions.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


We determine the transaction price based on fixed consideration in our contractual agreements with our customers and allocate the transaction price to each performance obligation based on the relative stand-alone selling price. We determine the relative stand-alone selling price utilizing our observable prices for the sale of the underlying goods.
We have not made any significant changes to judgments in applying ASC 606 to the Other category during the three and sixnine months ended JuneSeptember 30, 2019.
Contract Assets and Contract Liabilities
ASC 606 requires an entity to present a revenue contract as a contract asset when the entity performs its obligations under the contract by transferring goods or services to a customer before the customer pays consideration or before payment is due. ASC 606 also requires an entity to present a revenue contract as a contract liability in instances when a customer pays consideration, or an entity has a right to an amount of consideration that is unconditional (e.g. receivable), before the entity transfers a good or service to the customer.
We currently do not have any materialAs of September 30, 2019 and December 31, 2018, we had contract assets.assets of $9.8 million and $2.1 million, respectively, due to cardiac monitoring services.  Our contract assets are included as a component of Healthcare accounts receivable on our consolidated balance sheets.
As of JuneSeptember 30, 2019 and December 31, 2018, we had contract liabilities of $2.3$1.7 million and $3.1 million, respectively, primarily related to the Research segment where customers paid upfront deposits upon contract execution for future services to be performed by us. If the contract is canceled, these upfront deposits are refundable if service was not yet provided. Our contract liabilities are now included as a component of accrued liabilities on our consolidated balance sheets.
For the three months ended JuneSeptember 30, 2019, the amount recognized as revenue from the contract liabilities balance at March 31,June 30, 2019 was $0.9$0.6 million, while for the sixnine months ended JuneSeptember 30, 2019, the amount recognized as revenue from the contract liabilities balance as of December 31, 2018 was $1.6$1.9 million. Similarly, for the three months ended JuneSeptember 30, 2018, the amount recognized as revenue from the contract liabilities balance at March 31,June 30, 2018 was $1.4$1.0 million, while for the sixnine months ended JuneSeptember 30, 2018, the amount recognized as revenue from the contract liabilities balance as of
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


December 31, 2017 was $2.2$2.6 million. No significant changes or impairment losses occurred to contract balances during the sixnine months ended JuneSeptember 30, 2019.
Practical Expedient Elections
We have elected the following practical expedients in applying ASC 606 across all reportable segments unless otherwise noted below.
Unsatisfied Performance Obligations: Because all of our performance obligations relate to contracts with a duration of less than one year, we have elected to apply the optional exemption provided in ASC 606 and, therefore, are not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period.
Contract Costs: All incremental customer contract acquisition costs are expensed as they are incurred as the amortization period of the asset that we otherwise would have recognized is one year or less in duration.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


Significant Financing Component: We do not adjust the promised amount of consideration for the effects of a significant financing component as we expect, at contract inception, that the period between when we transfer a promised good or service to a customer and when the customer pays for that good or service will be one year or less.
Sales Tax Exclusion from the Transaction Price: We exclude from the measurement of the transaction price all taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction and collected by us from the customer.
Shipping and Handling Activities: For our otherOther category revenue, we account for shipping and handling activities we perform after a customer obtains control of the good as activities to fulfill the promise to transfer the good.


3. Acquisitions
ADEA Medical AB
During the second quarter of 2019, we acquired all of the remaining outstanding equity of ADEA Medical AB, now known as BioTel Europe AB (“ADEA” or “BioTel Europe”), a limited liability company incorporated and registered under the laws of Sweden. ADEABioTel Europe provides cardiac monitoring in northern Europe.
Pursuant to the acquisition agreement, we agreed to issue the owners of ADEA 50,000 shares of our common stock, with a fair value of approximately $2.1 million, as well as to pay approximately $0.2 million in cash. The shares are restricted, with the restrictions related to 10,000 shares expiring in the fourth quarter of 2019, and the restrictions on the remaining 40,000 shares expiring in the second quarter of 2022, and the shares are also available to satisfy indemnification obligations.
Prior to the second quarter of 2019, we accounted for our 23.8% stake in ADEA as an equity method investment. We accounted for the acquisition of the remaining equity of ADEA as a step acquisition, which required us to re-measure our previous ownership interest to fair value prior to application of purchase
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


accounting, and recognizewe recognized the immaterial difference between the fair value and the carrying value of the equity method investment.investment at that time. The total preliminary purchase price of ADEA iswas $3.3 million, primarily consisting of the equity and cash consideration paid in the second quarter of 2019, plus the amounts paid for our initial investment in ADEA in 2018. We then allocated this purchase price to the assets acquired and liabilities assumed. The acquired net assets consisted primarily of customer relationships and non-compete agreements. The excess of the fair value of the purchase price over the fair value of the net assets acquired has been recognized as goodwill, which represents the expected future benefits arising from the assembled workforce and other synergies attributable to cost savings opportunities. We have preliminarily recognized $2.3$2.6 million of goodwill as a result of the acquisition, all of which has been assigned to the Healthcare segment. NoneNaN of this goodwill will be deductible for tax purposes.
We have recordedfinalized our preliminary fair value estimates related to the ADEABioTel Europe acquisition as of Juneduring the three months ended September 30, 2019. There were no changes to the total purchase price, and the measurement period adjustment related to deferred income taxes during the three months ended September 30, 2019 which are subject to subsequent adjustment as additional information is obtained during the applicable measurement period. The primary areas of these estimates that arewas not yet finalized relate to the identifiable intangible assets and the accounting for deferred income taxes. We expect to finalize all accounting for the material.ADEA acquisition within one year of the acquisition date.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


We do not consider this acquisition to be significant to our results of operations. The transaction costs related to this acquisition and revenues and results of operations of ADEABioTel Europe prior to our acquisition were all immaterial.
Geneva Healthcare, Inc.
On March 1, 2019, we acquired Geneva Healthcare, Inc., now known as Geneva Healthcare, LLC (“Geneva”), for cash consideration in the amount of $45.9 million. In addition, pursuant to the terms of the Agreement and Plan of Merger, dated January 25, 2019, by and among Geneva, BioTelemetry, Inc., Tyersall Merger Sub, Inc., and the Securityholders’ Representative (the “Geneva Agreement”), on the third anniversary date of the closing date, the Securityholders (as defined in the Geneva Agreement) are eligible to receive additional consideration in the form of cash payments, as well as shares of BioTelemetry common stock, with a total estimated present value of $32.0 million as of the March 1, 2019 acquisition date, for a total aggregate purchase price of $77.9 million. Concurrent with the closing of the acquisition, the Securityholders made elections as to the percentage mix of their total additional consideration to be settled in cash or common stock.
The estimated additional consideration of $32.0 million, as of the March 1, 2019 acquisition date, consists of the following:
The Securityholders will, subject to potential deductions pursuant to the Geneva Agreement, receive additional consideration of $20.0 million, a total of $11.1 million of which will be paid in cash, and the remaining value will be settled in shares. We will issue a total of 131,594 shares of our common stock to settle the share-related portion of the obligation, based on the elections made by the Securityholders and the formulas within the Geneva Agreement.
The estimated present value of the future cash payment of $11.1 million, which totals $9.7 million as of the acquisition date, as well as the estimated fair value of our common stock of $9.1 million, has been included within the preliminary purchase price for Geneva. The estimated present value of the future cash payment is recorded as a component of other long-term liabilities and will be accreted to its redemption value through interest expense through the payment date. The estimated fair value of the 131,594 shares our common stock has been recorded within paid-in-capital.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


The Securityholders will also be eligible to receive additional consideration, in the form of both cash and shares, based on a predetermined formula that is driven by the future revenues of Geneva and does not have a predetermined limit. The total estimated acquisition-related contingent consideration as of the March 1, 2019 acquisition date is $13.2 million, which is also included in the preliminary purchase price of Geneva. The $13.2 million is recorded within other long-term liabilities and will be marked to market through earnings on a quarterly basis throughout the earn-out period. The equity portion of the acquisition-related contingent consideration requires liability classification and mark-to-market accounting pursuant to the provisions of ASC 815 - Derivatives and Hedging.
We acquired Geneva as part of our business strategy to go deeper and wider into the cardiac monitoring market. Geneva has developed an innovative proprietary cloud-based platform that aggregates data from the leading cardiac device manufacturers, enabling the Company to remotely monitor a physician’s patients with implantable cardiac devices such as pacemakers, defibrillators and loop recorders. Geneva’s platform provides physicians a single portal to order patient monitoring, review monitoring results and
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


request routine device checks, helping drive significant in-office efficiencies and patient compliance. We plan to merge this functionality with that of the Healthcare segment user interface, which we believe will drive greater workflow and data management efficiencies to the clients we serve.
We accounted for the transaction as a business combination, and as such, all assets acquired and liabilities assumed were recorded at their estimated fair values. The excess of the fair value of the purchase price over the fair value of the net assets acquired has been recognized as goodwill, which represents the expected future benefits arising from the assembled workforce and other synergies attributable to cost savings opportunities. We have preliminarily recognized $62.8 million of goodwill as a result of the acquisition, all of which has been assigned to the Healthcare segment. NoneNaN of this goodwill will be deductible for tax purposes.
The amounts in the table below represent our preliminaryfinal fair value estimates related to the Geneva acquisition as of June 30, 2019 and are subject to subsequent adjustment as additional information is obtained during the applicable measurement period.March 1, 2019. Measurement period adjustments recorded during the second quarter of 2019 consisted primarily of decreasing additional consideration by $2.2 million. The primary areas of these estimates that are not yetWe finalized relate to certain tangible assets acquired and liabilities assumed, including deferred taxes, as well as the identifiable intangible assets and theour fair value of the additional consideration. We expectestimates related to finalize all accounting for the Geneva acquisition within one year ofduring the acquisition date.
(in thousands, except years)Amount 
Weighted
Average Life
(Years)
Fair value of assets acquired:   
Cash and cash equivalents$1,376
  
