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Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2020	Apr. 23, 2020
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Trading Symbol	HSTM
Entity Registrant Name	HEALTHSTREAM INC
Entity Central Index Key	0001095565
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		31,997,499
Entity Shell Company	false
Entity File Number	000-27701
Entity Tax Identification Number	62-1443555
Entity Address, Address Line One	500 11th Avenue North
Entity Address, Address Line Two	Suite 1000
Entity Address, City or Town	Nashville
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37203
City Area Code	615
Local Phone Number	301-3100
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	TN
Document Quarterly Report	true
Document Transition Report	false
Title of 12(b) Security	Common Stock (Par Value $0.00)
Security Exchange Name	NASDAQ

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 107,425	$ 131,538
Marketable securities	34,585	41,328
Accounts receivable, net of allowance for doubtful accounts of $1,004 and $843 at March 31, 2020 and December 31, 2019, respectively	32,301	27,650
Accounts receivable - unbilled	2,454	2,726
Prepaid royalties, net of amortization	15,100	11,898
Other prepaid expenses and other current assets	8,791	9,432
Total current assets	200,656	224,572
Property and equipment, net of accumulated depreciation of $21,155 and $19,291 at March 31, 2020 and December 31, 2019, respectively	24,425	26,065
Capitalized software development, net of accumulated amortization of $60,752 and $57,768 at March 31, 2020 and December 31, 2019, respectively	22,209	21,445
Operating lease right of use assets, net	29,135	29,615
Goodwill	123,283	102,196
Deferred tax assets	269	269
Deferred commissions	17,088	17,645
Non-marketable equity investments	4,329	6,782
Other assets	792	874
Total assets	481,511	489,544
Current liabilities:
Accounts payable and accrued expenses	16,366	22,938
Accrued royalties	13,738	16,736
Deferred revenue	72,370	65,511
Total current liabilities	102,474	105,185
Deferred tax liabilities	11,565	13,183
Deferred revenue, noncurrent	1,591	1,918
Operating lease liability, noncurrent	30,108	30,733
Other long-term liabilities	357	357
Commitments and contingencies
Shareholders’ equity:
Common stock, no par value, 75,000 shares authorized; 32,003 and 32,379 shares issued and outstanding at March 31, 2020 and December 31, 2019, respectively	280,322	290,021
Retained earnings	55,235	48,143
Accumulated other comprehensive (loss) income	(141)	4
Total shareholders’ equity	335,416	338,168
Total liabilities and shareholders’ equity	481,511	489,544
Customer-Related Intangible Assets [Member]
Current assets:
Intangible assets, net	50,904	52,554
Other Intangible Assets [Member]
Current assets:
Intangible assets, net	$ 8,421	$ 7,527

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Allowance for doubtful accounts, net	$ 1,004	$ 843
Accumulated depreciation on property and equipment	21,155	19,291
Accumulated amortization on capitalized software development	$ 60,752	$ 57,768
Common stock, no par value
Common stock, shares authorized	75,000,000	75,000,000
Common stock, shares issued	32,003,000	32,379,000
Common stock, shares outstanding	32,003,000	32,379,000
Customer-Related Intangible Assets [Member]
Accumulated amortization on intangible assets	$ 31,446	$ 29,760
Other Intangible Assets [Member]
Accumulated amortization on intangible assets	$ 13,651	$ 12,735

Condensed Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Income Statement [Abstract]
Revenues, net	$ 61,572	$ 65,187
Operating costs and expenses:
Cost of revenues (excluding depreciation and amortization)	20,359	26,861
Product development	7,468	6,927
Sales and marketing	9,188	9,521
Other general and administrative expenses	9,864	9,970
Depreciation and amortization	7,449	6,539
Total operating costs and expenses	54,328	59,818
Operating income	7,244	5,369
Other income, net	1,706	822
Income from continuing operations before income tax provision	8,950	6,191
Income tax provision	1,858	1,411
Income from continuing operations	7,092	4,780
Gain on sale of discontinued operations		1,620
Income tax provision		426
Income from discontinued operations		1,194
Net income	$ 7,092	$ 5,974
Net income per share - basic:
Continuing operations	$ 0.22	$ 0.15
Discontinued operations		0.03
Net income per share - basic	0.22	0.18
Net income per share - diluted:
Continuing operations	0.22	0.15
Discontinued operations		0.03
Net income per share - diluted	$ 0.22	$ 0.18
Weighted average shares of common stock outstanding:
Basic	32,334	32,337
Diluted	32,357	32,377

