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Document and Entity Information - USD ($) $ in Millions	12 Months Ended
Document and Entity Information - USD ($) $ in Millions	Dec. 31, 2018	Feb. 21, 2019	Jun. 30, 2018
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2018
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	FY
Trading Symbol	HSTM
Entity Registrant Name	HEALTHSTREAM INC
Entity Central Index Key	0001095565
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		32,329,409
Entity Public Float			$ 703.7

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 134,321	$ 84,768
Marketable securities	34,497	46,350
Accounts receivable, net of allowance for doubtful accounts of $1,161 and $1,979 at December 31, 2018 and December 31, 2017, respectively	38,124	36,691
Accounts receivable - unbilled	2,880	1,327
Prepaid royalties, net of amortization	13,596	16,137
Other prepaid expenses and other current assets	18,016	8,330
Current assets of discontinued operations		6,125
Total current assets	241,434	199,728
Property and equipment, net of accumulated depreciation of $20,827 and $24,392 at December 31, 2018 and December 31, 2017, respectively	15,866	8,092
Capitalized software development, net of accumulated amortization of $46,757 and $37,174 at December 31, 2018 and December 31, 2017, respectively	18,352	16,014
Goodwill	86,144	86,144
Intangible assets, net	59,378	68,497
Deferred tax assets	145	45
Deferred commissions	16,470
Non-marketable equity investments	3,376	3,772
Other assets	783	754
Long-term assets of discontinued operations		28,073
Total assets	441,948	411,119
Current liabilities:
Accounts payable	8,497	4,178
Accrued royalties	15,756	12,849
Accrued liabilities	13,458	9,567
Accrued compensation and related expenses	3,082	2,762
Deferred revenue	66,061	64,938
Current liabilities of discontinued operations		6,772
Total current liabilities	106,854	101,066
Deferred tax liabilities	11,068
Deferred revenue, noncurrent	2,868	6,287
Other long term liabilities	2,211	1,048
Long-term liabilities of discontinued operations		2,548
Commitments and contingencies
Shareholders’ equity:
Common stock, no par value, 75,000 shares authorized; 32,325 and 31,908 shares issued and outstanding at December 31, 2018 and December 31, 2017, respectively	286,597	282,666
Retained earnings	32,373	17,542
Accumulated other comprehensive loss	(23)	(38)
Total shareholders’ equity	318,947	300,170
Total liabilities and shareholders’ equity	441,948	411,119
Customer-Related Intangible Assets [Member]
Current assets:
Intangible assets, net	53,469	59,681
Other Intangible Assets [Member]
Current assets:
Intangible assets, net	$ 5,909	$ 8,816

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Allowance for doubtful accounts, net	$ 1,161	$ 1,979
Accumulated depreciation on property and equipment	20,827	24,392
Accumulated amortization on capitalized software development	46,757	37,174
Accumulated amortization on intangible assets	$ 32,908	$ 24,741
Common stock, no par value
Common stock, shares authorized	75,000,000	75,000,000
Common stock, shares issued	32,325,000	31,908,000
Common stock, shares outstanding	32,325,000	31,908,000
Customer-Related Intangible Assets [Member]
Accumulated amortization on intangible assets	$ 23,245	$ 17,033
Other Intangible Assets [Member]
Accumulated amortization on intangible assets	$ 9,663	$ 7,708

Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Statement [Abstract]
Revenues, net	$ 231,616	$ 214,899	$ 192,124
Operating costs and expenses:
Cost of revenues (excluding depreciation and amortization)	96,014	87,208	74,966
Product development	25,735	24,148	24,234
Sales and marketing	35,698	38,606	34,929
Other general and administrative expenses	34,447	31,483	30,458
Depreciation and amortization	24,231	24,047	20,366
Total operating costs and expenses	216,125	205,492	184,953
Operating income	15,491	9,407	7,171
Other income, net	1,084	733	581
Income from continuing operations before income tax provision	16,575	10,140	7,752
Income tax provision	3,324	1,302	2,961
Income from continuing operations	13,251	8,838	4,791
(Loss) income from discontinued operations before income tax provision	(64)	393	(1,604)
Gain on sale of discontinued operations	29,489
Income tax provision (benefit)	10,459	(773)	(568)
Income (loss) from discontinued operations	18,966	1,166	(1,036)
Net Income	$ 32,217	$ 10,004	$ 3,755
Net income per share – basic:
Continuing operations	$ 0.41	$ 0.27	$ 0.15
Discontinued operations	0.59	0.04	(0.03)
Net income per share - basic	1.00	0.31	0.12
Net income per share - diluted:
Continuing operations	0.41	0.27	0.15
Discontinued operations	0.59	0.04	(0.03)
Net income per share - diluted	$ 1.00	$ 0.31	$ 0.12
Weighted average shares of common stock outstanding:
Basic	32,264	31,861	31,721
Diluted	32,335	32,196	32,068
Dividends declared per share	$ 1.00

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 32,217	$ 10,004	$ 3,755
Other comprehensive income, net of taxes:
Unrealized gain on marketable securities	15	13	19
Total other comprehensive income	15	13	19
Comprehensive income	$ 32,232	$ 10,017	$ 3,774

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details

Consolidated Statements of Shareholders' Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock [Member]	Retained Earnings (Accumulated Deficit) [Member]	Accumulated Other Comprehensive Income (Loss) [Member]
Beginning balance at Dec. 31, 2015	$ 280,320	$ 278,799	$ 1,591	$ (70)
Beginning balance, shares at Dec. 31, 2015		31,647
Net income	3,755		3,755
Comprehensive income	19			19
Stock based compensation	1,968	$ 1,968
Tax benefit from equity awards	217	217
Common stock issued under stock plans, net of shares withheld for employee taxes	(171)	$ (171)
Common stock issued under stock plans, net of shares withheld for employee taxes, shares		101
Ending balance at Dec. 31, 2016	286,108	$ 280,813	5,346	(51)
Ending balance, shares at Dec. 31, 2016		31,748
Cumulative effect of accounting change	2,192		2,192
Net income	10,004		10,004
Comprehensive income	13			13
Stock based compensation	1,852	$ 1,852
Common stock issued under stock plans, net of shares withheld for employee taxes	1	$ 1
Common stock issued under stock plans, net of shares withheld for employee taxes, shares		160
Ending balance at Dec. 31, 2017	$ 300,170	$ 282,666	17,542	(38)
Ending balance, shares at Dec. 31, 2017	31,908	31,908
Cumulative effect of accounting change	$ 15,132		15,132
Net income	32,217		32,217
Comprehensive income	15			15
Dividends declared on common stock ($1.00 per share)	(32,518)		(32,518)
Stock based compensation	1,686	$ 1,686
Common stock issued under stock plans, net of shares withheld for employee taxes	2,245	$ 2,245
Common stock issued under stock plans, net of shares withheld for employee taxes, shares		417
Ending balance at Dec. 31, 2018	$ 318,947	$ 286,597	$ 32,373	$ (23)
Ending balance, shares at Dec. 31, 2018	32,325	32,325

Consolidated Statements of Shareholders' Equity (Parenthetical)	12 Months Ended
	Dec. 31, 2018 $ / shares
Statement Of Stockholders Equity [Abstract]
Dividends per share common stock	$ 1.00

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
OPERATING ACTIVITIES:
Net income	$ 32,217	$ 10,004	$ 3,755
Income (loss) from discontinued operations	(18,966)	(1,166)	1,036
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	24,231	24,047	20,366
Stock-based compensation	1,777	1,736	1,895
Amortization of deferred commissions	7,659
Excess tax benefits from equity awards			(217)
Provision for doubtful accounts	1,033	1,568	590
Deferred income taxes	3,017	(2,144)	1,447
(Gain) loss on non-marketable equity investments	(42)	5	(120)
Change in fair value of cost method investments	1,271
Other	(9)	409	1,026
Changes in operating assets and liabilities:
Accounts and unbilled receivables	(4,050)	1,125	(7,964)
Prepaid royalties	1,639	2,046	(4,008)
Other prepaid expenses and other current assets	(3,938)	(25)	(1,176)
Deferred commissions	(11,577)
Other assets	(30)	(201)	323
Accounts payable and accrued expenses	2,008	5,784	1,674
Accrued royalties	2,907	(32)	3,675
Deferred revenue	5,103	(552)	1,586
Net cash provided by continuing operating activities	44,250	42,604	23,888
Net cash (used in) provided by discontinued operating activities	(1,004)	4,108	346
Net cash provided by operating activities	43,246	46,712	24,234
INVESTING ACTIVITIES:
Business combinations, net of cash acquired			(55,255)
Proceeds from sale of discontinued operations, net of tax	44,049
Proceeds from maturities of marketable securities	68,992	90,073	119,395
Purchases of marketable securities	(57,085)	(83,279)	(106,965)
Payments to acquire cost method investments	(833)	(500)
Proceeds for sale of long-lived assets			975
Payments associated with capitalized software development	(11,284)	(9,597)	(8,979)
Purchases of property and equipment	(7,166)	(5,515)	(4,806)
Net cash provided by (used in) continuing investing activities	36,673	(8,818)	(55,635)
Net cash used in discontinued investing activities	(115)	(2,761)	(1,021)
Net cash provided by (used in) investing activities	36,558	(11,579)	(56,656)
FINANCING ACTIVITIES:
Proceeds from exercise of stock options	2,582	413	145
Taxes paid related to net settlement of equity awards	(338)	(412)	(316)
Excess tax benefits from equity awards			217
Payment of earn-out related to prior acquisitions	(38)
Payment of debt issue costs	(100)
Payment of cash dividends	(32,357)
Net cash (used in) provided by financing activities	(30,251)	1	46
Net increase (decrease) in cash and cash equivalents	49,553	35,134	(32,376)
Cash and cash equivalents at beginning of period	84,768	49,634	82,010
Cash and cash equivalents at end of period	134,321	84,768	49,634
SUPPLEMENTAL CASH FLOW INFORMATION:
Interest paid	117	101	76
Income taxes paid	16,513	$ 638	$ 2,496
Non-cash additions to property and equipment	$ 1,013

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

1. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Reporting Entity and Segments

HealthStream, Inc. (the Company) was incorporated in 1990 as a Tennessee corporation and is headquartered in Nashville, Tennessee. As of December 31, 2018, the Company operated in two segments: HealthStream Workforce Solutions and HealthStream Provider Solutions. Workforce Solutions products consist of software-as-a-service (SaaS) based services and subscription-based solutions to meet the ongoing training, certification, assessment, and development needs of the healthcare community. These solutions provide, deliver, and track online education for our customers in the United States through our SaaS model. Provider Solutions products offer healthcare organizations software applications for administering and tracking provider credentialing, privileging, call center, and enrollment activities.

On February 12, 2018, the Company divested its Patient Experience (PX) business to Press Ganey Associates (Press Ganey) for $65.2 million in cash (after giving effect to the post-closing working capital adjustment). This sale of the PX business resulted in the divestiture of the Company’s patient experience solutions business segment. The results of operations for PX are presented as discontinued operations within the notes to consolidated financial statements herein.

Recently Adopted Accounting Standards

The Company adopted the Financial Accounting Standards Board (FASB) Accounting Standards Update (ASU) 2014-09, Revenue from Contracts with Customers, and related guidance (ASC 606), effective January 1, 2018 using the modified retrospective transition approach. ASC 606 requires entities to recognize revenues when control of the promised goods or services is transferred to the customer at an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. See Note 5 for further details.

In January 2016, the FASB issued ASU 2016-01, Financial Instruments – Overall (Sub Topic 825-10), which addresses certain aspects of the recognition, measurement, presentation, and disclosure of financial instruments. The guidance, among other things, requires equity investments (except those accounted for under the equity method of accounting or those that result in consolidation of the investee) to be measured at fair value with changes in fair value recognized in net income. The Company adopted ASU 2016-01 effective January 1, 2018 on a prospective basis. See Note 17 for additional information regarding ASU 2016-01 and its impact on the Company’s balance sheet and statements of income.

Recognition of Revenue

Revenues are recognized when control of the promised goods or services is transferred to the customer in an amount that reflects the consideration the Company expects to be entitled in exchange for transferring those goods or services.

Revenue is recognized based on the following five step model:

•

Identification of the contract with a customer

•

Identification of the performance obligations in the contract

•

Determination of the transaction price

•

Allocation of the transaction price to the performance obligations in the contract

•

Recognition of revenue when, or as, the Company satisfies a performance obligation

Subscription/SaaS services revenues primarily consist of fees in consideration of providing customers access to one or more of our SaaS-based solutions and/or courseware subscriptions, as well as fees related to licensing agreements, all of which include routine customer support and technology enhancements. Revenue is generally recognized over time during the contract term beginning when the service is made available to the customer. Subscription/SaaS contracts are generally non-cancelable, one to five years in length, and billed annually, semi-annually, quarterly, or monthly in advance.

Professional services revenues primarily consist of fees for implementation services, consulting, custom courseware development, and training. The majority of our professional services contracts are billed in advance based on a fixed price basis, and revenue is recognized over time as the services are performed. For both subscription/SaaS services and professional services, the time between billing the customer and when performance obligations are satisfied is generally not significant.

Our contracts with customers often contain multiple performance obligations. For these contracts, the Company accounts for individual performance obligations separately if they are distinct. The contract price, which represents transaction price, is allocated to the separate performance obligations on a relative standalone selling price basis. We generally determine standalone selling prices based on the standard list price for each product, taking into consideration certain factors, including contract length and the number of subscribers within the contract.

We receive payments from customers based on billing schedules established in our contracts. Accounts receivable - unbilled represent contract assets related to our conditional right to consideration for subscription/SaaS and professional services contracts where performance has occurred under the contract. Accounts receivable are primarily comprised of trade receivables that are recorded at the invoice amount, net of an allowance for doubtful accounts, when the right to consideration becomes unconditional. Other receivables, which are included within Accounts Receivable, include receivables from certain content partners and are not material.

Deferred revenue represents contract liabilities that are recorded when cash payments are received or are due in advance of our satisfaction of performance obligations.

Principles of Consolidation

The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation.

Use of Estimates

The consolidated financial statements are prepared in accordance with U.S. generally accepted accounting principles. These accounting principles require management to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying notes. Actual results could differ from those estimates and such differences could be material to the consolidated financial statements.