Healthcare accounts receivable1,500
  
Prepaid expenses and other current assets234
  
Identifiable intangible assets:   
Customer relationships3,500
 12
Technology8,900
 7
Trade names2,500
 15
Total identifiable intangible assets14,900
  
Total assets acquired18,010
  
Fair value of liabilities assumed:   
Accounts payable215
  
Accrued liabilities878
  
Deferred tax liabilities1,879
  
Total liabilities assumed2,972
  
    
Total identifiable net assets15,038
  
Goodwill62,842
  
Net assets acquired$77,880
  

three months ended September 30, 2019, during which time there were no material measurement period adjustments recorded.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


(in thousands, except years)Amount 
Weighted
Average Life
(Years)
Fair value of assets acquired:   
Cash and cash equivalents$1,376
  
Healthcare accounts receivable1,500
  
Prepaid expenses and other current assets234
  
Identifiable intangible assets:   
Customer relationships3,500
 12
Technology8,900
 7
Trade names2,500
 15
Total identifiable intangible assets14,900
  
Total assets acquired18,010
  
Fair value of liabilities assumed:   
Accounts payable215
  
Accrued liabilities872
  
Deferred tax liabilities1,879
  
Total liabilities assumed2,966
  
    
Total identifiable net assets15,044
  
Goodwill62,836
  
Net assets acquired$77,880
  

We have incurred $1.4 million of acquisition related costs associated with Geneva for the sixnine months ended JuneSeptember 30, 2019. The costs were included in other charges in our consolidated statements of income. The revenues and income of Geneva for periods prior to our acquisition were immaterial to our consolidated operating results.
ActiveCare
On October 2, 2018, we acquired, through our subsidiary Telcare Medical Supply, LLC, certain assets of ActiveCare, Inc. (“ActiveCare”) for $3.8 million in cash. The purchase price also includes a potential earn-out payment of $2.0 million, which is contingent on the achievement of certain revenue targets.targets by November 1, 2020. We accounted for the transaction as a business combination, and as such, all assets acquired were recorded at their estimated fair values. The excess of the fair value of the purchase price over the fair value of the net assets acquired has been recognized as goodwill, and has been assigned to the Corporate and Other category and will be deductible for tax purposes. The acquired net assets primarily consisted of customer relationships and software developed by ActiveCare. The earn-out was assigned no0 value as of the acquisition date as it was and is currently not probable of achievement. We finalized our fair value estimates related to the ActiveCare acquisition during the three months ended March 31, 2019, and there were no changes to the amounts initially recorded. The transaction costs related to this acquisition and revenues and net income of ActiveCare prior to our acquisition were all immaterial.


BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


4. Inventory
Inventory consists of the following:
(in thousands)June 30,
2019
 December 31,
2018
September 30,
2019
 December 31,
2018
Raw materials and supplies$3,277
 $3,667
$4,421
 $3,667
Finished goods2,760
 3,656
1,968
 3,656
Total inventory$6,037
 $7,323
$6,389
 $7,323

Inventory, which includes purchased parts, materials, direct labor and applied manufacturing overhead, is stated at the lower of cost or market (net realizable value or replacement cost), with cost determined by use of the first-in, first-out method.


5. Fair Value Measurements
We have determined that our long-term debt, classified as Level 2, has a fair value consistent with its carrying value, exclusivenet of debt discount and deferred charges, of $196.6$195.6 million and $198.5 million as of JuneSeptember 30, 2019 and December 31, 2018, respectively.
Acquisition-related contingent consideration represents our contingent payment obligations related to our acquisitions and is measured at fair value, based on significant inputs not observable in the market, which represents a Level 3 measurement within the fair value hierarchy. The valuation of acquisition-related contingent consideration uses assumptions we believe would be made by a market participant. We assess these estimates on an ongoing basis as additional data impacting the assumptions is obtained. The balance of the fair value of acquisition-related contingent consideration is recognized within other long-term liabilities on our consolidated balance sheet as of JuneSeptember 30, 2019. Subsequent toChanges in the measurement period, adjustments tofair value of the acquisition-related contingent consideration, after the final determination as of the acquistion date, resulting from changes in the variables used to compute the fair value, are recorded in other charges in the consolidated statements of operations.
The following table provides a reconciliation of the beginning and ending balances of acquisition-related contingent consideration:
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


Three Months Ended Nine Months Ended
Three Months Ended Six Months EndedSeptember 30, September 30,
(in thousands)June 30,
2019
 June 30,
2018
 June 30,
2019
 June 30,
2018
2019 2018 2019 2018
Beginning balance$15,990
 $
 $
 $700
$11,360
 $
 $
 $700
Initial acquisition-related contingent consideration
 
 15,990
 
Measurement period adjustments to acquisition-related contingent consideration(2,820) 
 (2,820) 
Acquisition-related contingent consideration
 
 13,170
 
Changes in fair value of acquisition-related contingent consideration(1,810) 
 (1,810) (700)90
 
 (1,720) (700)
Ending balance$11,360
 $
 $11,360
 $
$11,450
 $
 $11,450
 $

In conjunction with the Geneva acquisition, we recognized $13.2 million of acquisition-related contingent consideration on March 1, 2019 as a component of other long-term liabilities, as the contingency will be finalized after the third anniversary of the closing date. There was no0 value assigned to the acquisition-related contingent consideration related to the ActiveCare acquisition as the achievement of the contingency was not probable as of JuneSeptember 30, 2019.
The estimated fair value of the acquisition-related contingent consideration related to the Geneva acquisition was estimateddetermined using a Monte Carlo simulation, that considered numerous variables, including estimated
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


estimates for projected revenues, and estimatedfuture stock price, volatility in future periods, as well as estimated discount rates and discounts for lack of marketability of common stock. These estimates are subject to a significant level of judgment.
During the threenine months ended JuneSeptember 30, 2019, excluding the measurement period adjustments, the acquisition-related contingent consideration related to the Geneva acquisition declined $1.8$1.7 million primarily due primarily to changes in estimates associated with our future stock price. During the sixnine months ended JuneSeptember 30, 2018, the fair values of the acquisition-related contingent consideration related to our 2016 Telcare acquisition decreased $0.7 million, as it was no longer probable that any of the contingencies would be met.


6. Goodwill and Intangible Assets
Goodwill was recognized at the time of our acquisitions. The following table presents the carrying amount of goodwill allocated to our reportable segments, as well as the changes to goodwill during the sixnine months ended JuneSeptember 30, 2019:
Reporting Segment    Reporting Segment Corporate and Other  
(in thousands)Healthcare Research Corporate and Other TotalHealthcare Research Total
Balance at December 31, 2018$213,507
 $16,293
 $9,014
 $238,814
$213,507
 $16,293
 $9,014
 $238,814
Goodwill acquired65,167
 
 
 65,167
65,408
 
 
 65,408
Balance at June 30, 2019$278,674
 $16,293
 $9,014
 $303,981
Currency translation(121) 
 
 (121)
Balance at September 30, 2019$278,794
 $16,293
 $9,014
 $304,101

The goodwill acquired in the Healthcare segment is duerelated to the Geneva and ADEABioTel Europe acquisitions. Refer to “Note 3. Acquisitions” for details.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


The gross carrying amounts and accumulated amortization of our intangible assets are as follows:
(in thousands, except years)
Weighted
Average Life
(Years)
 June 30,
2019
 December 31,
2018
Weighted
Average Life
(Years)
 September 30,
2019
 December 31,
2018
Gross Carrying Value:     ��    
Customer relationships10.3 $150,523
 $146,200
10.3 $149,380
 $146,200
Technology including internally developed software6.0 27,957
 18,078
6.6 21,244
 18,078
Backlog3.7 6,860
 6,860
3.9 3,100
 6,860
Covenants not to compete4.9 1,205
 1,040
4.8 416
 1,040
Trade names15.0 2,500
 
15.0 2,500
 
Total intangible assets, gross 189,045
 172,178
 176,640
 172,178
Accumulated Amortization:        
Customer relationships (32,085) (24,870) (34,626) (24,870)
Technology including internally developed software (12,145) (10,879) (5,394) (10,879)
Backlog (6,214) (5,827) (2,648) (5,827)
Covenants not to compete (1,016) (949) (282) (949)
Trade names (55) 
 (97) 
Total accumulated amortization (51,515) (42,525) (43,047) (42,525)
Total intangible assets, net $137,530
 $129,653
 $133,593
 $129,653

During the three months ended September 30, 2019, we wrote off certain fully amortized intangible assets, primarily technology and backlog, and incurred an immaterial amount of foreign currency translation impact related to the customer relationships and covenants not to compete related to the BioTel Europe acquisition.
As of JuneSeptember 30, 2019, the estimated amortization for our finite-lived intangible assets for the remainder of 2019, the next four fiscal years, and thereafter, is summarized as follows:
(in thousands)(in thousands) (in thousands) 
Remainder of 2019Remainder of 2019$9,418
Remainder of 2019$4,910
2020202018,104
202018,343
2021202117,466
202117,708
2022202216,854
202216,972
2023202316,683
202316,678
ThereafterThereafter59,005
Thereafter58,982
Total estimated amortizationTotal estimated amortization$137,530
Total estimated amortization$133,593