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 7,092	$ 5,974
Other comprehensive income, net of taxes:
Foreign currency translation adjustments	(44)	(1)
Unrealized (loss) gain on marketable securities	(101)	33
Total other comprehensive (loss) income	(145)	32
Comprehensive income	$ 6,947	$ 6,006

- Definition

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

+ References + Details

Condensed Consolidated Statements of Shareholders' Equity (Unaudited) - USD ($) $ in Thousands	Total	Common Stock [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive Income (Loss) [Member]
Beginning balance at Dec. 31, 2018	$ 318,947	$ 286,597	$ 32,373	$ (23)
Beginning balance, shares at Dec. 31, 2018		32,325,000
Net income	5,974		5,974
Comprehensive income (loss)	32			32
Stock based compensation	516	$ 516
Common stock issued under stock plans, net of shares withheld for employee taxes	(328)	$ (328)
Common stock issued under stock plans, net of shares withheld for employee taxes, shares		63,000
Ending balance at Mar. 31, 2019	325,141	$ 286,785	38,347	9
Ending balance, shares at Mar. 31, 2019		32,388,000
Beginning balance at Dec. 31, 2019	$ 338,168	$ 290,021	48,143	4
Beginning balance, shares at Dec. 31, 2019	32,379,000	32,379,000
Net income	$ 7,092		7,092
Comprehensive income (loss)	(145)			(145)
Stock based compensation	550	$ 550
Common stock issued under stock plans, net of shares withheld for employee taxes	(373)	$ (373)
Common stock issued under stock plans, net of shares withheld for employee taxes, shares		62,000
Repurchase of common stock	$ (9,876)	$ (9,876)
Repurchase of common stock, shares	(438,142)	(438,000)
Ending balance at Mar. 31, 2020	$ 335,416	$ 280,322	$ 55,235	$ (141)
Ending balance, shares at Mar. 31, 2020	32,003,000	32,003,000

- Definition

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

+ References + Details

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2018
OPERATING ACTIVITIES:
Net income	$ 7,092	$ 5,974
Income from discontinued operations		(1,194)
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	7,449	6,539
Stock based compensation	550	516
Amortization of deferred commissions	2,159	2,121
Provision for doubtful accounts	288	2
Deferred income taxes	500	433
Loss (gain) on non-marketable equity investments	11	(54)
Non-cash royalty expense	(3,440)
Change in fair value of non-marketable equity investments	(1,152)		$ 1,300
Other	47	(28)
Changes in operating assets and liabilities:
Accounts and unbilled receivables	(4,573)	1,387
Prepaid royalties	(3,202)	(2,820)
Other prepaid expenses and other current assets	735	251
Deferred commissions	(1,602)	(1,382)
Other assets	134	(16)
Accounts payable and accrued expenses	(5,775)	(5,386)
Accrued royalties	442	3,342
Deferred revenue	6,453	6,400
Net cash provided by operating activities	6,116	16,085
INVESTING ACTIVITIES:
Business combinations, net of cash acquired	(21,421)	(18,002)
Proceeds from maturities of marketable securities	20,725	28,337
Purchases of marketable securities	(14,130)	(30,101)
Payments to acquire non-marketable equity investments		(3,342)
Payments associated with capitalized software development	(4,068)	(4,933)
Purchases of property and equipment	(1,010)	(11,338)
Net cash used in investing activities	(19,904)	(39,379)
FINANCING ACTIVITIES:
Proceeds from exercise of stock options		31
Taxes paid related to net settlement of equity awards	(373)	(359)
Payments of earn-outs related to acquisitions		(37)
Repurchase of common stock	(9,876)
Payment of cash dividends	(30)	(52)
Net cash used in financing activities	(10,279)	(417)
Effect of exchange rate changes on cash and cash equivalents	(46)
Net decrease in cash and cash equivalents	(24,113)	(23,711)
Cash and cash equivalents at beginning of period	131,538	134,321
Cash and cash equivalents at end of period	$ 107,425	$ 110,610	$ 134,321

Basis of Presentation

3 Months Ended

Mar. 31, 2020

Accounting Policies [Abstract]

Basis of Presentation

1. BASIS OF PRESENTATION

The accompanying unaudited Condensed Consolidated Financial Statements have been prepared in accordance with accounting principles generally accepted in the United States (“US GAAP”) for interim financial information and with the instructions to Form 10‑Q and Article 10 of Regulation S‑X. Accordingly, Condensed Consolidated Financial Statements do not include all of the information and footnotes required by US GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. All intercompany transactions have been eliminated in consolidation. Operating results for the three months ended March 31, 2020 are not necessarily indicative of the results that may be expected for the year ending December 31, 2020.