Cash Equivalents

The Company considers cash equivalents to be unrestricted, highly liquid investments with initial maturities of less than three months.

Marketable Securities

Marketable securities are classified as available for sale and are stated at fair market value, with the unrealized gains and losses, net of tax, reported in other accumulated comprehensive income (loss) on the accompanying consolidated balance sheets. Realized gains and losses and declines in market value judged to be other than temporary on investments in marketable securities are included in interest and other income on the accompanying consolidated statements of income. The cost of securities sold is based on the specific identification method. Interest and dividends on securities classified as available for sale are included in other income (expense) on the accompanying consolidated statements of income. Premiums and discounts are amortized over the life of the related available for sale security as an adjustment to the yield using the effective interest method.

Deferred Commissions

Deferred commissions represent costs to acquire contracts with customers, such as the initial sales commission payment, which are capitalized and amortized consistent with the transfer of the goods or services to the customer over the expected period of benefit. The capitalized contract cost is included under the caption “deferred commissions” in the accompanying consolidated balance sheet. The expected period of benefit is the contract term, except when the capitalized commission is expected to provide economic benefit to the Company for a period longer than the contract term, such as for new customer or incremental sales where renewals are expected and renewal commissions are not commensurate with initial commissions. Non-commensurate commissions are amortized over the greater of the contract term or expected customer relationship period, limited by the technological obsolescence period of approximately three years.

Prepaid Royalties

Prepaid royalties represents advance payments associated with the sale of third party products, such as courseware subscriptions. Royalties are typically paid in advance at the commencement of the revenue cycle or periodically throughout the revenue cycle, such as quarterly, bi-annual, or annual installments. Royalty payments are amortized over the term of the underlying contracts, which generally range from 12 to 60 months, in order to match the direct royalty costs to the same period the subscription revenue is recognized. Amortization of royalties is included under the caption “cost of revenues (excluding depreciation and amortization)” in the accompanying consolidated statements of income.

Allowance for Doubtful Accounts

The Company estimates its allowance for doubtful accounts to include accounts that may become uncollectible in the future, along with using a specific identification method in which management considers the facts and circumstances surrounding each potentially uncollectible receivable. Uncollectible receivables are written-off in the period management believes it has exhausted its ability to collect payment from the customer. Bad debt expense is recorded when events or circumstances indicate an additional allowance is required.

Changes in the allowance for doubtful accounts and the amounts charged to bad debt expense from continuing operations for the years ended December 31 were as follows (in thousands):

	Allowance Balance at Beginning of Period		Charged to Costs and Expenses		Write-offs			Allowance Balance at End of Period
2018	$	1,979	$	1,033	$	(1,851	)	$	1,161
2017		839		1,568		(428	)		1,979
2016		292		590		(43	)		839

Capitalized Software Development

Capitalized software development is stated on the basis of cost and is presented net of accumulated amortization. The Company capitalizes costs incurred during the software development phase for projects when such costs are material. These assets are generally amortized using the straight-line method over three years. The Company capitalized approximately $11.9 million and $10.2 million during 2018 and 2017, respectively. Amortization of capitalized software development from continuing operations was approximately $9.6 million, $8.9 million, and $6.8 million during 2018, 2017, and 2016, respectively. Maintenance and operating costs are expensed as incurred. As of December 31, 2018 and 2017, there were no capitalized software development costs for external computer software developed for resale.

Fair Value Measurements

Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in the principal or most advantageous market in an orderly transaction between market participants at the measurement date. The fair value hierarchy prioritizes the inputs to valuation techniques used in measuring fair value. There are three levels to the fair value hierarchy based on the reliability of inputs, as follows:

Level 1 – Observable inputs that reflect quoted prices (unadjusted) for identical assets or liabilities in active markets.

Level 2 – Inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly.

Level 3 – Unobservable inputs in which little or no market data exists, therefore requiring the Company to develop its own assumptions.

The Company evaluates assets and liabilities subject to fair value measurements on a recurring basis to determine the appropriate level at which to classify them for each reporting period. This determination requires significant judgments to be made by the Company. At December 31, 2018 and 2017, our assets measured at fair value on a recurring basis consisted of marketable securities, which are classified as available for sale (see Note 4 – Marketable Securities).

Property and Equipment

Property and equipment are stated on the basis of cost. Depreciation is provided on the straight-line method over the following estimated useful lives, except for assets under capital leases and leasehold improvements, which are amortized over the shorter of the estimated useful life or their respective lease term.

	Years
Furniture and fixtures	5 - 7
Equipment		3

Goodwill and Intangible Assets

Goodwill represents the excess of purchase price in a business combination over the fair value of the net identifiable assets acquired. The carrying amount of our goodwill is evaluated for impairment at least annually during the fourth quarter and whenever events or changes in facts or circumstances indicate that impairment may exist. In accordance with ASC 350, Intangibles – Goodwill and Other, companies may opt to first assess qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount. A qualitative assessment includes factors such as financial performance, industry and market metrics, and other factors affecting the reporting unit. If this assessment concludes that it is more likely than not that the fair value of a reporting unit exceeds its carrying value, then goodwill is not considered impaired and no further impairment testing is required. Conversely, if the qualitative assessment concludes that it is more likely than not that the fair value of a reporting unit is less than its carrying value, we must then compare the fair value of the reporting unit to its carrying value. The Company determines fair value of the reporting units using both income and market based models. These models require the use of various assumptions relating to cash flow projections, growth rates, discount rates and terminal value calculations. There were no goodwill impairments identified or recorded for the years ended December 31, 2018, 2017, or 2016.

As of December 31, 2018, intangible assets include customer relationships, internally-developed technology and patents, non-competition agreements, and trade names. These intangible assets are considered to have definite useful lives and are being amortized on a straight-line basis over periods ranging between five and thirteen years. The weighted average amortization period for definite lived intangible assets as of December 31, 2018 was 11.3 years. Intangible assets are reviewed for impairment whenever events or changes in facts or circumstances indicate that the carrying amount of the assets may not be recoverable. There were no intangible asset impairments identified or recorded for the years ended December 31, 2018, 2017, or 2016.

Long-Lived Assets

Long-lived assets to be held for use are reviewed for events or changes in facts and circumstances, both internally and externally, which may indicate that an impairment of long-lived assets held for use is present. The Company measures any impairment using observable market values or discounted future cash flows from the related long-lived assets. The cash flow estimates and discount rates incorporate management’s best estimates, using appropriate and customary assumptions and projections at the date of evaluation. Management periodically evaluates whether the carrying value of long-lived assets, including intangible assets, property and equipment, capitalized software development, deferred commissions, and other assets will be recoverable. There were no long-lived asset impairments identified or recorded for the years ended December 31, 2018, 2017, or 2016.

Non-Marketable Equity Investments

Non-marketable equity investments are accounted for using the equity method when the Company can exercise significant influence over the investee. Investments for which the Company is not able to exercise significant influence over the investee are accounted for under the cost method, and measured at fair value with changes in fair value recognized in net income. The proportionate share of income or loss from equity method investments and any changes in fair value of cost method investments are recorded under the caption “other income, net” in the accompanying consolidated statements of income.

Financial Instruments

The Company has various financial instruments, including cash and cash equivalents, accounts receivable, accounts receivable-unbilled, accounts payable, accrued liabilities, and deferred revenue. The carrying amounts of these financial instruments approximate fair value because of the short term maturity or short term nature of such instruments. The Company also has marketable securities, which are recorded at approximate fair value based on quoted market prices or alternative pricing sources (see Note 4 – Marketable Securities).

Advertising

The Company expenses the costs of advertising as incurred. Advertising expense for the years ended December 31, 2018, 2017, and 2016 was approximately $721,000, $868,000, and $824,000, respectively, and is included under the caption “sales and marketing expense” in the accompanying consolidated statements of income.

Shipping and Handling Costs

Shipping and handling costs that are associated with our products and services are included in cost of revenues.

Income Taxes

Income taxes are accounted for using the asset and liability method, whereby deferred tax assets and liabilities are determined based on the temporary differences between the financial statement and tax bases of assets and liabilities measured at tax rates that will be in effect for the year in which the differences are expected to affect taxable income. Management evaluates all available evidence, both positive and negative, to determine whether, based on the weight of that evidence, a valuation allowance is needed. Future realization of the tax benefit of an existing deductible temporary difference or carryforward ultimately depends on the existence of sufficient taxable income of the appropriate character within the carryback or carryforward period available under the tax law. There are four possible sources of taxable income that may be available under the tax law to realize a tax benefit for deductible temporary differences and carryforwards: 1) future reversals of existing taxable temporary differences, 2) future taxable income exclusive of reversing temporary differences and carryforwards, 3) taxable income in prior carryback year(s) if carryback is permitted under the tax law, and 4) tax-planning strategies that would, if necessary, be implemented to realize deductible temporary differences or carryforwards prior to their expiration. Management reviews the realizability of its deferred tax assets each reporting period to identify whether any significant changes in circumstances or assumptions have occurred that could materially affect the realizability of deferred tax assets. As of December 31, 2018, the Company had established a valuation allowance of $311,000 for the portion of its net deferred tax assets that are not more likely than not expected to be realized.The Company accounts for income tax uncertainties using a more-likely-than-not recognition threshold based on the technical merits of the tax position taken. Tax positions that meet the more-likely-than-not recognition threshold are measured in order to determine the tax benefit to be recognized in the financial statements. The Company expenses any penalties or interest associated with tax obligations as general and administrative expenses and interest expense, respectively.

Earnings per Share

Basic earnings per share is computed by dividing the net income available to common shareholders for the period by the weighted average number of common shares outstanding during the period. Diluted earnings per share is computed by dividing the net income for the period by the weighted average number of common and common equivalent shares outstanding during the period. Common equivalent shares are composed of incremental common shares issuable upon the exercise of stock options and restricted share units subject to vesting. The dilutive effect of common equivalent shares is included in diluted earnings per share by application of the treasury stock method. Common equivalent shares that have an anti-dilutive effect on diluted net income per share were excluded from the calculation of diluted weighted average shares outstanding for the years ended December 31, 2018, 2017, and 2016.

Concentrations of Credit Risk and Significant Customers

The Company’s credit risks relate primarily to cash and cash equivalents, marketable securities, and accounts receivable. The Company places its temporary excess cash investments in high quality, short-term money market instruments. At times, such investments may be in excess of the FDIC insurance limits. Marketable securities consist primarily of investment grade corporate debt securities and government sponsored enterprise debt securities.

The Company sells its products and services to various companies in the healthcare industry that are primarily located in the United States. Customer credit worthiness evaluations are performed on an ongoing basis, and the Company generally requires no collateral from customers. An allowance for doubtful accounts is maintained for potentially uncollectible accounts receivable. The Company did not have any single customer representing over 10% of net revenues or accounts receivable during 2018, 2017, or 2016.

Stock Based Compensation

As of December 31, 2018, the Company maintains two stock based compensation plans under which awards are outstanding, as described in Note 11. The Company accounts for stock based compensation using the fair-value based method for costs related to share-based payments, including stock options and restricted share units. The Company uses the Black Scholes option pricing model for calculating the fair value of option awards issued under its stock based compensation plan. The Company measures compensation cost of restricted share units based on the closing fair market value of the Company’s stock on the date of grant. Stock based compensation cost is measured at the grant date, based on the fair value of the award that is ultimately expected to vest, and is recognized as an expense over the requisite service period. The Company recognizes tax benefits from stock based compensation if an excess tax benefit is realized. Excess tax benefits are reflected in the statement of income as a component of the provision for income taxes when realized.

Recently Issued Accounting Pronouncements Not Yet Adopted
In February 2016, the FASB issued ASU 2016-02, Leases (ASC 842), which supersedes the lease requirements in ASC 840, Leases. ASC 842 requires lessees to recognize assets and liabilities for most leases and provide enhanced disclosures. The Company will adopt ASC 842 effective January 1, 2019 using a modified retrospective approach. As permitted under the transition guidance, we will carry forward the assessment of whether our contracts contain or are leases, classification of our leases, and remaining lease terms. Based on our portfolio of leases as of January 1, 2019, approximately $5.0 million of lease assets and liabilities relating to real estate will be recognized on our balance sheet upon adoption. Additionally, we anticipate recording a material lease asset and liability upon the commencement date of our new corporate headquarters of approximately $24 million. Except as set forth above, we do not anticipate that the adoption of ASC 842 will have any significant impact on the Company’s consolidated financial position and results of operations. We are substantially complete with our implementation efforts.

In June 2016, the FASB issued ASU 2016-03, Financial Instruments—Credit Losses (ASC 326): Measurement of Credit Losses on Financial Instruments, which amends guidance on reporting credit losses for assets held at amortized cost basis and available for sale debt securities. For assets held at amortized cost basis, ASC 326 eliminates the probable initial recognition threshold in current GAAP and, instead, requires an entity to reflect its current estimate of all expected credit losses. The standard will be effective for the first interim period within annual reporting periods beginning after December 15, 2019. The Company will adopt this ASU on January 1, 2020 and is currently evaluating the impact that adoption of this ASU will have on the Company’s consolidated financial position and results of operations.

Stockholders' Equity

12 Months Ended

Dec. 31, 2018

Equity [Abstract]

Stockholders' Equity

2. SHAREHOLDERS’ EQUITY

Common Stock

The Company is authorized to issue up to 75 million shares of common stock. The number of common shares issued and outstanding as of December 31, 2018 and 2017 was approximately 32.3 million and 31.9 million, respectively.

Preferred Stock

The Company is authorized to issue up to 10 million shares of preferred stock in one or more series, having the relative voting powers, designations, preferences, rights and qualifications, limitations or restrictions, and other terms as the Board of Directors may fix in providing for the issuance of such series, without any vote or action of the shareholders.