7. Equity Method Investments
On October 31, 2018, we acquired an ownership interest in ADEA, for approximately $0.9 million. This investment was accounted for under the equity method. During the second quarter of 2019, we acquired all of the remaining outstanding equity of ADEA. In conjunction with this step acquisition, we derecognized our equity method investment in ADEA and recognized the fair value of the assets acquired and liabilities
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


assumed fromrelated to ADEA in our consolidated financial statements. For more information, see “Note 3. Acquisitions.”
We hold an ownership interest in Well Bridge Health, Inc. (“Wellbridge”). The investment is accounted for under the equity method. Our Chief Executive Officer sits on Wellbridge’s board of directors,
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


and therefore, Wellbridge is considered a related party. There were no material related-party transactions between the parties during the three and sixnine months ended JuneSeptember 30, 2019.
As of JuneSeptember 30, 2019, our investment in Wellbridge represented 32.2% of their outstanding stock. A summary of our investments recorded as a component of other assets is as follows:
Three Months Ended Nine Months Ended
Three Months Ended Six Months EndedSeptember 30, September 30,
(in thousands)June 30,
2019
 June 30,
2018
 June 30,
2019
 June 30,
2018
2019 2018 2019 2018
Beginning balance$2,012
 $1,292
 $2,044
 $1,431
$1,112
 $1,247
 $2,044
 $1,431
Derecognition of ADEA investment(746) 
 (746) 

 
 (746) 
Loss on equity method investments(154) (45) (186) (184)(65) (54) (251) (238)
Ending balance$1,112
 $1,247
 $1,112
 $1,247
$1,047
 $1,193
 $1,047
 $1,193



8. Accrued Liabilities
Accrued liabilities consist of the following:
(in thousands)June 30,
2019
 December 31,
2018
September 30,
2019
 December 31,
2018
Compensation$9,093
 $13,443
$11,307
 $13,443
Right of use liabilities - operating leases5,257
 
5,291
 
Professional fees4,311
 4,260
4,661
 4,260
Non-income taxes2,180
 906
Contract liabilities2,286
 3,080
1,650
 3,080
Non-income taxes1,781
 906
Operating costs776
 1,095
Interest645
 702
583
 702
Operating costs671
 1,095
Facility costs105
 106
Other1,778
 1,097
2,039
 1,203
Total$25,927
 $24,689
$28,487
 $24,689



9. Credit Agreement
In 2017, we entered into a credit agreement with SunTrust Bank, as a lender and an agent for the lenders (the “Lenders”) (the “SunTrust Credit Agreement”). Pursuant to the SunTrust Credit Agreement, the Lenders agreed to make loans to us as follows: (i) a term loan in an aggregate principal amount equal to $205.0 million; and (ii) a $50.0 million revolving credit facility for ongoing working capital purposes.
The loans bear interest at an annual rate, at our election, of (i) with respect to LIBOR rate loans, LIBOR plus the applicable margin and (ii) with respect to base rate loans, the Base Rate (the “prime rate” as published in the Wall Street Journal) plus the applicable margin. The applicable margin for both LIBOR
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


and Base Rate loans is determined by reference to our Consolidated Total Net Leverage Ratio, as defined in the SunTrust Credit Agreement. As of JuneSeptember 30, 2019, the applicable margin is 1.5% for LIBOR loans and 0.5% for base rate loans.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


The carrying amount of the term loan was $196.6$195.6 million as of JuneSeptember 30, 2019, which is the principal amount outstanding, net of $3.8$3.5 million of unamortized deferred financing costs to be amortized over the remaining term of the credit facility. The revolving credit facility is subject to an unused commitment fee, which is determined by reference to our Consolidated Total Net Leverage Ratio.Ratio (as defined in the SunTrust Credit Agreement). Our unused commitment fee as of JuneSeptember 30, 2019 was 0.2%, and the revolving credit facility remains undrawn as of that date.
Covenants
The SunTrust Credit Agreement contains affirmative and financial covenants regarding the operations of our business and certain negative covenants that, among other things, limit our ability to incur additional indebtedness, grant certain liens, make certain investments, merge or consolidate, make certain restricted payments and engage in certain asset dispositions, including a sale of all, or substantially all, of our property. As of JuneSeptember 30, 2019, we were in compliance with our covenants.


10. Leases
We lease our administrative and service facilities, as well as certain office equipment, monitoring devices and information technology equipment under arrangements classified as leases under ASC 842. We adopted ASC 842 using the optional modified retrospective transition method as of January 1, 2019; therefore prior period amounts are not restated.
We have non-cancelable operating leases expiring at various dates through 2028. Certain leases are renewable at the end of the lease term at our option, none of which are certain at this time. We have also entered into and acquired finance leases with various expiration dates through 2022, which are used primarily to finance office equipment, monitoring devices and other information technology equipment.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


The components of our lease expense are as follows:
Three Months Ended Nine Months Ended
Three Months Ended Six Months EndedSeptember 30, September 30,
(in thousands)June 30,
2019
 June 30,
2019
2019 2019
Operating lease cost:      
Operating lease cost$1,513
 $2,921
$1,449
 $4,370
Short-term lease cost19
 165
83
 248
Total operating lease cost1,532
 3,086
1,532
 4,618
      
Finance lease cost:      
Amortization of right-of-use asset848
 1,713
Amortization of right-of-use assets181
 1,894
Interest on lease liabilities14
 38
11
 49
Total finance lease cost862
 1,751
192
 1,943
      
Total lease cost$2,394
 $4,837
$1,724
 $6,561

Supplemental balance sheet information related to leases as of September 30, 2019 is as follows:
(in thousands, except percentage and years)
Operating
Leases
 
Finance
Leases
Property and equipment, net$
 $757
Other assets17,581
 
Total right-of-use assets17,581
 757
    
Accrued liabilities5,291
 
Current portion of finance lease obligations
 490
Long-term portion of finance lease obligations
 348
Other long-term liabilities15,156
 
Total lease obligations$20,447
 $838
    
Weighted average remaining lease term (years)5.2
 2.0
Weighted average discount rate4.4% 4.7%

BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


Supplemental balance sheet information related to leases as of June 30, 2019 is as follows:
(in thousands, except percentage and years)
Operating
Leases
 
Finance
Leases
Property and equipment, net$
 $942
Other assets19,490
 
Total right-of-use assets19,490
 942
    
Accrued liabilities5,257
 
Current portion of finance lease obligations
 590
Long-term portion of finance lease obligations
 419
Other long-term liabilities16,386
 
Total lease obligations$21,643
 $1,009
    
Weighted average remaining lease term (years)5.3
 2.1
Weighted average discount rate4.4% 4.9%

Future maturities of lease liabilities are as follows:
(in thousands)
Operating
Leases
 
Finance
Leases
Operating
Leases
 
Finance
Leases
Remainder of 2019$3,059
 $357
$1,638
 $176
20205,807
 412
5,806
 412
20214,424
 191
4,422
 191
20223,058
 94
3,058
 93
20232,268
 
2,268
 
Thereafter5,806
 
5,806
 
Total minimum lease payments24,422
 1,054
22,998
 872
Less imputed interest(2,779) (45)(2,551) (34)
Total$21,643
 $1,009
$20,447
 $838

Supplemental cash flow information related to leases is as follows:
 Three Months Ended Nine Months Ended
 September 30, September 30,
(in thousands)2019 2019
Cash paid for amounts included in the measurement of lease liabilities:   
Operating cash flows from operating leases$(1,559) $(4,424)
Operating cash flows from finance leases(11) (49)
Financing cash flows from finance leases(76) (1,735)
    
Right-of-use assets obtained in exchange for lease obligations, net of incentives:   
Operating leases(669) 21,147
Finance leases$
 $787
 Three Months Ended Six Months Ended
(in thousands)June 30,
2019
 June 30,
2019
Cash paid for amounts included in the measurement of lease liabilities:   
Operating cash flows from operating leases$(1,393) $(2,865)
Operating cash flows from finance leases(14) (38)
Financing cash flows from finance leases(496) (1,659)
    
Right-of-use assets obtained in exchange for lease obligations:   
Operating leases6
 21,816
Finance leases$
 $787


BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


11. Other Charges
We account for expenses associated with exit or disposal activities in accordance with ASC 420 - Exit or Disposal Cost Obligations and record the expenses in other charges in our consolidated statements of operations. The related accruals are recorded in the accrued liabilities line of our consolidated balance sheets.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


We account for expenses associated with our acquisitions and certain litigation as other charges as incurred. These expenses are primarily a result of activities surrounding our acquisitions and legal fees related to patent litigation in which we are the plaintiff. Other charges are costs that are not considered necessary to the ongoing business operations. We have reclassified the disclosure of these costs to more closely align with the discussion in “Part I,I; Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations” of this report and in our earnings release, which are summarized as follows:
Three Months Ended Nine Months Ended
Three Months Ended Six Months EndedSeptember 30, September 30,
(in thousands)June 30,
2019
 June 30,
2018
 June 30,
2019
 June 30,
2018
2019 2018 2019 2018
LifeWatch AG integration costs$241
 $2,208
 $378
 $7,204
$212
 $661
 $590
 $7,865
Geneva integration costs1,181
 
