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MDRX Allscripts Healthcare Solutions

Document and Entity Information

Document and Entity Information - shares9 Months Ended
Sep. 30, 2021Nov. 01, 2021
Cover [Abstract]
Document Type10-Q
Amendment Flagfalse
Document Period End DateSep. 30,
2021
Document Fiscal Year Focus2021
Document Fiscal Period FocusQ3
Trading SymbolMDRX
Entity Registrant NameALLSCRIPTS HEALTHCARE SOLUTIONS, INC.
Entity Central Index Key0001124804
Entity Current Reporting StatusYes
Current Fiscal Year End Date--12-31
Entity Filer CategoryLarge Accelerated Filer
Entity Shell Companyfalse
Entity Small Businessfalse
Entity Emerging Growth Companyfalse
Entity Common Stock, Shares Outstanding122,572,462
Entity File Number001-35547
Entity Tax Identification Number36-4392754
Entity Address, Address Line One222 Merchandise Mart
Entity Address, Address Line TwoSuite 2024
Entity Address, City or TownChicago
Entity Address, State or ProvinceIL
Entity Address, Postal Zip Code60654
City Area Code800
Local Phone Number334-8534
Entity Interactive Data CurrentYes
Title of 12(b) SecurityCommon Stock, par value $0.01 per share
Security Exchange NameNASDAQ
Entity Incorporation, State or Country CodeDE
Document Quarterly Reporttrue
Document Transition Reportfalse

CONSOLIDATED BALANCE SHEETS (Un

CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020
Current assets:
Cash and cash equivalents $ 214,179 $ 531,104
Restricted cash2,141 6,361
Accounts receivable, net of allowance of $30,022 and $31,596 as of September 30, 2021 and December 31, 2020, respectively340,924 347,355
Contract assets, net of allowance of $1,068 as of September 30, 2021 and December 31, 2020123,244 106,717
Income tax receivable0 25,421
Prepaid expenses and other current assets124,473 136,264
Total current assets804,961 1,153,222
Fixed assets, net53,667 72,162
Software development costs, net176,721 193,202
Intangible assets, net248,408 286,602
Goodwill974,427 974,729
Deferred taxes, net6,118 5,790
Contract assets - long-term, net of allowance of $4,273 as of September 30, 2021 and December 31, 202051,119 43,682
Right-of-use assets - operating leases70,297 96,601
Other assets98,588 91,628
Total assets2,484,306 2,917,618
Current liabilities:
Accounts payable21,801 35,905
Accrued expenses93,546 100,262
Accrued compensation and benefits92,737 118,771
Deferred revenue337,884 334,764
Current operating lease liabilities19,264 22,264
Current liabilities attributable to discontinued operations1,708 322,811
Total current liabilities566,940 934,777
Long-term debt373,187 167,587
Deferred revenue4,538 3,471
Deferred taxes, net16,494 18,186
Long-term operating lease liabilities67,057 93,463
Other liabilities37,503 33,891
Total liabilities1,065,719 1,251,375
Commitments and contingencies
Stockholders’ equity:
Preferred stock: $0.01 par value, 1,000 shares authorized, no shares issued and outstanding as of September 30, 2021 and December 31, 20200 0
Common stock: $0.01 par value, 349,000 shares authorized as of September 30, 2021 and December 31, 2020; 276,697 and 122,570 shares issued and outstanding as of September 30, 2021, respectively; 274,558 and 139,942 shares issued and outstanding as of December 31, 2020, respectively2,766 2,745
Treasury stock: at cost, 154,126 and 134,616 shares as of September 30, 2021 and December 31, 2020, respectively(1,213,315)(870,558)
Additional paid-in capital1,952,097 1,902,776
Retained earnings680,281 633,118
Accumulated other comprehensive loss(3,242)(1,838)
Total stockholders’ equity1,418,587 1,666,243
Total liabilities and stockholders’ equity $ 2,484,306 $ 2,917,618

CONSOLIDATED BALANCE SHEETS (_2

CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020
Statement Of Financial Position [Abstract]
Accounts receivable, allowance $ 30,022 $ 31,596
Contract assets, allowance1,068 1,068
Contract assets - long-term, allowance $ 4,273 $ 4,273
Preferred stock, par value $ 0.01 $ 0.01
Preferred stock, shares authorized1,000,000 1,000,000
Preferred stock, shares issued0 0
Preferred stock, shares outstanding0 0
Common stock, par value $ 0.01 $ 0.01
Common stock, shares authorized349,000,000 349,000,000
Common stock, shares issued276,697,000 274,558,000
Common stock, shares outstanding122,570,000 139,942,000
Treasury stock at cost, shares154,126,000 134,616,000

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Revenue:
Revenue from contract with customers $ 369,272 $ 365,618 $ 1,111,338 $ 1,116,286
Cost of revenue:
Amortization of software development and acquisition-related assets29,894 30,708 89,444 88,237
Total cost of revenue220,498 230,480 660,766 711,614
Gross profit148,774 135,138 450,572 404,672
Selling, general and administrative expenses78,794 93,442 239,592 296,164
Research and development45,540 46,352 145,932 151,774
Asset impairment charges6,519 210 11,763 210
Amortization of intangible and acquisition-related assets5,817 6,295 17,466 19,326
Income (loss) from operations12,104 (11,161)35,819 (62,802)
Interest expense(3,617)(6,667)(9,709)(27,646)
Other income, net4,700 398 22,494 45
Gain on sale of businesses, net8,363 0 8,363 0
Impairment of long-term investments0 (1,025)0 (1,575)
Equity in net (loss) income of unconsolidated investments(257)383 (321)17,417
Income (loss) from continuing operations before income taxes21,293 (18,072)56,646 (74,561)
Income tax (provision) benefit(5,099)4,116 (9,954)6,641
Income (loss) from continuing operations, net of tax16,194 (13,956)46,692 (67,920)
(Loss) income from discontinued operations(14)19,545 (7)54,601
Gain on sale of discontinued operations0 0 647 0
Income tax effect on discontinued operations0 (5,047)(169)(14,098)
(Loss) income from discontinued operations, net of tax(14)14,498 471 40,503
Net income (loss) $ 16,180 $ 542 $ 47,163 $ (27,417)
Basic
Continuing operations $ 0.13 $ (0.09) $ 0.35 $ (0.42)
Discontinued operations0 0.090 0.25
Net income (loss) per share - Basic0.130 0.35(0.17)
Diluted
Continuing operations0.12(0.09)0.33(0.42)
Discontinued operations0 0.090 0.25
Net income (loss) per share - Diluted $ 0.12 $ 0 $ 0.33 $ (0.17)
Software delivery, Support and Maintenance [Member]
Revenue:
Revenue from contract with customers $ 222,726 $ 219,850 $ 670,840 $ 680,124
Cost of revenue:
Total cost of revenue68,462 72,411 208,496 216,625
Client services [Member]
Revenue:
Revenue from contract with customers146,546 145,768 440,498 436,162
Cost of revenue:
Total cost of revenue $ 122,142 $ 127,361 $ 362,826 $ 406,752

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Unaudited) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Statement Of Income And Comprehensive Income [Abstract]
Net income (loss) $ 16,180 $ 542 $ 47,163 $ (27,417)
Other comprehensive income (loss):
Foreign currency translation adjustments(805)983 (285)(611)
Change in fair value of derivatives qualifying as cash flow hedges0 1,009 (1,509)1,620
Other comprehensive (loss) income before income tax benefit(805)1,992 (1,794)1,009
Income tax benefit related to items in other comprehensive income (loss)0 (260)390 (418)
Total other comprehensive income (loss)(805)1,732 (1,404)591
Comprehensive income (loss) $ 15,375 $ 2,274 $ 45,759 $ (26,826)

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Unaudited) - USD ($) shares in Thousands, $ in ThousandsTotalCommon Stock Issued [Member]Treasury Stock [Member]Additional Paid-In Capital [Member]Retained Earnings (Accumulated Deficit) [Member]Retained Earnings (Accumulated Deficit) [Member]Cumulative Effect Period Of Adoption Adjustment [Member]Revision Of Prior Period Accounting Standards Update Adjustment [Member]Accumulated Other Comprehensive Loss [Member]Noncontrolling Interest
Beginning Balance, Shares at Dec. 31, 2019272,609 (110,134)
Beginning Balance at Dec. 31, 2019 $ 1,285,188 $ 2,725 $ (571,157) $ 1,907,348 $ (49,336) $ (17,953) $ (4,392)
Stock-based compensation25,931
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares1,862
Common stock issued under stock compensation plans, net of shares withheld for employee taxes $ 19 (5,604)
Capped call transactions797
Issuance of treasury stock, Shares90
Issuance of treasury stock752 $ 1,193 (440)
Purchase of treasury stock, Shares(6,449)
Purchase of treasury stock $ (55,282)
Accelerated share repurchase program, Shares0
Accelerated share repurchase program $ 0 0
Warrants issued1,364
Net income (loss)(27,417)
Foreign currency translation adjustments, net(611)(611)
Unrecognized gain (loss) on derivatives qualifying as cash flow hedges, net of tax1,202
Ending Balance, Shares at Sep. 30, 2020274,471 (116,493)
Ending Balance at Sep. 30, 20201,208,387 $ 2,744 $ (625,246)1,929,396 (94,706) $ (3,801)
Beginning Balance, Shares at Dec. 31, 2019272,609 (110,134)
Beginning Balance at Dec. 31, 2019 $ 1,285,188 $ 2,725 $ (571,157)1,907,348 (49,336)(17,953)(4,392)
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares1,900
Ending Balance, Shares at Dec. 31, 2020274,558 274,558 (134,616)
Ending Balance at Dec. 31, 2020 $ 1,666,243 $ 2,745 $ (870,558)1,902,776 633,118 0 (1,838)
Beginning Balance, Shares at Jun. 30, 2020274,463 (111,493)
Beginning Balance at Jun. 30, 20201,242,929 $ 2,743 $ (579,678)1,920,645 (95,248)0 (5,533)
Stock-based compensation8,811
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares8
Common stock issued under stock compensation plans, net of shares withheld for employee taxes $ 1 (60)
Capped call transactions0
Issuance of treasury stock, Shares0
Issuance of treasury stock $ 0 0
Purchase of treasury stock, Shares(5,000)
Purchase of treasury stock $ (45,568)
Accelerated share repurchase program, Shares0
Accelerated share repurchase program $ 0 0
Warrants issued0
Net income (loss)542
Foreign currency translation adjustments, net983 983
Unrecognized gain (loss) on derivatives qualifying as cash flow hedges, net of tax749
Ending Balance, Shares at Sep. 30, 2020274,471 (116,493)
Ending Balance at Sep. 30, 2020 $ 1,208,387 $ 2,744 $ (625,246)1,929,396 (94,706)(3,801)
Beginning Balance, Shares at Dec. 31, 2020274,558 274,558 (134,616)
Beginning Balance at Dec. 31, 2020 $ 1,666,243 $ 2,745 $ (870,558)1,902,776 633,118 0 (1,838)
Stock-based compensation25,861
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares2,100 2,139
Common stock issued under stock compensation plans, net of shares withheld for employee taxes $ 21 (13,988)
Capped call transactions0
Issuance of treasury stock, Shares33
Issuance of treasury stock $ 534 $ 465 69
Purchase of treasury stock, Shares(6,397)
Purchase of treasury stock $ (108,953)
Accelerated share repurchase program, Shares(13,146)
Accelerated share repurchase program $ (234,269)34,269
Warrants issued3,110
Net income (loss) $ 47,163
Accounting Standards Update Extensible ListAccounting Standards Update 2016-13 [Member]
Foreign currency translation adjustments, net $ (285)(285)
Unrecognized gain (loss) on derivatives qualifying as cash flow hedges, net of tax(1,119)
Ending Balance, Shares at Sep. 30, 2021276,697 276,697 (154,126)
Ending Balance at Sep. 30, 2021 $ 1,418,587 $ 2,766 $ (1,213,315)1,952,097 680,281 (3,242)
Beginning Balance, Shares at Jun. 30, 2021276,668 (151,657)
Beginning Balance at Jun. 30, 20211,393,474 $ 2,766 $ (1,174,498)1,903,542 664,101 $ 0 (2,437)
Stock-based compensation8,777
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares29
Common stock issued under stock compensation plans, net of shares withheld for employee taxes $ 0 (76)
Capped call transactions0
Issuance of treasury stock, Shares0
Issuance of treasury stock $ 0 0
Purchase of treasury stock, Shares0
Purchase of treasury stock $ 0
Accelerated share repurchase program, Shares(2,469)
Accelerated share repurchase program $ (38,817)38,817
Warrants issued1,037
Net income (loss)16,180
Foreign currency translation adjustments, net $ (805)(805)
Unrecognized gain (loss) on derivatives qualifying as cash flow hedges, net of tax $ 0
Ending Balance, Shares at Sep. 30, 2021276,697 276,697 (154,126)
Ending Balance at Sep. 30, 2021 $ 1,418,587 $ 2,766 $ (1,213,315) $ 1,952,097 $ 680,281 $ (3,242)

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands3 Months Ended9 Months Ended12 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020Dec. 31, 2020
Cash flows from operating activities:
Net income (loss) $ 16,180 $ 542 $ 47,163 $ (27,417)
Less: Income from discontinued operations(14)14,498 471 40,503
Income (loss) from continuing operations16,194 (13,956)46,692 (67,920)
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:
Depreciation and amortization132,989 146,016
Non-cash lease expense, net(3,048)561
Stock-based compensation expense25,861 25,931
Deferred taxes(1,650)2,930
Impairment of assets and long-term investments11,763 1,785
Equity in net loss (income) of unconsolidated investments257 (383)321 (17,417)
Gain on sale of businesses, net(8,363)0 (8,363)0
Other income, net(9,881)(4,423)
Changes in operating assets and liabilities (net of businesses acquired):
Accounts receivable and contract assets, net55 60,440
Prepaid expenses and other assets13,086 4,232
Accounts payable(13,671)(49,458)
Accrued expenses21,630 (3,487)
Accrued compensation and benefits(25,513)29,975
Deferred revenue(11,862)(26,028)
Other liabilities3,614 (3,110)
Accrued DOJ settlement0 (88,745)
Net cash provided by operating activities - continuing operations182,023 11,282
Net cash (used in) provided by operating activities - discontinued operations(322,495)60,623
Net cash (used in) provided by operating activities(140,472)71,905
Cash flows from investing activities:
Capital expenditures(4,551)(7,798)
Capitalized software(55,482)(71,337)
Sale of businesses and other investments, net of cash divested, and distributions received7,581 24,884
Purchases of equity securities, other investments and related intangible assets, net(2,421)(3,888)
Net cash used in investing activities - continuing operations(54,873)(58,139)
Net cash used in investing activities - discontinued operations0 (6,793)
Net cash used in investing activities(54,873)(64,932)
Cash flows from financing activities:
Taxes paid related to net share settlement of equity awards(13,967)(5,589)
Repayment of Convertible Senior Notes0 (352,361)
Credit facility payments(50,000)(175,000)
Credit facility borrowings, net of issuance costs250,000 673,625
Repurchase of common stock(308,953)(55,282)
Payment of acquisition and other financing obligations(2,400)(5,127)
Net cash (used in) provided by financing activities(125,320)80,266
Effect of exchange rate changes on cash and cash equivalents(480)132
Net (decrease) increase in cash and cash equivalents(321,145)87,371
Cash, cash equivalents and restricted cash, beginning of period537,465 137,539 $ 137,539
Cash, cash equivalents and restricted cash, end of period $ 216,320 $ 224,910 $ 216,320 $ 224,910 $ 537,465

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies9 Months Ended
Sep. 30, 2021
Accounting Policies [Abstract]
Basis of Presentation and Significant Accounting Policies1. Basis of Presentation and Significant Accounting Policies Principles of Consolidation The consolidated financial statements include the accounts of Allscripts Healthcare Solutions, Inc. (“Allscripts”) and its wholly-owned subsidiaries and controlled affiliates. All significant intercompany balances and transactions have been eliminated. Each of the terms “we,” “us,” “our” or the “Company” as used herein refers collectively to Allscripts Healthcare Solutions, Inc. and its wholly-owned subsidiaries and controlled affiliates, unless otherwise stated. Unaudited Interim Financial Information The unaudited interim consolidated financial statements as of and for the three and nine months ended September 30, 2021 and 2020 have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim financial reporting. These interim consolidated financial statements are unaudited and, in the opinion of our management, include all adjustments, consisting of normal recurring adjustments and accruals, necessary Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted in accordance with the SEC's rules and regulations for interim reporting. The Company believes that the disclosures made are adequate to make these unaudited interim consolidated financial statements not misleading. They should be read in conjunction with the consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2020 (our “Form 10-K”). Use of Estimates The preparation of consolidated financial statements in accordance with GAAP requires us to make estimates and assumptions that affect the amounts reported and disclosed in the consolidated financial statements and the accompanying notes. Our estimates and assumptions consider the economic implications of COVID-19 on our critical and significant accounting estimates. Actual results could differ materially from these estimates. Change in Presentation During the third quarter of 2021, we changed our reportable segments from Core Clinical and Financial Solutions, Data, Analytics and Care Coordination, and Unallocated to Hospital and Large Physician Practices, Veradigm, and Unallocated. Certain business units reported within the historical segments have been reallocated into the new segments. Refer to Note 16 “Business Segments” for further discussion on the impact of the change. Certain reclassifications were made to prior period amounts in order to conform to the current period presentation. These reclassifications had no impact on the reported consolidated prior period financial results. Significant Accounting Policies There have been no changes to our significant accounting policies from those disclosed in our Form 10-K. Recently Adopted Accounting Pronouncements In December 2019, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2019-12, “ Income Taxes (Topic 740) Accounting Pronouncements Not Yet Adopted In August 2020, the FASB issued Accounting Standards Update No. 2020-06, “ Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity” We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, will have a material impact on our consolidated financial statements.