Earnings Per Share

12 Months Ended

Dec. 31, 2018

Earnings Per Share [Abstract]

Earnings Per Share

3. EARNINGS PER SHARE

The following table sets forth the computation of basic and diluted earnings per share for the three years ended December 31, 2018 (in thousands, except per share amounts):

	Year Ended December 31,
	2018		2017		2016
Numerator:
Income from continuing operations	$	13,251	$	8,838	$	4,791
Income (loss) from discontinued operations		18,966		1,166		(1,036	)
Net income	$	32,217	$	10,004	$	3,755
Denominator:
Weighted-average shares outstanding		32,264		31,861		31,721
Effect of dilutive shares		71		335		347
Weighted-average diluted shares		32,335		32,196		32,068

Earnings (loss) per share – basic:
Continuing operations	$	0.41	$	0.27	$	0.15
Discontinued operations		0.59		0.04		(0.03	)
Earnings per share - basic	$	1.00	$	0.31	$	0.12

Earnings (loss) per share – diluted:
Continuing operations	$	0.41	$	0.27	$	0.15
Discontinued operations		0.59		0.04		(0.03	)
Earnings per share - diluted	$	1.00	$	0.31	$	0.12

Potentially dilutive shares representing approximately 91,000, 58,000, and 38,000 shares of common stock for the years ended December 31, 2018, 2017, and 2016, respectively, were excluded from the calculation of diluted earnings per share because their effect would have been anti-dilutive.

Marketable Securities

12 Months Ended

Dec. 31, 2018

Investments Debt And Equity Securities [Abstract]

Marketable Securities

4. MARKETABLE SECURITIES

At December 31, 2018 and 2017, the fair value of marketable securities, which were all classified as available for sale, included the following (in thousands):

	December 31, 2018
	Adjusted Cost		Unrealized Gains		Unrealized Losses			Fair Value
Level 2:
Corporate debt securities	$	31,521	$	—	$	(23	)	$	31,498
Government-sponsored enterprise debt securities		2,999		—		—			2,999
Total	$	34,520	$	—	$	(23	)	$	34,497

	December 31, 2017
	Adjusted Cost		Unrealized Gains		Unrealized Losses			Fair Value
Level 2:
Corporate debt securities	$	41,900	$	1	$	(39	)	$	41,862
Government-sponsored enterprise debt securities		4,488		1		(1	)		4,488
Total	$	46,388	$	2	$	(40	)	$	46,350

The carrying amounts of the marketable securities reported in the consolidated balance sheets approximate fair value based on quoted market prices or alternative pricing sources and models utilizing market observable inputs. As of December 31, 2018, the Company does not consider any of its marketable securities to be other than temporarily impaired. During the years ended December 31, 2018 and 2017, the Company did not reclassify any items out of accumulated other comprehensive income to net income. All investments in marketable securities are classified as a current asset on the balance sheet because the underlying securities mature within one year from the balance sheet date.

Revenue Recognition And Sales Commissions

12 Months Ended

Dec. 31, 2018

Revenue From Contract With Customer [Abstract]

Revenue Recognition And Sales Commissions

5. REVENUE RECOGNITION AND SALES COMMISSIONS

Adoption of ASC 606, Revenue from Contracts with Customers

On January 1, 2018, the Company adopted ASC 606 using the modified retrospective approach applied to contracts not completed as of January 1, 2018. As such, results for reporting periods beginning after January 1, 2018 are presented under ASC 606, while prior period amounts continue to be reported in accordance with ASC 605.

The cumulative effect of the changes made to the Company’s consolidated January 1, 2018 balance sheet in connection with the adoption of ASC 606 was as follows (in thousands):

Balance Sheet	Balance at December 31, 2017		ASC 606 Adjustments			Balance at January 1, 2018
Assets
Unbilled receivables	$	1,327	$	31		$	1,358
Prepaid royalties, net		16,137		(902	)		15,235
Other prepaid expenses and other current assets		8,330		(2,900	)		5,430
Current assets of discontinued operations		6,125		(274	)		5,851
Deferred commissions		—		12,552			12,552
Deferred tax assets		45		(45	)		—
Non-current assets of discontinued operations		28,073		3,166			31,239

Liabilities
Deferred revenue, current		64,938		(4,488	)		60,450
Current liabilities of discontinued operations		6,772		(1,374	)		5,398
Deferred tax liabilities		—		5,205			5,205
Deferred revenue, noncurrent		6,287		(2,848	)		3,439

Shareholders’ equity
Retained earnings		17,542		15,132			32,674

The impact of adopting ASC 606 on the Company’s consolidated balance sheet as of December 31, 2018 and statements of income for the year ended December 31, 2018 was as follows (in thousands):

	December 31, 2018
Balance Sheet	As reported		Balances without Adoption of ASC 606		Effect of Change Higher/(Lower)
Assets
Prepaid royalties, net	$	13,596	$	14,801	$	(1,205	)
Other prepaid expenses and other current assets		18,016		20,167		(2,151	)
Deferred commissions		16,470		—		16,470

Liabilities
Deferred revenue, current		66,061		70,796		(4,735	)
Deferred revenue, noncurrent		2,868		6,210		(3,342	)

Shareholders’ equity
Retained earnings		32,373		29,382		2,991

	Year Ended December 31, 2018
Income Statement	As reported		Balances without Adoption of ASC 606		Effect of Change Higher/(Lower)
Revenues, net	$	231,616	$	230,876	$	740

Costs and expenses
Cost of revenues (excluding depreciation and amortization)		96,014		95,711		303
Sales and marketing		35,698		39,008		(3,310	)
Operating income		15,491		11,744		3,747
Income from continuing operations before income tax provision		16,575		12,828		3,747
Income tax provision		3,324		2,568		756
Income from continuing operations		13,251		10,260		2,991
Net income		32,217		29,226		2,991

Revenue Recognition

Revenue is recognized based on the following five step model:

•

Identification of the contract with a customer

•

Identification of the performance obligations in the contract

•

Determination of the transaction price

•

Allocation of the transaction price to the performance obligations in the contract

•

Recognition of revenue when, or as, the Company satisfies a performance obligation

The following table represents revenues included in continuing operations disaggregated by revenue source for the year ended December 31, 2018 (in thousands). Sales taxes are excluded from revenues.

	Year Ended December 31, 2018
Business Segments	Workforce Solutions		Provider Solutions		Consolidated
Subscription/SaaS services	$	184,926	$	35,542	$	220,468
Professional services		5,213		5,935		11,148
Total revenues, net	$	190,139	$	41,477	$	231,616

Subscription/SaaS services revenues primarily consist of fees in consideration of providing customers access to one or more of our SaaS-based solutions and/or courseware subscriptions, as well as for license arrangements, all of which include routine customer support and technology enhancements. Revenue is generally recognized over time during the contract term beginning when the service is made available to the customer. Subscription/SaaS contracts are generally non-cancelable, one to five years in length, and billed annually, semi-annually, quarterly, or monthly in advance.

Deferred revenue represents contract liabilities that are recorded when cash payments are received or are due in advance of our satisfaction of performance obligations. During the year ended December 31, 2018, we recognized revenues of approximately $63.7 million from amounts included in deferred revenue at the beginning of the period. As of December 31, 2018, approximately $447 million of revenue is expected to be recognized from remaining performance obligations under contracts with customers. We expect to recognize revenue on approximately 48% of these remaining performance obligations over the 12 months ending December 31, 2019, with the remaining amounts recognized thereafter.

Sales Commissions

Sales commissions earned by our sales organization are considered incremental and recoverable costs of obtaining a contract with a customer. The Company’s sales commission plans for 2018 typically include multiple payments, including initial payments in the period a customer contract is obtained and subsequent payments either 15 or 27 months after the initial payment. Under ASC 606, costs to acquire contracts with customers, such as the initial sales commission payment, are capitalized and amortized consistent with the pattern of revenue recognition, whereas subsequent sales commission payments which require a substantive performance condition of the employee are expensed ratably through the payment date. In contrast, under ASC 605, initial sales commission payments were expensed in the period earned. Under ASC 606, the initial commission payments are capitalized in the period a customer contract is obtained and are amortized consistent with the transfer of the goods or services to the customer over the expected period of benefit. The capitalized contract cost is included under the caption “deferred commissions” in the accompanying consolidated balance sheet. The expected period of benefit is the contract term, except when the capitalized commission is expected to provide economic benefit to the Company for a period longer than the contract term, such as for new customer or incremental sales where renewals are expected and renewal commissions are not commensurate with initial commissions. Non-commensurate commissions are amortized over the greater of the contract term or expected customer relationship period, limited by the technological obsolescence period of approximately three years. The Company recorded amortization of deferred commissions of $7.7 million for the year ended December 31, 2018, which is included in Sales and marketing expenses in the accompanying consolidated statement of income.

Property and Equipment

12 Months Ended

Dec. 31, 2018

Property Plant And Equipment [Abstract]

Property and Equipment

6. PROPERTY AND EQUIPMENT

Property and equipment consist of the following (in thousands):

	December 31,
	2018			2017
Equipment	$	21,129		$	23,776
Leasehold improvements		11,572			4,951
Furniture and fixtures		3,992			3,757
Gross property and equipment		36,693			32,484
Accumulated depreciation and amortization		(20,827	)		(24,392	)
Property and equipment, net	$	15,866		$	8,092

Depreciation of property and equipment totaled approximately $5.5 million, $5.9 million, and $6.1 million for the years ended December 31, 2018, 2017, and 2016, respectively.

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2018

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

7. GOODWILL AND INTANGIBLE ASSETS

The changes in the carrying amount of goodwill for the years ended December 31, 2018 and 2017 are as follows (in thousands):

	Workforce Solutions		Provider Solutions		Total
Balance at January 1, 2018	$	16,381	$	69,763	$	86,144
Changes in carrying amount		—		—		—
Balance at December 31, 2018	$	16,381	$	69,763	$	86,144

	Workforce Solutions		Provider Solutions		Total
Balance at January 1, 2017	$	16,381	$	69,230	$	85,611
Acquisition of Morrisey Associates, Inc.		—		533		533
Balance at December 31, 2017	$	16,381	$	69,763	$	86,144

During the year ended December 31, 2017, the Company recorded a measurement period adjustment of approximately $533,000 of additional goodwill in relation to the August 2016 acquisition of Morrisey Associates, Inc.

Intangible assets other than goodwill are considered to have finite useful lives. Customer-related intangibles include customer relationships and are amortized over their estimated useful lives ranging from five to thirteen years. Other intangible assets include technology and patents and trade names and are amortized over their estimated useful lives ranging from five to nine years. Amortization of intangible assets was approximately $9.1 million, $9.2 million, and $7.4 million for the years ended December 31, 2018, 2017, and 2016, respectively.

Identifiable intangible assets are comprised of the following (in thousands):

	As of December 31, 2018							As of December 31, 2017
	Gross Amount		Accumulated Amortization			Net		Gross Amount		Accumulated Amortization			Net
Customer related	$	76,714	$	(23,245	)	$	53,469	$	76,714	$	(17,033	)	$	59,681
Other		15,572		(9,663	)		5,909		16,524		(7,708	)		8,816
Total	$	92,286	$	(32,908	)	$	59,378	$	93,238	$	(24,741	)	$	68,497

The expected future annual amortization expense for the years ending December 31, is as follows (in thousands):

2019	$	8,792
2020		8,139
2021		7,356
2022		6,277
2023		5,649
Thereafter		23,165
Total	$	59,378

Discontinued Operations

12 Months Ended

Dec. 31, 2018

Discontinued Operations And Disposal Groups [Abstract]

Discontinued Operations

8. DISCONTINUED OPERATIONS

On February 12, 2018, the Company divested its PX business to Press Ganey for $65.2 million in cash (after giving effect to the post-closing working capital adjustment), resulting in a gain, net of tax, of $19.0 million. Approximately $6.55 million of the proceeds are being held in escrow for a period of time following the closing as a source of recovery for any indemnification claims by Press Ganey. The Company estimated the fair value of the contingent consideration asset based on the likelihood of receiving cash proceeds from the escrow. Such contingent consideration is remeasured at fair value based on changes in facts each period and are recorded within the “Gain on sale of discontinued operations” caption within the consolidated statements of income. The sale of the PX business was effected (i) by the contribution by the Company of specified assets and certain liabilities used in the PX business to a newly-formed wholly-owned subsidiary of the Company, and (ii) immediately thereafter, the sale by the Company to Press Ganey of all the outstanding equity interests of such wholly-owned subsidiary. In connection with such contribution, the Company retained certain liabilities related to the PX business.

This sale of the PX business resulted in the divestiture of the Company’s patient experience solutions business segment. The Company has classified the results of its PX business segment as discontinued operations in its consolidated statements of income and cash flows for all periods presented. Additionally, the related assets and liabilities are reported as assets and liabilities of discontinued operations in the Company’s consolidated balance sheet as of December 31, 2017.

The financial results of the PX business for the period prior to divestiture during the years ended December 31, 2018, 2017, and 2016 are presented in discontinued operations in the Company’s consolidated statements of income. The following table presents the financial results of the PX business (in thousands):

	Year Ended December 31,
	2018			2017			2016
Revenues, net	$	3,342		$	32,763		$	33,850
Operating costs and expenses:
Cost of revenues (excluding depreciation and amortization)		1,982			18,792			21,668
Product development		554			3,751			4,664
Sales and marketing		460			4,310			4,074
Other general and administrative expenses		229			3,282			3,208
Depreciation and amortization		181			2,235			1,840
Total operating costs and expenses		3,406			32,370			35,454

Operating (loss) income		(64	)		393			(1,604	)

Other income		—			—			—

(Loss) income from discontinued operations before income tax provision		(64	)		393			(1,604	)
Income tax benefit		—			(773	)		(568	)
(Loss) income from discontinued operations, net of income taxes	$	(64	)	$	1,166		$	(1,036	)

The following table presents the aggregate carrying amounts of the classes of assets and liabilities of discontinued operations as of December 31, 2017 (in thousands):

Carrying amounts of assets included as part of discontinued operations:
Accounts receivable, net	$	4,158
Accounts receivable – unbilled		1,275
Prepaid royalties, net of amortization		37
Other prepaid expenses and other current assets		655
Current assets of discontinued operations		6,125

Property and equipment, net		901
Capitalized software development, net		2,683
Goodwill		24,154
Customer-related intangibles, net		276
Other intangible assets, net		42
Other assets		17
Long-term assets of discontinued operations		28,073

Total assets of discontinued operations in the consolidated balance sheet	$	34,198

Carrying amounts of liabilities included as part of discontinued operations:
Accounts payable and accrued expenses	$	2,728
Accrued royalties		27
Deferred revenue		4,017
Current liabilities of discontinued operations		6,772

Deferred tax liabilities		1,971
Deferred revenue, noncurrent		15
Other long term liabilities		562
Long-term liabilities of discontinued operations		2,548

Total liabilities of discontinued operations in the consolidated balance sheet	$	9,320

Business Segments

12 Months Ended

Dec. 31, 2018

Segment Reporting [Abstract]

Business Segments

9. BUSINESS SEGMENTS

The Company provides services to healthcare organizations and other members within the healthcare industry. The Company’s services are focused on the delivery of workforce development products and services (HealthStream Workforce Solutions) and provider credentialing, privileging, call center, and enrollment products and services (HealthStream Provider Solutions).