 2,604
 
122
 
 2,726
 
Reserve for note receivable
 1,793
 
 1,793

 
 
 1,793
Change in fair value of acquisition-related contingent consideration(1,810) 
 (1,810) (700)90
 
 (1,720) (700)
Patent and other litigation2,622
 781
 3,651
 1,212
2,144
 339
 5,807
 1,551
Other costs
 426
 481
 784
30
 330
 499
 1,114
Total$2,234
 $5,208
 $5,304
 $10,293
$2,598
 $1,330
 $7,902
 $11,623



12. Equity
Common Stock
As of JuneSeptember 30, 2019 and December 31, 2018, we were authorized to issue 200,000,000 shares of common stock. As of JuneSeptember 30, 2019 and December 31, 2018, we had 33,888,92033,991,107 and 33,406,364, respectively, shares issued and outstanding.
Preferred Stock
As of JuneSeptember 30, 2019 and December 31, 2018, we were authorized to issue 10,000,000 shares of preferred stock. As of JuneSeptember 30, 2019 and December 31, 2018, there were no0 shares of preferred stock issued or outstanding.
Noncontrolling Interest
During 2018, after a formal restructuring of shareholdings approved by the board of directors of LifeWatch Turkey Holding AG (“LifeWatch Turkey”), we became the sole shareholder of LifeWatch Turkey. No cash or other consideration was exchanged to effect this transaction. As a result, we no longer reflect a noncontrolling interest on our consolidated balance sheet; however, we reflected the net loss
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


attributable to the noncontrolling interest in our consolidated statement of operations during 2018 for the period of time where we did not own the entire entity.


BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


13. Stock-Based Compensation
We have three3 stock plans: our 2017 Omnibus Incentive Plan (“OIP”), our 2008 Equity Incentive Plan (the “2008 Plan”) and our 2003 Equity Incentive Plan (the “2003 Plan”) (collectively, the “Plans”). The OIP is the only remaining stock plan actively granting new equity.  The purpose of these stock plans was, and the OIP is, to grant incentive stock options to employees and non-qualified stock options, RSUs, PSOs, PSUs and other stock-based incentive awards to officers, directors, employees and consultants.  The Plans are administered by our Board of Directors (the “Board”) or its delegates. The number, type, exercise price and vesting terms of awards are determined by the Board or its delegates in accordance with the terms of the Plans. The stock options granted expire on a date specified by the Board but generally not more than ten years from the grant date. Stock option grants to employees generally vest over four years while RSUs generally vest after three years.
2017 Omnibus Incentive Plan (OIP)
In May 2017, our stockholders approved the OIP, which replaced the 2008 Plan. Stock options, RSUs, PSUs and PSOs have been granted under the OIP. There were 2,020,9401,987,190 shares available for grant under the OIP as of JuneSeptember 30, 2019.
2008 Equity Incentive Plan
Our 2008 Plan became effective on March 18, 2008 and replaced our 2003 Plan. Under the terms of the 2008 Plan, all available shares in the 2003 Plan share reserve automatically rolled into the 2008 Plan. Any cancellations or forfeitures of granted stock options under the 2003 Plan also automatically rolled into the 2008 Plan. There are no0 shares available to grant under the 2008 Plan subsequent to the approval of the OIP.
Stock option and PSO activity is summarized as follows:
Stock Options
Number of
Shares
 
Weighted
Average
Exercise Price
 Weighted Average Remaining Contractual Term
(years)
 Aggregate Intrinsic Value
(in thousands)
Number of
Shares
 
Weighted
Average
Exercise Price
 Weighted Average Remaining Contractual Term
(years)
 Aggregate Intrinsic Value
(in thousands)
Outstanding as of December 31, 20182,661,282
 $15.94
 
 

2,661,282
 $15.94
 
 

Granted277,142
 70.31
 
 

317,142
 66.79
 
 

Forfeited(44,168) 26.67
 
 

(49,168) 27.73
 
 

Exercised(186,235) 6.43
 
 

(233,885) 7.75
 
 

Outstanding as of June 30, 20192,708,021
 $21.98
 6.1 $79,332
Exercisable as of June 30, 20191,747,093
 $9.16
 4.7 $68,115
Expected to vest as of June 30, 2019872,033
 $45.29
 8.6 $10,179
Outstanding as of September 30, 20192,695,371
 $22.42
 5.8 $60,821
Exercisable as of September 30, 20191,751,943
 $9.92
 4.5 $54,075
Expected to vest as of September 30, 2019856,160
 $45.63
 8.2 $6,122

BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


Performance Stock Options
Number of
Shares
 
Weighted
Average
Exercise Price
 Weighted Average Remaining Contractual Term
(years)
 Aggregate Intrinsic Value
(in thousands)
Number of
Shares
 
Weighted
Average
Exercise Price
 Weighted Average Remaining Contractual Term
(years)
 Aggregate Intrinsic Value
(in thousands)
Outstanding as of December 31, 2018135,000
 $20.64
    135,000
 $20.64
    
Granted
 
  
 
  
Forfeited
 
  
 
  
Exercised(105,000) 20.41
  (105,000) 20.41
  
Outstanding as of June 30, 201930,000
 $21.45
 7.5 $801
Exercisable as of June 30, 201930,000
 $21.45
 7.5 $801
Outstanding as of September 30, 201930,000
 $21.45
 7.3 $578
Exercisable as of September 30, 201930,000
 $21.45
 7.3 $578

The table below summarizes certain additional information with respect to our options:
 Three Months Ended Nine Months Ended
 Three Months Ended Six Months Ended September 30, September 30,
(in thousands, except per option amounts)(in thousands, except per option amounts)June 30,
2019
 June 30,
2018
 June 30,
2019
 June 30,
2018
(in thousands, except per option amounts)2019 2018 2019 2018
Aggregate intrinsic value of options exercisedAggregate intrinsic value of options exercised$864
 $15,715
 $16,923
 $17,879
Aggregate intrinsic value of options exercised$1,261
 $20,398
 $18,184
 $38,277
Cash received from the exercise of stock optionsCash received from the exercise of stock options418
 3,665
 3,341
 4,992
Cash received from the exercise of stock options614
 3,493
 3,955
 8,485
Weighted average grant date fair value per optionWeighted average grant date fair value per option$30.24
 $20.17
 $40.76
 $19.79
Weighted average grant date fair value per option$24.00
 $33.12
 $38.64
 $20.91

The total compensation cost of options granted but not yet vested at JuneSeptember 30, 2019 was $22.2$21.1 million, which is expected to be recognized over a weighted average period of approximately three years.
RSU and PSU activity is summarized as follows:
Restricted Stock Units Performance Stock UnitsRestricted Stock Units Performance Stock Units
Number
of Shares
 
Weighted Average
Grant Date Fair
Value
 
Number
of Shares
 
Weighted Average
Grant Date Fair
Value
Number
of Shares
 
Weighted Average
Grant Date Fair
Value
 
Number
of Shares
 
Weighted Average
Grant Date Fair
Value
Units outstanding as of December 31, 2018358,683
 $22.22
 87,109
 $37.79
358,683
 $22.22
 87,109
 $37.79
Granted77,248
 65.53
 34,088
 86.29
77,248
 65.53
 34,088
 86.29
Forfeited(10,834) 30.24
 (25,000) 37.79
(12,084) 30.21
 (25,000) 37.79
Vested(173,664) 13.73
 
 
(173,664) 13.73
 
 
Units outstanding as of June 30, 2019251,433
 $41.04
 96,197
 $54.98
Units outstanding as of September 30, 2019250,183
 $41.09
 96,197
 $54.98

Consistent with 2018, during 2019, we granted awards to certain participants in the form of PSUs. These PSUs will vest at the end of a three-year performance period only if specific financial performance metrics are met, and the vested shares will then be modified based on relative total shareholder return. The 34,088 2019 PSUs were granted at “target” levels; however, for share pool purposes, we have reserved an additional 34,088 shares in the event that the combined financial performance and market conditions achieve maximum levels. For the 2018 and 2019 PSUs combined, we have 96,197 shares reserved as of JuneSeptember 30, 2019 in the event that actual results exceed “target” levels. For the three and sixnine months ended JuneSeptember 30, 2019, stock-based compensation expense related to these PSUs was recognized in accordance with ASC 718 for both employees and non-employees, as amended by the adoption of ASU 2018-07 (see “Note 1.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


2018-07 (see “Note 1. Summary of Significant Accounting Policies; m) Recent Accounting Pronouncements; Accounting Pronouncements Recently Adopted” for further detail regarding ASU 2018-07).
Additional information about our RSUs is summarized as follows:
 Three Months Ended Nine Months Ended
 Three Months Ended Six Months Ended September 30, September 30,
(in thousands)(in thousands)June 30,
2019
 June 30,
2018
 June 30,
2019
 June 30,
2018
(in thousands)2019 2018 2019 2018
Aggregate market value of RSUs vestedAggregate market value of RSUs vested$1,279
 $1,478
 $12,833
 $7,873
Aggregate market value of RSUs vested$
 $
 $12,833
 $7,873