On February 12, 2018, the Company divested its Patient Experience (“PX”) business to Press Ganey Associates, Inc. (“Press Ganey”). The sale of the PX business resulted in the divestiture of the Company’s patient experience solutions business segment. The Company has classified the gain on sale of its previously owned PX business as discontinued operations in its Condensed Consolidated Statements of Income for all periods presented. See Note 10 for additional information.

The Condensed Consolidated Balance Sheet at December 31, 2019 was derived from the audited Consolidated Financial Statements at that date but does not include all of the information and footnotes required by US GAAP for a complete set of financial statements. For further information, refer to the Consolidated Financial Statements and footnotes thereto for the year ended December 31, 2019 (included in the Company's Annual Report on Form 10-K, filed with the Securities and Exchange Commission on February 26, 2020).

Recent Accounting Pronouncements

3 Months Ended

Mar. 31, 2020

Accounting Changes And Error Corrections [Abstract]

Recent Accounting Pronouncements

2. RECENT ACCOUNTING PRONOUNCEMENTS

Accounting Standards Recently Adopted

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 Company adopted this ASU on January 1, 2020, and the effect of adoption on the Company’s Consolidated Financial Statements and related disclosures was not material.

Revenue Recognition and Sales Commissions

3 Months Ended

Mar. 31, 2020

Revenue From Contract With Customer [Abstract]

Revenue Recognition and Sales Commissions

3. REVENUE RECOGNITION AND SALES COMMISSIONS

Revenue Recognition

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

The following table represents revenues disaggregated by revenue source for the three months ended March 31, 2020 and 2019 (in thousands). Sales taxes are excluded from revenues.

	Three Months Ended March 31, 2020						Three Months Ended March 31, 2019
Business Segments	Workforce Solutions		Provider Solutions		Consolidated		Workforce Solutions		Provider Solutions		Consolidated
Subscription services	$	48,717	$	9,627	$	58,344	$	52,805	$	9,080	$	61,885
Professional services		1,107		2,121		3,228		1,490		1,812		3,302
Total revenues, net	$	49,824	$	11,748	$	61,572	$	54,295	$	10,892	$	65,187

For the three months ended March 31, 2020 and 2019, the Company recognized $288,000 and $2,000, respectively, in impairment losses on receivables and contract assets arising from the Company’s contracts with customers.

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 three months ended March 31, 2020 and 2019, we recognized revenues of approximately $31.6 million and $31.2 million, respectively, from amounts included in deferred revenue at the beginning of the respective periods. As of March 31, 2020, approximately $402 million of revenue is expected to be recognized from remaining performance obligations under contracts with customers. We expect to recognize revenue related to approximately 47% of these remaining performance obligations over the next 12 months, with the remaining amounts recognized thereafter.

Sales Commissions

Sales commissions earned by our sales force are considered incremental and recoverable costs of obtaining a contract with a customer. The sales commission plan for 2020 typically includes two payments; the initial payment is due in the period a customer contract is obtained and the final payment is due 60 days after product implementation is completed. The sales commission plan for 2019 typically included an initial payment in the period a customer contract was obtained and subsequent payments either 15 or 27 months after the initial payment depending on the contract term. Under ASC 606, costs to acquire contracts with customers, such as the initial sales commission payment, 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, whereas subsequent sales commission payments which require a substantive performance condition of the employee are expensed ratably through the payment date. Under the 2020 plan, both the initial payment and subsequent payment are capitalized in the period the contract is obtained, whereas under the 2019 plan, only the initial payment was capitalized, and the subsequent payment was expensed ratably through the payment date. The primary change from an accounting perspective under the 2020 plan compared to the 2019 plan is the time between when the contract is obtained and when it is implemented does not result in a substantive performance condition of the employee. The capitalized contract cost is included in Deferred commissions in the accompanying Condensed 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 technological obsolescence period of approximately three years. The Company recorded amortization of deferred commissions of approximately $2.2 million and $2.1 million for the three months ended March 31, 2020 and 2019, respectively, which is included in sales and marketing expenses in the accompanying Condensed Consolidated Statements of Income.

Income Taxes

3 Months Ended

Mar. 31, 2020

Income Tax Disclosure [Abstract]

Income Taxes

4. 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.