The Company measures segment performance based on operating income before income taxes and prior to the allocation of certain corporate overhead expenses, interest income, interest expense, gains and losses from equity investments, and depreciation. The Unallocated component below includes corporate functions, such as accounting, human resources, legal, investor relations, administrative and executive personnel, depreciation, a portion of amortization, and certain other expenses, which are not currently allocated in measuring segment performance. The following is the Company’s business segment information as of and for the years ended December 31, 2018, 2017, and 2016 (in thousands).

Revenues, net:	2018		2017		2016
Workforce Solutions	$	190,139	$	178,061	$	168,040
Provider Solutions		41,477		36,838		24,084
Total revenues, net	$	231,616	$	214,899	$	192,124

Operating income:	2018			2017			2016
Workforce Solutions	$	38,834		$	33,579		$	37,329
Provider Solutions		3,474			879			(2,443	)
Unallocated		(26,817	)		(25,051	)		(27,715	)
Total operating income	$	15,491		$	9,407		$	7,171

Segment assets *	December 31, 2018		December 31, 2017
Workforce Solutions	$	104,668	$	90,055
Provider Solutions		145,637		150,797
Discontinued operations		—		34,198
Unallocated		191,643		136,069
Total assets	$	441,948	$	411,119

* Segment assets include accounts and unbilled receivables, prepaid royalties, prepaid and other current assets, other assets, capitalized software development, deferred commissions, certain property and equipment, and intangible assets. Cash and cash equivalents and marketable securities are not allocated to individual segments, and are included within Unallocated. A significant portion of property and equipment assets are included within Unallocated.

Income Taxes

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Income Taxes

10. INCOME TAXES

The provision (benefit) for income taxes is comprised of the following (in thousands):

	Year Ended December 31,
	2018			2017			2016
Current federal	$	(79	)	$	1,819		$	514
Current state		386			923			1,032
Deferred federal		2,661			(1,464	)		1,176
Deferred state		356			24			239
Provision for income taxes	$	3,324		$	1,302		$	2,961

A reconciliation of income taxes at the statutory federal income tax rate to the provision for income taxes included in the accompanying consolidated statements of income is as follows (in thousands):

	Year Ended December 31,
	2018			2017			2016
Federal tax provision at the statutory rate	$	3,482		$	3,549		$	2,713
State income tax provision, net of federal benefit		658			491			757
Tax credits		(509	)		(583	)		(560	)
Change in state valuation allowance		2			151			132
Tax Act revaluation of deferred tax balances		—			(1,680	)		—
Stock compensation		(560	)		(626	)		(9	)
Other		251			—			(72	)
Provision for income taxes	$	3,324		$	1,302		$	2,961

Management periodically assesses the realizability of its deferred tax assets, and to the extent that a recovery is not likely, a valuation allowance is established to reduce the deferred tax asset to the amount estimated to be recoverable. At December 31, 2018, a valuation allowance of $311,000 exists.

As of December 31, 2018, the Company had state net operating loss carryforwards of $4.8 million. These loss carryforwards will expire in years 2030 through 2038. The Company is subject to income taxation at the federal and various state levels. The Company is subject to U.S. federal tax examinations for tax years 2015 through 2018. Loss carryforwards and credit carryforwards generated or utilized in years earlier than 2015 are also subject to examination and adjustment. The Company has completed examinations with the Internal Revenue Service for tax years 2013 and 2014.

On December 22, 2017, the President signed into law the Tax Cuts and Jobs Act (the Tax Act), reducing the U.S. corporate income tax rate to 21% effective January 1, 2018. Under ASC 740, the effects of new legislation are recognized in the period that includes the date of enactment.

Subsequent to the enactment of the Tax Act, the SEC staff issued Staff Accounting Bulletin No. 118, Income Tax Accounting Implications of the Tax Cuts and Jobs Act (SAB 118), which allows companies to record provisional amounts related to the effects of the Tax Act to the extent that a company’s accounting for certain income tax effects of the Tax Act is incomplete but the company is able to determine a reasonable estimate during a measurement period not to extend beyond one year from the enactment date. The Company previously made provisional estimates for the impact of the Tax Act as of and for the year ended December 31, 2017 related to the remeasurement of our deferred tax liability. The impact was to remeasure our deferred tax liability by $1.7 million as of December 31, 2017, which has been reflected in our effect tax rate reconciliation. As of December 31, 2018, we have completed our accounting and measurement analyses related to the income tax effects of the Tax Act, and no significant adjustments to the provisional amounts were recorded during the year ended December 31, 2018.

A reconciliation of the beginning and ending liability for gross unrecognized tax benefits at December 31, 2018 and 2017 are as follows (in thousands):

	December 31,
	2018			2017
Balance at beginning of year	$	360		$	397
Additions for tax positions in the current year		2			10
Reductions for tax positions of prior years		(23	)		(47	)
Balance at end of year	$	339		$	360

The Company recognized a nominal amount for interest and penalties related to unrecognized tax benefits within the provision for income taxes during the years ended December 31, 2018 and 2017. Unrecognized tax benefits included tax positions of approximately $339,000 and $337,000 at December 31, 2018 and 2017, respectively, that if recognized would impact the Company’s effective tax rate. The reduction for tax positions of prior years reflected in the table above as of December 31, 2018 relates to an item considered to be effectively settled due to lapse of the statute of limitations.

Deferred federal and state income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Significant components of deferred tax assets and deferred tax liabilities are as follows (in thousands):

	December 31,
	2018			2017
Deferred tax assets:
Allowance for doubtful accounts	$	297		$	488
Accrued liabilities		2,276			1,580
Tax credits		—			3,115
Stock based compensation		623			743
Deferred revenue		135			1,467
Depreciation		—			621
Basis difference on investments		396			327
Net operating loss carryforwards		291			215
Total deferred tax assets		4,018			8,556
Less: Valuation allowance		(311	)		(310	)
Deferred tax assets, net of valuation allowance		3,707			8,246
Deferred tax liabilities:
Deductible goodwill		1,760			1,212
Nondeductible intangible assets		1,049			1,330
Prepaid assets		5,698			1,784
Capitalized software development		4,746			3,875
Depreciation		659			—
PX sale deferral		718			—
Total deferred tax liabilities		14,630			8,201

Net deferred tax liabilities (assets)	$	10,923		$	(45	)

The Company realized approximately $540,000 of excess tax benefits related to stock based awards during the year ended December 31, 2018, which was reflected in the statement of income as a component of the provision for income taxes.

Stock Based Compensation

12 Months Ended

Dec. 31, 2018

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock Based Compensation

11. STOCK BASED COMPENSATION

Stock Incentive Plans

The Company has outstanding equity-based awards under its 2016 Omnibus Incentive Plan (2016 Plan) and 2010 Stock Incentive Plan (2010 Plan) (collectively, the 2016 Plan and the 2010 Plan, referred to as the Plans). In addition, the 2016 Plan authorizes the grant of options, restricted share units (RSUs), or other forms of stock based compensation to employees, officers, directors, and others, and such grants must be approved by the Compensation Committee of the Board of Directors. Options which have been granted under the Plans have terms of no more than ten years, with certain restrictions. The 2016 Plan allows the Compensation Committee of the Board of Directors to determine the vesting period and parameters of each grant. The vesting period of the options and RSUs granted has historically ranged from immediate vesting to annual vesting up to four years, generally beginning one year after the grant date. As of December 31, 2018, approximately 1.1 million shares of unissued common stock remained reserved for future stock incentive grants under the 2016 Plan. The Company issues new shares of common stock when options are exercised or when RSUs become vested.

Stock Option Activity

A summary of activity and various other information relative to stock options for the year ended December 31, 2018 is presented in the tables below (in thousands, except exercise price).

				Weighted-
	Common			Average		Aggregate
	Shares			Exercise Price		Intrinsic Value
Outstanding at beginning of period		376		$	7.44
Granted		—			—
Exercised		(357	)		7.23
Expired		—			—
Forfeited		—			—
Outstanding at end of period		19		$	11.27	$	245
Exercisable at end of period		19		$	11.27	$	245

The aggregate intrinsic value for stock options in the table above represents the total difference between the Company’s closing stock price on December 31, 2018 (the last trading day of the year) of $24.15 per share and the option exercise price, multiplied by the number of in-the-money options as of December 31, 2018. The weighted average remaining contractual term of options outstanding at December 31, 2018 was 0.3 years. Options exercisable at December 31, 2018 have a weighted average remaining contractual term of 0.3 years.

Other information relative to option activity during the three years ended December 31, 2018 is as follows (in thousands):

	2018		2017		2016
Total grant date fair value of stock options vested	$	—	$	—	$	—
Total intrinsic value of stock options exercised	$	6,130	$	1,973	$	820
Cash proceeds from exercise of stock options	$	2,582	$	413	$	145

Restricted Share Unit Activity

A summary of activity relative to RSUs for the year ended December 31, 2018 is as follows (in thousands, except weighted average grant date fair value):

				Weighted-
	Number of			Average Grant Date		Aggregate
	RSU’s			Fair Value		Intrinsic Value
Outstanding at beginning of period		254		$	23.13
Granted		163			25.65
Vested		(73	)		23.94
Forfeited		(55	)		23.28
Outstanding at end of period		289		$	24.31	$	6,975

The aggregate fair value of RSUs that vested during the year ended December 31, 2018 and 2017, as of the respective vesting dates, was approximately $1.8 million and $1.9 million, respectively. A portion of RSUs that vested in 2018 and 2017 were net-share settled such that the Company withheld shares with 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. The total shares withheld for RSUs during 2018 and 2017 were 13,300 and 17,122, respectively, and were based on the value of the RSUs on their respective settlement dates as determined by the Company’s closing stock price. Total payments related to RSUs for the employees’ tax obligations to taxing authorities were approximately $338,000 in 2018, $412,000 in 2017, and $316,000 in 2016, and are reflected as a financing activity within the consolidated statements of cash flows. These net-share settlements had the effect of share repurchases by the Company as they reduced and retired the number of shares that would have otherwise been issued as a result of the vesting and did not represent an expense to the Company.

Stock Based Compensation

Total stock based compensation expense, which is recorded in our consolidated statements of income, recorded for the years ended December 31, is as follows (in thousands):

	Years Ended December 31,
	2018		2017		2016
Cost of revenues (excluding depreciation and amortization)	$	37	$	29	$	62
Product development		296		228		174
Sales and marketing		183		244		274
Other general and administrative		1,261		1,235		1,385
Total stock based compensation expense	$	1,777	$	1,736	$	1,895

The Company amortizes the fair value of all stock based awards, net of estimated forfeitures, on a straight-line basis over the requisite service period, which generally is the vesting period. As of December 31, 2018, total unrecognized compensation expense related to non-vested stock options and RSUs was approximately $3.2 million, net of estimated forfeitures, with a weighted average expense recognition period remaining of 2.2 years. The Company realized approximately $540,000 of excess tax benefits related to stock based awards during the year ended December 31, 2018, which was reflected in the statement of income as a component of the provision for income taxes.

Stock based compensation cost for RSUs is measured based on the closing fair market value of the Company’s stock on the date of grant. Stock based compensation cost for stock options is estimated at the grant date based on the fair value calculated using the Black-Scholes method. The Company did not grant any stock options during the years ended December 31, 2018, 2017, or 2016.

Employee Benefit Plan

12 Months Ended

Dec. 31, 2018

Compensation And Retirement Disclosure [Abstract]

Employee Benefit Plan

12. EMPLOYEE BENEFIT PLAN

401(k) Plan

The Company has a defined-contribution employee benefit plan (401(k) Plan) incorporating provisions of Section 401(k) of the Internal Revenue Code. Employees must have attained the age of 21 and have completed thirty days of service to be eligible to participate in the 401(k) Plan. Under the provisions of the 401(k) Plan, a plan member may make contributions, on a tax-deferred basis, subject to IRS limitations. The Company elected to provide eligible employees with matching contributions totaling approximately $1.3 million, $764,000, and $311,000 for the years ended December 31, 2018, 2017, and 2016, respectively.

Debt

12 Months Ended

Dec. 31, 2018

Debt Disclosure [Abstract]

Debt

13. DEBT

At December 31, 2018 and 2017, the Company had no debt outstanding.

Revolving Credit Facility

The Company entered into a Second Amendment to Revolving Credit Agreement (Revolving Credit Facility), amending the Revolving Credit Facility, dated as of December 31, 2018 with SunTrust Bank (SunTrust), extending the maturity date to November 24, 2020. Under the Revolving Credit Facility, the Company may borrow up to $50.0 million, which includes a $5.0 million swing line sub-facility and a $5.0 million letter of credit sub-facility, as well as an accordion feature that allows the Company to increase the Revolving Credit Facility by a total of up to $25.0 million, subject to securing additional commitments from existing lenders or new lending institutions. The obligations under the Revolving Credit Facility are guaranteed by each of the Company’s subsidiaries. At the Company’s election, the borrowings under the Revolving Credit Facility bear interest at either (1) a rate per annum equal to the highest of SunTrust’s prime rate or 0.5% in excess of the Federal Funds Rate or 1.0% in excess of one-month LIBOR (the Base Rate), plus an applicable margin, or (2) the one, two, three, or six-month per annum LIBOR for deposits in the applicable currency (the Eurocurrency Rate), as selected by the Company, plus an applicable margin. The applicable margin for Eurocurrency Rate loans depends on the Company’s funded debt leverage ratio and varies from 1.50% to 2.00%. The applicable margin for Base Rate loans depends on the Company’s funded debt leverage ratio and varies from 0.50% to 1.50%. Commitment fees and letter of credit fees are also payable under the Revolving Credit Facility. Principal is payable in full at maturity on November 24, 2020, and there are no scheduled principal payments prior to maturity. The Company is required to pay a commitment fee ranging between 20 and 30 basis points per annum of the average daily unused portion of the Revolving Credit Facility, depending on the Company’s funded debt leverage ratio.