The total compensation cost of RSUs and PSUs granted but not yet vested, inclusive of the PSUs for which vesting has been deemed probable at JuneSeptember 30, 2019, was $8.6$7.5 million, which is expected to be recognized over a weighted average period of approximately two years. Additionally, there were 588,359 RSUs vested but not released at JuneSeptember 30, 2019.
Employee Stock Purchase Plan
In May 2017, our stockholders approved the BioTelemetry, Inc. 2017 Employee Stock Purchase Plan (“2017 ESPP”) with 500,000 shares reserved for issuance, which replaced the 2008 Employee Stock Purchase Plan. Substantially all of our employees are eligible to participate in the 2017 ESPP. Under the 2017 ESPP, each participant may purchase option value of our shares, through payroll deductions, upnot to $21,500exceed $25,000 of our sharesgrant date fair value in a calendar year. The price per share is equal to the lower of 85% of the fairclosing market price on the first day of the offering period or 85% of the fairclosing market price on the day of purchase. Proceeds received from the issuance of shares are credited to stockholders’ equity in the period that the shares are issued. Purchases under the 2017 ESPP are made in March and September. For the sixnine months ended JuneSeptember 30, 2019, an aggregate of 43,88898,425 shares were purchased in accordance with the 2017 ESPP. Net proceeds from the issuance of shares of common stock under the 2017 ESPP for the sixnine months ended JuneSeptember 30, 2019 were $1.4$3.1 million. At JuneSeptember 30, 2019, 287,208232,671 shares remain available for purchase under the 2017 ESPP.
Our aggregate stock-based compensation expense is summarized as follows:
Three Months Ended Nine Months Ended
Three Months Ended Six Months EndedSeptember 30, September 30,
(in thousands)June 30,
2019
 June 30,
2018
 June 30,
2019
 June 30,
2018
2019 2018 2019 2018
Stock options$1,820
 $1,717
 $3,279
 $2,828
$1,927
 $304
 $5,206
 $3,132
Restricted stock units1,074
 840
 1,993
 1,560
941
 832
 2,934
 2,392
Performance stock units152
 
 71
 
121
 
 192
 
Employee stock purchase plan431
 301
 683
 535
647
 219
 1,330
 754
Total stock-based compensation expense$3,477
 $2,858
 $6,026
 $4,923
$3,636
 $1,355
 $9,662
 $6,278



14. Income Taxes
The income tax provision for interim periods is determined using an estimated annual effective tax rate adjusted for discrete items, if any, which are taken into account in the quarterly period in which they
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


occur. We review and update our estimated annual effective tax rate each quarter. We recorded an income tax provision of $4.8$3.5 million and $2.7$6.2 million for the three and sixnine months ended JuneSeptember 30, 2019, respectively, based on our estimated annual effective tax rate adjusted for discrete items. We recognized an income tax
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


benefit of $1.5$1.3 million and $1.6$2.9 million for the three and sixnine months ended JuneSeptember 30, 2018, respectively, primarily due primarily to a discrete benefit recorded for equity compensation deductions.
At JuneSeptember 30, 2019 and December 31, 2018, we had deferred tax assets, net of deferred tax liabilities and valuation allowance, of $16.1$12.8 million and $20.0 million, respectively.
We recognize interest and penalties, where applicable, related to unrecognized tax benefits within the (provision for)/benefit from/(provision for)from income taxes line in the consolidated statements of operations. During the sixnine months ended JuneSeptember 30, 2019, we recognized an immaterial amount of interest expense in the consolidated statements of operations associated with our unrecognized tax benefits.
At JuneSeptember 30, 2019 and December 31, 2018, we had net reserves of $33.6$34.3 million and $31.3 million, respectively, for unrecognized tax benefits, which are recorded as a component of other long-term liabilities within our consolidated balance sheets.


15. Segment Information
We operate under two2 reportable segments: Healthcare and Research. The Healthcare segment is focused on remote cardiac monitoring to identify cardiac arrhythmias or heart rhythm disorders and to monitor the functionality of implantable cardiac devices. We offer cardiologists, electrophysiologists, neurologists and primary care physicians a full spectrum of solutions, which provides them with a single source of cardiac monitoring services. These services range from the differentiated MCT service, to event, traditional Holter, extended-wearextended Holter, Pacemaker and International Normalized Ratio monitoring. The Research segment is engaged in centralized core laboratory services providing cardiac monitoring, imaging services, scientific consulting and data management services for drug and medical device trials. Included in the Corporate and Other category is the manufacturing, testing and marketing of cardiac and blood glucose monitoring devices to medical companies, clinics and hospitals and corporate overhead and other items not allocated to any of our reportable segments.
Expenses that can be specifically identified with a segment have been included as deductions in determining pre-tax segment income.income/(loss). Any remaining expenses including integration, restructuring and other charges, as well as the elimination of costs associated with intercompany revenue, are included in Corporate and Other. Also included in Corporate and Other is our net interest expense and other financing expenses. We do not allocate assets to the individual segments.
Three Months Ended September 30, 2019
Three Months Ended June 30, 2019Reporting Segment 
Corporate
and Other
  
(in thousands)Healthcare Research 
Corporate
and Other
 ConsolidatedHealthcare Research Consolidated
Revenue$95,004
 $13,879
 $2,920
 $111,803
$93,873
 $14,236
 $3,182
 $111,291
Gross profit64,387
 5,335
 518
 70,240
62,780
 5,758
 801
 69,339
Income/(loss) before income taxes32,514
 1,052
 (20,459) 13,107
29,843
 1,964
 (20,056) 11,751
Depreciation and amortization8,458
 1,004
 861
 10,323
8,337
 1,059
 899
 10,295
Capital expenditures9,080
 1,306
 372
 10,758
6,428
 774
 392
 7,594
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


Three Months Ended September 30, 2018
Three Months Ended June 30, 2018Reporting Segment 
Corporate
and Other
  
(in thousands)Healthcare Research 
Corporate
and Other
 ConsolidatedHealthcare Research Consolidated
Revenue$86,723
 $12,546
 $2,091
 $101,360
$84,196
 $13,464
 $2,353
 $100,013
Gross profit60,882
 5,328
 (455) 65,755
56,040
 5,938
 759
 62,737
Income/(loss) before income taxes34,875
 1,520
 (27,451) 8,944
28,662
 1,951
 (15,893) 14,720
Depreciation and amortization4,948
 967
 4,139
 10,054
8,413
 944
 992
 10,349
Capital expenditures7,077
 911
 (1,989) 5,999
2,765
 472
 4,324
 7,561
Nine Months Ended September 30, 2019
Six Months Ended June 30, 2019Reporting Segment 
Corporate
and Other
  
(in thousands)Healthcare Research 
Corporate
and Other
 ConsolidatedHealthcare Research Consolidated
Revenue$183,013
 $26,843
 $5,926
 $215,782
$276,886
 $41,079
 $9,108
 $327,073
Gross profit124,251
 9,669
 1,098
 135,018
187,031
 15,427
 1,899
 204,357
Income/(loss) before income taxes62,122
 1,816
 (41,219) 22,719
91,965
 3,780
 (61,275) 34,470
Depreciation and amortization16,618
 1,932
 1,663
 20,213
24,955
 2,991
 2,562
 30,508
Capital expenditures13,522
 1,788
 782
 16,092
19,950
 2,562
 1,174
 23,686
 Six Months Ended June 30, 2018
(in thousands)Healthcare Research 
Corporate
and Other
 Consolidated
Revenue$167,274
 $23,790
 $4,792
 $195,856
Gross profit113,851
 10,246
 (294) 123,803
Income/(loss) before income taxes52,599
 2,306
 (41,067) 13,838
Depreciation and amortization16,384
 1,977
 1,521
 19,882
Capital expenditures12,141
 1,202
 (3,406) 9,937

 Nine Months Ended September 30, 2018
 Reporting Segment 
Corporate
and Other
  
(in thousands)Healthcare Research  Consolidated
Revenue$251,470
 $37,254
 $7,145
 $295,869
Gross profit169,891
 16,184
 465
 186,540
Income/(loss) before income taxes81,261
 4,257
 (56,960) 28,558
Depreciation and amortization24,797
 2,921
 2,513
 30,231
Capital expenditures14,906
 1,674
 918
 17,498


Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The following discussion and analysis should be read in conjunction with our Annual Report on Form 10-K for the year ended December 31, 2018, and in conjunction with the accompanying quarterly unaudited consolidated financial statements and related notes. This discussion contains forward-looking statements reflecting our current expectations that involve risks and uncertainties. Our actual results and the timing of certain events could differ materially from those contained in these forward-looking statements due to a number of factors, including, but not limited to, those set forth herein and elsewhere in this report and in our other filings with the U.S. Securities and Exchange Commission (“SEC”). See the “Cautionary Note Regarding Forward-Looking Statements” at the beginning of this report. Unless otherwise noted, the figures in the following discussions are unaudited.
Company Background
We are the leading remote medical technology company focused on the delivery of health information to improve quality of life and reduce cost of care. We provide remote cardiac monitoring, remote blood glucose monitoring, centralized core laboratory services for clinical trials, remote blood glucose monitoring and original


equipment manufacturing that serves both healthcare and clinical research customers. We operate under two reportable segments: Healthcare and Research. Healthcare is focused on the diagnosis andremote cardiac monitoring ofto identify cardiac arrhythmias or heart rhythm disorders as well as monitoringand to monitor the functionality of implantable cardiac devices. We offer cardiologists, electrophysiologists, neurologists and primary care physicians a full spectrum of solutions, which provides them with a single source of cardiac monitoring services. These services range from the differentiated remote cardiac telemetry service to event, traditional Holter, extended-wearextended Holter, Pacemaker and International Normalized Ratio monitoring. Research is engaged in centralized core laboratory services providing cardiac monitoring, imaging services, scientific consulting and data management services for drug and medical device trials. Included in the Corporate and Other category is the manufacturing, testing and marketing of cardiac and blood glucose monitoring devices to medical companies, clinics and hospitals and corporate overhead and other items not allocated to any of our reportable segments.
Recent Developments
On March 1,In October 2019, we acquired Geneva Healthcare, Inc. (“Geneva”), an early stage company that provides remote monitoring for implantable cardiac devices utilizing a proprietary cloud-based platform.
We acquired Geneva asdetected suspicious activity on our information technology network. As part of our business strategycomprehensive response plan, we immediately took certain systems offline to go deepercontain the activity and wider intoengaged an outside forensics team to conduct an independent investigation. While the cardiac monitoring market. Geneva has developed an innovative proprietary cloud-based platform that aggregates data from the leading cardiac device manufacturers, enablingincident did temporarily disrupt services, substantially all systems have resumed operation and our technical team continues to work closely with third-party consultants to further address this matter. Although the Company has insurance coverage for costs and business interruption resulting from cyber-attacks, disputes over the extent of insurance coverage for claims are not uncommon. As a result, we may incur expenditures related to remotely monitor a physician’s patients with implantable cardiac devices such as pacemakers, defibrillatorsaddressing this incident, that may not be covered, and loop recorders. Geneva’s platform provides physicians a single portalwe anticipate fourth quarter financial results to order patient monitoring, review monitoring results and request routine device checks, helping drive significant in-office efficiencies and patient compliance. We planbe negatively impacted by the temporary disruption to mergenormal operations. At this functionality with thattime, there is no evidence of the Healthcare segment user interface, which we believe will drive greater workflow and data management efficiencies to the clients we serve.any unauthorized transfer or misuse of customer or employee data.

Critical Accounting Policies and Estimates
We have prepared the consolidated financial statements and accompanying notes included in “Part I; Item 1. Financial Statements” of this report in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”).principles. This requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. These estimates and assumptions are based on historical experience, analysis of current trends, and various other factors that we believe to be reasonable under the circumstances. Actual results could differ from those estimates under different assumptions or conditions.
We periodically reevaluate our accounting policies, assumptions, and estimates and make adjustments when facts and circumstances warrant. Our significant accounting policies are described in “Part II; Item 8. Financial Statements and Supplementary Data; Notes to Consolidated Financial Statements; Note 2. Summary of Significant Accounting Policies” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2018. The accounting policies and related assumptions that we consider to be more critical to the preparation of our consolidated financial statements and accompanying notes and involve the most significant management judgments and estimates are described in “Part II; Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations; Critical Accounting Policies and Estimates” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2018. Except for the implementation of Accounting Standards Codification (“ASC”) 842 - Leases and the acquisition-related contingent consideration associated with the Geneva acquisition,thereHealthcare Inc.


(“Geneva”) acquisition,there were no material changes in, or additions to, our critical accounting policies or in the assumptions or estimates we used to prepare the financial information appearing in this report.

Results of Operations
Three Months Ended JuneSeptember 30, 2019 and JuneSeptember 30, 2018
Revenue
Three Months Ended    
Three Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Healthcare$95,004
 $86,723
 $8,281
 9.5%$93,873
 $84,196
 $9,677
 11.5%
Research13,879
 12,546
 1,333
 10.6%14,236
 13,464
 772
 5.7%
Other2,920
 2,091
 829
 39.6%3,182
 2,353
 829
 35.2%
Total revenue$111,803
 $101,360
 $10,443
 10.3%$111,291
 $100,013
 $11,278
 11.3%
Total revenue for the three months ended JuneSeptember 30, 2019 increased 10.3%11.3%, due to growth in revenue across all of our businesses. Healthcare revenue growth was primarily driven by increased patient volume, primarily forrelated to our mobile cardiac telemetry (MCT) and extended wear Holter services, as well as the addition of the implantable device monitoring revenue contributed by Geneva, which we acquired on March 1, 2019. The positive impact of the higher patient volume was partially offset by the reduction of MCT Medicare rate reduction,reimbursement, which went into effect January 1, 2019.2019, as well as payor mix. Research revenue continues to benefit from new studies resulting from the utilization of ePatch™, our extended Holter device. Other revenue increased due to continued growth of diabetic product sales.
Gross Profit
Three Months Ended    
Three Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Gross profit$70,240
 $65,755
 $4,485
 6.8%$69,339
 $62,737
 $6,602
 10.5%
Percentage of revenue62.8% 64.9%    62.3% 62.7%    
Gross profit for the three months ended JuneSeptember 30, 2019 increased primarily due to the higher revenue. OurThe 42 basis point decrease in gross profit percentage declined 205 basis points. The Company’s hiringwas due to the impact of operational staff did not keep pace with our volume growth in early 2018, creating a higher than average gross margin percentage in the second quarter 2018. In addition, our gross margin percent was impacted by the reduction of MCT Medicare reimbursement, which went into effect January 1, 2019.2019, as well as increased costs to support Research studies. This was partially offset by the positive impact of Healthcare operational efficiencies.


General and Administrative Expense
Three Months Ended    
Three Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
General and administrative expense$30,587
 $28,741
 $1,846
 6.4%$29,651
 $26,325
 $3,326
 12.6%
Percentage of revenue27.4% 28.4%    26.6% 26.3%    
General and administrative expense increased for the three months ended JuneSeptember 30, 2019 increased primarily due to costs associated with the ongoing investment in our business systems and infrastructure increased charitable contributions to fund pediatric cardiac procedures in developing countries, as well as the addition of Geneva.
Sales and Marketing Expense
Three Months Ended    
Three Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Sales and marketing expense$12,795
 $11,075
 $1,720
 15.5%$12,572
 $10,120
 $2,452
 24.2%
Percentage of revenue11.4% 10.9%    11.3% 10.1%    
Sales and marketing expense increased for the three months ended JuneSeptember 30, 2019 increased primarily due to increased headcount-related expenses due to the ongoing investment in our Healthcare field sales force as well as the addition of Geneva.
Bad Debt Expense
Three Months Ended    
Three Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Bad debt expense$5,379
 $6,875
 $(1,496) (21.8)%$5,858
 $5,157
 $701
 13.6%
Percentage of revenue4.8% 6.8%    5.3% 5.2%    
Bad debt expense decreased for the three months ended JuneSeptember 30, 2019 increased primarily due to a prior year $1.1 million specific reserve related to a customer bankruptcy in the Other category. The majorityincreased Healthcare revenue and the timing of our badHealthcare collections. Bad debt expense relates to our Healthcare business. Bad debt expensefor the three months ended September 30, 2019 in Research and the Other category was minimal and is recorded on a specific account basis.
Research and Development Expense
Three Months Ended    
Three Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Research and development expense$3,532
 $2,733
 $799
 29.2%$3,661
 $2,429
 $1,232
 50.7%
Percentage of revenue3.2% 2.7%    3.3% 2.4%    
Research and development expense for the three months ended JuneSeptember 30, 2019 increased due to our ongoing investment in new products and technologies, including the further incorporation of artificial intelligence and machine learning into our services.


Other Charges
Three Months Ended    
Three Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Other charges$2,234
 $5,208
 $(2,974) (57.1)%$2,598
 $1,330
 $1,268
 95.3%
Percentage of revenue2.0% 5.1%    2.3% 1.3%    
Other charges for the three months ended JuneSeptember 30, 2019 decreasedincreased primarily due to a $2.0 million reduction of integration expense related to the LifeWatch AG (“LifeWatch“) acquisition, the $1.8 million impact from changes in acquisition-related contingent consideration and a $1.8 million prior year reserve for a note receivable with a bankrupt customer. This decrease was partially offset by a $1.8 million increase in patent litigation and other legal expense as well as the addition of $1.2 million of costs related to thepartially offset by a reduction in acquisition and integration ofexpenses. For further details, please see Geneva.“Part I; Item 1, Financial Statements; Note 11. Other Charges.”
Other Expense
Three Months Ended    
Three Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Interest expense$(2,538) $(2,684) $146
 (5.4)%$(2,338) $(2,408) $70
 (2.9)%
Loss on equity method investment(154) (45) (109) 242.2 %(65) (54) (11) 20.4 %
Other non-operating income, net86
 550
 (464) (84.4)%
Other non-operating expense, net(845) (194) (651) 335.6 %
Total other expense, net$(2,606) $(2,179) $(427) 19.6 %$(3,248) $(2,656) $(592) 22.3 %
Percentage of revenue2.3% 2.2%    2.9% 2.7%    
Total other expense for the three months ended JuneSeptember 30, 2019 increased primarily due to the effect of non-cash foreign currency partially offset by a gain associated with the termination of a former LifeWatch foreign pension plan.transaction losses.
Income Taxes
Three Months Ended    
Three Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
(Provision for)/benefit from income taxes$(4,807) $1,500
 $(6,307) (420.5)%$(3,468) $1,281
 $(4,749) (370.7)%
Effective tax rate36.7% (16.8)%    29.5% (8.7)%    
For the three months ended JuneSeptember 30, 2019, we recorded an income tax provision based on our estimated annual effective tax rate, adjusted for discrete items. For the three months ended JuneSeptember 30, 2018, we recorded an income tax benefit primarily due to a discrete benefit recorded for equity compensation deductions. After considering benefits from the exercise of stock options, we expect our 2019 annual effective tax rate to be in the range of 19% to 21%, absent changes in tax laws or significant changes in unrecognized tax benefits.