Revenue from Contracts with Cus

Revenue from Contracts with Customers9 Months Ended
Sep. 30, 2021
Revenue From Contract With Customer [Abstract]
Revenue from Contracts with Customers2. Revenue from Contracts with Customers Our two primary revenue streams are (i) software delivery, support and maintenance and (ii) client services. Software delivery, support and maintenance revenue consists of all of our proprietary software sales (either under a perpetual or term license delivery model), subscription-based software sales, transaction-related revenue, the resale of hardware and third-party software and revenue from post-contract client support and maintenance services, which include telephone support services, maintaining and upgrading software and ongoing enhanced maintenance. Client services revenue consists of revenue from managed services solutions, such as private cloud hosting, outsourcing and revenue cycle management, as well as other client services and project-based revenue from implementation, training and consulting services. For some clients, we host the software applications licensed from us using our own or third-party servers. For other clients, we offer an outsourced service in which we assume partial to total responsibility for a healthcare organization’s IT operations using our employees. At September 30, 2021 and December 31, 2020, we had capitalized costs to obtain or fulfill a contract of $15.1 million and $16.8 million, respectively, in Prepaid and other current assets and $26.1 million and $27.9 million, respectively, in Other assets. During the three months ended September 30, 2021 and 2020, we recognized $5.0 million and $6.0 million, respectively, of amortization expense related to such capitalized costs. During the nine months ended September 30, 2021 and 2020, we recognized $15.7 million and $18.5 million, respectively, of amortization expense related to such capitalized costs. The amortization of these capitalized costs to obtain a contract are included in Selling, general and administrative expense within our consolidated statements of operations. The timing of revenue recognition, billings and cash collections results in billed and unbilled accounts receivable, contract assets and customer advances and deposits. Accounts receivable, net includes both billed and unbilled amounts where the right to receive payment is unconditional and only subject to the passage of time. Contract assets include amounts where revenue recognized exceeds the amount billed to the customer and the right to payment is not solely subject to the passage of time. Deferred revenue includes advanced payments and billings in excess of revenue recognized. Our contract assets and deferred revenue are reported in a net position on an individual contract basis at the end of each reporting period. Contract assets are classified as current or long-term based on the timing of when we expect to complete the related performance obligations and bill the customer. Deferred revenue is classified as current or long-term based on the timing of when we expect to recognize revenue. The breakdown of revenue recognized based on the origination of performance obligations and elected accounting expedients is presented in the table below:
(In thousands)
Three Months Ended March 31, 2021
Three Months Ended June 30, 2021
Three Months Ended September 30, 2021
Revenue related to deferred revenue balance at beginning of period
$
137,848
$
151,857
$
144,696
Revenue related to new performance obligations satisfied during the period
173,316
158,910
159,149
Revenue recognized under "right-to-invoice" expedient
56,811
62,422
64,820
Reimbursed travel expenses, shipping and other revenue
377
525
607
Total revenue
$
368,352
$
373,714
$
369,272
(In thousands)
Three Months Ended March 31, 2020
Three Months Ended June 30, 2020
Three Months Ended September 30, 2020
Revenue related to deferred revenue balance at beginning of period
$
105,366
$
119,545
$
118,300
Revenue related to new performance obligations satisfied during the period
216,580
195,308
192,658
Revenue recognized under "right-to-invoice" expedient
58,059
54,082
54,313
Reimbursed travel expenses, shipping and other revenue
1,359
369
347
Total revenue
$
381,364
$
369,304
$
365,618
The aggregate amount of contract transaction price related to remaining unsatisfied performance obligations (commonly referred to as “backlog”) represents contracted revenue that has not yet been recognized and includes both deferred revenue and amounts that will be invoiced and recognized as revenue in future periods. Total backlog equaled $3.9 billion as of September 30, 2021, of which we expect to recognize approximately 35% over the next 12 months, and the remaining 65% thereafter. Revenue Recognition We recognize revenue only when we satisfy an identified performance obligation (or bundle of obligations) by transferring control of a promised product or service to a customer. We consider a product or service to be transferred when a customer obtains control because a customer has sole possession of the right to use (or the right to direct the use of) the product or service for the remainder of its economic life or to consume the product or service in its own operations. We evaluate the transfer of control primarily from the customer’s perspective as this reduces the risk that revenue is recognized for activities that do not transfer control to the customer. The majority of our revenue is recognized over time because a customer continuously and simultaneously receives and consumes the benefits of our performance. The exceptions to this pattern are our sales of perpetual and term software licenses, and hardware, where we determined that a customer obtains control of the asset upon granting of access, delivery or shipment. We disaggregate our revenue from contracts with customers based on the type of revenue and nature of revenue stream, as we believe those categories best depict how the nature, amount, timing and uncertainty of our revenue and cash flows are affected by economic factors. The below tables summarize revenue by type and nature of revenue stream as well as by our reportable segments:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Revenue:
Recurring revenue
$
304,724
$
301,616
$
904,016
$
914,792
Non-recurring revenue
64,548
64,002
207,322
201,494
Total revenue
$
369,272
$
365,618
$
1,111,338
$
1,116,286
Three Months Ended September 30, 2021
(In thousands)
Hospital and Large Physician Practices
Veradigm
Unallocated Amounts
Total
Software delivery, support and maintenance
$
104,809
$
113,075
$
4,842
$
222,726
Client services
120,876
24,093
1,577
146,546
Total revenue
$
225,685
$
137,168
$
6,419
$
369,272
Three Months Ended September 30, 2020
(In thousands)
Hospital and Large Physician Practices
Veradigm
Unallocated Amounts
Total
Software delivery, support and maintenance
$
113,112
$
101,171
$
5,567
$
219,850
Client services
120,518
23,902
1,348
145,768
Total revenue
$
233,630
$
125,073
$
6,915
$
365,618
Nine Months Ended September 30, 2021
(In thousands)
Hospital and Large Physician Practices
Veradigm
Unallocated Amounts
Total
Software delivery, support and maintenance
$
333,277
$
323,462
$
14,101
$
670,840
Client services
362,150
73,525
4,823
440,498
Total revenue
$
695,427
$
396,987
$
18,924
$
1,111,338
Nine Months Ended September 30, 2020
(In thousands)
Hospital and Large Physician Practices
Veradigm
Unallocated Amounts
Total
Software delivery, support and maintenance
$
351,098
$
314,550
$
14,476
$
680,124
Client services
361,440
70,975
3,747
436,162
Total revenue
$
712,538
$
385,525
$
18,223
$
1,116,286
Contract Assets – Estimate of Credit Losses We adopted ASU 2016-13 on January 1, 2020 using the cumulative-effect adjustment transition method. The guidance required the recognition of lifetime estimated credit losses expected to occur for contract assets and trade receivables. The guidance also required that we pool assets with similar risk characteristics and consider current economic conditions when estimating losses. The adoption of ASU 2016-13 for contract assets was recorded as a debit to retained earnings of $5.3 million as of January 1, 2020. Refer to Note 3, “Accounts Receivable”, for the adoption impact related to trade receivables. At adoption, we segmented the contract asset population into pools based on their risk assessment. Risks related to contract assets are a customer’s inability to pay or bankruptcy. Each pool was defined by an internal credit assessment and business size. The pools were aligned with management’s review of financial performance at the time. In the fourth quarter of 2020, we used each customer’s primary business unit in our pooling determination. This assessment provides additional information of the customer including size, segment and industry. Using this perspective, we added one new pool. We reallocated pools and loss rates accordingly and noted slight shifts in each pool. The new pools are aligned with management’s current review of financial performance. For the nine months ended September 30, 2021, no adjustment to the pools was necessary. We utilized a loss-rate method to measure expected credit loss for each pool. The loss rate is calculated using a twenty-four-month lookback period of credit memos and adjustments divided by the average contract asset balance for each pool during that period. We considered current economic conditions, including how the COVID-19 pandemic is impacting the global economy, internal forecasts, cash collection and credit memos written during the current period when assessing loss rates. We reviewed these factors and concluded that no adjustments should be made to the historical loss rate data. The September 30, 2021 analysis resulted in no change in the ending estimate of credit losses. Changes in the estimate of credit losses for contract assets are presented in the table below.
(In thousands)
Total
Balance at December 31, 2020
$
5,341
Current period provision
0
Balance at September 30, 2021
$
5,341
Less: Contract assets, short-term
1,068
Total contract assets, long-term
$
4,273

Accounts Receivable

Accounts Receivable9 Months Ended
Sep. 30, 2021
Receivables [Abstract]
Accounts Receivable3. Accounts Receivable Trade Accounts Receivable – Estimate of Credit Losses We adopted ASU 2016-13 on January 1, 2020 using the cumulative-effect adjustment transition method. The guidance required the recognition of lifetime estimated credit losses expected to occur for trade accounts receivable, which resulted in the recording of a debit to retained earnings of $12.6 million as of January 1, 2020. Refer to Note 2, “Revenue from Contracts with Customers” for additional information regarding the adoption of ASU 2016-13 Changes in the estimate of credit losses for trade accounts receivable are presented in the table below.
(In thousands)
Total
Balance at December 31, 2020
$
31,596
Current period provision
2,110
Write-offs
(4,164
)
Recoveries
480
Balance at September 30, 2021
$
30,022

Leases

Leases9 Months Ended
Sep. 30, 2021
Lessee Disclosure [Abstract]
Leases4. Leases We determine whether an arrangement is a lease at inception. Assets leased under an operating lease arrangement are recorded in Right-of-use assets – operating leases and the associated lease liabilities are included in Current operating lease liabilities and Long-term operating lease liabilities within the consolidated balance sheets. Assets leased under finance lease arrangements are recorded within fixed assets and the associated lease liabilities are recorded within Accrued expenses and Other liabilities within the consolidated balance sheets. Right-of-use assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease right-of-use assets and liabilities are recognized at the commencement date based on the present value of lease payments over the expected lease term. Since our lease arrangements do not provide an implicit rate, we use our incremental borrowing rate in conjunction with the market swap rate for the expected remaining lease term at the commencement date for new leases in determining the present value of future lease payments. Our expected lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Operating lease expense is recognized on a straight-line basis over the lease term. We have elected the group of practical expedients under ASU 2016-02 to forego assessing upon adoption: (1) whether any expired contracts are or contain leases; (2) the lease classification for any existing or expired leases and (3) any indirect costs that would have qualified for capitalization for any existing leases. We have lease agreements with lease and non-lease components, which are generally accounted for separately except for real estate and vehicle leases, which we have elected to combine through a practical expedient under ASU 2016-02. Non-lease components for our leases typically consist of executory costs, and the practical expedient allows for executory costs to be recorded as lease payments. Additionally, for certain equipment leases, we apply a portfolio approach to effectively record right-of-use assets and liabilities. Our operating leases mainly include office leases and our finance leases include office and computer equipment leases. Our finance leases are not significant. Our leases have remaining lease terms up to 7 years, some of which include options to extend the leases for up to 5 years, which may include options to terminate the leases within 1 year. Operating costs associated with leased assets are as follows:
(In thousands)
Three Months Ended September 30,
Nine Months Ended September 30,
2021
2020
2021
2020
Operating lease cost (1)
$
5,366
$
6,251
$
17,063
$
19,265
Less: Sublease income
(64
)
(257
)
(221
)
(1,026
)
Total operating lease costs
$
5,302
$
5,994
$
16,842
$
18,239
(1)
Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statements of operations. Supplemental cash flow information for operating leases is as follows:
(In thousands)
Nine Months Ended September 30,
2021
2020
Operating cash flows from operating leases
$
16,035
$
20,571
Right-of-use assets obtained in exchange for operating lease obligations
$
307
$
22,262
The balance sheet location and balances for operating leases are as follows:
(In thousands, except lease term and discount rate)
September 30, 2021
December 31, 2020
Right-of-use assets - operating leases
$
70,297
$
96,601
Current operating lease liabilities
$
19,264
$
22,264
Long-term operating lease liabilities
$
67,057
$
93,463
Weighted average remaining lease term (in years)
5
6
Weighted average discount rate
3.3
%
3.6
% The future maturities of our leasing arrangements including lease and non-lease components are shown in the below table. The maturities are calculated using foreign currency exchange rates in effect as of September 30, 2021.
September 30, 2021
(In thousands)
Operating Leases
Remainder of 2021
$
5,669
2022
21,469
2023
19,650
2024
14,105
2025
12,748
Thereafter
20,130
Total lease liabilities
93,771
Less: Amount representing interest
(7,450
)
Less: Short-term lease liabilities
(19,264
)
Total long-term lease liabilities
$
67,057

Business Combinations and Dives

Business Combinations and Divestitures9 Months Ended
Sep. 30, 2021
Business Combinations [Abstract]
Business Combinations and Divestitures5. Business Combinations and Divestitures Acquisitions On July 2, 2019, we acquired the Pinnacle and Diabetes Collaborative Registries from the American College of Cardiology (“ACC”) as part of our broader strategic partnership with the ACC. The total purchase price was $19.7 million, consisting of an initial payment of $11.7 million plus up to an aggregate of $8.0 million pending the attainment of certain milestones over the next 18 months. The contingent consideration of up to $8.0 million was valued at $5.0 million at the time of closing. As part of this partnership, we operate Pinnacle and Diabetes Collaborative Registries, which extends our EHR-enabled ambulatory network to create a large-scale chronic disease network. During the first quarter of 2021, we extended the ACC earnout agreement to June 30, 2021. In the second quarter of 2021, we paid $0.9 million related to the earnout agreement. The remaining payment was accrued as contingent consideration within our consolidated financial statements. Refer to Note 6, “Fair Value Measurements and Long-term Investments” for additional information regarding the contingent consideration. The business is included in our Veradigm business segment. Divestitures On August 23, 2021, we completed the sale of substantially all of the assets of our 2bPrecise business to a third party for a non-controlling interest in the combined entity. We realized a pre-tax gain upon the sale of $8.4 million, which was included in the Gain on sale of businesses, net line in our consolidated statements of operations for the three and nine months ended September 30, 2021. The 2bPrecise business was previously reported within our Data, Analytics and Care Coordination segment. However, due to the reportable segment changes in the third quarter of 2021, the historical 2bPrecise business is now presented in our “Unallocated Amounts” category. Refer to Note 16, “Business Segments” for additional information. On December 31, 2020, we completed the sale of substantially all of the assets of our CarePort business to a subsidiary of WellSky Corp., a Delaware corporation (“WellSky”), pursuant to a purchase agreement (the “CarePort Purchase Agreement”). The total consideration for CarePort was $1.35 billion, which was subject to certain adjustments for liabilities assumed by WellSky and net working capital as described in the CarePort Purchase Agreement. We realized a pre-tax gain upon the sale of $933.9 million, which was included in the Gain on sale of discontinued operations line in our consolidated statements of operations for the year ended December 31, 2020. For the nine months ended September 30, 2021, we recorded a $0.6 million gain that primarily related to net working capital adjustments in the Gain on sale of discontinued operations line in our consolidated statements of operations. The divestiture was treated as a discontinued operation as of December 31, 2020. Refer to Note 15, “Discontinued Operations” for additional information. On December 31, 2020, we repaid $161.0 million of the Term Loan (as defined below) as a result of the sale, which was a mandatory prepayment in accordance with the Second Amended Credit Agreement (as defined below). On October 15, 2020, we completed the sale of substantially all of the assets of our EPSi TM Strata Decision Technology LLC, an Illinois limited liability company (“Strata”), and Roper Technologies, Inc., a Delaware corporation, pursuant to a purchase agreement (the “EPSi Purchase Agreement”) . Refer to Note 15, “Discontinued Operations” for additional information. On October 29, 2020, we repaid $19.0 million of the Term Loan (as defined below) as a result of the sale, which was a mandatory prepayment in accordance with the Second Amended Credit Agreement (as defined below).