The purpose of the Revolving Credit Facility is for general working capital needs, permitted acquisitions (as defined in the Loan Agreement), and for stock repurchase and/or redemption transactions that the Company may authorize.

The Revolving Credit Facility contains certain covenants that, among other things, restrict additional indebtedness, liens and encumbrances, changes to the character of the Company’s business, acquisitions, asset dispositions, mergers and consolidations, sale or discount of receivables, creation or acquisitions of additional subsidiaries, and other matters customarily restricted in such agreements.

In addition, the Revolving Credit Facility requires the Company to meet certain financial tests, including, without limitation:

•

a funded debt leverage ratio (consolidated debt/consolidated EBITDA) of not greater than 3.0 to 1.0; and

•

an interest coverage ratio (consolidated EBITDA/consolidated interest expense) of not less than 3.0 to 1.0.

As of December 31, 2018, the Company was in compliance with all covenants. There were no balances outstanding on the Revolving Credit Facility as of December 31, 2018 and there were no borrowings under the Revolving Credit Facility during the year ended December 31, 2018.

Leases

12 Months Ended

Dec. 31, 2018

Leases [Abstract]

Leases

14. LEASES

The Company has non-cancellable operating leases primarily for office space and hosting facilities. Some lease agreements contain provisions for escalating rent payments over the initial terms of the lease. The Company accounts for these leases by recognizing rent expense on a straight-line basis and adjusting the deferred rent expense liability for the difference between the straight-line rent expense and the amount of rent paid. The terms of the lease agreements generally provide the Company the option to renew. Total rent expense under all operating leases was approximately $7.4 million, $6.6 million, and $4.1 million for the years ended December 31, 2018, 2017, and 2016, respectively.

Future rental payment commitments at December 31, 2018 under non-cancelable operating leases, with initial terms of one year or more, are as follows (in thousands):

2019	$	2,156
2020		4,013
2021		3,766
2022		3,602
2023		3,678
Thereafter		26,085
Total minimum lease payments	$	43,300

Collaborative Arrangement

12 Months Ended

Dec. 31, 2018

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Collaborative Arrangement

15. COLLABORATIVE ARRANGEMENT

The Company participated in a collaborative arrangement, SimVentures^TM, with Laerdal Medical A/S (Laerdal Medical), which ended effective March 1, 2018. Prior to the termination of this collaborative arrangement, the Company received 50 percent of the profits or losses generated from the collaborative arrangement. For the year ended December 31, 2018, the Company recorded $391,000 of revenues and $187,000 of expenses related to the collaborative arrangement. For the year ended December 31, 2017, the Company recorded $2.2 million of revenues and $1.2 million of expenses related to the collaborative arrangement. For the year ended December 31, 2016, the Company recorded $2.7 million of revenues and $1.4 million of expenses related to the collaborative arrangement.

Litigation

12 Months Ended

Dec. 31, 2017

Commitments And Contingencies Disclosure [Abstract]

Litigation

16. LITIGATION

In connection with its business, the Company is from time to time involved in various legal actions. The litigation process is inherently uncertain and it is possible that the resolution of such matters might have a material adverse effect upon the financial condition and/or results of operations of the Company. However, in the opinion of the Company’s management, matters currently pending or threatened against the Company are not expected to have a material adverse effect on the financial position or results of operations of the Company.

Non-Marketable Equity Investments

12 Months Ended

Dec. 31, 2018

Investments Debt And Equity Securities [Abstract]

Non-Marketable Equity Investments

17. NON-MARKETABLE EQUITY INVESTMENTS

Non-marketable equity investments are accounted for using the equity method when the Company can exercise significant influence over the investee. Non-marketable equity investments where the Company is not able to exercise significant influence over the investee are accounted for under the cost method. ASU 2016-01, Financial Instruments – Overall (Subtopic 825-10), became effective for the Company as of January 1, 2018 and requires equity investments (except those accounted for under the equity method of accounting or those that result in consolidation of the investee) to be measured at fair value with changes in fair value recognized in net income. For the year ended December 31, 2018, the Company recorded a $1.3 million reduction to the carrying value of a cost method investment due to a change in fair value, based on observable prices from an orderly transaction for a similar investment made in this investee. The fair value adjustment is included in “Other (loss) income, net” in the accompanying consolidated statements of income. The aggregate carrying amount of all cost method investments was $2.1 million and $2.5 million as of December 31, 2018 and December 31, 2017, respectively, which carrying value the Company evaluates for impairment at each reporting period. The fair value of a cost method investment is not estimated if there are no identified events or changes in circumstances that may have a significant adverse effect on the fair value of the investment.

Subsequent Events

12 Months Ended

Dec. 31, 2018

Subsequent Events [Abstract]

Subsequent Events

18. SUBSEQUENT EVENTS

On January 10, 2019, the Company acquired the outstanding equity of Providigm, LLC, a Denver-based company focused on quality assurance and performance improvement in healthcare, primarily serving skilled nursing facilities, for $18.0 million in cash, subject to a post-closing working capital adjustment. In addition, up to an additional $500,000 in cash may be paid contingent upon the performance of Providigm during an 18-month period following closing. The acquisition will be accounted for using the acquisition method of business combination under ASC 805, Business Combinations. The initial accounting for the business combination is incomplete due to the timing of the acquisition. Therefore, we are unable disclose certain information required by ASC 805. We will provide preliminary purchase price allocation information in our Quarterly Report on Form 10-Q for the quarter ending March 31, 2019.

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Reporting Entity and Segments

Recently Adopted Accounting Standards

Recognition of Revenue

Revenue is recognized based on the following five step model:

•

Identification of the contract with a customer

•

Identification of the performance obligations in the contract

•

Determination of the transaction price

•

Allocation of the transaction price to the performance obligations in the contract

•

Recognition of revenue when, or as, the Company satisfies a performance obligation

Deferred revenue represents contract liabilities that are recorded when cash payments are received or are due in advance of our satisfaction of performance obligations.

Principles of Consolidation

The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation.

Use of Estimates

Cash Equivalents

The Company considers cash equivalents to be unrestricted, highly liquid investments with initial maturities of less than three months.

Marketable Securities

Deferred Commissions

Prepaid Royalties

Allowance for Doubtful Accounts

Changes in the allowance for doubtful accounts and the amounts charged to bad debt expense from continuing operations for the years ended December 31 were as follows (in thousands):

	Allowance Balance at Beginning of Period		Charged to Costs and Expenses		Write-offs			Allowance Balance at End of Period
2018	$	1,979	$	1,033	$	(1,851	)	$	1,161
2017		839		1,568		(428	)		1,979
2016		292		590		(43	)		839

Capitalized Software Development

Fair Value Measurements

Level 1 – Observable inputs that reflect quoted prices (unadjusted) for identical assets or liabilities in active markets.

Level 2 – Inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly.

Level 3 – Unobservable inputs in which little or no market data exists, therefore requiring the Company to develop its own assumptions.

Property and Equipment

	Years
Furniture and fixtures	5 - 7
Equipment		3

Goodwill and Intangible Assets

Long-Lived Assets

Non-Marketable Equity Investments

Financial Instruments

Advertising

Shipping and Handling Costs

Shipping and handling costs that are associated with our products and services are included in cost of revenues.

Income Taxes

Earnings Per Share

Earnings per Share

Concentrations of Credit Risk and Significant Customers

Stock Based Compensation

Recently Issued Accounting Pronouncements Not Yet Adopted

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Changes in the Allowance for Doubtful Accounts and the Amounts Charged to Bad Debt Expense

Changes in the allowance for doubtful accounts and the amounts charged to bad debt expense from continuing operations for the years ended December 31 were as follows (in thousands):

	Allowance Balance at Beginning of Period		Charged to Costs and Expenses		Write-offs			Allowance Balance at End of Period
2018	$	1,979	$	1,033	$	(1,851	)	$	1,161
2017		839		1,568		(428	)		1,979
2016		292		590		(43	)		839

Estimated Useful Lives of Property and Equipment

	Years
Furniture and fixtures	5 - 7
Equipment		3

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2018

Earnings Per Share [Abstract]

Computation of Basic and Diluted Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share for the three years ended December 31, 2018 (in thousands, except per share amounts):

	Year Ended December 31,
	2018		2017		2016
Numerator:
Income from continuing operations	$	13,251	$	8,838	$	4,791
Income (loss) from discontinued operations		18,966		1,166		(1,036	)
Net income	$	32,217	$	10,004	$	3,755
Denominator:
Weighted-average shares outstanding		32,264		31,861		31,721
Effect of dilutive shares		71		335		347
Weighted-average diluted shares		32,335		32,196		32,068

Earnings (loss) per share – basic:
Continuing operations	$	0.41	$	0.27	$	0.15
Discontinued operations		0.59		0.04		(0.03	)
Earnings per share - basic	$	1.00	$	0.31	$	0.12

Earnings (loss) per share – diluted:
Continuing operations	$	0.41	$	0.27	$	0.15
Discontinued operations		0.59		0.04		(0.03	)
Earnings per share - diluted	$	1.00	$	0.31	$	0.12

Marketable Securities (Tables)

12 Months Ended

Dec. 31, 2018

Investments Debt And Equity Securities [Abstract]

Fair Value of Available for Sale Marketable Securities

At December 31, 2018 and 2017, the fair value of marketable securities, which were all classified as available for sale, included the following (in thousands):

	December 31, 2018
	Adjusted Cost		Unrealized Gains		Unrealized Losses			Fair Value
Level 2:
Corporate debt securities	$	31,521	$	—	$	(23	)	$	31,498
Government-sponsored enterprise debt securities		2,999		—		—			2,999
Total	$	34,520	$	—	$	(23	)	$	34,497

	December 31, 2017
	Adjusted Cost		Unrealized Gains		Unrealized Losses			Fair Value
Level 2:
Corporate debt securities	$	41,900	$	1	$	(39	)	$	41,862
Government-sponsored enterprise debt securities		4,488		1		(1	)		4,488
Total	$	46,388	$	2	$	(40	)	$	46,350

Revenue Recognition And Sales Commissions (Tables)

12 Months Ended

Dec. 31, 2018

Revenue From Contract With Customer [Abstract]

Schedule of Cumulative Effect for the Adoption of ASC 606

The cumulative effect of the changes made to the Company’s consolidated January 1, 2018 balance sheet in connection with the adoption of ASC 606 was as follows (in thousands):

Balance Sheet	Balance at December 31, 2017		ASC 606 Adjustments			Balance at January 1, 2018
Assets
Unbilled receivables	$	1,327	$	31		$	1,358
Prepaid royalties, net		16,137		(902	)		15,235
Other prepaid expenses and other current assets		8,330		(2,900	)		5,430
Current assets of discontinued operations		6,125		(274	)		5,851
Deferred commissions		—		12,552			12,552
Deferred tax assets		45		(45	)		—
Non-current assets of discontinued operations		28,073		3,166			31,239

Liabilities
Deferred revenue, current		64,938		(4,488	)		60,450
Current liabilities of discontinued operations		6,772		(1,374	)		5,398
Deferred tax liabilities		—		5,205			5,205
Deferred revenue, noncurrent		6,287		(2,848	)		3,439

Shareholders’ equity
Retained earnings		17,542		15,132			32,674

Schedule of Impact of Adopting of ASC 606 on Condensed Consolidated Balance Sheet and Statements of Income

The impact of adopting ASC 606 on the Company’s consolidated balance sheet as of December 31, 2018 and statements of income for the year ended December 31, 2018 was as follows (in thousands):

	December 31, 2018
Balance Sheet	As reported		Balances without Adoption of ASC 606		Effect of Change Higher/(Lower)
Assets
Prepaid royalties, net	$	13,596	$	14,801	$	(1,205	)
Other prepaid expenses and other current assets		18,016		20,167		(2,151	)
Deferred commissions		16,470		—		16,470

Liabilities
Deferred revenue, current		66,061		70,796		(4,735	)
Deferred revenue, noncurrent		2,868		6,210		(3,342	)

Shareholders’ equity
Retained earnings		32,373		29,382		2,991

	Year Ended December 31, 2018
Income Statement	As reported		Balances without Adoption of ASC 606		Effect of Change Higher/(Lower)
Revenues, net	$	231,616	$	230,876	$	740

Costs and expenses
Cost of revenues (excluding depreciation and amortization)		96,014		95,711		303
Sales and marketing		35,698		39,008		(3,310	)
Operating income		15,491		11,744		3,747
Income from continuing operations before income tax provision		16,575		12,828		3,747
Income tax provision		3,324		2,568		756
Income from continuing operations		13,251		10,260		2,991
Net income		32,217		29,226		2,991

Schedule of Revenues Included in Continuing Operations Disaggregated by Revenue Source

The following table represents revenues included in continuing operations disaggregated by revenue source for the year ended December 31, 2018 (in thousands). Sales taxes are excluded from revenues.