SixNine Months Ended JuneSeptember 30, 2019 and JuneSeptember 30, 2018
Revenue
Nine Months Ended    
Six Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Healthcare$183,013
 $167,274
 $15,739
 9.4%$276,886
 $251,470
 $25,416
 10.1%
Research26,843
 23,790
 3,053
 12.8%41,079
 37,254
 3,825
 10.3%
Other5,926
 4,792
 1,134
 23.7%9,108
 7,145
 1,963
 27.5%
Total revenue$215,782
 $195,856
 $19,926
 10.2%$327,073
 $295,869
 $31,204
 10.5%
Total revenue for the sixnine months ended JuneSeptember 30, 2019 increased 10.2%10.5%, due to growth in revenue across all of our businesses. Healthcare revenue growth was driven by increased patient volume, primarily forrelated to our MCT and extended wear Holter services, as well as the addition of the implantable device monitoring revenue contributed by Geneva, which we acquired on March 1, 2019. The positive impact of the higher patient volume was partially offset by the reduction of MCT Medicare rate reduction,reimbursement, which went into effect January 1, 2019.2019, as well as payor mix. Research revenue continues to benefit from new studies resulting from the utilization of ePatch™, our extended Holter device. Other revenue increased due to continued growth of diabetic product sales.
Gross Profit
Nine Months Ended    
Six Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Gross profit$135,018
 $123,803
 $11,215
 9.1%$204,357
 $186,540
 $17,817
 9.6%
Percentage of revenue62.6% 63.2%    62.5% 63.0%    
Gross profit for the sixnine months ended JuneSeptember 30, 2019 increased primarily due to the higher revenue. The 6457 basis point decrease in gross profit percentage was due to the impact of the reduction of MCT Medicare reimbursement, which went into effect January 1, 2019.2019, as well as increased costs to support Research studies. This was partially offset by the positive impact of Healthcare operational efficiencies.
General and Administrative Expense
Nine Months Ended    
Six Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
General and administrative expense$58,194
 $55,460
 $2,734
 4.9%$87,845
 $81,785
 $6,060
 7.4%
Percentage of revenue27.0% 28.3%    26.9% 27.6%    
General and administrative expense increased for the sixnine months ended JuneSeptember 30, 2019 increased primarily due to costs associated with the ongoing investment in our business systems and infrastructure, increased charitable contributions to fund pediatric cardiac procedures in developing countries as well as the addition of Geneva.


Sales and Marketing Expense
Nine Months Ended    
Six Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Sales and marketing expense$25,235
 $22,415
 $2,820
 12.6%$37,807
 $32,535
 $5,272
 16.2%
Percentage of revenue11.7% 11.4%    11.6% 11.0%    
Sales and marketing expense increased for the sixnine months ended JuneSeptember 30, 2019 increased primarily due to increased headcount-related expenses due to the ongoing investment in our Healthcare field sales force as well as the addition of Geneva.
Bad Debt Expense
Nine Months Ended    
Six Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Bad debt expense$10,527
 $11,754
 $(1,227) (10.4)%$16,385
 $16,911
 $(526) (3.1)%
Percentage of revenue4.9% 6.0%    5.0% 5.7%    
Bad debt expense decreased for the sixnine months ended JuneSeptember 30, 2019 decreased primarily due to a prior year $1.1 million specific reserve related to a customer bankruptcy in the Other category. The majorityThis was partially offset by the increased Healthcare revenue and the timing of our badHealthcare collections. Bad debt expense relates to our Healthcare business. Bad debt expensefor the nine months ended September 30, 2019 in Research and the Other category was minimal and is recorded on a specific account basis.
Research and Development Expense
Nine Months Ended    
Six Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Research and development expense$6,865
 $6,022
 $843
 14.0%$10,526
 $8,451
 $2,075
 24.6%
Percentage of revenue3.2% 3.1%    3.2% 2.9%    
Research and development expense for the sixnine months ended JuneSeptember 30, 2019 increased due to our ongoing investment in new products and technologies, including the further incorporation of artificial intelligence and machine learning into our services.
Other Charges
Nine Months Ended  
Six Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Other charges$5,304
 $10,293
 $(4,989) (48.5)%$7,902
 $11,623
 $(3,721) (32.0)%
Percentage of revenue2.5% 5.3%    2.4% 3.9%    
Other charges for the sixnine months ended JuneSeptember 30, 2019 decreased primarily due to a $6.8$7.3 million reduction of integration expense related to the LifeWatch AG (“LifeWatch”) acquisition, a $1.8 million prior year reserve for a note receivable with a bankrupt customer and the $1.1$1.0 million impact from


changes in acquisition-related contingent consideration. This decrease was partially offset by $2.6$2.7 million of costs related to theour Geneva acquisition, and integration of Geneva and a $2.4$4.3 million increase in patent litigation and other legal expense. For further details, please see


“Part I; Item 1, Financial Statements; Note 11. Other Charges.”
Other Expense
Nine Months Ended    
Six Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
Interest expense$(5,020) $(4,574) $(446) 9.8 %$(7,358) $(6,982) $(376) 5.4 %
Loss on equity method investment(186) (184) (2) 1.1 %(251) (238) (13) 5.5 %
Other non-operating (expense)/income, net(968) 737
 (1,705) (231.3)%(1,813) 543
 (2,356) (433.9)%
Total other expense, net$(6,174) $(4,021) $(2,153) 53.5 %$(9,422) $(6,677) $(2,745) 41.1 %
Percentage of revenue2.9% 2.1%    2.9% 2.3%    
Total other expense for the sixnine months ended JuneSeptember 30, 2019 increased primarily due to the effect of non-cash foreign currency andtransaction losses, the impact of higher interest rates due to changes in LIBOR on our long-term debt as well as interest expense on the deferred purchase consideration for Geneva. These increases were partially offset by a current year gain associated with the termination of a former LifeWatch foreign pension plan.plan as well as prior year interest expense related to a legal settlement.
Income Taxes
Nine Months Ended  
Six Months Ended ChangeSeptember 30, Change
(in thousands, except percentages)June 30,
2019
 June 30,
2018
 $ %2019 2018 $ %
(Provision for)/benefit from income taxes$(2,734) $1,642
 $(4,376) (266.5)%$(6,202) $2,923
 $(9,125) (312.2)%
Effective tax rate12.0% (11.9)%    18.0% (10.2)%    
For the sixnine months ended JuneSeptember 30, 2019, we recorded an income tax provision based on our estimated annual effective tax rate, adjusted for a net discrete benefit primarily related to equity compensation deductions. For the sixnine months ended JuneSeptember 30, 2018, we recorded an income tax benefit primarily due to a discrete benefit recorded for equity compensation deductions. After considering benefits from the exercise of stock options, we expect our 2019 annual effective tax rate to be in the range of 19% to 21%, absent changes in tax laws or significant changes in unrecognized tax benefits.



Liquidity and Capital Resources
The following table highlights certain information related to our liquidity and capital resources:
(in thousands, except ratios)June 30,
2019
 December 31,
2018
Cash and cash equivalents$51,712
 $80,889
Healthcare accounts receivable, net of allowance for doubtful accounts48,307
 37,754
Other accounts receivable, net of allowance for doubtful accounts15,026
 14,874
Availability under revolving credit facility50,000
 50,000
    
Working capital$70,756
 $97,037
Current ratio2.2
 3.0
    
Total operating lease obligations(1)
$21,643
 $
Total finance lease obligations1,009
 1,769
Total debt$196,608
 $198,549


(in thousands, except ratios)September 30,
2019
 December 31,
2018
Cash and cash equivalents$61,573
 $80,889
Healthcare accounts receivable, net of allowance for doubtful accounts56,832
 37,754
Other accounts receivable, net of allowance for doubtful accounts15,637
 14,874
Availability under revolving credit facility50,000
 50,000
    
Working capital$89,066
 $97,037
Current ratio2.5
 3.0
    
Total operating lease obligations(1)
$20,447
 $
Total finance lease obligations838
 1,769
Total debt$195,638
 $198,549
________________
(1) 
We adopted ASC 842 - Leases, effective January 1, 2019, which resulted in the recognition of most of our operating leases on our balance sheet, both as a right-of-use asset and right-of-use liability. Since we adopted this standard using the optional modified retrospective method, we have not restated prior year amounts.
The following table highlights certain cash flow activities:
Six Months EndedNine Months Ended
(in thousands)June 30,
2019
 June 30,
2018
September 30,
2019
 September 30,
2018
Net income$19,985
 $15,480
$28,268
 $31,481
Non-cash adjustments to net income37,159
 33,342
60,683
 49,782
Cash used for working capital(21,014) (32,686)(36,349) (36,976)
Cash provided by operating activities36,130
 16,136
52,602
 44,287
      
Cash used in investing activities(60,858) (9,937)(68,452) (17,498)
      
Cash used in financing activities$(4,448) $(2,621)
Cash (used in)/provided by financing activities$(3,489) $500
For the sixnine months ended JuneSeptember 30, 2019, non-cash adjustments to income primarily relate to bad debt, depreciation, amortization and stock compensation expense and deferred taxes, offset by the changes in acquisition-related contingent consideration. The decrease in cash used for working capital was primarily due to the timing of cash receipts and cash payments, as well as changes in accruals.receipts. The increase in cash used in investing activities was primarily due to the Geneva acquisition. The increasechange in the cash used inflows from financing activities was due to increased payments of tax withholdings related to vesting of share-based awards, the increase in our principal payments on our long-term debt and a decrease in the proceeds received related to the exercise of stock options, offset partially by the impact of the prior year acquistion of noncontrolling interests.
In 2017, we established a new credit agreement with SunTrust Bank and lenders named therein in the form of a $205.0 million term loan and a $50.0 million revolving credit facility. For further details regarding this agreement, please see “Part II; Item 8. Financial Statements and Supplementary Data;


Notes to Consolidated Financial Statements; Note 11. Credit Agreement” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2018. As of JuneSeptember 30, 2019, our revolving credit facility remains undrawn.