Fair Value Measurements and Lon

Fair Value Measurements and Long-term Investments9 Months Ended
Sep. 30, 2021
Fair Value Disclosures [Abstract]
Fair Value Measurements and Long-term Investments6. Fair Value Measurements and Long-term Investments Fair value measurements are based upon observable and unobservable inputs. Level 1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities at the measurement date. Level 2: Quoted prices for similar instruments in active markets with inputs that are observable, either directly or indirectly. Our Level 2 derivative financial instruments include foreign currency forward contracts valued based upon observable values of spot and forward foreign currency exchange rates. Level 3: Unobservable inputs are significant to the fair value of the asset or liability, and include situations where there is little, if any, market activity for the asset or liability. Our Level 3 instrument includes the fair value of contingent consideration related to a completed acquisition. The fair value is based on a discounted cash flow analysis reflecting the likelihood of achieving specified performance measures or events and captures the contractual nature of the contingencies, commercial risk, or time value of money. The following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates:
Balance Sheet
September 30, 2021
December 31, 2020
(In thousands)
Classifications
Level 1
Level 2
Level 3
Total
Level 1
Level 2
Level 3
Total
Foreign exchange derivative assets
Prepaid expenses and other current assets
$
0
$
0
$
0
$
0
$
0
$
1,509
$
0
$
1,509
Total assets
$
0
$
0
$
0
$
0
$
0
$
1,509
$
0
$
1,509
Contingent consideration - current
Accrued expenses
$
0
$
0
$
153
$
153
$
0
$
0
$
1,011
$
1,011
Total liabilities
$
0
$
0
$
153
$
153
$
0
$
0
$
1,011
$
1,011
The changes in our Level 3 liability measured at fair value on a recurring basis at September 30, 2021 is summarized as follows:
(In thousands)
Contingent Consideration
Balance at December 31, 2020
$
1,011
Payments
(858
)
Balance at September 30, 2021
$
153
The following table summarizes the quantitative information about our Level 3 fair value measurements at September 30, 2021:
September 30, 2021
(In thousands, except the discount rate)
Fair Value
Valuation Technique
Significant Unobservable Inputs
Ranges of Inputs
Weighted Average (1)
Financial instruments:
Contingent consideration
$
153
Probability Weighted Discounted cash flow
Discount rate
5.3% to 5.5%
5.4
%
Registry members
0 to 1,551
776
Patient data volume
0 to 52,845
26,422
Projected year of payment
2021
Total financial instruments
$
153
(1)
The weighted average is calculated based upon the absolute fair value of the instruments. Long-term Investments The following table summarizes our long-term equity investments which are included in Other assets in the accompanying consolidated balance sheets:
Number of Investees
Original
Carrying Value at
(In thousands, except for number of investees)
at September 30, 2021
Cost
September 30, 2021
December 31, 2020
Equity method investments (1)
3
$
7,099
$
10,181
$
10,744
Cost less impairment
8
49,336
49,127
25,059
Total long-term equity investments
11
$
56,435
$
59,308
$
35,803
(1)
Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag. During the three months ended September 30, 2021, we divested one of our businesses to a new third-party in exchange for a non-controlling interest in the combined entity, which is a cost method investment. The divestiture resulted in an $8.4 million gain, which is included in the Gain on sale of businesses, net line in our consolidated statements of operations for the three and nine months ended September 30, 2021. During the nine months ended September 30, 2021, one of our third-party cost method investments converted its notes and we received 475 thousand shares as a result of the conversion. We also revalued our existing investment based on the note conversion share price. The note conversion and the revaluation of the existing investment resulted in a $9.7 million gain, which is included in the Other income (loss), net line in our consolidated statements of operations for the nine months ended September 30, 2021 During the nine months ended September 30, 2020, we recorded a $16.8 million gain from the sale of a third-party equity method investment. As of September 30, 2021, it is not possible to estimate the fair value of our non-marketable cost and equity method investments, primarily because of their illiquidity and restricted marketability. The factors we considered in trying to determine fair value include, but are not limited to, available financial information, the issuer’s ability to meet its current obligations, the issuer’s subsequent or planned raises of capital and observable price changes in orderly transactions. Impairment of Long-term Investments Each quarter, management performs an assessment of each of our investments on an individual basis to determine if there have been any declines in fair value. Based on our assessment, we determined no impairment charges were necessary for the nine months ended September 30, 2021. Long-term Financial Liabilities Our long-term financial liabilities include amounts outstanding under our senior secured credit facility (as described in Note 10, “Debt”), with carrying values that approximate fair value since the interest rates approximate current market rates. Refer to Note 10, “Debt,” for further information regarding our long-term financial liabilities.

Stockholders' Equity

Stockholders' Equity9 Months Ended
Sep. 30, 2021
Equity [Abstract]
Stockholders' Equity7. Stockholders' Equity Stock-based Compensation Expense Stock-based compensation expense recognized during the three and nine months ended September 30, 2021 and 2020 is included in our consolidated statements of operations as shown in the below table. Stock-based compensation expense includes both non-cash expense related to grants of stock-based awards as well as cash expense related to the employee discount applied to purchases of our common stock under our employee stock purchase plan. No stock-based compensation costs were capitalized during the three and nine months ended September 30, 2021 and 2020.
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Cost of revenue:
Software delivery, support and maintenance
$
305
$
295
$
1,112
$
1,213
Client services
816
1,519
3,162
3,418
Total cost of revenue
1,121
1,814
4,274
4,631
Selling, general and administrative expenses
7,832
6,728
23,426
18,851
Research and development
1,361
2,127
4,828
5,950
Total stock-based compensation expense
$
10,314
$
10,669
$
32,528
$
29,432
Allscripts Long-Term Incentive Plan We measure stock-based compensation expense at the grant date based on the fair value of the award. We recognize the expense for service-based share awards over the requisite service period on a straight-line basis, net of estimated forfeitures. We recognize the expense for performance-based and market-based share awards over the vesting period under the accelerated attribution method, net of estimated forfeitures. In addition, we recognize stock-based compensation cost for awards with performance conditions if and when we conclude that it is probable that the performance conditions will be achieved. The fair value of service-based and performance-based restricted stock units is measured at the underlying closing share price of our common stock on the date of grant. The fair value of market-based restricted stock units is measured using the Monte Carlo pricing model. No stock options were granted during the three and nine months ended September 30, 2021 and 2020. We granted stock-based awards as follows:
Three Months Ended September 30, 2021
Nine Months Ended September 30, 2021
Weighted-Average
Weighted-Average
Grant Date
Grant Date
(In thousands, except per share amounts)
Shares
Fair Value
Shares
Fair Value
Service-based restricted stock units
42
$
16.59
2,487
$
15.38
Performance-based restricted stock units with a service condition
33
$
15.35
268
$
15.18
Market-based restricted stock units with a service condition
0
$
0.00
235
$
17.19
75
$
16.04
2,990
$
15.51
During the nine months ended September 30, 2021 and the year ended December 31, 2020, 2.1 million and 1.9 million shares of common stock, respectively, were issued in connection with the release of restrictions on stock awards. Net Share-settlements Upon vesting, restricted stock units are generally net share-settled to cover the required withholding tax, and the remaining amount is converted into an equivalent number of shares of common stock. The majority of restricted stock units and awards that vested during the nine months ended September 30, 2021 and 2020 were net-share settled such that we withheld shares with fair value equivalent to the employees’ minimum statutory obligation for the applicable income and other employment taxes and remitted the cash to the appropriate taxing authorities. Total payments for the employees' minimum statutory tax obligations to the taxing authorities are reflected as a financing activity within the accompanying consolidated statements of cash flows. The total shares withheld for the nine months ended September 30, 2021 and 2020 were 900 thousand and 770 thousand, respectively, and were based on the value of the restricted stock units on their vesting date as determined by our closing stock price. These net-share settlements had the effect of share repurchases by us as they reduced the number of shares that would have otherwise been issued as a result of the vesting. Stock Repurchases On November 18, 2020, we announced that our Board approved a stock purchase program (the “2020 Program”) under which we may repurchase up to $300 million of our common stock through December 31, 2021. The 2020 Program replaced a previous program and the 2020 program was fully exhausted by May of 2021. During the nine months ended September 30, 2021, we repurchased 5.6 million shares of our common stock under the 2020 Program, which was inclusive of the shares we received at final settlement of the accelerated share repurchase program we entered into on November 30, 2020, described below. During the three months ended September 30, 2020, we repurchased 5.0 million shares of our common stock under the previous program for a total of $45.6 million. During the nine months ended September 30, 2020, we repurchased 6.5 million shares of our common stock under the previous program for a total of $55.3 million. On May 26, 2021, we announced that our Board approved a new stock purchase program (the “2021 Program”) under which we may repurchase up to $350 million of our common stock. The 2021 Program replaced the 2020 Program and does not have a termination date. During the three months ended September 30, 2021, we received 2.4 million shares of our common stock at final settlement of the accelerated share repurchase program entered into on June 14, 2021, described below. During the nine months ended September 30, 2021, we repurchased 13.9 million shares of our common stock under the 2021 Program. This is inclusive of the shares we received at initial and final settlement of the accelerated share repurchase program entered into on June 14, 2021, described below. On November 30, 2020, we entered into separate Master Confirmations (each, a “Master Confirmation”) and Supplemental Confirmations (each, together with the related Master Confirmation, an “ASR Agreement”), with JPMorgan Chase Bank, National Association and Wells Fargo Bank, National Association (each, an “ASR Counterparty”, or collectively, the “ASR Counterparties”), to purchase shares of our common stock for a total payment of $200.0 million (the “Prepayment Amount”). Under the terms of the ASR Agreements, on November 30, 2020, we paid the Prepayment Amount to the ASR Counterparties and received on December 2, 2020 an initial delivery of approximately 11.7 million shares of our common stock, which is approximately 80% of the total number of shares that could be repurchased under the ASR Agreements if the final purchase price per share equaled the closing price of our common stock on November 30, 2020. These repurchased shares became treasury shares and were recorded as a $165.7 million reduction to stockholders’ equity. The remaining $34.3 million of the Prepayment Amount was recorded as a reduction to stockholders’ equity as an unsettled forward contract indexed to our common stock. The total number of shares received under the ASR Agreements, after final settlement, was based on the average daily volume weighted average price of our common stock during the repurchase period, less an agreed upon discount. Final settlement of the ASR Agreements occurred in May 2021, resulting in the receipt of 1.6 million additional shares, which yielded a weighted-average share repurchase price of approximately $15.07. On June 14, 2021, we entered into Supplemental Confirmations (each, a “June 2021 Supplemental Confirmation”) to the Master Confirmations dated November 30, 2020 (each, as supplemented by the corresponding June 2021 Supplemental Confirmation, a “June 2021 ASR Agreement”), with each of the ASR Counterparties, to purchase shares of our common stock for a total payment of $200.0 million (the “June 2021 Prepayment Amount”). Under the terms of the June 2021 ASR Agreements, on June 14, 2021, we paid the June 2021 Prepayment Amount to the ASR Counterparties and received on June 16, 2021 an initial delivery of approximately 9.1 million shares of our common stock, which is approximately 80% of the total number of shares that could be repurchased under the June 2021 ASR Agreements if the final purchase price per share equaled the closing price of our common stock on June 14, 2021. These repurchased shares became treasury shares and were recorded as a $161.2 million reduction to stockholders’ equity. The remaining $38.8 million of the June 2021 Prepayment Amount was recorded as a reduction to stockholders’ equity as an unsettled forward contract indexed to our common stock. The total number of shares received under the June 2021 ASR Agreements, after final settlement, was based on the average daily volume weighted average price of our common stock during the repurchase period, less an agreed upon discount. Final settlement of the June 2021 ASR Agreements occurred in August 2021, resulting in the receipt of 2.4 million additional shares, which yielded a weighted-average share repurchase price of approximately $17.28. The approximate dollar value of shares of our common stock that may yet be purchased under the 2021 Program was $108.4 million as of September 30, 2021. Any future stock repurchase transactions may be made through open market transactions, block trades, privately negotiated transactions (including accelerated share repurchase transactions) or other means, subject to market conditions. Any repurchase activity will depend on many factors such as our working capital needs, cash requirements for investments, debt repayment obligations, economic and market conditions at the time, including the price of our common stock, and other factors that we consider relevant. Our stock repurchase program may be accelerated, suspended, delayed or discontinued at any time.

Earnings (Loss) Per Share

Earnings (Loss) Per Share9 Months Ended
Sep. 30, 2021
Earnings Per Share [Abstract]
Earnings (Loss) Per Share8. Earnings (Loss) Per Share Basic earnings (loss) per share is computed by dividing net income (loss) by the weighted-average shares of common stock outstanding. For purposes of calculating diluted earnings (loss) per share, the denominator includes both the weighted-average shares of common stock outstanding and dilutive common stock equivalents. Dilutive common stock equivalents consist of restricted stock unit awards and warrants calculated under the treasury stock method. The calculations of earnings (loss) per share are as follows:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands, except per share amounts)
2021
2020
2021
2020
Basic earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax
$
16,194
$
(13,956
)
$
46,692
$
(67,920
)
(Loss) income from discontinued operations, net of tax
(14
)
14,498
471
40,503
Net income (loss)
$
16,180
$
542
$
47,163
$
(27,417
)
Weighted-average common shares outstanding
123,892
161,144
133,517
162,092
Basic earnings (loss) from continuing operations per Common Share
$
0.13
$
(0.09
)
$
0.35
$
(0.42
)
Basic earnings from discontinued operations per Common Share
0.00
0.09
0.00
0.25
Net earnings (loss) per Common Share
$
0.13
$
0.00
$
0.35
$
(0.17
)
Diluted earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax
$
16,194
$
(13,956
)
$
46,692
$
(67,920
)
(Loss) income from discontinued operations, net of tax
(14
)
14,498
471
40,503
Net income (loss)
$
16,180
$
542
$
47,163
$
(27,417
)
Weighted-average common shares outstanding
123,892
161,144
133,517
162,092
Plus: Dilutive effect of restricted stock unit awards and warrants
7,460
0
8,564
0
Weighted-average common shares outstanding assuming dilution
131,352
161,144
142,081
162,092
Diluted earnings (loss) from continuing operations per Common Share
$
0.12
$
(0.09
)
$
0.33
$
(0.42
)
Diluted earnings from discontinued operations per Common Share
0.00
0.09
0.00
0.25
Net earnings (loss) per Common Share
$
0.12
$
0.00
$
0.33
$
(0.17
) Due to the loss from continuing operations, net of tax and the net loss for the three and nine months ended September 30, 2020, respectively, we used basic weighted-average common shares outstanding in the calculation of diluted loss per share, since the inclusion of any stock equivalents would be anti-dilutive. The following restricted stock unit awards and warrants are not included in the computation of diluted earnings (loss) per share as the effect of including such restricted stock unit awards and warrants in the computation would be anti-dilutive:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Shares subject to anti-dilutive restricted stock unit awards and warrants excluded from calculation
1,504
47,162
1,502
48,816

Goodwill and Intangible Assets

Goodwill and Intangible Assets9 Months Ended
Sep. 30, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets9. Goodwill and Intangible Assets Goodwill and intangible assets consist of the following:
September 30, 2021
December 31, 2020
Gross
Gross
Carrying
Accumulated
Intangible
Carrying
Accumulated
Intangible
(In thousands)
Amount
Amortization
Assets, Net
Amount
Amortization
Assets, Net
Intangibles subject to amortization:
Proprietary technology
$
534,999
$
(485,810
)
$
49,189
$
535,092
$
(465,292
)
$
69,800
Customer contracts and relationships
674,034
(526,815
)
147,219
674,336
(509,534
)
164,802
Total
$
1,209,033
$
(1,012,625
)
$
196,408
$
1,209,428
$
(974,826
)
$
234,602
Intangibles not subject to amortization:
Registered trademarks
$
52,000
$
52,000
Goodwill
974,427
974,729
Total
$
1,026,427
$
1,026,729
Changes in the carrying amounts of goodwill by reportable segment for the nine months ended September 30, 2021 were as follows:
(In thousands)
Hospital & Large Physician Practices
Veradigm
Unallocated
Total
Balance as of December 31, 2020
531,393
433,188
10,148
974,729
Foreign exchange translation
(302
)
0
0
(302
)
Balance as of September 30, 2021
$
531,091
$
433,188
$
10,148
$
974,427
There were no accumulated impairment losses associated with goodwill as of September 30, 2021 and December 31, 2020.

Debt

Debt9 Months Ended
Sep. 30, 2021
Debt Disclosure [Abstract]
Debt10. Debt Debt outstanding, excluding lease obligations, consists of the following:
September 30, 2021
December 31, 2020
(In thousands)
Principal Balance
Unamortized Discount and Debt Issuance Costs
Net Carrying Amount
Principal Balance
Unamortized Discount and Debt Issuance Costs
Net Carrying Amount
0.875% Convertible Senior Notes (1)
$
167,853
$
(7,578
)
$
175,431
$
167,853
$
(3,166
)
$
171,019
Senior Secured Credit Facility
200,000
2,244
197,756
0
3,432
(3,432
)
Total debt
$
367,853
$
(5,334
)
$
373,187
$
167,853
$
266
$
167,587
(1)
Principal balance is $207,911 thousand; $167,853 thousand is recognized in debt and $40,058 thousand is recognized in additional paid-in capital. Interest expense consists of the following:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Interest expense
$
1,742
$
4,651
$
4,109
$
14,199
Amortization of discounts and debt issuance costs
1,875
2,016
5,600
13,447
Total interest expense
$
3,617
$
6,667
$
9,709
$
27,646
Interest expense related to the 0.875% Convertible Senior Notes and the 1.25% Cash Convertible Senior Notes (which matured and were repaid in full on July 1, 2020), included in the table above, consisted of the following:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Coupon interest
$
454
$
451
$
1,364
$
3,561
Amortization of discounts and debt issuance costs
1,479
1,454
4,412
12,030
Total interest expense related to the convertible notes
$
1,933
$
1,905
$
5,776
$
15,591
Allscripts Senior Secured Credit Facility On February 15, 2018, Allscripts and Allscripts Healthcare LLC entered into a Second Amended and Restated Credit Agreement (the “Second Amended Credit Agreement”), with JPMorgan Chase Bank, N.A., as administrative agent. The Second Amended Credit Agreement provides for a $400 million senior secured term loan (the “Term Loan”) and a $900 million senior secured revolving facility (the “Revolving Facility”), each with a five-year As of September 30, 2021, $200.0 million under the Revolving Facility and $1.0 million in letters of credit were outstanding under the Second Amended Credit Agreement. As of September 30, 2021, the interest rate on the borrowings under the Second Amended Credit Agreement was LIBOR plus 1.50%, which totaled 1.58%. We were in compliance with all covenants under the Second Amended Credit Agreement as of September 30, 2021. In connection with the sale of our EPSi which is further discussed in Note 5, “Business Combinations and Divestitures”, the terms of our Second Amended Credit Agreement required us to make a mandatory prepayment of our Term Loan in the amount of $19.0 million on October 29, 2020. In connection with the sale of our CarePort business on December 31, 2020, which is further discussed in Note 5, “Business Combinations and Divestitures”, the terms of our Second Amended Credit Agreement required us to make a mandatory prepayment of our Term Loan in the amount of $161.0 million on December 31, 2020. On August 7, 2019, we entered into a First Amendment to the Second Amended Credit Agreement in order to remain compliant with the covenants of our Second Amended Credit Agreement. The First Amendment provided the financial flexibility to settle the U.S. Department of Justice’s investigations as discussed in Note 14, “Contingencies”, while maintaining our compliance with the covenants of our Second Amended Credit Agreement. None of the original terms of our Second Amended Credit Agreement relating to scheduled future principal payments, applicable interest rates and margins or borrowing capacity under our Revolving Facility were amended. On July 20, 2020, we entered into a Second Amendment to the Second Amended Credit Agreement. None of the original terms of our Second Amended Credit Agreement relating to scheduled future principal payments, applicable interest rates and margins or borrowing capacity under our Revolving Facility were amended. In connection with this amendment, we incurred fees and other costs totaling $1.4 million, of which a majority was capitalized. As of September 30, 2021, we had $699.0 million available borrowing capacity, net of outstanding letters of credit, under the Revolving Facility. There can be no assurance that we will be able to draw on the full available balance of the Revolving Facility if the financial institutions that have extended such credit commitments become unwilling or unable to fund such borrowings or if we are unable to maintain compliance with applicable covenants. 0.875% Convertible Senior Notes The issuance in December 2019 of the combined $ 218.0 0.7 million in debt issuance costs, which were paid in January 2020. We have separately recorded liability and equity components of the 0.875% Convertible Senior Notes, including any discounts and issuance costs, by allocating the proceeds from the issuance between the liability component and the embedded conversion option, or equity component. This allocation was completed by first estimating an interest rate at the time of issuance for similar notes that do not include an embedded conversion option. The semi-annual interest rate of 1.95 % was used to compute the initial fair value of the liability component, which totaled $ 177.9 time of issuance. The excess of the initial proceeds received from the 0.875% Convertible Senior Notes and the $177.9 million liability component was allocated to the equity component, which totaled $ 40.1 17.2 1.1 Future Debt Payments The following table summarizes future debt principal payment obligations as of September 30, 2021:
(In thousands)
Total
Remainder of 2021
2022
2023
2024
2025
Thereafter
0.875% Convertible Senior Notes (1)
$
207,911
$
0
$
0
$
0
$
0
$
0
$
207,911
Revolving Facility (2)
200,000
0
0
200,000
0
0
0
Total debt
$
407,911
$
0
$
0
$
200,000
$
0
$
0
$
207,911
(1)
Amount represents face value of the 0.875% Convertible Senior Notes, which includes both the liability and equity portion.
(2)
Assumes no additional borrowings after September 30, 2021, payment of any required periodic installments of principal when due and that all drawn amounts are repaid upon maturity.