	Year Ended December 31, 2018
Business Segments	Workforce Solutions		Provider Solutions		Consolidated
Subscription/SaaS services	$	184,926	$	35,542	$	220,468
Professional services		5,213		5,935		11,148
Total revenues, net	$	190,139	$	41,477	$	231,616

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2018

Property Plant And Equipment [Abstract]

Summary of Property and Equipment

Property and equipment consist of the following (in thousands):

	December 31,
	2018			2017
Equipment	$	21,129		$	23,776
Leasehold improvements		11,572			4,951
Furniture and fixtures		3,992			3,757
Gross property and equipment		36,693			32,484
Accumulated depreciation and amortization		(20,827	)		(24,392	)
Property and equipment, net	$	15,866		$	8,092

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2018

Goodwill And Intangible Assets Disclosure [Abstract]

Changes in Carrying Amount of Goodwill

The changes in the carrying amount of goodwill for the years ended December 31, 2018 and 2017 are as follows (in thousands):

	Workforce Solutions		Provider Solutions		Total
Balance at January 1, 2018	$	16,381	$	69,763	$	86,144
Changes in carrying amount		—		—		—
Balance at December 31, 2018	$	16,381	$	69,763	$	86,144

	Workforce Solutions		Provider Solutions		Total
Balance at January 1, 2017	$	16,381	$	69,230	$	85,611
Acquisition of Morrisey Associates, Inc.		—		533		533
Balance at December 31, 2017	$	16,381	$	69,763	$	86,144

Identifiable Intangible Assets

Identifiable intangible assets are comprised of the following (in thousands):

	As of December 31, 2018							As of December 31, 2017
	Gross Amount		Accumulated Amortization			Net		Gross Amount		Accumulated Amortization			Net
Customer related	$	76,714	$	(23,245	)	$	53,469	$	76,714	$	(17,033	)	$	59,681
Other		15,572		(9,663	)		5,909		16,524		(7,708	)		8,816
Total	$	92,286	$	(32,908	)	$	59,378	$	93,238	$	(24,741	)	$	68,497

Expected Annual Amortization Expense

The expected future annual amortization expense for the years ending December 31, is as follows (in thousands):

2019	$	8,792
2020		8,139
2021		7,356
2022		6,277
2023		5,649
Thereafter		23,165
Total	$	59,378

Discontinued Operations (Tables)

12 Months Ended

Dec. 31, 2018

Discontinued Operations And Disposal Groups [Abstract]

Schedule of Discontinued Operations, Income Statement and Balance Sheet

The following table presents the financial results of the PX business (in thousands):

	Year Ended December 31,
	2018			2017			2016
Revenues, net	$	3,342		$	32,763		$	33,850
Operating costs and expenses:
Cost of revenues (excluding depreciation and amortization)		1,982			18,792			21,668
Product development		554			3,751			4,664
Sales and marketing		460			4,310			4,074
Other general and administrative expenses		229			3,282			3,208
Depreciation and amortization		181			2,235			1,840
Total operating costs and expenses		3,406			32,370			35,454

Operating (loss) income		(64	)		393			(1,604	)

Other income		—			—			—

(Loss) income from discontinued operations before income tax provision		(64	)		393			(1,604	)
Income tax benefit		—			(773	)		(568	)
(Loss) income from discontinued operations, net of income taxes	$	(64	)	$	1,166		$	(1,036	)

The following table presents the aggregate carrying amounts of the classes of assets and liabilities of discontinued operations as of December 31, 2017 (in thousands):

Carrying amounts of assets included as part of discontinued operations:
Accounts receivable, net	$	4,158
Accounts receivable – unbilled		1,275
Prepaid royalties, net of amortization		37
Other prepaid expenses and other current assets		655
Current assets of discontinued operations		6,125

Property and equipment, net		901
Capitalized software development, net		2,683
Goodwill		24,154
Customer-related intangibles, net		276
Other intangible assets, net		42
Other assets		17
Long-term assets of discontinued operations		28,073

Total assets of discontinued operations in the consolidated balance sheet	$	34,198

Carrying amounts of liabilities included as part of discontinued operations:
Accounts payable and accrued expenses	$	2,728
Accrued royalties		27
Deferred revenue		4,017
Current liabilities of discontinued operations		6,772

Deferred tax liabilities		1,971
Deferred revenue, noncurrent		15
Other long term liabilities		562
Long-term liabilities of discontinued operations		2,548

Total liabilities of discontinued operations in the consolidated balance sheet	$	9,320

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
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-URI http://asc.fasb.org/extlink&oid=109222650&loc=SL51721665-107760

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

Business Segments (Tables)

12 Months Ended

Dec. 31, 2018

Segment Reporting [Abstract]

Business Segment Information Based on Net Revenues

The following is the Company’s business segment information as of and for the years ended December 31, 2018, 2017, and 2016 (in thousands).

Revenues, net:	2018		2017		2016
Workforce Solutions	$	190,139	$	178,061	$	168,040
Provider Solutions		41,477		36,838		24,084
Total revenues, net	$	231,616	$	214,899	$	192,124

Business Segment Information Based on Operating Income

Operating income:	2018			2017			2016
Workforce Solutions	$	38,834		$	33,579		$	37,329
Provider Solutions		3,474			879			(2,443	)
Unallocated		(26,817	)		(25,051	)		(27,715	)
Total operating income	$	15,491		$	9,407		$	7,171

Business Segment Information Based on Assets

Segment assets *	December 31, 2018		December 31, 2017
Workforce Solutions	$	104,668	$	90,055
Provider Solutions		145,637		150,797
Discontinued operations		—		34,198
Unallocated		191,643		136,069
Total assets	$	441,948	$	411,119

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Summary of Provision (Benefit) for Income Taxes

The provision (benefit) for income taxes is comprised of the following (in thousands):

	Year Ended December 31,
	2018			2017			2016
Current federal	$	(79	)	$	1,819		$	514
Current state		386			923			1,032
Deferred federal		2,661			(1,464	)		1,176
Deferred state		356			24			239
Provision for income taxes	$	3,324		$	1,302		$	2,961

Reconciliation of Income Taxes at the Statutory Federal Income Tax Rate to the Provision for Income Taxes

	Year Ended December 31,
	2018			2017			2016
Federal tax provision at the statutory rate	$	3,482		$	3,549		$	2,713
State income tax provision, net of federal benefit		658			491			757
Tax credits		(509	)		(583	)		(560	)
Change in state valuation allowance		2			151			132
Tax Act revaluation of deferred tax balances		—			(1,680	)		—
Stock compensation		(560	)		(626	)		(9	)
Other		251			—			(72	)
Provision for income taxes	$	3,324		$	1,302		$	2,961

Reconciliation of the Beginning and Ending liability for Gross Unrecognized Tax Benefits

A reconciliation of the beginning and ending liability for gross unrecognized tax benefits at December 31, 2018 and 2017 are as follows (in thousands):

	December 31,
	2018			2017
Balance at beginning of year	$	360		$	397
Additions for tax positions in the current year		2			10
Reductions for tax positions of prior years		(23	)		(47	)
Balance at end of year	$	339		$	360

Significant Components of Deferred Tax Assets and Deferred Tax Liabilities

Significant components of deferred tax assets and deferred tax liabilities are as follows (in thousands):

	December 31,
	2018			2017
Deferred tax assets:
Allowance for doubtful accounts	$	297		$	488
Accrued liabilities		2,276			1,580
Tax credits		—			3,115
Stock based compensation		623			743
Deferred revenue		135			1,467
Depreciation		—			621
Basis difference on investments		396			327
Net operating loss carryforwards		291			215
Total deferred tax assets		4,018			8,556
Less: Valuation allowance		(311	)		(310	)
Deferred tax assets, net of valuation allowance		3,707			8,246
Deferred tax liabilities:
Deductible goodwill		1,760			1,212
Nondeductible intangible assets		1,049			1,330
Prepaid assets		5,698			1,784
Capitalized software development		4,746			3,875
Depreciation		659			—
PX sale deferral		718			—
Total deferred tax liabilities		14,630			8,201

Net deferred tax liabilities (assets)	$	10,923		$	(45	)

Stock Based Compensation (Tables)

12 Months Ended

Dec. 31, 2018

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Summary of Activity and Various Other Information Relative to Stock Options

A summary of activity and various other information relative to stock options for the year ended December 31, 2018 is presented in the tables below (in thousands, except exercise price).

				Weighted-
	Common			Average		Aggregate
	Shares			Exercise Price		Intrinsic Value
Outstanding at beginning of period		376		$	7.44
Granted		—			—
Exercised		(357	)		7.23
Expired		—			—
Forfeited		—			—
Outstanding at end of period		19		$	11.27	$	245
Exercisable at end of period		19		$	11.27	$	245

Other Information Relative to Option Activity

Other information relative to option activity during the three years ended December 31, 2018 is as follows (in thousands):

	2018		2017		2016
Total grant date fair value of stock options vested	$	—	$	—	$	—
Total intrinsic value of stock options exercised	$	6,130	$	1,973	$	820
Cash proceeds from exercise of stock options	$	2,582	$	413	$	145

Summary of Activity Relative to RSU's

A summary of activity relative to RSUs for the year ended December 31, 2018 is as follows (in thousands, except weighted average grant date fair value):

				Weighted-
	Number of			Average Grant Date		Aggregate
	RSU’s			Fair Value		Intrinsic Value
Outstanding at beginning of period		254		$	23.13
Granted		163			25.65
Vested		(73	)		23.94
Forfeited		(55	)		23.28
Outstanding at end of period		289		$	24.31	$	6,975

Stock Based Compensation Expense Recorded in Consolidated Statements of Income

Total stock based compensation expense, which is recorded in our consolidated statements of income, recorded for the years ended December 31, is as follows (in thousands):

	Years Ended December 31,
	2018		2017		2016
Cost of revenues (excluding depreciation and amortization)	$	37	$	29	$	62
Product development		296		228		174
Sales and marketing		183		244		274
Other general and administrative		1,261		1,235		1,385
Total stock based compensation expense	$	1,777	$	1,736	$	1,895

Leases (Tables)

12 Months Ended

Dec. 31, 2018

Leases [Abstract]

Future Rental Payment Commitments under Non-Cancelable Operating Leases

Future rental payment commitments at December 31, 2018 under non-cancelable operating leases, with initial terms of one year or more, are as follows (in thousands):

2019	$	2,156
2020		4,013
2021		3,766
2022		3,602
2023		3,678
Thereafter		26,085
Total minimum lease payments	$	43,300

Summary of Significant Accounting Policies - Additional Information (Detail)		12 Months Ended
	Feb. 12, 2018 USD ($)	Dec. 31, 2018 USD ($) Segment SourcesofTaxableIncome Plan	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)	Jan. 01, 2019 USD ($)
Business And Basis Of Presentation [Line Items]
Number of operating segments \| Segment		2
Maturity of unrestricted cash equivalent		Less than three months
Deferred commissions, amortization period		3 years
Assets amortized cost		3 years
Capitalized software development amount		$ 11,900,000	$ 10,200,000
Amortization of capitalized software development from continuing operations		9,600,000	8,900,000	$ 6,800,000
Capitalized software development costs for external computer software developed for resale		0	0
Goodwill impairments identified or recorded		0	0	0
Impairments identified or recorded		0	0	0
Impairments identified or recorded for long-lived assets		$ 0	0	0
Number of sources of taxable income \| SourcesofTaxableIncome		4
Valuation allowance		$ 311,000	310,000
Concentration risk, customer		The Company did not have any single customer representing over 10% of net revenues or accounts receivable during 2018, 2017, or 2016
Number of stock based compensation plans \| Plan		2
Subsequent Event [Member]
Business And Basis Of Presentation [Line Items]
Lease assets					$ 5,000,000
Lease liability					5,000,000
Subsequent Event [Member] \| New Corporate Headquarters [Member]
Business And Basis Of Presentation [Line Items]
Lease assets					24,000,000
Lease liability					$ 24,000,000
Sales and Marketing Expense [Member]
Business And Basis Of Presentation [Line Items]
Advertising expense		$ 721,000	$ 868,000	$ 824,000
Minimum [Member]
Business And Basis Of Presentation [Line Items]
Royalty payments amortization period		12 months
Finite lived intangible assets amortization period		5 years
Maximum [Member]
Business And Basis Of Presentation [Line Items]
Royalty payments amortization period		60 months
Finite lived intangible assets amortization period		13 years
Weighted Average [Member]
Business And Basis Of Presentation [Line Items]
Finite lived intangible assets amortization period		11 years 3 months 18 days
Patient Experience Solutions [Member]
Business And Basis Of Presentation [Line Items]
Consideration received	$ 65,200,000

Summary of Significant Accounting Policies - Changes in the Allowance for Doubtful Accounts and the Amounts Charged to Bad Debt Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Allowance Balance at Beginning of Period	$ 1,979	$ 839	$ 292
Charged to Costs and Expenses	1,033	1,568	590
Write-offs	(1,851)	(428)	(43)
Allowance Balance at End of Period	$ 1,161	$ 1,979	$ 839

Summary of Significant Accounting Policies - Estimated Useful Lives of Property and Equipment (Detail)	12 Months Ended
	Dec. 31, 2018
Furniture and Fixtures [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment useful life	5 years
Furniture and Fixtures [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment useful life	7 years
Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment useful life	3 years

Shareholders Equity - Additional Information (Detail) - shares	Dec. 31, 2018	Dec. 31, 2017
Class of Stock [Line Items]
Common stock, shares authorized	75,000,000	75,000,000
Common stock, shares issued	32,325,000	31,908,000
Common stock, shares outstanding	32,325,000	31,908,000
Maximum [Member]
Class of Stock [Line Items]
Common stock, shares authorized	75,000,000
Preferred stock, shares authorized	10,000,000

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Numerator:
Income from continuing operations	$ 13,251	$ 8,838	$ 4,791
Income (loss) from discontinued operations	18,966	1,166	(1,036)
Net Income	$ 32,217	$ 10,004	$ 3,755
Denominator:
Weighted-average shares outstanding	32,264	31,861	31,721
Effect of dilutive shares	71	335	347
Weighted-average diluted shares	32,335	32,196	32,068
Earnings (loss) per share – basic:
Continuing operations	$ 0.41	$ 0.27	$ 0.15
Discontinued operations	0.59	0.04	(0.03)
Net income per share - basic	1.00	0.31	0.12
Earnings (loss) per share – diluted:
Continuing operations	0.41	0.27	0.15
Discontinued operations	0.59	0.04	(0.03)
Net income per share - diluted	$ 1.00	$ 0.31	$ 0.12

Earnings Per Share - Additional Information (Detail) - shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Earnings Per Share [Abstract]
Total number of common equivalent shares excluded from the calculations of diluted earnings per share	91,000	58,000	38,000