During the three months ended March 31, 2020 and 2019, the Company recorded a provision for income taxes from continuing operations of approximately $1.9 million and $1.4 million, respectively. The Company’s effective tax rate for continuing operations for the three months ended March 31, 2020 and 2019 was 21% and 23%, respectively. The Company’s effective tax rate primarily reflects the statutory corporate income tax rate, the net effect of state taxes, and the effect of various permanent tax differences. During the three months ended March 31, 2020, the Company recorded a $1.2 million change in fair value of non-marketable equity investments as a result of the NurseGrid acquisition, which is not a taxable transaction, resulting in a tax benefit of $0.3 million. The Company recognizes excess tax benefits and tax deficiencies associated with stock based awards as a component of its provision for income taxes. The Company recorded additional income tax expense associated with tax deficiencies of approximately $26,000 during the three months ended March 31, 2020 and recorded a reduction to income tax expense for excess tax benefits of approximately $83,000 during the three months ended March 31, 2019.

Shareholders' Equity

3 Months Ended

Mar. 31, 2020

Equity [Abstract]

Shareholders' Equity

5. SHAREHOLDERS’ EQUITY

Stock Based Compensation

The Company has stock awards outstanding under its 2016 Omnibus Incentive Plan. The Company accounts for its stock based compensation plan using the fair-value based method for costs related to share based payments, including restricted share units (“RSUs”). During the three months ended March 31, 2020, the Company issued 111,510 RSUs, subject to service-based time vesting, with a grant date fair value of $22.96 per share, measured based on the closing fair market value of the Company’s stock on the date of grant. During the three months ended March 31, 2019, the Company issued 86,220 RSUs, subject to service-based time vesting, with a weighted average grant date fair value of $27.39 per share, measured based on the closing fair market value of the Company’s stock on the date of grant.

During the three months ended June 30, 2018, the Company issued 70,000 performance-based RSUs, the vesting of which occurs over a five-year period and is contingent upon continued service and achieving certain performance criteria established by the Compensation Committee on an annual basis in increments of 10%, 15%, 20%, 25%, and 30% based on performance in 2018, 2019, 2020, 2021, and 2022, respectively. The performance criteria for 14,000 of these performance-based RSUs will be based on 2020 performance. The measurement date for these 14,000 performance-based RSUs was established during the three months ended March 31, 2020 with a grant date fair value of $22.96 per share, measured based on the closing fair market value of the Company’s stock on the date the performance criteria was established. The performance criteria for 17,500 of these performance-based RSUs was previously established based on performance in 2018 and 2019, as applicable, and the performance criteria for the remaining 38,500 performance-based RSUs has not yet been determined and will be established on an annual basis based on performance in 2021 and 2022, as applicable; therefore, the measurement date for these remaining 38,500 performance-based RSUs cannot be determined until the performance criteria have been established.

Total stock based compensation expense recognized for the three months ended March 31, 2020 and 2019 in the Condensed Consolidated Statements of Income is as follows (in thousands):

	Three Months Ended March 31,
	2020		2019
Cost of revenues (excluding depreciation and amortization)	$	7	$	1
Product development		81		53
Sales and marketing		49		56
Other general and administrative		413		406
Total stock based compensation expense	$	550	$	516

Share Repurchase Plan

On March 13, 2020, the Company’s Board of Directors authorized a share repurchase program to repurchase up to $30.0 million of outstanding shares of common stock. The share repurchase program will terminate on the earlier of March 12, 2021 or when the maximum dollar amount has been expended. Pursuant to this authorization, repurchases have been made, and may continue to be made from time to time in the open market through privately negotiated transactions or otherwise, including under a Rule 10b5-1 plan, which permits shares to be repurchased when the Company might otherwise be precluded from doing so under insider trading laws in accordance with specific prearranged terms related to timing, price, and volume (among others), without further direction from the Company. The share repurchase program does not require the Company to acquire any amount of shares and may be suspended or discontinued at any time. Under this program during the first quarter of 2020, the Company repurchased 438,142 shares at an aggregate fair value of $9.9 million, reflecting an average price per share of $22.52 (excluding the cost of broker commissions).

Earnings Per Share

3 Months Ended

Mar. 31, 2020

Earnings Per Share [Abstract]

Earnings Per Share

6. 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 available to common shareholders for the period by the weighted average number of potentially dilutive 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 RSUs subject to vesting. The dilutive effect of common equivalent shares is included in diluted earnings per share by application of the treasury stock method. The total number of common equivalent shares excluded from the calculations of diluted earnings per share, due to their anti-dilutive effect or contingent performance conditions, was approximately 106,000 and 136,000 for the three months ended March 31, 2020 and 2019, respectively.