Item 3. Quantitative and Qualitative Disclosures About Market Risk
Our cash and cash equivalents as of JuneSeptember 30, 2019 were $51.7$61.6 million. We do not invest in any short-term or long-term securities, nor do we hold any derivative financial instruments for trading or speculative purposes.
At JuneSeptember 30, 2019, we had $196.6$195.6 million of variable rate debt, inclusive of debt discounts and deferred charges, at a rate of LIBOR plus the applicable margin, or the prime rate plus the applicable margin. A 1.0% change in either the LIBOR rate, prime rate, or the applicable margin would result in a change in interest expense of approximately $2.0 million. For further details regarding the debt, rates or applicable margin, please refer to “Part II; Item 8. Financial Statements and Supplementary Data; Notes to Consolidated Financial Statements; Note 11. Credit Agreement” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2018.



Item 4.  Controls and Procedures
Evaluation of Disclosure Controls and Procedures
We maintain disclosure controls and procedures designed to ensure information required to be disclosed in our reports filed under the Securities Exchange Act of 1934, as amended (“Exchange Act”), is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms.  Disclosure controls and procedures are designed to provide reasonable assurance that information required to be disclosed in our reports filed under the Exchange Act is accumulated and communicated to management, including our Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure. It should be noted that the design of any system of controls is based in part upon certain assumptions about the likelihood of future events, and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions, regardless of how remote.
Our management, with the participation of our Chief Executive Officer and Chief Financial Officer, has evaluated the effectiveness of our disclosure controls and procedures pursuant to Rule 13a-15(b) of the Exchange Act as of the end of the period covered by this report. Based on that evaluation, our Chief Executive Officer (the Principal Executive Officer) and Chief Financial Officer (the Principal Financial Officer) have concluded that our disclosure controls and procedures were effective as of JuneSeptember 30, 2019.  This evaluation of the effectiveness of our internal control over financial reporting did not include the internal controls of Geneva, which was acquired in the first quarter of 2019, nor ADEA Medical AB, which was acquired in the second quarter of 2019, due to the timing of these acquisitions. Geneva and ADEA Medical AB will be included in our evaluation of the effectiveness of our internal control over financial reporting for periods beginning after January 1, 2020.
Changes in Internal Control over Financial Reporting
During the second quarter of 2019, we completed our acquisition of ADEA. We are also in the process of integrating ADEA, and our management is in the process of evaluating any related changes to our internal control over financial reporting as a result of this integration. Except for any changes relating to this integration, there has been no change in our internal control over financial reporting (as defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act) for the three months ended June 30, 2019 that materially affected or is reasonably likely to materially affect our internal control over financial reporting.



PART II - OTHER INFORMATION
Item 1. Legal Proceedings
From time to time, in the ordinary course of business, and like others in the industry, we receive requests for information from government agencies in connection with their regulatory or investigational authority or are involved in traditional employment or business litigation.  We review such requests and notices and take appropriate action.
On April 5, 2019, a complaint filed under seal in the U.S. District Court for the Eastern District of Pennsylvania against the Company by private relators under the Federal False Claims Act, and analogous state acts, was unsealed. The U.S. Department of Justice notified the District Court of its decision not to intervene in the case at this time.
The relators’ complaint alleges, among other things, that the Company engaged in the offshoring of certain activities and improper performance of work at certain U.S. locations in violation of applicable law. The relators seek unspecified damages on behalf of the U.S. and various states.
The Company is evaluating the complaint, but, at this point, it believes the allegations in the complaint are without merit and intends to vigorously defend the litigation. The Company also does not believe these claims will have a material impact on its business operations or strategic plans.
The final outcome of any current or future litigation or governmental or internal investigations cannot be accurately predicted, nor can we predict any resulting penalties, fines or other sanctions that may be imposed at the discretion of federal or state regulatory authorities. We record accruals for such contingencies to the extent that we conclude it is probable that a liability has been incurred and the amount of the loss can be estimated.

Item 1A.  Risk Factors
In evaluating an investment in BioTelemetry common stock, investors should consider carefully, among other things, “Part I; Item 1A. Risk Factors” of our Annual Report on Form 10-K for the year ended December 31, 2018, as well as the information contained in this Quarterly Report on Form 10-Q, which could materially affect the Company’s business, financial condition or future results. The risks described in this Quarterly Report on Form 10-Q and the Company’s Annual Report on Form 10-K are not the only risks facing the Company. Additional risks and uncertainty not currently known to the Company or that the Company currently deems immaterial also may materially adversely affect the Company’s business, financial condition or future results.
We are increasingly dependent on sophisticated information technology systems to operate our business, and if we fail to properly maintain the integrity of our data or if our products do not operate as intended or we experience a cyber-attack or other breach of these systems, our business could be materially affected.
We are increasingly dependent on sophisticated information technology for our products and infrastructure. We rely on information technology systems to process, transmit and store electronic information in our day-to-day operations. The size and complexity of our information technology systems makes them vulnerable to increasingly sophisticated cyber-attacks, malicious intrusion, breakdown, destruction, loss of data privacy or other significant disruption. For example, in October 2019, we detected suspicious activity on our information technology network, which required services and systems to be taken


offline for a period of time. Our information systems require an ongoing commitment of significant resources to maintain, protect and enhance existing systems and develop new systems to keep pace with continuing changes in information processing technology, evolving systems and regulatory standards, the increasing need to protect patient and customer information and changing customer patterns. As a result of technology initiatives, recently enacted regulations, changes in our system platforms and integration of new business acquisitions, we have been consolidating and integrating the number of systems we operate and have upgraded and expanded our information systems capabilities.
In addition, third parties may attempt to hack into our products or systems and may obtain data relating to patients with our products or our proprietary information. If we fail to maintain or protect our information systems and data integrity effectively, we could lose existing customers, have difficulty attracting new customers, have problems in determining product cost estimates and establishing appropriate pricing, have difficulty preventing, detecting and controlling fraud, have disputes with customers, physicians and other reportshealth care professionals, have regulatory sanctions or penalties imposed, have increases in operating expenses, incur expenses or lose revenue as a result of a data privacy breach or suffer other adverse consequences. There can be no assurance that our process of consolidating the number of systems we operate, upgrading and registration statements filed by usexpanding our information systems capabilities, protecting and enhancing our systems and developing new systems to keep pace with continuing changes in information processing technology will be successful or that additional systems issues will not arise in the SEC.future. Any significant breakdown, intrusion, interruption, corruption or destruction of these systems, as well as any data breaches, could have a material adverse effect on our business.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
In connection with our acquisition of ADEA, 50,000 shares of our common stock were issued to the former holders of the outstanding equity of ADEA on June 25, 2019. The offer and sale of the shares were not registered and were made in reliance upon the exemption from registration under Section 4(a)(2) of the Securities Act of 1933, as amended, for an issuance not involving a public offering.Not applicable.

Item 3.  Defaults Upon Senior Securities
Not applicable.



Item 4.  Mine Safety Disclosures
Not applicable.

Item 5.  Other Information
Not applicable.




Item 6.  Exhibits
EXHIBIT INDEX
Incorporated by ReferenceFiled/Furnished Herewith
Exhibit
    Incorporated by Reference Filed/Furnished Herewith
Exhibit
Number
 Description Form File No. Exhibit Filing Date 
10.1  8-K 000-558039 10.1 August 22, 2019  
31.1          
31.2          
32          +
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101.SCH XBRL Taxonomy Extension Schema Document.         
101.CAL XBRL Taxonomy Extension Calculation Linkbase Document.         
101.LAB XBRL Taxonomy Extension Label Linkbase Document.         
101.PRE XBRL Taxonomy Extension Presentation Linkbase Document.         
104 Cover Page Interactive Data File, formatted in Inline XBRL (contained in Exhibit 101).          
Number
DescriptionFormFile No.ExhibitFiling Date
10.1 *
31.1
31.2
32+
101.INSXBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded withing the Inline XBRL document.
101.DEFXBRL Taxonomy Extension Definition Linkbase Document.
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101.PREXBRL Taxonomy Extension Presentation Linkbase Document.
*Indicates a management plan or compensatory plan or arrangement.

Filed herewith.

+Furnished herewith.




BioTelemetry, Inc.

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
 
 BIOTELEMETRY, INC.
   
   
Date: July 30,November 5, 2019By:/s/ Heather C. Getz
  Heather C. Getz
  Executive Vice President, and Chief Financial and Administrative Officer
  (Principal Financial Officer and authorized officer of the Registrant)

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