Marketable Securities - Fair Value of Available for Sale Marketable Securities (Detail) - Level 2 [Member] - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Schedule of Available-for-sale Securities [Line Items]
Available for sale securities, Adjusted Cost	$ 34,520	$ 46,388
Available for sale securities, Unrealized Gains		2
Available for sale securities, Unrealized Losses	(23)	(40)
Available for sale securities, Fair Value	34,497	46,350
Corporate Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Available for sale securities, Adjusted Cost	31,521	41,900
Available for sale securities, Unrealized Gains		1
Available for sale securities, Unrealized Losses	(23)	(39)
Available for sale securities, Fair Value	31,498	41,862
Government-Sponsored Enterprises Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Available for sale securities, Adjusted Cost	2,999	4,488
Available for sale securities, Unrealized Gains		1
Available for sale securities, Unrealized Losses		(1)
Available for sale securities, Fair Value	$ 2,999	$ 4,488

Revenue Recognition and Sales Commissions - Schedule of Cumulative Effect for the Adoption of ASC 606 (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Jan. 01, 2018	Dec. 31, 2017
Assets
Unbilled receivables	$ 2,880		$ 1,327
Prepaid royalties, net	13,596		16,137
Other prepaid expenses and other current assets	18,016		8,330
Current assets of discontinued operations			6,125
Deferred commissions	16,470
Deferred tax assets	145		45
Non-current assets of discontinued operations			28,073
Liabilities
Deferred revenue, current	66,061		64,938
Current liabilities of discontinued operations			6,772
Deferred tax liabilities	11,068
Deferred revenue, noncurrent	2,868		6,287
Shareholders’ equity
Retained earnings	32,373		$ 17,542
Accounting Standards Update 2014-09 [Member]
Assets
Unbilled receivables		$ 1,358
Prepaid royalties, net		15,235
Other prepaid expenses and other current assets		5,430
Current assets of discontinued operations		5,851
Deferred commissions		12,552
Non-current assets of discontinued operations		31,239
Liabilities
Deferred revenue, current		60,450
Current liabilities of discontinued operations		5,398
Deferred tax liabilities		5,205
Deferred revenue, noncurrent		3,439
Shareholders’ equity
Retained earnings		32,674
ASC 606 Adjustments [Member] \| Accounting Standards Update 2014-09 [Member]
Assets
Unbilled receivables		31
Prepaid royalties, net	(1,205)	(902)
Other prepaid expenses and other current assets	(2,151)	(2,900)
Current assets of discontinued operations		(274)
Deferred commissions	16,470	12,552
Deferred tax assets		(45)
Non-current assets of discontinued operations		3,166
Liabilities
Deferred revenue, current	(4,735)	(4,488)
Current liabilities of discontinued operations		(1,374)
Deferred tax liabilities		5,205
Deferred revenue, noncurrent	(3,342)	(2,848)
Shareholders’ equity
Retained earnings	$ 2,991	$ 15,132

Revenue Recognition and Sales Commissions - Schedule of Impact of Adopting of ASC 606 on Condensed Consolidated Balance Sheet (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Jan. 01, 2018	Dec. 31, 2017
Assets
Prepaid royalties, net	$ 13,596		$ 16,137
Other prepaid expenses and other current assets	18,016		8,330
Deferred commissions	16,470
Liabilities
Deferred revenue, current	66,061		64,938
Deferred revenue, noncurrent	2,868		6,287
Shareholders’ equity
Retained earnings	32,373		$ 17,542
Accounting Standards Update 2014-09 [Member]
Assets
Prepaid royalties, net		$ 15,235
Other prepaid expenses and other current assets		5,430
Deferred commissions		12,552
Liabilities
Deferred revenue, current		60,450
Deferred revenue, noncurrent		3,439
Shareholders’ equity
Retained earnings		32,674
Balances without Adoption of ASC 606 [Member] \| Accounting Standards Update 2014-09 [Member]
Assets
Prepaid royalties, net	14,801
Other prepaid expenses and other current assets	20,167
Liabilities
Deferred revenue, current	70,796
Deferred revenue, noncurrent	6,210
Shareholders’ equity
Retained earnings	29,382
ASC 606 Adjustments [Member] \| Accounting Standards Update 2014-09 [Member]
Assets
Prepaid royalties, net	(1,205)	(902)
Other prepaid expenses and other current assets	(2,151)	(2,900)
Deferred commissions	16,470	12,552
Liabilities
Deferred revenue, current	(4,735)	(4,488)
Deferred revenue, noncurrent	(3,342)	(2,848)
Shareholders’ equity
Retained earnings	$ 2,991	$ 15,132

Revenue Recognition and Sales Commissions - Schedule of Impact of Adopting of ASC 606 on Condensed Consolidated Statements of Income (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Revenues, net	$ 231,616	$ 214,899	$ 192,124
Costs and expenses
Cost of revenues (excluding depreciation and amortization)	96,014	87,208	74,966
Sales and marketing	35,698	38,606	34,929
Operating income	15,491	9,407	7,171
Income from continuing operations before income tax provision	16,575	10,140	7,752
Income tax provision	3,324	1,302	2,961
Income from continuing operations	13,251	8,838	4,791
Net income	32,217	$ 10,004	$ 3,755
Balances without Adoption of ASC 606 [Member] \| Accounting Standards Update 2014-09 [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Revenues, net	230,876
Costs and expenses
Cost of revenues (excluding depreciation and amortization)	95,711
Sales and marketing	39,008
Operating income	11,744
Income from continuing operations before income tax provision	12,828
Income tax provision	2,568
Income from continuing operations	10,260
Net income	29,226
ASC 606 Adjustments [Member] \| Accounting Standards Update 2014-09 [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Revenues, net	740
Costs and expenses
Cost of revenues (excluding depreciation and amortization)	303
Sales and marketing	(3,310)
Operating income	3,747
Income from continuing operations before income tax provision	3,747
Income tax provision	756
Income from continuing operations	2,991
Net income	$ 2,991

Revenue Recognition and Sales Commissions - Schedule of Revenues Included in Continuing Operations Disaggregated by Revenue Source (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disaggregation Of Revenue [Line Items]
Total revenues, net	$ 231,616	$ 214,899	$ 192,124
Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	190,139
Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	41,477
Subscription SaaS Services [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	220,468
Subscription SaaS Services [Member] \| Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	184,926
Subscription SaaS Services [Member] \| Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	35,542
Professional Services [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	11,148
Professional Services [Member] \| Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	5,213
Professional Services [Member] \| Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	$ 5,935

Revenue Recognition and Sales Commissions - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Revenue Recognition and Sales Commissions [Line Items]
Revenues recognized in period, included in deferred revenue at beginning of the period	$ 63,700
Estimated revenue expected to be recognized in future under contract with customers	$ 447,000
Description of sales commission plan	Sales commissions earned by our sales organization are considered incremental and recoverable costs of obtaining a contract with a customer. The Company’s sales commission plans for 2018 typically include multiple payments, including initial payments in the period a customer contract is obtained and subsequent payments either 15 or 27 months after the initial payment.
Sales Commissions, amortization term description	Non-commensurate commissions are amortized over the greater of the contract term or expected customer relationship period, limited by the technological obsolescence period of approximately three years.
Sales Commissions, amortization period	3 years
Amortization of deferred commissions	$ 7,659
Customer Contracts [Member]
Revenue Recognition and Sales Commissions [Line Items]
Impairment losses on receivables and contract asset	$ 1,000	$ 1,600
Subscription SaaS Services [Member]
Revenue Recognition and Sales Commissions [Line Items]
Description of contracts with customer	Subscription/SaaS contracts are generally non-cancelable, one to five years in length, and billed annually, semi-annually, quarterly, or monthly in advance.
Subscription SaaS Services [Member] \| Minimum [Member]
Revenue Recognition and Sales Commissions [Line Items]
Period of contract with customer	1 year
Subscription SaaS Services [Member] \| Maximum [Member]
Revenue Recognition and Sales Commissions [Line Items]
Period of contract with customer	5 years

Revenue Recognition and Sales Commissions - Additional Information (Detail 1) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2019-01-01	Dec. 31, 2018
Revenue Recognition and Sales Commissions [Line Items]
Estimated revenue, expected recognition period	12 months
Percentage of remaining performance obligations expects revenue	48.00%

Property and Equipment - Summary of Property and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Gross property and equipment	$ 36,693	$ 32,484
Accumulated depreciation and amortization	(20,827)	(24,392)
Property and equipment, net	15,866	8,092
Equipment [Member]
Property, Plant and Equipment [Line Items]
Gross property and equipment	21,129	23,776
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Gross property and equipment	11,572	4,951
Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Gross property and equipment	$ 3,992	$ 3,757

Property and Equipment - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Property Plant And Equipment [Abstract]
Depreciation of property and equipment	$ 5.5	$ 5.9	$ 6.1

Goodwill and Intangible Assets - Changes in Carrying Amount of Goodwill (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Goodwill [Line Items]
Goodwill, beginning balance	$ 86,144	$ 85,611
Changes in carrying amount	0
Goodwill, ending balance	86,144	86,144
Morrisey Associates Inc [Member]
Goodwill [Line Items]
Goodwill acquired		533
Workforce Solutions [Member]
Goodwill [Line Items]
Goodwill, beginning balance	16,381	16,381
Changes in carrying amount	0
Goodwill, ending balance	16,381	16,381
Provider Solutions [Member]
Goodwill [Line Items]
Goodwill, beginning balance	69,763	69,230
Changes in carrying amount	0
Goodwill, ending balance	$ 69,763	69,763
Provider Solutions [Member] \| Morrisey Associates Inc [Member]
Goodwill [Line Items]
Goodwill acquired		$ 533

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Line Items]
Amortization of intangible assets	$ 9,100	$ 9,200	$ 7,400
Minimum [Member]
Goodwill [Line Items]
Finite lived intangible assets amortization period	5 years
Minimum [Member] \| Customer Relationships [Member]
Goodwill [Line Items]
Finite lived intangible assets amortization period	5 years
Minimum [Member] \| Other Intangible Assets [Member]
Goodwill [Line Items]
Finite lived intangible assets amortization period	3 years
Maximum [Member]
Goodwill [Line Items]
Finite lived intangible assets amortization period	13 years
Maximum [Member] \| Customer Relationships [Member]
Goodwill [Line Items]
Finite lived intangible assets amortization period	13 years
Maximum [Member] \| Other Intangible Assets [Member]
Goodwill [Line Items]
Finite lived intangible assets amortization period	9 years
Morrisey Associates Inc [Member]
Goodwill [Line Items]
Adjustment to goodwill		$ 533,000

Goodwill and Intangible Assets - Identifiable Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Finite Lived Intangible Assets [Line Items]
Gross Amount	$ 92,286	$ 93,238
Accumulated Amortization	(32,908)	(24,741)
Net	59,378	68,497
Customer Relationships [Member]
Finite Lived Intangible Assets [Line Items]
Gross Amount	76,714	76,714
Accumulated Amortization	(23,245)	(17,033)
Net	53,469	59,681
Other Intangible Assets [Member]
Finite Lived Intangible Assets [Line Items]
Gross Amount	15,572	16,524
Accumulated Amortization	(9,663)	(7,708)
Net	$ 5,909	$ 8,816

Goodwill and Intangible Assets - Expected Annual Amortization Expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Goodwill And Intangible Assets Disclosure [Abstract]
2019	$ 8,792
2020	8,139
2021	7,356
2022	6,277
2023	5,649
Thereafter	23,165
Net	$ 59,378	$ 68,497

Discontinued Operations - Additional Information (Detail) - Patient Experience Solutions [Member] $ in Thousands	Feb. 12, 2018 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Consideration received	$ 65,200
Gain on sale of business, net of tax	19,000
Escrow deposit	$ 6,550

Discontinued Operations - Schedule of Discontinued Operations Income Statement (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Operating costs and expenses:
(Loss) income from discontinued operations before income tax provision	$ (64)	$ 393	$ (1,604)
Income tax benefit	10,459	(773)	(568)
Income (loss) from discontinued operations	18,966	1,166	(1,036)
Patient Experience Solutions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenues, net	3,342	32,763	33,850
Operating costs and expenses:
Cost of revenues (excluding depreciation and amortization)	1,982	18,792	21,668
Product development	554	3,751	4,664
Sales and marketing	460	4,310	4,074
Other general and administrative expenses	229	3,282	3,208
Depreciation and amortization	181	2,235	1,840
Total operating costs and expenses	3,406	32,370	35,454
Operating (loss) income	(64)	393	(1,604)
(Loss) income from discontinued operations before income tax provision	(64)	393	(1,604)
Income tax benefit		(773)	(568)
Income (loss) from discontinued operations	$ (64)	$ 1,166	$ (1,036)

Discontinued Operations - Schedule of Discontinued Operations Balance Sheet (Detail) $ in Thousands	Dec. 31, 2017 USD ($)
Carrying amounts of assets included as part of discontinued operations:
Current assets of discontinued operations	$ 6,125
Long-term assets of discontinued operations	28,073
Carrying amounts of liabilities included as part of discontinued operations:
Current liabilities of discontinued operations	6,772
Long-term liabilities of discontinued operations	2,548
Patient Experience Solutions [Member]
Carrying amounts of assets included as part of discontinued operations:
Accounts receivable, net	4,158
Accounts receivable – unbilled	1,275
Prepaid royalties, net of amortization	37
Other prepaid expenses and other current assets	655
Current assets of discontinued operations	6,125
Property and equipment, net	901
Capitalized software development, net	2,683
Goodwill	24,154
Customer-related intangibles, net	276
Other intangible assets, net	42
Other assets	17
Long-term assets of discontinued operations	28,073
Total assets of discontinued operations in the consolidated balance sheet	34,198
Carrying amounts of liabilities included as part of discontinued operations:
Accounts payable and accrued expenses	2,728
Accrued royalties	27
Deferred revenue	4,017
Current liabilities of discontinued operations	6,772
Deferred tax liabilities	1,971
Deferred revenue, noncurrent	15
Other long term liabilities	562
Long-term liabilities of discontinued operations	2,548
Total liabilities of discontinued operations in the consolidated balance sheet	$ 9,320

Business Segments - Business Segment Information Based on Net Revenues and Operating Income (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenues, net:
Revenues, net	$ 231,616	$ 214,899	$ 192,124
Operating income:
Operating income	15,491	9,407	7,171
Workforce Solutions [Member]
Revenues, net:
Revenues, net	190,139
Provider Solutions [Member]
Revenues, net:
Revenues, net	41,477
Operating Segments [Member] \| Workforce Solutions [Member]
Revenues, net:
Revenues, net	190,139	178,061	168,040
Operating income:
Operating income	38,834	33,579	37,329
Operating Segments [Member] \| Provider Solutions [Member]
Revenues, net:
Revenues, net	41,477	36,838	24,084
Operating income:
Operating income	3,474	879	(2,443)
Unallocated [Member]
Operating income:
Operating income	$ (26,817)	$ (25,051)	$ (27,715)