Income Taxes

Income Taxes9 Months Ended
Sep. 30, 2021
Income Tax Disclosure [Abstract]
Income Taxes11. Income Taxes We account for income taxes under FASB Accounting Standards Codification 740, “ Income Taxes”
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands, except effective tax rate)
2021
2020
2021
2020
Income (loss) from continuing operations before income taxes
$
21,293
$
(18,072
)
$
56,646
$
(74,561
)
Income tax (provision) benefit
$
(5,099
)
$
4,116
$
(9,954
)
$
6,641
Effective tax rate
23.9
%
22.8
%
17.6
%
8.9
% Our provision for income taxes differs from the tax computed at the U.S. federal statutory income tax rate primarily due to permanent differences, income attributable to foreign jurisdictions taxed at different rates, state taxes, tax credits and certain discrete items including a windfall benefit of $4.6 million for the nine months ended September 30, 2021 and a shortfall expense of $6.9 million for the nine months ended September 30, 2020. Our effective tax rates for the three and nine months ended September 30, 2021, compared with the prior year comparable periods, differ primarily due to the fact that the permanent items, credits and the impact of foreign earnings had more impact on the pre-tax income of $21.3 million and $56.6 million in the three and nine months ended September 30, 2021, respectively, compared to the impact of these items on a pre-tax loss of $18.1 million and $74.6 million for the three and nine months ended September 30, 2020, respectively. In evaluating our ability to recover our deferred tax assets within the jurisdictions from which they arise, we consider all available evidence, including scheduled reversals of deferred tax liabilities, tax-planning strategies, and results of recent operations. In evaluating the objective evidence that historical results provide, we consider three years of cumulative operating income (loss). During the nine months ended September 30, 2021, we released valuation allowances of $0.7 million related to U.S. and foreign net operating loss carryforwards. Our unrecognized income tax benefits were $29.9 million and $28.9 million as of September 30, 2021 and December 31, 2020, respectively. If any portion of our unrecognized tax benefits is recognized, it could impact our effective tax rate. The tax reserves are reviewed periodically and adjusted considering changing facts and circumstances, such as progress of tax audits, lapse of applicable statutes of limitations and changes in tax law.

Derivative Financial Instrument

Derivative Financial Instruments9 Months Ended
Sep. 30, 2021
Derivative Instruments And Hedging Activities Disclosure [Abstract]
Derivative Financial Instruments12. Derivative Financial Instruments The following tables provide information about the fair values of our derivative financial instruments as of the respective balance sheet dates:
September 30, 2021
Asset Derivatives
(In thousands)
Balance Sheet Location
Fair Value
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts
Prepaid expenses and other current assets
$
0
Total derivatives
$
0
December 31, 2020
Asset Derivatives
(In thousands)
Balance Sheet Location
Fair Value
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts
Prepaid expenses and other current assets
$
1,509
Total derivatives
$
1,509
Foreign Exchange Contracts We have entered into non-deliverable forward foreign currency exchange contracts with reputable banking counterparties to hedge a portion of our forecasted future Indian Rupee-denominated (“INR”) expenses against foreign currency fluctuations between the United States dollar and the INR. These forward contracts cover a percentage of forecasted monthly INR expenses over time. As of September 30, 2021, we had no forward contracts outstanding. In the future, we may enter into additional forward contracts to increase the amount of hedged monthly INR expenses or initiate hedges. The following tables show the impact of derivative instruments designated as cash flow hedges on the consolidated statements of operations and the consolidated statements of comprehensive loss:
Amount of Gain (Loss) Recognized in OCI
Amount of Gain (Loss) Reclassified from AOCI into Income
(In thousands)
Three Months Ended September 30, 2021
Nine Months Ended September 30, 2021
Location of Gain (Loss) Reclassified from AOCI into Income
Three Months Ended September 30, 2021
Nine Months Ended September 30, 2021
Foreign exchange contracts
$
0
$
121
Cost of Revenue
$
0
$
611
Selling, general and administrative expenses
0
351
Research and development
$
0
$
668
Amount of Gain (Loss) Recognized in OCI
Amount of Gain (Loss) Reclassified from AOCI into Income
(In thousands)
Three Months Ended September 30, 2020
Nine Months Ended September 30, 2020
Location of Gain (Loss) Reclassified from AOCI into Income
Three Months Ended September 30, 2020
Nine Months Ended September 30, 2020
Foreign exchange contracts
$
1,280
$
1,798
Cost of Revenue
$
107
$
71
Selling, general and administrative expenses
52
34
Research and development
$
111
$
73

Accumulated Other Comprehensive

Accumulated Other Comprehensive Loss9 Months Ended
Sep. 30, 2021
Equity [Abstract]
Accumulated Other Comprehensive Loss13. Accumulated Other Comprehensive Loss Accumulated Other Comprehensive Loss Changes in the balances of each component included in accumulated other comprehensive income (loss) (“AOCI”) are presented in the tables below. All amounts are net of tax.
(In thousands)
Foreign Currency Translation Adjustments
Unrealized Net Gains (Losses) on Foreign Exchange Contracts
Total
Balance as of December 31, 2020 (1)
$
(2,957
)
$
1,119
$
(1,838
)
Other comprehensive (loss) income before reclassifications
(285
)
90
(195
)
Net losses (gains) reclassified from accumulated other comprehensive loss
0
(1,209
)
(1,209
)
Net other comprehensive income (loss)
(285
)
(1,119
)
(1,404
)
Balance as of September 30, 2021
$
(3,242
)
$
0
$
(3,242
)
(1)
Net of taxes of $390 thousand for unrealized net gains on foreign exchange contract derivatives.
(In thousands)
Foreign Currency Translation Adjustments
Unrealized Net Gains (Losses) on Foreign Exchange Contracts
Total
Balance as of December 31, 2019 (1)
$
(4,392
)
$
0
$
(4,392
)
Other comprehensive (loss) income before reclassifications
(611
)
1,334
723
Net losses (gains) reclassified from accumulated other comprehensive loss
0
(132
)
(132
)
Net other comprehensive income (loss)
(611
)
1,202
591
Balance as of September 30, 2020 (2)
$
(5,003
)
$
1,202
$
(3,801
)
(1)
Net of taxes of $149 thousand arising from the revaluation of tax effects included in AOCI.
(2)
Net of taxes of $418 thousand for unrealized net gains on foreign exchange contract derivatives. Income Tax Effects Related to Components of Other Comprehensive Income (Loss) The following tables reflect the tax effects allocated to each component of other comprehensive income (loss) (“OCI”):
Three Months Ended September 30,
2021
2020
(In thousands)
Before-Tax Amount
Tax Effect
Net Amount
Before-Tax Amount
Tax Effect
Net Amount
Foreign currency translation adjustments
$
(805
)
$
0
$
(805
)
$
983
$
0
$
983
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period
0
0
0
1,280
(330
)
950
Net (gains) losses reclassified into income
0
0
0
(271
)
70
(201
)
Net change in unrealized gains (losses) on foreign exchange contracts
0
0
0
1,009
(260
)
749
Other comprehensive (loss) income
$
(805
)
$
0
$
(805
)
$
1,992
$
(260
)
$
1,732
Nine Months Ended September 30,
2021
2020
(In thousands)
Before-Tax Amount
Tax Effect
Net Amount
Before-Tax Amount
Tax Effect
Net Amount
Foreign currency translation adjustments
$
(285
)
$
0
$
(285
)
$
(611
)
$
0
$
(611
)
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period
121
(31
)
90
1,798
(464
)
1,334
Net (gains) losses reclassified into income
(1,630
)
421
(1,209
)
(178
)
46
(132
)
Net change in unrealized (losses) gains on foreign exchange contracts
(1,509
)
390
(1,119
)
1,620
(418
)
1,202
Other comprehensive (loss) income
$
(1,794
)
$
390
$
(1,404
)
$
1,009
$
(418
)
$
591

Contingencies

Contingencies9 Months Ended
Sep. 30, 2021
Commitments And Contingencies Disclosure [Abstract]
Contingencies14. Contingencies In addition to commitments and obligations in the ordinary course of business, we are currently subject to various legal proceedings and claims that have not been fully adjudicated. We intend to vigorously defend ourselves, as appropriate, in these matters. No less than quarterly, we review the status of each significant matter and assess our potential financial exposure. We accrue a liability for an estimated loss if the potential loss from any legal proceeding or claim is considered probable and the amount can be reasonably estimated. Significant judgment is required in both the determination of probability and the determination as to whether the amount of an exposure is reasonably estimable, and accruals are based only on the information available to our management at the time the judgment is made. The outcome of legal proceedings is inherently uncertain, and we may incur substantial defense costs and expenses defending any of these matters. In the opinion of our management, the ultimate disposition of pending legal proceedings or claims will not have a material adverse effect on our consolidated financial position, liquidity or results of operations. However, if one or more of these legal proceedings were resolved against or settled by us in a reporting period for amounts in excess of our management’s expectations, our consolidated financial statements for that and subsequent reporting periods could be materially adversely affected. Additionally, the resolution of a legal proceeding against us could prevent us from offering our products and services to current or prospective clients or cause us to incur increased compliance costs, either of which could further adversely affect our operating results. The Enterprise Information Solutions business (the “EIS Business”) acquired from McKesson Corporation (“McKesson”) on October 2, 2017 is subject to a May 2017 civil investigative demand (“CID”) related to the Horizon Clinicals software from the U.S. Attorney’s Office for the Eastern District of New York. In August 2018, McKesson received an additional CID (together with the May 2017 CID, the “McKesson CIDs”), which relates to the Paragon software. The McKesson CIDs request documents and information related to the certification McKesson obtained in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program. McKesson has agreed, with respect to the CIDs, to indemnify Allscripts for amounts paid or payable to the government (or any private relator) involving any products or services marketed, sold or licensed by the EIS Business as of or prior to the closing of the acquisition. In October 2021, Allscripts received a CID seeking information about its acquisition of the EIS Business from McKesson and the Horizon Clinicals software. McKesson has agreed to assume defense of this CID. Practice Fusion, acquired by Allscripts on February 13, 2018, received in March 2017 a request for documents and information from the U.S. Attorney’s Office for the District of Vermont pursuant to a CID. Between April 2018 and June 2019, Practice Fusion received from the U.S. Department of Justice (the “DOJ”) seven additional requests for documents and information through four additional CIDs and three Health Insurance Portability and Accountability Act (“HIPAA”) subpoenas. The document and information requests received by Practice Fusion related to both the certification Practice Fusion obtained in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program and Practice Fusion’s compliance with the Anti-Kickback Statute (“AKS”) and HIPAA as it relates to certain business practices engaged in by Practice Fusion. In March 2019, Practice Fusion received a grand jury subpoena in connection with a criminal investigation related to Practice Fusion’s compliance with the AKS. On August 6, 2019, Practice Fusion reached an agreement in principle with the DOJ to resolve all of the DOJ’s outstanding civil and criminal investigations, including the investigation by the U.S. Attorney’s Office for the District of Vermont, and we announced that on January 27, 2020, Practice Fusion entered into a deferred prosecution agreement (the “Deferred Prosecution Agreement”) and various civil settlement agreements, including with the Medicaid programs for each U.S. state, the District of Columbia and Puerto Rico (collectively, the “ Settlement Agreements ”) resolving the investigations conducted by the DOJ and the U.S. Attorney’s Office. The Settlement Agreements require d Practice Fusion to , among other matters, pay a criminal fine of $ 25.3 million , a forfeiture payment of $ 959,700 and a civil settlement of $ 118.6 million, which includes $ 5.2 million designated for the state Medicaid program expenditures , all of which , as of December 31, 2020, have been paid in full . The Deferred Prosecution Agreement required Practice Fusion to retain an Oversight Organization to oversee the Practice Fusion’s implementation of certain compliance measures and ongoing compliance efforts. On August 17, 2021, Practice Fusion’s initial Oversight Organization resigned, and on August 25, 2021, Practice Fusion received a notice from the U.S. Attorney’s Office for the District of Vermont stating Practice Fusion was in breach of the Deferred Prosecution Agreement due to such resignation. On September 17, 2021, Practice Fusion engaged a new Oversight Organization, and it continues to engage in discussions with the U.S. Attorney’s Office concerning the claim that a breach of the Deferred Prosecution Agreement occurred.

Discontinued Operations

Discontinued Operations9 Months Ended
Sep. 30, 2021
Discontinued Operations And Disposal Groups [Abstract]
Discontinued Operations15. Discontinued Operations During 2020, we implemented a strategic initiative to sell two of our businesses, EPSi and CarePort. Since both businesses were part of the same strategic initiative and were sold within the same period, the combined sale of EPSi and CarePort represented a strategic shift that had a major effect on our operations and financial results. As of December 31, 2020, these businesses were reported together as discontinued operations. On October 15, 2020, we completed the sale of our EPSi business. Prior to the sale, EPSi was part of the “Unallocated Amounts” category as it did not meet the requirements to be a reportable segment nor the criteria to be aggregated into our two reportable segments. On its own, the divestiture of the EPSi business did not represent a strategic shift that had a major effect on our operations and financial results. However, the combined sale of EPSi and CarePort represented a strategic shift that had a major effect on our operations and financial results. Therefore, EPSi was treated as a discontinued operation. On December 31, 2020, we completed the sale of our CarePort business. Prior to the sale, CarePort was part of the former Data, Analytics and Care Coordination reportable segment. On its own, the divestiture of the CarePort business represented a strategic shift that had a major effect on our operations and financial results. The following table summarizes the major classes of assets and liabilities of EPSi and CarePort, as reported on the consolidated balance sheets as of September 30, 2021 and December 31, 2020:
(In thousands)
September 30, 2021
December 31, 2020
Carrying amounts of major classes of liabilities associated with EPSi and CarePort included as part of discontinued operations:
Accrued expenses
$
1,708
$
6,669
Income tax payable
0
316,142
Total current liabilities attributable to discontinued operations
$
1,708
$
322,811
The following table summarizes the major income and expense line items of EPSi and CarePort as reported in the consolidated statements of operations for the three and nine months ended September 30, 2021 and 2020. The activity during the three and nine months ended September 30, 2021 relates to certain adjustments made in connection with the sale of EPSi and CarePort, primarily of which relates to net working capital adjustments that impacted the gain on the sale of the discontinued operations.
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Major income and expense line items related to EPSi and CarePort:
Revenue:
Software delivery, support and maintenance
$
6
$
32,894
$
6
$
96,807
Client services
0
3,517
0
11,883
Total revenue
6
36,411
6
108,690
Cost of revenue:
Software delivery, support and maintenance
15
2,900
(178
)
9,254
Client services
4
4,553
149
13,431
Amortization of software development and acquisition-related assets
0
2,499
0
7,623
Total cost of revenue
19
9,952
(29
)
30,308
Gross (loss) profit
(13
)
26,459
35
78,382
Selling, general and administrative expenses
2
3,788
76
12,974
Research and development
0
2,118
(32
)
7,133
Amortization of intangible assets
0
7
0
22
(Loss) income from discontinued operations for EPSi and CarePort
(15
)
20,546
(9
)
58,253
Interest expense
0
(995
)
0
(3,634
)
Other income, net
1
0
2
0
Gain on sale of discontinued operations
0
0
647
0
(Loss) income from discontinued operations for EPSi and CarePort before income taxes (1)
(14
)
19,551
640
54,619
Income tax provision
0
(5,047
)
(169
)
(14,098
)
(Loss) income from discontinued operations, net of tax for EPSi and CarePort (2)
$
(14
)
$
14,504
$
471
$
40,521
(1) (Loss) income from discontinued operations for EPSi and CarePort does not agree to the consolidated statements of operations for the three and nine months ended September 30, 2020, due to residual amounts related to Netsmart (as defined below) (2) (Loss) income from discontinued operations, net of tax for EPSi and CarePort does not agree to the consolidated statements of operations for the three and nine months ended September 30, 2020 due to residual amounts related to Netsmart (as defined below). Refer to Note 17, Supplemental Disclosures” for additional information.