Business Segments - Business Segment Information Based on Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Segment Reporting Information [Line Items]
Total assets	$ 441,948	$ 411,119
Operating Segments [Member] \| Workforce Solutions [Member]
Segment Reporting Information [Line Items]
Total assets	104,668	90,055
Operating Segments [Member] \| Provider Solutions [Member]
Segment Reporting Information [Line Items]
Total assets	145,637	150,797
Unallocated [Member]
Segment Reporting Information [Line Items]
Total assets	$ 191,643	136,069
Discontinued Operations [Member]
Segment Reporting Information [Line Items]
Total assets		$ 34,198

Income Taxes - Summary of Provision (Benefit) for Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Current federal	$ (79)	$ 1,819	$ 514
Current state	386	923	1,032
Deferred federal	2,661	(1,464)	1,176
Deferred state	356	24	239
Provision for income taxes	$ 3,324	$ 1,302	$ 2,961

Income Taxes - Reconciliation of Income Taxes at the Statutory Federal Income Tax Rate to the Provision for Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Federal tax provision at the statutory rate	$ 3,482	$ 3,549	$ 2,713
State income tax provision, net of federal benefit	658	491	757
Tax credits	(509)	(583)	(560)
Change in state valuation allowance	2	151	132
Tax Act revaluation of deferred tax balances		(1,680)
Stock compensation	(560)	(626)	(9)
Other	251		(72)
Provision for income taxes	$ 3,324	$ 1,302	$ 2,961

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Income Taxes Disclosure [Line Items]
Valuation allowance	$ 311,000	$ 310,000
U.S. federal corporate income tax rate	21.00%
2017 Tax Act, reduction in deferred tax liability		1,680,000
Unrecognized tax benefits	$ 339,000	$ 337,000
Excess tax benefits related to stock based awards	540,000
State [Member]
Income Taxes Disclosure [Line Items]
Net operating loss carryforwards	$ 4,800,000
Earliest Tax Year [Member]
Income Taxes Disclosure [Line Items]
Loss carryforwards will expire in years	Dec. 31, 2030
Latest Tax Year [Member]
Income Taxes Disclosure [Line Items]
Loss carryforwards will expire in years	Dec. 31, 2038
Federal [Member] \| Earliest Tax Year [Member]
Income Taxes Disclosure [Line Items]
U.S. federal tax examinations for tax period	2015
Federal [Member] \| Latest Tax Year [Member]
Income Taxes Disclosure [Line Items]
U.S. federal tax examinations for tax period	2018

Income Taxes - Reconciliation of the Beginning and Ending Liability for Gross Unrecognized Tax Benefits (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Balance at beginning of year	$ 360	$ 397
Additions for tax positions in the current year	2	10
Reductions for tax positions of prior years	(23)	(47)
Balance at end of year	$ 339	$ 360

Income Taxes - Significant Components of Deferred Tax Assets and Deferred Tax Liabilities (Detail) - USD ($)	Dec. 31, 2018	Dec. 31, 2017
Deferred tax assets:
Allowance for doubtful accounts	$ 297,000	$ 488,000
Accrued liabilities	2,276,000	1,580,000
Tax credits		3,115,000
Stock based compensation	623,000	743,000
Deferred revenue	135,000	1,467,000
Depreciation		621,000
Basis difference on investments	396,000	327,000
Net operating loss carryforwards	291,000	215,000
Total deferred tax assets	4,018,000	8,556,000
Less: Valuation allowance	(311,000)	(310,000)
Deferred tax assets, net of valuation allowance	3,707,000	8,246,000
Deferred tax liabilities:
Deductible goodwill	1,760,000	1,212,000
Nondeductible intangible assets	1,049,000	1,330,000
Prepaid assets	5,698,000	1,784,000
Capitalized software development	4,746,000	3,875,000
Depreciation	659,000
PX sale deferral	718,000
Total deferred tax liabilities	14,630,000	8,201,000
Net deferred tax liabilities	$ 10,923,000
Net deferred tax (assets)		$ (45,000)

Stock Based Compensation - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unissued common stock reserved for future stock option grants	1,100,000
Closing stock price	$ 24.15
Weighted average remaining contractual term of options, outstanding	3 months 18 days
Weighted average remaining contractual term of options, exercisable	3 months 18 days
Payments related to RSUs and stock options for the employees' tax obligations to taxing authorities	$ 338,000	$ 412,000	$ 316,000
Excess tax benefits related to stock based awards	$ 540,000
Stock options granted	0
Stock Options and RSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total unrecognized compensation expense related to non-vested stock options and RSUs	$ 3,200,000
Weighted average expense recognition period	2 years 2 months 12 days
Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options granted	0	0	0
RSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate fair value of RSU awards that vested	$ 1,800,000	$ 1,900,000
Shares withheld for RSUs		13,300	17,122
Payments related to RSUs and stock options for the employees' tax obligations to taxing authorities	$ 338,000	$ 412,000	$ 316,000
Maximum [Member] \| Stock Options and RSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period of the options and RSU's granted	4 years
Maximum [Member] \| Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Term of options granted	10 years

Stock Based Compensation - Summary of Activity and Various Other Information Relative to Stock Options (Detail) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2018 USD ($) $ / shares shares
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Outstanding at beginning of period, Common Shares \| shares	376
Granted, Common Shares \| shares	0
Exercised, Common Shares \| shares	(357)
Expired, Common Shares \| shares	0
Forfeited, Common Shares \| shares	0
Outstanding at end of period, Common Shares \| shares	19
Exercisable at end of period, Common Shares \| shares	19
Outstanding at beginning of period, Weighted-Average Exercise Price \| $ / shares	$ 7.44
Granted, Weighted-Average Exercise Price \| $ / shares	0
Exercised, Weighted-Average Exercise Price \| $ / shares	7.23
Expired, Weighted-Average Exercise Price \| $ / shares	0
Forfeited, Weighted-Average Exercise Price \| $ / shares	0
Outstanding at end of period, Weighted-Average Exercise Price \| $ / shares	11.27
Exercisable at end of period, Weighted-Average Exercise Price \| $ / shares	$ 11.27
Outstanding at end of period, Aggregate Intrinsic Value \| $	$ 245
Exercisable at end of period, Aggregate Intrinsic Value \| $	$ 245

Stock Based Compensation - Other Information Relative to Option Activity (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Total intrinsic value of stock options exercised	$ 6,130	$ 1,973	$ 820
Cash proceeds from exercise of stock options	$ 2,582	$ 413	$ 145

Stock Based Compensation - Summary of Activity Relative to RSU's (Detail) - RSUs [Member] $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2018 USD ($) $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding at beginning of period, shares \| shares	254
Granted \| shares	163
Vested \| shares	(73)
Forfeited \| shares	(55)
Outstanding at end of period, shares \| shares	289
Outstanding at beginning of period, Weighted-Average Grant Date Fair Value \| $ / shares	$ 23.13
Granted, Weighted-Average Grant Date Fair Value \| $ / shares	25.65
Vested, Weighted-Average Grant Date Fair Value \| $ / shares	23.94
Forfeited, Weighted-Average Grant Date Fair Value \| $ / shares	23.28
Outstanding at end of period, Weighted-Average Grant Date Fair Value \| $ / shares	$ 24.31
Aggregate intrinsic Value \| $	$ 6,975

Stock Based Compensation - Stock Based Compensation Expense Recorded in Consolidated Statements of Income (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	$ 1,777	$ 1,736	$ 1,895
Cost of Revenues (Excluding Depreciation and Amortization) [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	37	29	62
Product Development [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	296	228	174
Sales and Marketing [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	183	244	274
Other General and Administrative [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	$ 1,261	$ 1,235	$ 1,385

Employee Benefit Plan - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Schedule Of Sale Of Subsidiary [Abstract]
Employees minimum age eligibility to participate in plan	21 years
Minimum number of days required to be eligible for participation in plan	30 days
Defined contribution plan, employer matching contribution amount	$ 1,300,000	$ 764,000	$ 311,000

Debt - Additional Information (Detail) - USD ($)	12 Months Ended
Debt - Additional Information (Detail) - USD ($)	Dec. 31, 2018	Dec. 31, 2017
Line of Credit Facility [Line Items]
Debt outstanding	$ 0	$ 0
SunTrust Bank [Member]
Line of Credit Facility [Line Items]
Description of Line of credit facility Covenant	A funded debt leverage ratio (consolidated debt/consolidated EBITDA) of not greater than 3.0 to 1.0; and  an interest coverage ratio (consolidated EBITDA/consolidated interest expense) of not less than 3.0 to 1.0.
SunTrust Bank [Member] \| Minimum [Member]
Line of Credit Facility [Line Items]
Commitment fee paid per annum	0.20%
SunTrust Bank [Member] \| Maximum [Member]
Line of Credit Facility [Line Items]
Commitment fee paid per annum	0.30%
Revolving Credit Facility [Member] \| Minimum [Member]
Line of Credit Facility [Line Items]
Interest coverage ratio	300.00%
Revolving Credit Facility [Member] \| SunTrust Bank [Member]
Line of Credit Facility [Line Items]
Maturity date of Loan agreement	Nov. 24, 2020
Interest rate under credit facility	The borrowings under the Revolving Credit Facility bear interest at either (1) a rate per annum equal to the highest of SunTrust’s prime rate or 0.5% in excess of the Federal Funds Rate or 1.0% in excess of one-month LIBOR (the “Base Rate”), plus an applicable margin, or (2) the one, two, three, or six-month per annum LIBOR for deposits in the applicable currency (the “Eurocurrency Rate”), as selected by the Company, plus an applicable margin. The applicable margin for Eurocurrency Rate loans depends on the Company’s funded debt leverage ratio and varies from 1.50% to 2.00%. The applicable margin for Base Rate loans depends on the Company’s funded debt leverage ratio and varies from 0.50% to 1.50%
Maximum borrowing capacity under credit facility	$ 50,000,000
Increase in revolving credit facility	25,000,000
Principal payments prior to maturity	0
Outstanding balance on revolving credit facility	0
Revolving credit facility borrowings	0
Revolving Credit Facility [Member] \| SunTrust Bank [Member] \| Swing Line Sub Facility [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity under credit facility	5,000,000
Revolving Credit Facility [Member] \| SunTrust Bank [Member] \| Letter of Credit Subfacility [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity under credit facility	$ 5,000,000
Revolving Credit Facility [Member] \| SunTrust Bank [Member] \| Federal Funds Effective Swap Rate [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility, Interest Rate During Period	0.50%
Revolving Credit Facility [Member] \| SunTrust Bank [Member] \| Base Rate [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility, Interest Rate During Period	1.00%
Revolving Credit Facility [Member] \| SunTrust Bank [Member] \| Minimum [Member] \| Base Rate [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	0.50%
Revolving Credit Facility [Member] \| SunTrust Bank [Member] \| Minimum [Member] \| Eurodollar [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	1.50%
Revolving Credit Facility [Member] \| SunTrust Bank [Member] \| Maximum [Member]
Line of Credit Facility [Line Items]
Maximum total leverage ratio	300.00%
Revolving Credit Facility [Member] \| SunTrust Bank [Member] \| Maximum [Member] \| Base Rate [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	1.50%
Revolving Credit Facility [Member] \| SunTrust Bank [Member] \| Maximum [Member] \| Eurodollar [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	2.00%

Leases - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Leases [Abstract]
Total rent expense under all operating leases	$ 7.4	$ 6.6	$ 4.1

Leases - Future Rental Payment Commitments under Non-Cancelable Operating Leases (Detail) $ in Thousands	Dec. 31, 2018 USD ($)
Leases [Abstract]
2019	$ 2,156
2020	4,013
2021	3,766
2022	3,602
2023	3,678
Thereafter	26,085
Total minimum lease payments	$ 43,300

Collaborative Arrangement - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Feb. 28, 2018
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]
Collaborative arrangement profit/loss sharing percentage				50.00%
Expenses related to collaborative arrangement	$ 187,000	$ 1,200,000	$ 1,400,000
Collaborative Arrangement, Product [Member]
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]
Collaborative arrangement revenues	$ 391,000	$ 2,200,000	$ 2,700,000

Non-Marketable Equity Investments - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Investments Debt And Equity Securities [Abstract]
Reduction to carrying value of cost method investment due to change in fair value	$ 1,271
Aggregate carrying amount of cost method investments	$ 2,100	$ 2,500

Subsequent Events - Additional Information (Detail) - Providigmn, LLC [Member] - Subsequent Event [Member]	Jan. 10, 2019 USD ($)
Subsequent Event [Line Items]
Consideration paid for acquisition in cash	$ 18,000,000
Additional contingent consideration	$ 500,000

Stock Based Compensation - Summary of Activity and Various Other Information Relative to Stock Options (Detail) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2018 USD ($) $ / shares shares
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Outstanding at beginning of period, Common Shares \| shares	376
Granted, Common Shares \| shares	0
Exercised, Common Shares \| shares	(357)
Expired, Common Shares \| shares	0
Forfeited, Common Shares \| shares	0
Outstanding at end of period, Common Shares \| shares	19
Exercisable at end of period, Common Shares \| shares	19
Outstanding at beginning of period, Weighted-Average Exercise Price \| $ / shares	$ 7.44
Granted, Weighted-Average Exercise Price \| $ / shares	0
Exercised, Weighted-Average Exercise Price \| $ / shares	7.23
Expired, Weighted-Average Exercise Price \| $ / shares	0
Forfeited, Weighted-Average Exercise Price \| $ / shares	0
Outstanding at end of period, Weighted-Average Exercise Price \| $ / shares	11.27
Exercisable at end of period, Weighted-Average Exercise Price \| $ / shares	$ 11.27
Outstanding at end of period, Aggregate Intrinsic Value \| $	$ 245
Exercisable at end of period, Aggregate Intrinsic Value \| $	$ 245