Business Segments

Business Segments9 Months Ended
Sep. 30, 2021
Segment Reporting [Abstract]
Business Segments16. Business Segments We primarily derive our revenues from sales of our proprietary software (either as a direct license sale or under a subscription delivery model), which also serves as the basis for our recurring service contracts for software support and maintenance and certain transaction-related services. In addition, we provide various other client services, including installation, and managed services, such as outsourcing, private cloud hosting and revenue cycle management. During the third quarter of 2021, we realigned our reporting structure as a result of certain organizational changes. As a result, we changed the presentation of our reportable segments to Hospital and Large Physician Practices and Veradigm. As of September 30, 2021, we had two operating segments. The operating segments are equivalent to the reportable segments. The Hospital and Large Physician Practices segment derives its revenue from the sale of integrated clinical and financial management solutions, which primarily include EHR-related software, related installation, support and maintenance, outsourcing and private cloud hosting. The Veradigm segment derives its revenue from payer and life sciences solutions, which are mainly targeted at payers, life sciences companies and other key healthcare stakeholders; the sale of EHR software to single-specialty and small and mid-sized physician practices, including related clinical, financial, administrative and operational solutions; and software applications for patient engagement. These solutions enable clients to transition, analyze, coordinate care and improve the quality, efficiency and value of healthcare delivery across the entire care community. The “Unallocated Amounts” category consists of the 2bPrecise business, certain products that were shifted from the previous Core Clinical and Financial Solutions reportable segment due to the organizational changes (“Certain Products”), transfer pricing revenues and as of January 1, 2021 also includes certain corporate-related expenses. The amounts included in the “Unallocated Amounts” category for 2bPrecise and Certain Products do not meet the requirements to be reportable segments nor the criteria to be aggregated into the two reportable segments. The segment disclosures below have been revised to conform to the current year presentation. Our chief operating decision maker uses segment revenues, gross profit and income (loss) from operations as measures of performance and to make decisions about the allocation of resources. We do not track our assets by segment.
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Revenue:
Hospital and Large Physician Practices
$
225,685
$
233,630
$
695,427
$
712,538
Veradigm
137,168
125,073
396,987
385,525
Unallocated Amounts
6,419
6,915
18,924
18,223
Total revenue
$
369,272
$
365,618
$
1,111,338
$
1,116,286
Gross profit:
Hospital and Large Physician Practices
$
79,135
$
73,359
$
249,594
$
210,582
Veradigm
65,698
56,685
187,963
180,981
Unallocated Amounts
3,941
5,094
13,015
13,109
Total gross profit
$
148,774
$
135,138
$
450,572
$
404,672
Income (loss) from operations:
Hospital and Large Physician Practices
$
(6,160
)
$
(16,913
)
$
(6,995
)
$
(75,982
)
Veradigm
16,877
8,820
46,386
24,518
Unallocated Amounts
1,387
(3,068
)
(3,572
)
(11,338
)
Total income (loss) from operations
$
12,104
$
(11,161
)
$
35,819
$
(62,802
)

Supplemental Disclosures

Supplemental Disclosures9 Months Ended
Sep. 30, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Supplemental Disclosures17. Supplemental Disclosures Supplemental Consolidated Statements of Cash Flows Information The majority of the restricted cash balance as of September 30, 2021 represents lease deposits. The majority of the restricted cash balance as of September 30, 2020 represents lease deposits and an escrow account established as part of the acquisition of Netsmart LLC (“Netsmart”) in 2016, to be used by Netsmart to facilitate the integration of Allscripts’ former Homecare TM
September 30,
(In thousands)
2021
2020
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents
$
214,179
$
218,701
Restricted cash
2,141
6,209
Total cash, cash equivalents and restricted cash
$
216,320
$
224,910
Nine Months Ended September 30,
(In thousands)
2021
2020
Supplemental non-cash information:
Sale of 2bPrecise business in exchange for a non-controlling interest in the combined entity
$
11,768
$
0
Issuance of treasury stock to commercial partner
$
534
$
752

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policies)9 Months Ended
Sep. 30, 2021
Accounting Policies [Abstract]
Principles of ConsolidationPrinciples of Consolidation The consolidated financial statements include the accounts of Allscripts Healthcare Solutions, Inc. (“Allscripts”) and its wholly-owned subsidiaries and controlled affiliates. All significant intercompany balances and transactions have been eliminated. Each of the terms “we,” “us,” “our” or the “Company” as used herein refers collectively to Allscripts Healthcare Solutions, Inc. and its wholly-owned subsidiaries and controlled affiliates, unless otherwise stated.
Unaudited Interim Financial InformationUnaudited Interim Financial Information The unaudited interim consolidated financial statements as of and for the three and nine months ended September 30, 2021 and 2020 have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim financial reporting. These interim consolidated financial statements are unaudited and, in the opinion of our management, include all adjustments, consisting of normal recurring adjustments and accruals, necessary Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted in accordance with the SEC's rules and regulations for interim reporting. The Company believes that the disclosures made are adequate to make these unaudited interim consolidated financial statements not misleading. They should be read in conjunction with the consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2020 (our “Form 10-K”).
Use of EstimatesUse of Estimates The preparation of consolidated financial statements in accordance with GAAP requires us to make estimates and assumptions that affect the amounts reported and disclosed in the consolidated financial statements and the accompanying notes. Our estimates and assumptions consider the economic implications of COVID-19 on our critical and significant accounting estimates. Actual results could differ materially from these estimates.
Change in PresentationChange in Presentation During the third quarter of 2021, we changed our reportable segments from Core Clinical and Financial Solutions, Data, Analytics and Care Coordination, and Unallocated to Hospital and Large Physician Practices, Veradigm, and Unallocated. Certain business units reported within the historical segments have been reallocated into the new segments. Refer to Note 16 “Business Segments” for further discussion on the impact of the change. Certain reclassifications were made to prior period amounts in order to conform to the current period presentation. These reclassifications had no impact on the reported consolidated prior period financial results.
Recently Adopted Accounting PronouncementsSignificant Accounting Policies There have been no changes to our significant accounting policies from those disclosed in our Form 10-K. Recently Adopted Accounting Pronouncements In December 2019, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2019-12, “ Income Taxes (Topic 740)
Accounting Pronouncements Not Yet AdoptedAccounting Pronouncements Not Yet Adopted In August 2020, the FASB issued Accounting Standards Update No. 2020-06, “ Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity” We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, will have a material impact on our consolidated financial statements.
Revenue RecognitionRevenue Recognition We recognize revenue only when we satisfy an identified performance obligation (or bundle of obligations) by transferring control of a promised product or service to a customer. We consider a product or service to be transferred when a customer obtains control because a customer has sole possession of the right to use (or the right to direct the use of) the product or service for the remainder of its economic life or to consume the product or service in its own operations. We evaluate the transfer of control primarily from the customer’s perspective as this reduces the risk that revenue is recognized for activities that do not transfer control to the customer. The majority of our revenue is recognized over time because a customer continuously and simultaneously receives and consumes the benefits of our performance. The exceptions to this pattern are our sales of perpetual and term software licenses, and hardware, where we determined that a customer obtains control of the asset upon granting of access, delivery or shipment.

Revenue from Contracts with C_2

Revenue from Contracts with Customers (Tables)9 Months Ended
Sep. 30, 2021
Summary of Revenue Recognized on Various Performance Obligations and Elected Accounting ExpedientsThe breakdown of revenue recognized based on the origination of performance obligations and elected accounting expedients is presented in the table below:
(In thousands)
Three Months Ended March 31, 2021
Three Months Ended June 30, 2021
Three Months Ended September 30, 2021
Revenue related to deferred revenue balance at beginning of period
$
137,848
$
151,857
$
144,696
Revenue related to new performance obligations satisfied during the period
173,316
158,910
159,149
Revenue recognized under "right-to-invoice" expedient
56,811
62,422
64,820
Reimbursed travel expenses, shipping and other revenue
377
525
607
Total revenue
$
368,352
$
373,714
$
369,272
(In thousands)
Three Months Ended March 31, 2020
Three Months Ended June 30, 2020
Three Months Ended September 30, 2020
Revenue related to deferred revenue balance at beginning of period
$
105,366
$
119,545
$
118,300
Revenue related to new performance obligations satisfied during the period
216,580
195,308
192,658
Revenue recognized under "right-to-invoice" expedient
58,059
54,082
54,313
Reimbursed travel expenses, shipping and other revenue
1,359
369
347
Total revenue
$
381,364
$
369,304
$
365,618
Summary of Revenue by Type and Nature of Revenue Stream by Reportable SegmentsThe below tables summarize revenue by type and nature of revenue stream as well as by our reportable segments:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Revenue:
Recurring revenue
$
304,724
$
301,616
$
904,016
$
914,792
Non-recurring revenue
64,548
64,002
207,322
201,494
Total revenue
$
369,272
$
365,618
$
1,111,338
$
1,116,286
Summary of Changes in Estimate of Credit Losses for Contract AssetsChanges in the estimate of credit losses for contract assets are presented in the table below.
(In thousands)
Total
Balance at December 31, 2020
$
5,341
Current period provision
0
Balance at September 30, 2021
$
5,341
Less: Contract assets, short-term
1,068
Total contract assets, long-term
$
4,273
Revenue by Segment [Member]
Summary of Revenue by Type and Nature of Revenue Stream by Reportable SegmentsThree Months Ended September 30, 2021
(In thousands)
Hospital and Large Physician Practices
Veradigm
Unallocated Amounts
Total
Software delivery, support and maintenance
$
104,809
$
113,075
$
4,842
$
222,726
Client services
120,876
24,093
1,577
146,546
Total revenue
$
225,685
$
137,168
$
6,419
$
369,272
Three Months Ended September 30, 2020
(In thousands)
Hospital and Large Physician Practices
Veradigm
Unallocated Amounts
Total
Software delivery, support and maintenance
$
113,112
$
101,171
$
5,567
$
219,850
Client services
120,518
23,902
1,348
145,768
Total revenue
$
233,630
$
125,073
$
6,915
$
365,618
Nine Months Ended September 30, 2021
(In thousands)
Hospital and Large Physician Practices
Veradigm
Unallocated Amounts
Total
Software delivery, support and maintenance
$
333,277
$
323,462
$
14,101
$
670,840
Client services
362,150
73,525
4,823
440,498
Total revenue
$
695,427
$
396,987
$
18,924
$
1,111,338
Nine Months Ended September 30, 2020
(In thousands)
Hospital and Large Physician Practices
Veradigm
Unallocated Amounts
Total
Software delivery, support and maintenance
$
351,098
$
314,550
$
14,476
$
680,124
Client services
361,440
70,975
3,747
436,162
Total revenue
$
712,538
$
385,525
$
18,223
$
1,116,286

Accounts Receivable (Tables)

Accounts Receivable (Tables)9 Months Ended
Sep. 30, 2021
Trade Accounts Receivable [Member]
Accounts Notes And Loans Receivable [Line Items]
Schedule of Changes in Estimate of Credit Losses for Trade Accounts ReceivableChanges in the estimate of credit losses for trade accounts receivable are presented in the table below.
(In thousands)
Total
Balance at December 31, 2020
$
31,596
Current period provision
2,110
Write-offs
(4,164
)
Recoveries
480
Balance at September 30, 2021
$
30,022

Leases (Tables)

Leases (Tables)9 Months Ended
Sep. 30, 2021
Lessee Disclosure [Abstract]
Summary of Operating Costs Associated with Leased AssetsOperating costs associated with leased assets are as follows:
(In thousands)
Three Months Ended September 30,
Nine Months Ended September 30,
2021
2020
2021
2020
Operating lease cost (1)
$
5,366
$
6,251
$
17,063
$
19,265
Less: Sublease income
(64
)
(257
)
(221
)
(1,026
)
Total operating lease costs
$
5,302
$
5,994
$
16,842
$
18,239
(1)
Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statements of operations.
Supplemental Cash Flow Information for Operating LeasesSupplemental cash flow information for operating leases is as follows:
(In thousands)
Nine Months Ended September 30,
2021
2020
Operating cash flows from operating leases
$
16,035
$
20,571
Right-of-use assets obtained in exchange for operating lease obligations
$
307
$
22,262
Summary of Balance Sheet Location and Balances for Operating LeasesThe balance sheet location and balances for operating leases are as follows:
(In thousands, except lease term and discount rate)
September 30, 2021
December 31, 2020
Right-of-use assets - operating leases
$
70,297
$
96,601
Current operating lease liabilities
$
19,264
$
22,264
Long-term operating lease liabilities
$
67,057
$
93,463
Weighted average remaining lease term (in years)
5
6
Weighted average discount rate
3.3
%
3.6
%
Summary of Future Maturities of Lease and Non-Lease ComponentsThe future maturities of our leasing arrangements including lease and non-lease components are shown in the below table. The maturities are calculated using foreign currency exchange rates in effect as of September 30, 2021.
September 30, 2021
(In thousands)
Operating Leases
Remainder of 2021
$
5,669
2022
21,469
2023
19,650
2024
14,105
2025
12,748
Thereafter
20,130
Total lease liabilities
93,771
Less: Amount representing interest
(7,450
)
Less: Short-term lease liabilities
(19,264
)
Total long-term lease liabilities
$
67,057

Fair Value Measurements and L_2

Fair Value Measurements and Long-term Investments (Tables)9 Months Ended
Sep. 30, 2021
Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring BasisThe following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates:
Balance Sheet
September 30, 2021
December 31, 2020
(In thousands)
Classifications
Level 1
Level 2
Level 3
Total
Level 1
Level 2
Level 3
Total
Foreign exchange derivative assets
Prepaid expenses and other current assets
$
0
$
0
$
0
$
0
$
0
$
1,509
$
0
$
1,509
Total assets
$
0
$
0
$
0
$
0
$
0
$
1,509
$
0
$
1,509
Contingent consideration - current
Accrued expenses
$
0
$
0
$
153
$
153
$
0
$
0
$
1,011
$
1,011
Total liabilities
$
0
$
0
$
153
$
153
$
0
$
0
$
1,011
$
1,011
Summary of Changes in Liability Measured at Fair Value on Recurring BasisThe changes in our Level 3 liability measured at fair value on a recurring basis at September 30, 2021 is summarized as follows:
(In thousands)
Contingent Consideration
Balance at December 31, 2020
$
1,011
Payments
(858
)
Balance at September 30, 2021
$
153
Summary of Quantitative Information About Fair Value MeasurementsThe following table summarizes the quantitative information about our Level 3 fair value measurements at September 30, 2021:
September 30, 2021
(In thousands, except the discount rate)
Fair Value
Valuation Technique
Significant Unobservable Inputs
Ranges of Inputs
Weighted Average (1)
Financial instruments:
Contingent consideration
$
153
Probability Weighted Discounted cash flow
Discount rate
5.3% to 5.5%
5.4
%
Registry members
0 to 1,551
776
Patient data volume
0 to 52,845
26,422
Projected year of payment
2021
Total financial instruments
$
153
(1)
The weighted average is calculated based upon the absolute fair value of the instruments.
Long-Term Equity and Cost Method Investments [Member]
Summary of Long-term Equity Investments Included in Other AssetsThe following table summarizes our long-term equity investments which are included in Other assets in the accompanying consolidated balance sheets:
Number of Investees
Original
Carrying Value at
(In thousands, except for number of investees)
at September 30, 2021
Cost
September 30, 2021
December 31, 2020
Equity method investments (1)
3
$
7,099
$
10,181
$
10,744
Cost less impairment
8
49,336
49,127
25,059
Total long-term equity investments
11
$
56,435
$
59,308
$
35,803
(1)
Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)9 Months Ended
Sep. 30, 2021
Equity [Abstract]
Share-Based Compensation ExpenseThree Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Cost of revenue:
Software delivery, support and maintenance
$
305
$
295
$
1,112
$
1,213
Client services
816
1,519
3,162
3,418
Total cost of revenue
1,121
1,814
4,274
4,631
Selling, general and administrative expenses
7,832
6,728
23,426
18,851
Research and development
1,361
2,127
4,828
5,950
Total stock-based compensation expense
$
10,314
$
10,669
$
32,528
$
29,432
Share-Based Awards GrantedWe granted stock-based awards as follows:
Three Months Ended September 30, 2021
Nine Months Ended September 30, 2021
Weighted-Average
Weighted-Average
Grant Date
Grant Date
(In thousands, except per share amounts)
Shares
Fair Value
Shares
Fair Value
Service-based restricted stock units
42
$
16.59
2,487
$
15.38
Performance-based restricted stock units with a service condition
33
$
15.35
268
$
15.18
Market-based restricted stock units with a service condition
0
$
0.00
235
$
17.19
75
$
16.04
2,990
$
15.51

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)9 Months Ended
Sep. 30, 2021
Earnings Per Share [Abstract]
Calculations of Earnings (Loss) Per ShareThe calculations of earnings (loss) per share are as follows:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands, except per share amounts)
2021
2020
2021
2020
Basic earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax
$
16,194
$
(13,956
)
$
46,692
$
(67,920
)
(Loss) income from discontinued operations, net of tax
(14
)
14,498
471
40,503
Net income (loss)
$
16,180
$
542
$
47,163
$
(27,417
)
Weighted-average common shares outstanding
123,892
161,144
133,517
162,092
Basic earnings (loss) from continuing operations per Common Share
$
0.13
$
(0.09
)
$
0.35
$
(0.42
)
Basic earnings from discontinued operations per Common Share
0.00
0.09
0.00
0.25
Net earnings (loss) per Common Share
$
0.13
$
0.00
$
0.35
$
(0.17
)
Diluted earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax
$
16,194
$
(13,956
)
$
46,692
$
(67,920
)
(Loss) income from discontinued operations, net of tax
(14
)
14,498
471
40,503
Net income (loss)
$
16,180
$
542
$
47,163
$
(27,417
)
Weighted-average common shares outstanding
123,892
161,144
133,517
162,092
Plus: Dilutive effect of restricted stock unit awards and warrants
7,460
0
8,564
0
Weighted-average common shares outstanding assuming dilution
131,352
161,144
142,081
162,092
Diluted earnings (loss) from continuing operations per Common Share
$
0.12
$
(0.09
)
$
0.33
$
(0.42
)
Diluted earnings from discontinued operations per Common Share
0.00
0.09
0.00
0.25
Net earnings (loss) per Common Share
$
0.12
$
0.00
$
0.33
$
(0.17
)
Anti-Dilutive Stock Options, Restricted Stock Unit Awards and Warrants Excluded from Computation of Diluted Earnings (Loss) Per ShareThe following restricted stock unit awards and warrants are not included in the computation of diluted earnings (loss) per share as the effect of including such restricted stock unit awards and warrants in the computation would be anti-dilutive:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Shares subject to anti-dilutive restricted stock unit awards and warrants excluded from calculation
1,504
47,162
1,502
48,816

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)9 Months Ended
Sep. 30, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible AssetsGoodwill and intangible assets consist of the following:
September 30, 2021
December 31, 2020
Gross
Gross
Carrying
Accumulated
Intangible
Carrying
Accumulated
Intangible
(In thousands)
Amount
Amortization
Assets, Net
Amount
Amortization
Assets, Net
Intangibles subject to amortization:
Proprietary technology
$
534,999
$
(485,810
)
$
49,189
$
535,092
$
(465,292
)
$
69,800
Customer contracts and relationships
674,034
(526,815
)
147,219
674,336
(509,534
)
164,802
Total
$
1,209,033
$
(1,012,625
)
$
196,408
$
1,209,428
$
(974,826
)
$
234,602
Intangibles not subject to amortization:
Registered trademarks
$
52,000
$
52,000
Goodwill
974,427
974,729
Total
$
1,026,427
$
1,026,729
Changes in Carrying Amount of GoodwillChanges in the carrying amounts of goodwill by reportable segment for the nine months ended September 30, 2021 were as follows:
(In thousands)
Hospital & Large Physician Practices
Veradigm
Unallocated
Total
Balance as of December 31, 2020
531,393
433,188
10,148
974,729
Foreign exchange translation
(302
)
0
0
(302
)
Balance as of September 30, 2021
$
531,091
$
433,188
$
10,148
$
974,427

Debt (Tables)

Debt (Tables)9 Months Ended
Sep. 30, 2021
Debt Instrument [Line Items]
Debt Outstanding Excluding Lease ObligationsDebt outstanding, excluding lease obligations, consists of the following:
September 30, 2021
December 31, 2020
(In thousands)
Principal Balance
Unamortized Discount and Debt Issuance Costs
Net Carrying Amount
Principal Balance
Unamortized Discount and Debt Issuance Costs
Net Carrying Amount
0.875% Convertible Senior Notes (1)
$
167,853
$
(7,578
)
$
175,431
$
167,853
$
(3,166
)
$
171,019
Senior Secured Credit Facility
200,000
2,244
197,756
0
3,432
(3,432
)
Total debt
$
367,853
$
(5,334
)
$
373,187
$
167,853
$
266
$
167,587
(1)
Principal balance is $207,911 thousand; $167,853 thousand is recognized in debt and $40,058 thousand is recognized in additional paid-in capital.
Interest ExpenseInterest expense consists of the following:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Interest expense
$
1,742
$
4,651
$
4,109
$
14,199
Amortization of discounts and debt issuance costs
1,875
2,016
5,600
13,447
Total interest expense
$
3,617
$
6,667
$
9,709
$
27,646
Summary of Future Debt Payment ObligationsFuture Debt Payments The following table summarizes future debt principal payment obligations as of September 30, 2021:
(In thousands)
Total
Remainder of 2021
2022
2023
2024
2025
Thereafter
0.875% Convertible Senior Notes (1)
$
207,911
$
0
$
0
$
0
$
0
$
0
$
207,911
Revolving Facility (2)
200,000
0
0
200,000
0
0
0
Total debt
$
407,911
$
0
$
0
$
200,000
$
0
$
0
$
207,911
(1)
Amount represents face value of the 0.875% Convertible Senior Notes, which includes both the liability and equity portion.
(2)
Assumes no additional borrowings after September 30, 2021, payment of any required periodic installments of principal when due and that all drawn amounts are repaid upon maturity.
0.875% Convertible Senior Notes and the 1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Interest Expense Related to 0.875% Convertible Senior Notes and 1.25% Cash Convertible Senior NotesInterest expense related to the 0.875% Convertible Senior Notes and the 1.25% Cash Convertible Senior Notes (which matured and were repaid in full on July 1, 2020), included in the table above, consisted of the following:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Coupon interest
$
454
$
451
$
1,364
$
3,561
Amortization of discounts and debt issuance costs
1,479
1,454
4,412
12,030
Total interest expense related to the convertible notes
$
1,933
$
1,905
$
5,776
$
15,591

Income Taxes (Tables)

Income Taxes (Tables)9 Months Ended
Sep. 30, 2021
Income Tax Disclosure [Abstract]
Effective Tax RatesThe effective tax rates were as follows:
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands, except effective tax rate)
2021
2020
2021
2020
Income (loss) from continuing operations before income taxes
$
21,293
$
(18,072
)
$
56,646
$
(74,561
)
Income tax (provision) benefit
$
(5,099
)
$
4,116
$
(9,954
)
$
6,641
Effective tax rate
23.9
%
22.8
%
17.6
%
8.9
%

Derivative Financial Instrume_2

Derivative Financial Instruments (Tables)9 Months Ended
Sep. 30, 2021
Derivative Instruments And Hedging Activities Disclosure [Abstract]
Fair Value and Balance Sheet LocationsThe following tables provide information about the fair values of our derivative financial instruments as of the respective balance sheet dates:
September 30, 2021
Asset Derivatives
(In thousands)
Balance Sheet Location
Fair Value
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts
Prepaid expenses and other current assets
$
0
Total derivatives
$
0
December 31, 2020
Asset Derivatives
(In thousands)
Balance Sheet Location
Fair Value
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts
Prepaid expenses and other current assets
$
1,509
Total derivatives
$
1,509
Derivatives Instruments Designated as Cash Flow HedgesThe following tables show the impact of derivative instruments designated as cash flow hedges on the consolidated statements of operations and the consolidated statements of comprehensive loss:
Amount of Gain (Loss) Recognized in OCI
Amount of Gain (Loss) Reclassified from AOCI into Income
(In thousands)
Three Months Ended September 30, 2021
Nine Months Ended September 30, 2021
Location of Gain (Loss) Reclassified from AOCI into Income
Three Months Ended September 30, 2021
Nine Months Ended September 30, 2021
Foreign exchange contracts
$
0
$
121
Cost of Revenue
$
0
$
611
Selling, general and administrative expenses
0
351
Research and development
$
0
$
668
Amount of Gain (Loss) Recognized in OCI
Amount of Gain (Loss) Reclassified from AOCI into Income
(In thousands)
Three Months Ended September 30, 2020
Nine Months Ended September 30, 2020
Location of Gain (Loss) Reclassified from AOCI into Income
Three Months Ended September 30, 2020
Nine Months Ended September 30, 2020
Foreign exchange contracts
$
1,280
$
1,798
Cost of Revenue
$
107
$
71
Selling, general and administrative expenses
52
34
Research and development
$
111
$
73

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Loss (Tables)9 Months Ended
Sep. 30, 2021
Equity [Abstract]
Components of Accumulated Other Comprehensive LossChanges in the balances of each component included in accumulated other comprehensive income (loss) (“AOCI”) are presented in the tables below. All amounts are net of tax.
(In thousands)
Foreign Currency Translation Adjustments
Unrealized Net Gains (Losses) on Foreign Exchange Contracts
Total
Balance as of December 31, 2020 (1)
$
(2,957
)
$
1,119
$
(1,838
)
Other comprehensive (loss) income before reclassifications
(285
)
90
(195
)
Net losses (gains) reclassified from accumulated other comprehensive loss
0
(1,209
)
(1,209
)
Net other comprehensive income (loss)
(285
)
(1,119
)
(1,404
)
Balance as of September 30, 2021
$
(3,242
)
$
0
$
(3,242
)
(1)
Net of taxes of $390 thousand for unrealized net gains on foreign exchange contract derivatives.
(In thousands)
Foreign Currency Translation Adjustments
Unrealized Net Gains (Losses) on Foreign Exchange Contracts
Total
Balance as of December 31, 2019 (1)
$
(4,392
)
$
0
$
(4,392
)
Other comprehensive (loss) income before reclassifications
(611
)
1,334
723
Net losses (gains) reclassified from accumulated other comprehensive loss
0
(132
)
(132
)
Net other comprehensive income (loss)
(611
)
1,202
591
Balance as of September 30, 2020 (2)
$
(5,003
)
$
1,202
$
(3,801
)
(1)
Net of taxes of $149 thousand arising from the revaluation of tax effects included in AOCI.
(2)
Net of taxes of $418 thousand for unrealized net gains on foreign exchange contract derivatives.
Income Tax Effects Related to Components of Other Comprehensive Income (Loss)The following tables reflect the tax effects allocated to each component of other comprehensive income (loss) (“OCI”):
Three Months Ended September 30,
2021
2020
(In thousands)
Before-Tax Amount
Tax Effect
Net Amount
Before-Tax Amount
Tax Effect
Net Amount
Foreign currency translation adjustments
$
(805
)
$
0
$
(805
)
$
983
$
0
$
983
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period
0
0
0
1,280
(330
)
950
Net (gains) losses reclassified into income
0
0
0
(271
)
70
(201
)
Net change in unrealized gains (losses) on foreign exchange contracts
0
0
0
1,009
(260
)
749
Other comprehensive (loss) income
$
(805
)
$
0
$
(805
)
$
1,992
$
(260
)
$
1,732
Nine Months Ended September 30,
2021
2020
(In thousands)
Before-Tax Amount
Tax Effect
Net Amount
Before-Tax Amount
Tax Effect
Net Amount
Foreign currency translation adjustments
$
(285
)
$
0
$
(285
)
$
(611
)
$
0
$
(611
)
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period
121
(31
)
90
1,798
(464
)
1,334
Net (gains) losses reclassified into income
(1,630
)
421
(1,209
)
(178
)
46
(132
)
Net change in unrealized (losses) gains on foreign exchange contracts
(1,509
)
390
(1,119
)
1,620
(418
)
1,202
Other comprehensive (loss) income
$
(1,794
)
$
390
$
(1,404
)
$
1,009
$
(418
)
$
591

Discontinued Operations (Tables

Discontinued Operations (Tables)9 Months Ended
Sep. 30, 2021
EPSi and CarePort [Member]
Summary of Discontinued Operations in Financial StatementsThe following table summarizes the major classes of assets and liabilities of EPSi and CarePort, as reported on the consolidated balance sheets as of September 30, 2021 and December 31, 2020:
(In thousands)
September 30, 2021
December 31, 2020
Carrying amounts of major classes of liabilities associated with EPSi and CarePort included as part of discontinued operations:
Accrued expenses
$
1,708
$
6,669
Income tax payable
0
316,142
Total current liabilities attributable to discontinued operations
$
1,708
$
322,811
The following table summarizes the major income and expense line items of EPSi and CarePort as reported in the consolidated statements of operations for the three and nine months ended September 30, 2021 and 2020. The activity during the three and nine months ended September 30, 2021 relates to certain adjustments made in connection with the sale of EPSi and CarePort, primarily of which relates to net working capital adjustments that impacted the gain on the sale of the discontinued operations.
Three Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Major income and expense line items related to EPSi and CarePort:
Revenue:
Software delivery, support and maintenance
$
6
$
32,894
$
6
$
96,807
Client services
0
3,517
0
11,883
Total revenue
6
36,411
6
108,690
Cost of revenue:
Software delivery, support and maintenance
15
2,900
(178
)
9,254
Client services
4
4,553
149
13,431
Amortization of software development and acquisition-related assets
0
2,499
0
7,623
Total cost of revenue
19
9,952
(29
)
30,308
Gross (loss) profit
(13
)
26,459
35
78,382
Selling, general and administrative expenses
2
3,788
76
12,974
Research and development
0
2,118
(32
)
7,133
Amortization of intangible assets
0
7
0
22
(Loss) income from discontinued operations for EPSi and CarePort
(15
)
20,546
(9
)
58,253
Interest expense
0
(995
)
0
(3,634
)
Other income, net
1
0
2
0
Gain on sale of discontinued operations
0
0
647
0
(Loss) income from discontinued operations for EPSi and CarePort before income taxes (1)
(14
)
19,551
640
54,619
Income tax provision
0
(5,047
)
(169
)
(14,098
)
(Loss) income from discontinued operations, net of tax for EPSi and CarePort (2)
$
(14
)
$
14,504
$
471
$
40,521
(1) (Loss) income from discontinued operations for EPSi and CarePort does not agree to the consolidated statements of operations for the three and nine months ended September 30, 2020, due to residual amounts related to Netsmart (as defined below) (2) (Loss) income from discontinued operations, net of tax for EPSi and CarePort does not agree to the consolidated statements of operations for the three and nine months ended September 30, 2020 due to residual amounts related to Netsmart (as defined below). Refer to Note 17, Supplemental Disclosures” for additional information.

Business Segments (Tables)

Business Segments (Tables)9 Months Ended
Sep. 30, 2021
Segment Reporting [Abstract]
Revenues and Income (Loss) from Operations Related to Segment Within Reconciliation to Consolidated AmountsThree Months Ended September 30,
Nine Months Ended September 30,
(In thousands)
2021
2020
2021
2020
Revenue:
Hospital and Large Physician Practices
$
225,685
$
233,630
$
695,427
$
712,538
Veradigm
137,168
125,073
396,987
385,525
Unallocated Amounts
6,419
6,915
18,924
18,223
Total revenue
$
369,272
$
365,618
$
1,111,338
$
1,116,286
Gross profit:
Hospital and Large Physician Practices
$
79,135
$
73,359
$
249,594
$
210,582
Veradigm
65,698
56,685
187,963
180,981
Unallocated Amounts
3,941
5,094
13,015
13,109
Total gross profit
$
148,774
$
135,138
$
450,572
$
404,672
Income (loss) from operations:
Hospital and Large Physician Practices
$
(6,160
)
$
(16,913
)
$
(6,995
)
$
(75,982
)
Veradigm
16,877
8,820
46,386
24,518
Unallocated Amounts
1,387
(3,068
)
(3,572
)
(11,338
)
Total income (loss) from operations
$
12,104
$
(11,161
)
$
35,819
$
(62,802
)

Supplemental Disclosures (Table

Supplemental Disclosures (Tables)9 Months Ended
Sep. 30, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Supplemental DisclosuresThe majority of the restricted cash balance as of September 30, 2021 represents lease deposits. The majority of the restricted cash balance as of September 30, 2020 represents lease deposits and an escrow account established as part of the acquisition of Netsmart LLC (“Netsmart”) in 2016, to be used by Netsmart to facilitate the integration of Allscripts’ former Homecare TM
September 30,
(In thousands)
2021
2020
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents
$
214,179
$
218,701
Restricted cash
2,141
6,209
Total cash, cash equivalents and restricted cash
$
216,320
$
224,910
Nine Months Ended September 30,
(In thousands)
2021
2020
Supplemental non-cash information:
Sale of 2bPrecise business in exchange for a non-controlling interest in the combined entity
$
11,768
$
0
Issuance of treasury stock to commercial partner
$
534
$
752

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) - Accounting Standards Update 2019-12 [Member]Sep. 30, 2021
Basis Of Presentation And Significant Accounting Policies [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]true
Change in Accounting Principle, Accounting Standards Update, Adoption DateJan. 1,
2021
Change in Accounting Principle, Accounting Standards Update, Immaterial Effect [true false]true

Revenue from Contracts with C_3

Revenue from Contracts with Customers - Additional Information (Detail) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021USD ($)Sep. 30, 2020USD ($)Sep. 30, 2021USD ($)Revenue_StreamSep. 30, 2020USD ($)Jun. 30, 2021USD ($)Dec. 31, 2020USD ($)Jun. 30, 2020USD ($)Jan. 01, 2020USD ($)Dec. 31, 2019USD ($)
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Number of primary revenue streams | Revenue_Stream2
Total backlog $ 3,900,000 $ 3,900,000
Total backlog, percentage, year one35.00%35.00%
Total backlog, percentage after year one65.00%65.00%
Cumulative impact on retained earnings (accumulated deficit) $ 1,418,587 $ 1,208,387 $ 1,418,587 $ 1,208,387 $ 1,393,474 $ 1,666,243 $ 1,242,929 $ 1,285,188
ASU 2016-13 [Member] | Cumulative Effect Period Of Adoption Adjustment [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Cumulative impact on retained earnings (accumulated deficit) $ (5,300)
Selling, General and Administrative Expenses [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost Amortization5,000 $ 6,000 15,700 $ 18,500
Prepaid Expenses and Other Current Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross15,100 15,100 16,800
Other Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross $ 26,100 $ 26,100 $ 27,900

Revenue from Contracts with C_4

Revenue from Contracts with Customers - Summary of Revenue Recognized on Various Performance Obligations and Elected Accounting Expedients (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Jun. 30, 2021Mar. 31, 2021Sep. 30, 2020Jun. 30, 2020Mar. 31, 2020Sep. 30, 2021Sep. 30, 2020
Revenue From Contract With Customer [Abstract]
Revenue related to deferred revenue balance at beginning of period $ 144,696 $ 151,857 $ 137,848 $ 118,300 $ 119,545 $ 105,366
Revenue related to new performance obligations satisfied during the period159,149 158,910 173,316 192,658 195,308 216,580
Revenue recognized under "right-to-invoice" expedient64,820 62,422 56,811 54,313 54,082 58,059
Reimbursed travel expenses, shipping and other revenue607 525 377 347 369 1,359
Total revenue $ 369,272 $ 373,714 $ 368,352 $ 365,618 $ 369,304 $ 381,364 $ 1,111,338 $ 1,116,286

Revenue from Contracts with C_5

Revenue from Contracts with Customers - Summary of Revenue by Type and Nature of Revenue Stream by Reportable Segments (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Jun. 30, 2021Mar. 31, 2021Sep. 30, 2020Jun. 30, 2020Mar. 31, 2020Sep. 30, 2021Sep. 30, 2020
Disaggregation Of Revenue [Line Items]
Recurring revenue $ 304,724 $ 301,616 $ 904,016 $ 914,792
Non-recurring revenue64,548 64,002 207,322 201,494
Total revenue369,272 $ 373,714 $ 368,352 365,618 $ 369,304 $ 381,364 1,111,338 1,116,286
Unallocated Amounts [Member]
Disaggregation Of Revenue [Line Items]
Total revenue6,419 6,915 18,924 18,223
Hospital and Large Physician Practices [Member]
Disaggregation Of Revenue [Line Items]
Total revenue225,685 233,630 695,427 712,538
Hospital and Large Physician Practices [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue225,685 233,630 695,427 712,538
Veradigm [Member]
Disaggregation Of Revenue [Line Items]
Total revenue137,168 125,073 396,987 385,525
Veradigm [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue137,168 125,073 396,987 385,525
Software delivery, Support and Maintenance [Member]
Disaggregation Of Revenue [Line Items]
Total revenue222,726 219,850 670,840 680,124
Software delivery, Support and Maintenance [Member] | Unallocated Amounts [Member]
Disaggregation Of Revenue [Line Items]
Total revenue4,842 5,567 14,101 14,476
Software delivery, Support and Maintenance [Member] | Hospital and Large Physician Practices [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue104,809 113,112 333,277 351,098
Software delivery, Support and Maintenance [Member] | Veradigm [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue113,075 101,171 323,462 314,550
Client services [Member]
Disaggregation Of Revenue [Line Items]
Total revenue146,546 145,768 440,498 436,162
Client services [Member] | Unallocated Amounts [Member]
Disaggregation Of Revenue [Line Items]
Total revenue1,577 1,348 4,823 3,747
Client services [Member] | Hospital and Large Physician Practices [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue120,876 120,518 362,150 361,440
Client services [Member] | Veradigm [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue $ 24,093 $ 23,902 $ 73,525 $ 70,975

Revenue from Contracts with C_6

Revenue from Contracts with Customers - Summary of Changes in Estimate of Credit Losses for Contract Assets (Detail) - USD ($) $ in Thousands9 Months Ended
Sep. 30, 2021Dec. 31, 2020
Revenue From Contract With Customer [Abstract]
Balance at December 31, 2020 $ 5,341
Current period provision0
Balance at September 30, 20215,341
Contract assets, allowance1,068 $ 1,068
Total contract assets, long-term $ 4,273 $ 4,273

Accounts Receivable - Additiona

Accounts Receivable - Additional Information (Detail) - Trade Accounts Receivable [Member] - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020Jan. 01, 2020
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, allowance for credit loss $ 30,022 $ 31,596
Accounting Standards Update 2016-13 [Member]
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, allowance for credit loss $ 12,600

Accounts Receivable - Schedule

Accounts Receivable - Schedule of Changes in Estimate of Credit Losses for Trade Accounts Receivable (Detail) - Trade Accounts Receivable [Member] $ in Thousands9 Months Ended
Sep. 30, 2021USD ($)
Accounts Notes And Loans Receivable [Line Items]
Balance at December 31, 2020 $ 31,596
Current period provision2,110
Write-offs(4,164)
Recoveries480
Balance at September 30, 2021 $ 30,022

Leases - Additional Information

Leases - Additional Information (Detail) - Maximum [Member]9 Months Ended
Sep. 30, 2021
Lessee Lease Description [Line Items]
Operating leases, remaining lease terms7 years
Operating leases, options to extend leases term5 years
Operating leases, options to terminate leases term1 year

Leases - Summary of Operating C

Leases - Summary of Operating Costs Associated with Leased Assets (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Leases [Abstract]
Operating lease cost[1] $ 5,366 $ 6,251 $ 17,063 $ 19,265
Less: Sublease income(64)(257)(221)(1,026)
Total operating lease costs $ 5,302 $ 5,994 $ 16,842 $ 18,239
[1]Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statements of operations.

Leases - Supplemental Cash Flow

Leases - Supplemental Cash Flow Information for Operating Leases (Detail) - USD ($) $ in Thousands9 Months Ended
Sep. 30, 2021Sep. 30, 2020
Leases [Abstract]
Operating cash flows from operating leases $ 16,035 $ 20,571
Right-of-use assets obtained in exchange for operating lease obligations $ 307 $ 22,262

Leases - Summary of Balance She

Leases - Summary of Balance Sheet Location and Balances for Operating Leases (Detail) - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020
Leases [Abstract]
Right-of-use assets - operating leases $ 70,297 $ 96,601
Current operating lease liabilities19,264 22,264
Long-term operating lease liabilities $ 67,057 $ 93,463
Weighted average remaining lease term (in years)5 years6 years
Weighted average discount rate3.30%3.60%

Leases - Summary of Future Matu

Leases - Summary of Future Maturities of Lease and Non-Lease Components (Detail) - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020
Operating Leases [Abstract]
Operating Leases, Remainder of 2021 $ 5,669
Operating Leases, 202221,469
Operating Leases, 202319,650
Operating Leases, 202414,105
Operating Leases, 202512,748
Operating Leases, Thereafter20,130
Operating Leases, Total lease liabilities93,771
Operating Leases, Less: Amount representing interest(7,450)
Operating Leases, Less: Short-term lease liabilities(19,264) $ (22,264)
Operating Leases, Total long-term lease liabilities $ 67,057 $ 93,463

Business Combinations and Div_2

Business Combinations and Divestitures - Additional Information (Detail) - USD ($)Aug. 23, 2021Dec. 31, 2020Oct. 29, 2020Oct. 15, 2020Jul. 02, 2019Sep. 30, 2021Jun. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020Dec. 31, 2020
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business $ 8,363,000 $ 0 $ 8,363,000 $ 0
2bPrecise [Member]
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business $ 8,400,000
CarePort Purchase Agreement [Member] | Senior Secured Term Loan [Member] | Second Amended Credit Agreement [Member]
Business Acquisition [Line Items]
Prepayment of debt $ 161,000,000
CarePort Purchase Agreement [Member] | WellSky Corp [Member]
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business $ 933,900,000 $ 600,000
Sale of business unit1,350,000,000
CarePort Purchase Agreement [Member] | WellSky Corp [Member] | Senior Secured Term Loan [Member] | Second Amended Credit Agreement [Member]
Business Acquisition [Line Items]
Prepayment of debt $ 161,000,000
EPSi Purchase Agreement [Member] | Senior Secured Term Loan [Member] | Second Amended Credit Agreement [Member]
Business Acquisition [Line Items]
Prepayment of debt $ 19,000,000
EPSi Purchase Agreement [Member] | Strata Decision Technology LLC [Member]
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business $ 222,600,000
Sale of business unit $ 365,000,000
EPSi Purchase Agreement [Member] | Strata Decision Technology LLC [Member] | Senior Secured Term Loan [Member] | Second Amended Credit Agreement [Member]
Business Acquisition [Line Items]
Prepayment of debt $ 19,000,000
ACC Pinnacle and Diabetes Collaborative Registries [Member]
Business Acquisition [Line Items]
Total purchase price $ 19,700,000
Purchase price initial payment11,700,000
Potential milestone/earnout payments5,000,000
Payments related to earnout agreement $ 900,000
ACC Pinnacle and Diabetes Collaborative Registries [Member] | Maximum [Member]
Business Acquisition [Line Items]
Potential milestone/earnout payments $ 8,000,000

Fair Value Measurements and L_3

Fair Value Measurements and Long-term Investments - Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets $ 124,473 $ 136,264
Total assets0 1,509
Total liabilities153 1,011
Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets0 0
Total liabilities0 0
Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets0 1,509
Total liabilities0 0
Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets0 0
Total liabilities153 1,011
Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets0 1,509
Foreign exchange derivative assets [Member] | Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets0 0
Foreign exchange derivative assets [Member] | Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets0 1,509
Foreign exchange derivative assets [Member] | Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets0 0
Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses153 1,011
Contingent Consideration Current [Member] | Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses0 0
Contingent Consideration Current [Member] | Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses0 0
Contingent Consideration Current [Member] | Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses $ 153 $ 1,011

Fair Value Measurements and L_4

Fair Value Measurements and Long-term Investments - Summary of Changes in Liability Measured at Fair Value on Recurring Basis (Detail) - Contingent Consideration [Member] $ in Thousands9 Months Ended
Sep. 30, 2021USD ($)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance at December 31, 2020 $ 1,011
Payments(858)
Balance at September 30, 2021 $ 153

Fair Value Measurements and L_5

Fair Value Measurements and Long-term Investments - Summary of Quantitative Information About Fair Value Measurements (Detail) - Level 3 [Member] $ in Thousands9 Months Ended
Sep. 30, 2021USD ($)RegistryMemberPatientDataVolume
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total financial instruments | $ $ 153
Projected year of payment2021
Registry Members [Member] | Minimum [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Ranges of Inputs | RegistryMember0
Registry Members [Member] | Maximum [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Ranges of Inputs | RegistryMember1,551
Registry Members [Member] | Weighted Average [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Ranges of Inputs | RegistryMember776 [1]
Patient Data Volume [Member] | Minimum [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Ranges of Inputs | PatientDataVolume0
Patient Data Volume [Member] | Maximum [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Ranges of Inputs | PatientDataVolume52,845
Patient Data Volume [Member] | Weighted Average [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Ranges of Inputs | PatientDataVolume26,422 [1]
Contingent Consideration [Member] | Probability Weighted Discounted Cash Flow [Member] | Discount Rate [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total financial instruments | $ $ 153
Contingent Consideration [Member] | Probability Weighted Discounted Cash Flow [Member] | Discount Rate [Member] | Minimum [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Ranges of Inputs5.3
Contingent Consideration [Member] | Probability Weighted Discounted Cash Flow [Member] | Discount Rate [Member] | Maximum [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Ranges of Inputs5.5
Contingent Consideration [Member] | Probability Weighted Discounted Cash Flow [Member] | Discount Rate [Member] | Weighted Average [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Ranges of Inputs5.4 [1]
[1]The weighted average is calculated based upon the absolute fair value of the instruments.

Fair Value Measurements and L_6

Fair Value Measurements and Long-term Investments - Summary of Long-term Equity Investments Included in Other Assets (Detail) $ in Thousands9 Months Ended
Sep. 30, 2021USD ($)InvestmentDec. 31, 2020USD ($)
Fair Value Disclosures [Abstract]
Equity method investments, Number of Investees | Investment[1]3
Cost less impairments, Number of investees | Investment8
Total long-term equity investments, Number of Investees | Investment11
Equity method investments, Original Cost[1] $ 7,099
Cost less impairment, Original Cost49,336
Total long-term equity investments, Original Cost56,435
Equity method investments, Carrying Value[1]10,181 $ 10,744
Cost less impairment, Carrying Value49,127 25,059
Total long-term equity investments, Carrying Value $ 59,308 $ 35,803
[1]Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Fair Value Measurements and L_7

Fair Value Measurements and Long-term Investments - Additional Information (Detail) - USD ($) shares in Thousands, $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Gain from sale of a third-party equity method investment $ 16,800
Impairment of long-term investments $ 0 $ 1,025 0 $ 1,575
Gain on Sale of Businesses, Net [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Gain on sale of businesses $ 8,400 $ 8,400
Third-party Cost Method Investments [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Conversion of notes into shares475 475
Third-party Cost Method Investments [Member] | Other Income (Loss), Net [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Gain on note conversion and revaluation of existing investment $ 9,700 $ 9,700

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - USD ($)Jun. 16, 2021Jun. 14, 2021May 26, 2021Dec. 02, 2020Nov. 30, 2020Nov. 18, 2020Aug. 31, 2021May 31, 2021Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020Dec. 31, 2020
Class Of Stock [Line Items]
Capitalized stock-based compensation costs $ 0 $ 0 $ 0 $ 0
Stock options granted0 0 0 0
Share issued, exercise of options and release of stock awards2,100,000 1,900,000
Shares settled for tax withholding900,000 770,000
Common stock repurchased, amount $ 308,953,000 $ 55,282,000
November 2020 Stock Repurchase Program [Member]
Class Of Stock [Line Items]
Common stock repurchased, amount $ 300,000,000
Common stock repurchased, shares5,600,000
Previous Program [Member]
Class Of Stock [Line Items]
Common stock repurchased, amount $ 45,600,000 $ 55,300,000
Common stock repurchased, shares5,000,000 6,500,000
May 2021 Stock Purchase Program [Member]
Class Of Stock [Line Items]
Common stock repurchased, amount $ 350,000,000
Common stock repurchased, shares2,400,000 13,900,000
Accelerated Share Repurchase Agreement [Member]
Class Of Stock [Line Items]
Common stock repurchased, amount $ 200,000,000 $ 200,000,000
Initial delivery received $ 9,100,000 $ 11,700,000
Percentage of expected shares repurchased80.00%80.00%
Reduction to shareholders equity $ 161,200,000 $ 165,700,000
Reduction to shareholders equity as an unsettled forward contract $ 38,800,000 $ 34,300,000
Receipt of shares as part of final settlement2,400,000 1,600,000
Weighted-average share repurchase price $ 17.28 $ 15.07
Shares of common stock yet to be repurchased, amount $ 108,400,000 $ 108,400,000

Stockholders' Equity - Stock-Ba

Stockholders' Equity - Stock-Based Compensation Expense (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense $ 10,314 $ 10,669 $ 32,528 $ 29,432
Cost of revenue [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense1,121 1,814 4,274 4,631
Cost of revenue [Member] | Software delivery, Support and Maintenance [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense305 295 1,112 1,213
Cost of revenue [Member] | Client services [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense816 1,519 3,162 3,418
Selling, General and Administrative Expenses [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense7,832 6,728 23,426 18,851
Research and development [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense $ 1,361 $ 2,127 $ 4,828 $ 5,950

Stockholders' Equity - Stock-_2

Stockholders' Equity - Stock-Based Awards Granted (Detail) - $ / shares shares in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted75 2,990
Weighted-Average Grant Date Fair Value, granted $ 16.04 $ 15.51
Service-Based Restricted Stock Units [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted42 2,487
Weighted-Average Grant Date Fair Value, granted $ 16.59 $ 15.38
Performance-Based Restricted Stock Units with a Service Condition [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted33 268
Weighted-Average Grant Date Fair Value, granted $ 15.35 $ 15.18
Market-Based Restricted Stock Units with a Service Condition [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted0 235
Weighted-Average Grant Date Fair Value, granted $ 0 $ 17.19

Earnings (Loss) Per Share - Cal

Earnings (Loss) Per Share - Calculations of Earnings (Loss) Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Basic earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax $ 16,194 $ (13,956) $ 46,692 $ (67,920)
(Loss) income from discontinued operations, net of tax(14)14,498 471 40,503
Net income (loss) $ 16,180 $ 542 $ 47,163 $ (27,417)
Weighted-average common shares outstanding123,892 161,144 133,517 162,092
Basic earnings (loss) from continuing operations per Common Share $ 0.13 $ (0.09) $ 0.35 $ (0.42)
Basic earnings from discontinued operations per Common Share0 0.090 0.25
Net income (loss) per share - Basic $ 0.13 $ 0 $ 0.35 $ (0.17)
Diluted earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax $ 16,194 $ (13,956) $ 46,692 $ (67,920)
(Loss) income from discontinued operations, net of tax(14)14,498 471 40,503
Net income (loss) $ 16,180 $ 542 $ 47,163 $ (27,417)
Weighted-average common shares outstanding123,892 161,144 133,517 162,092
Plus: Dilutive effect of restricted stock unit awards and warrants7,460 0 8,564 0
Weighted-average common shares outstanding assuming dilution131,352 161,144 142,081 162,092
Diluted earnings (loss) from continuing operations per Common Share $ 0.12 $ (0.09) $ 0.33 $ (0.42)
Diluted earnings from discontinued operations per Common Share0 0.090 0.25
Net income (loss) per share - Diluted $ 0.12 $ 0 $ 0.33 $ (0.17)

Earnings (Loss) Per Share - Ant

Earnings (Loss) Per Share - Anti-Dilutive Stock Options, Restricted Stock Unit Awards and Warrants Excluded from Computation of Diluted Earnings (Loss) Per Share (Detail) - shares shares in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Earnings Per Share [Abstract]
Shares subject to anti-dilutive restricted stock unit awards and warrants excluded from calculation1,504 47,162 1,502 48,816

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Goodwill and Intangible Assets (Detail) - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount $ 1,209,033 $ 1,209,428
Accumulated Amortization(1,012,625)(974,826)
Intangible Assets, Net196,408 234,602
Registered trademarks52,000 52,000
Goodwill974,427 974,729
Total1,026,427 1,026,729
Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount534,999 535,092
Accumulated Amortization(485,810)(465,292)
Intangible Assets, Net49,189 69,800
Customer Contracts and Relationships [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount674,034 674,336
Accumulated Amortization(526,815)(509,534)
Intangible Assets, Net $ 147,219 $ 164,802

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Changes in Carrying Amount of Goodwill (Detail) $ in Thousands9 Months Ended
Sep. 30, 2021USD ($)
Goodwill [Line Items]
Goodwill $ 974,729
Foreign exchange translation(302)
Goodwill, net974,427
Hospital and Large Physician Practices [Member] | Operating Segments [Member]
Goodwill [Line Items]
Goodwill531,393
Foreign exchange translation(302)
Goodwill, net531,091
Veradigm [Member] | Operating Segments [Member]
Goodwill [Line Items]
Goodwill433,188
Foreign exchange translation0
Goodwill, net433,188
Unallocated [Member] | Operating Segments [Member]
Goodwill [Line Items]
Goodwill10,148
Foreign exchange translation0
Goodwill, net $ 10,148

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)Sep. 30, 2021Dec. 31, 2020
Goodwill And Intangible Assets Disclosure [Abstract]
Accumulated impairment losses associated with goodwill $ 0 $ 0

Debt - Debt Outstanding Excludi

Debt - Debt Outstanding Excluding Lease Obligations (Detail) - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020
Debt Instrument [Line Items]
Principal Balance $ 367,853 $ 167,853
Unamortized Discount and Debt Issuance Costs(5,334)266
Net Carrying Amount373,187 167,587
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Principal Balance167,853 167,853
Unamortized Discount and Debt Issuance Costs(7,578)(3,166)
Net Carrying Amount175,431 171,019
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Principal Balance200,000 0
Unamortized Discount and Debt Issuance Costs2,244 3,432
Net Carrying Amount $ 197,756 $ (3,432)

Debt - Debt Outstanding Exclu_2

Debt - Debt Outstanding Excluding Lease Obligations (Parenthetical) (Detail) - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020Dec. 31, 2019
Debt Instrument [Line Items]
Debt recognized $ 367,853 $ 167,853
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument principal amount207,911 $ 218,000
Debt recognized167,853 167,853
Additional Paid-In Capital [Member] | 0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Additional paid-in capital recognized $ 40,058 $ 40,058 $ 40,100

Debt - Interest Expense (Detail

Debt - Interest Expense (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Debt Instrument [Line Items]
Total interest expense $ 3,617 $ 6,667 $ 9,709 $ 27,646
Convertible Senior Notes and Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Interest expense1,742 4,651 4,109 14,199
Amortization of discounts and debt issuance costs1,875 2,016 5,600 13,447
Total interest expense $ 3,617 $ 6,667 $ 9,709 $ 27,646

Debt - Interest Expense Related

Debt - Interest Expense Related to 0.875% Convertible Senior Notes and 1.25% Cash Convertible Senior Notes (Detail) - 0.875% Convertible Senior Notes and the 1.25% Cash Convertible Senior Notes [Member] - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Debt Instrument [Line Items]
Coupon interest $ 454 $ 451 $ 1,364 $ 3,561
Amortization of discounts and debt issuance costs1,479 1,454 4,412 12,030
Total interest expense related to the convertible notes $ 1,933 $ 1,905 $ 5,776 $ 15,591

Debt - Additional Information (

Debt - Additional Information (Detail) - USD ($)Oct. 29, 2020Jul. 20, 2020Feb. 15, 2018Jun. 30, 2020Dec. 31, 2019Sep. 30, 2021Dec. 31, 2020
Debt Instrument [Line Items]
Debt instrument principal amount $ 367,853,000 $ 167,853,000
Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Credit facility, amount available borrowing capacity699,000,000
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Debt instrument principal amount200,000,000 0
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument principal amount167,853,000 167,853,000
Debt instrument principal amount $ 218,000,000 $ 207,911,000
Interest rate0.875%0.875%0.875%
Debt issuance costs $ 700,000
Percentage of interest rate used to to compute the initial fair value of the liability component1.95%
Debt instrument, initial fair value of liability component $ 177,900,000
Debt instrument, net carrying value of equity component $ 12,200,000
Payments for repurchase debt instrument $ 7,700,000
Debt instrument aggregate principal amount repurchased10,100,000
Gain on repurchase of debt instrument500,000
Proceeds due to termination of capped call transaction300,000
Reduction to capped call fees800,000
Loss in capped call $ 500,000
0.875% Convertible Senior Notes [Member] | Additional Paid-In Capital [Member]
Debt Instrument [Line Items]
Debt instrument, equity component amount40,100,000 $ 40,058,000 40,058,000
Payments of capped call fees17,200,000
Debt discounts and issuance costs $ 1,100,000
Letter of Credit [Member]
Debt Instrument [Line Items]
Portion of facility available for issuance $ 50,000,000
Swing Loans [Member]
Debt Instrument [Line Items]
Portion of facility available for issuance10,000,000
Foreign Currencies [Member]
Debt Instrument [Line Items]
Portion of facility available for issuance100,000,000
Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity $ 400,000,000
Senior secured credit facilities term, years5 years
Line of credit facility, frequency of paymentsThe Term Loan was repayable in quarterly installments, which began on June 30, 2018. We repaid the Term Loan in full on December 31, 2020.
Second Amended Credit Agreement [Member] | Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Debt instrument principal amount $ 200,000,000
Second Amended Credit Agreement [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Letters of credit outstanding $ 1,000,000
Second Amended Credit Agreement [Member] | Senior Secured Credit Facility [Member] | United States dollars [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate, effective percentage1.58%
Second Amended Credit Agreement [Member] | Senior Secured Credit Facility [Member] | LIBOR Rate [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread1.50%
Second Amended Credit Agreement [Member] | Senior Secured Term Loan [Member] | EPSi Purchase Agreement [Member]
Debt Instrument [Line Items]
Prepayment of debt $ 19,000,000
Second Amended Credit Agreement [Member] | Senior Secured Term Loan [Member] | CarePort Purchase Agreement [Member]
Debt Instrument [Line Items]
Prepayment of debt $ 161,000,000
Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity $ 900,000,000
Senior secured credit facilities term, years5 years
Fees and other costs, incurred $ 1,400,000

Debt - Summary of Future Debt P

Debt - Summary of Future Debt Payment Obligations (Detail) $ in ThousandsSep. 30, 2021USD ($)
Debt Instrument [Line Items]
Total $ 407,911
Remainder of 20210
20220
2023200,000
20240
20250
Thereafter207,911
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Total207,911
Remainder of 20210
20220
20230
20240
20250
Thereafter207,911
Revolving Facility [Member]
Debt Instrument [Line Items]
Total200,000
Remainder of 20210
20220
2023200,000
20240
20250
Thereafter $ 0

Debt - Summary of Future Debt_2

Debt - Summary of Future Debt Payment Obligations (Parenthetical) (Detail)Sep. 30, 2021Jun. 30, 2020Dec. 31, 2019
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Interest rate0.875%0.875%0.875%

Effective Tax Rates (Detail)

Effective Tax Rates (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Income Tax Disclosure [Abstract]
Income (loss) from continuing operations before income taxes $ 21,293 $ (18,072) $ 56,646 $ (74,561)
Income tax (provision) benefit $ (5,099) $ 4,116 $ (9,954) $ 6,641
Effective tax rate23.90%22.80%17.60%8.90%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020Dec. 31, 2020
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Windfall benefit $ 4,600
Shortfall expense $ 6,900
Income (loss) from continuing operations before income taxes $ 21,293 $ (18,072) $ 56,646 $ (74,561)
Cumulative operating income loss period considered3 years
Unrecognized income tax benefits $ 29,900 $ 29,900 $ 28,900
U.S. and Foreign Net Operating Loss Carryforwards [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Valuation allowance $ 700

Derivative Financial Instrume_3

Derivative Financial Instruments - Fair Value and Balance Sheet Locations - (Detail) - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020
Derivatives Fair Value [Line Items]
Derivative asset, fair value $ 0 $ 1,509
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Prepaid Expenses and Other Current Assets [Member]
Derivatives Fair Value [Line Items]
Derivative asset, fair value $ 0 $ 1,509

Derivative Financial Instrume_4

Derivative Financial Instruments - Additional Information (Detail)Sep. 30, 2021Derivative
Foreign Exchange Forward Contracts [Member]
Derivative [Line Items]
Number of contracts0

Derivative Financial Instrume_5

Derivative Financial Instruments - Derivatives Instruments Designated as Cash Flow Hedges - (Detail) - Cash Flow Hedging [Member] - Foreign Exchange Contract [Member] - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Recognized in OCI $ 0 $ 1,280 $ 121 $ 1,798
Cost of revenue [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income0 107 611 71
Selling, General and Administrative Expenses [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income0 52 351 34
Research and development [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income $ 0 $ 111 $ 668 $ 73

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period $ 1,666,243
Other comprehensive (loss) income before reclassifications(195) $ 723
Net losses (gains) reclassified from accumulated other comprehensive loss(1,209)(132)
Total other comprehensive income (loss) $ (805) $ 1,732 (1,404)591
Balance at the end of the period1,418,587 1,418,587
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period(2,957)(4,392)
Other comprehensive (loss) income before reclassifications(285)(611)
Net losses (gains) reclassified from accumulated other comprehensive loss0 0
Total other comprehensive income (loss)(285)(611)
Balance at the end of the period(3,242)(5,003)(3,242)(5,003)
Derivatives Qualifying as Cash Flow Hedges [Member] | Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period1,119 0
Other comprehensive (loss) income before reclassifications90 1,334
Net losses (gains) reclassified from accumulated other comprehensive loss(1,209)(132)
Total other comprehensive income (loss)(1,119)1,202
Balance at the end of the period0 1,202 0 1,202
Accumulated Other Comprehensive Loss [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period(1,838)(4,392)
Balance at the end of the period $ (3,242) $ (3,801) $ (3,242) $ (3,801)

Accumulated Other Comprehensi_4

Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) - Foreign Exchange Contract [Member] - USD ($) $ in Thousands12 Months Ended
Dec. 31, 2019Dec. 31, 2020Sep. 30, 2020
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized net gains (losses), taxes (benefits) $ 390 $ 418
Revaluation of tax effects $ 149

Accumulated Other Comprehensi_5

Accumulated Other Comprehensive Loss - Income Tax Effects Related to Components of Other Comprehensive Income (Loss) (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Accumulated Other Comprehensive Income Loss [Line Items]
Foreign currency translation adjustments, Before-Tax Amount $ (805) $ 983 $ (285) $ (611)
Other comprehensive (loss) income before income tax benefit(805)1,992 (1,794)1,009
Foreign currency translation adjustments, Tax Effect0 0 0 0
Other comprehensive income (loss), Tax effect0 (260)390 (418)
Foreign currency translation adjustments, Net(805)983 (285)(611)
Other comprehensive (loss) income(805)1,732 (1,404)591
Derivatives Qualifying as Cash Flow Hedges [Member] | Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Before-Tax, Amount0 1,280 121 1,798
Derivatives qualifying as cash flow hedges, net (gains) losses reclassified into income, Before-Tax Amount0 (271)(1,630)(178)
Derivatives qualifying as cash flow hedges, net change in unrealized gains (losses) on foreign exchange contracts, Before-Tax Amount0 1,009 (1,509)1,620
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Tax Effect0 (330)(31)(464)
Derivatives qualifying as cash flow hedges, net (gains) losses reclassified into income, Tax Effect0 70 421 46
Derivatives qualifying as cash flow hedges, net change in unrealized gains (losses) on foreign exchange contracts, Tax Effect0 (260)390 (418)
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Net0 950 90 1,334
Derivatives qualifying as cash flow hedges, net (gains) losses reclassified into income, Net0 (201)(1,209)(132)
Derivatives qualifying as cash flow hedges, net change in unrealized gains (losses) on foreign exchange contracts, Net $ 0 $ 749 (1,119)1,202
Other comprehensive (loss) income $ (1,119) $ 1,202

Contingencies - Additional Info

Contingencies - Additional Information (Detail) - Practice Fusion, Inc. [Member] - US Department of Justice and US Attorney [Member]12 Months Ended
Dec. 31, 2020USD ($)
Criminal Fine [Member]
Loss Contingencies [Line Items]
Litigation settlement, amount $ 25,300,000
Forfeiture Payment [Member]
Loss Contingencies [Line Items]
Litigation settlement, amount959,700
Civil Settlements [Member]
Loss Contingencies [Line Items]
Litigation settlement, amount118,600,000
State Medicaid Program Expenditures [Member]
Loss Contingencies [Line Items]
Litigation settlement, amount $ 5,200,000

Discontinued Operations - Addit

Discontinued Operations - Additional Information (Detail)12 Months Ended
Dec. 31, 2020Business
Discontinued Operations And Disposal Groups [Abstract]
Number of businesses sold2

Discontinued Operations - Summa

Discontinued Operations - Summary of Major Classes of Assets and Liabilities as Reported on Consolidated Balance Sheets (Detail) - USD ($) $ in ThousandsSep. 30, 2021Dec. 31, 2020
Carrying amounts of major classes of liabilities associated with EPSi and CarePort included as part of discontinued operations:
Total current liabilities attributable to discontinued operations $ 1,708 $ 322,811
EPSi and CarePort [Member]
Carrying amounts of major classes of liabilities associated with EPSi and CarePort included as part of discontinued operations:
Accrued expenses1,708 6,669
Income tax payable0 316,142
Total current liabilities attributable to discontinued operations $ 1,708 $ 322,811

Discontinued Operations - Sum_2

Discontinued Operations - Summary of Major Income and Expense Line Items Reported in Consolidated Statements of Operations (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Sep. 30, 2020Sep. 30, 2021Sep. 30, 2020
Cost of revenue:
Gain on sale of discontinued operations $ 0 $ 0 $ 647 $ 0
(Loss) income from discontinued operations for EPSi and CarePort before income taxes(14)19,545 (7)54,601
Income tax benefit (provision)0 (5,047)(169)(14,098)
(Loss) income from discontinued operations, net of tax(14)14,498 471 40,503
EPSi and CarePort [Member]
Revenue:
Total revenue6 36,411 6 108,690
Cost of revenue:
Total cost of revenue19 9,952 (29)30,308
Amortization of software development and acquisition-related assets0 2,499 0 7,623
Gross (loss) profit(13)26,459 35 78,382
Selling, general and administrative expenses2 3,788 76 12,974
Research and development0 2,118 (32)7,133
Amortization of intangible assets0 7 0 22
(Loss) income from discontinued operations for EPSi and CarePort(15)20,546 (9)58,253
Interest expense0 (995)0 (3,634)
Other income, net1 0 2 0
Gain on sale of discontinued operations0 0 647 0
(Loss) income from discontinued operations for EPSi and CarePort before income taxes[1](14)19,551 640 54,619
Income tax benefit (provision)0 (5,047)(169)(14,098)
(Loss) income from discontinued operations, net of tax[2](14)14,504 471 40,521
Software delivery, Support and Maintenance [Member] | EPSi and CarePort [Member]
Revenue:
Total revenue6 32,894 6 96,807
Cost of revenue:
Total cost of revenue15 2,900 (178)9,254
Client services [Member] | EPSi and CarePort [Member]
Revenue:
Total revenue0 3,517 0 11,883
Cost of revenue:
Total cost of revenue $ 4 $ 4,553 $ 149 $ 13,431
[1](Loss) income from discontinued operations for EPSi and CarePort does not agree to the consolidated statements of operations for the three and nine months ended September 30, 2020, due to residual amounts related to Netsmart (as defined below)
[2](Loss) income from discontinued operations, net of tax for EPSi and CarePort does not agree to the consolidated statements of operations for the three and nine months ended September 30, 2020 due to residual amounts related to Netsmart (as defined below). Refer to Note 17, Supplemental Disclosures” for additional information.

Business Segments - Additional

Business Segments - Additional Information (Detail)9 Months Ended
Sep. 30, 2021Segment
Segment Reporting [Abstract]
Number of operating segments2

Business Segments - Revenues an

Business Segments - Revenues and Income (Loss) from Operations Related to Segment Within Reconciliation to Consolidated Amounts (Detail) - USD ($) $ in Thousands3 Months Ended9 Months Ended
Sep. 30, 2021Jun. 30, 2021Mar. 31, 2021Sep. 30, 2020Jun. 30, 2020Mar. 31, 2020Sep. 30, 2021Sep. 30, 2020
Segment Reporting Information [Line Items]
Revenue $ 369,272 $ 373,714 $ 368,352 $ 365,618 $ 369,304 $ 381,364 $ 1,111,338 $ 1,116,286
Gross profit148,774 135,138 450,572 404,672
Income (loss) from operations:12,104 (11,161)35,819 (62,802)
Unallocated Amounts [Member]
Segment Reporting Information [Line Items]
Revenue6,419 6,915 18,924 18,223
Gross profit3,941 5,094 13,015 13,109
Income (loss) from operations:1,387 (3,068)(3,572)(11,338)
Hospital and Large Physician Practices [Member]
Segment Reporting Information [Line Items]
Revenue225,685 233,630 695,427 712,538
Gross profit79,135 73,359 249,594 210,582
Income (loss) from operations:(6,160)(16,913)(6,995)(75,982)
Veradigm [Member]
Segment Reporting Information [Line Items]
Revenue137,168 125,073 396,987 385,525
Gross profit65,698 56,685 187,963 180,981
Income (loss) from operations: $ 16,877 $ 8,820 $ 46,386 $ 24,518

Supplemental Disclosures - Supp

Supplemental Disclosures - Supplemental Disclosures (Detail) - USD ($) $ in Thousands9 Months Ended
Sep. 30, 2021Sep. 30, 2020Dec. 31, 2020
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents $ 214,179 $ 218,701 $ 531,104
Restricted cash2,141 6,209 $ 6,361
Total cash, cash equivalents and restricted cash216,320 224,910
Supplemental non-cash information:
Issuance of treasury stock534 752
2bPrecise [Member]
Supplemental non-cash information:
Sale of 2bPrecise business in exchange for a non-controlling interest in the combined entity $ 11,768 $ 0