The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2020 and 2019 (in thousands, except per share data):

	Three Months Ended March 31,
	2020		2019
Numerator:
Income from continuing operations	$	7,092	$	4,780
Income from discontinued operations		—		1,194
Net income	$	7,092	$	5,974
Denominator:
Weighted-average shares outstanding		32,334		32,337
Effect of dilutive shares		23		40
Weighted-average diluted shares		32,357		32,377

Net income per share - basic:
Continuing operations	$	0.22	$	0.15
Discontinued operations		—		0.03
Net income per share - basic	$	0.22	$	0.18

Net income per share - diluted:
Continuing operations	$	0.22	$	0.15
Discontinued operations		—		0.03
Net income per share - diluted	$	0.22	$	0.18

Marketable Securities

3 Months Ended

Mar. 31, 2020

Investments Debt And Equity Securities [Abstract]

Marketable Securities

7. MARKETABLE SECURITIES

At March 31, 2020 and December 31, 2019, the fair value of marketable securities, which were all classified as available for sale, included the following (in thousands):

	March 31, 2020
	Adjusted Cost		Unrealized Gains		Unrealized Losses			Fair Value
Level 2:
Corporate debt securities	$	34,686	$	—	$	(101	)	$	34,585
Total	$	34,686	$	—	$	(101	)	$	34,585

	December 31, 2019
	Adjusted Cost		Unrealized Gains		Unrealized Losses			Fair Value
Level 2:
Corporate debt securities	$	37,325	$	7	$	(5	)	$	37,327
Government-sponsored enterprise debt securities		4,001		—		—			4,001
Total	$	41,326	$	7	$	(5	)	$	41,328

The carrying amounts reported in the Condensed Consolidated Balance Sheet approximate the fair value based on quoted market prices or alternative pricing sources and models utilizing market observable inputs. As of March 31, 2020, the Company did not recognize any allowance for credit impairments on its available for sale debt securities. All investments in marketable securities are classified as current assets on the balance sheet because the underlying securities mature within one year from the balance sheet date.

Business Combinations

3 Months Ended

Mar. 31, 2020

Business Combinations [Abstract]

Business Combinations

8. BUSINESS COMBINATIONS

CrendentialMyDoc

On December 16, 2019, the Company acquired substantially all the assets of Covenant Technology Group, LLC (“CredentialMyDoc”), a Savannah, Georgia-based company focusing on intuitive, easy to use, and fast to implement software-as-a-service solution, especially in ambulatory care settings. The consideration paid for CredentialMyDoc consisted of $9.0 million in cash, subject to a post-closing working capital adjustment. Of the purchase price paid at closing, $1.1 million is being held in escrow for a period of time following the closing to serve as a source of recovery for the working capital adjustment and certain potential indemnification claims by the Company. The results of operations for CredentialMyDoc have been included in the Provider Solutions segment of the Company’s Financial Statements from the date of acquisition.

A summary of the purchase price is as follows (in thousands):

Cash paid at closing	$	7,920
Cash held in escrow		1,080
Total consideration paid	$	9,000

The following table summarizes the preliminary fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands):

Accounts and unbilled receivable, net	$	216
Prepaid and other current assets		3
Operating lease right-of-use assets		30
Deferred tax assets		71
Goodwill		4,657
Intangible assets		4,340
Accounts payable and accrued liabilities		(7	)
Deferred revenue		(280	)
Operating lease liabilities		(30	)
Net assets acquired	$	9,000

The excess of preliminary purchase price over the preliminary fair values of net tangible and intangible assets is recorded as goodwill. The preliminary fair values of tangible and identifiable intangible assets and liabilities are based on management’s estimates and assumptions. The primary intangible assets acquired were customer relationships and developed technology. The fair value estimate for customer relationships intangible asset included significant assumptions in the prospective financial information, such as revenue growth, customer attrition, and EBITDA margin, and the discount rate. The fair value estimate for developed technology intangible asset included significant assumptions, including the estimate of employee hours that would be needed to recreate the technology. Additionally, these assumptions are forward looking and could be affected by future economic and market conditions. The preliminary fair values of assets acquired and liabilities assumed continue to be subject to change during the measurement period (up to one year from the acquisition date) as the Company finalizes the valuation of these items. The primary areas of the preliminary purchase price allocation that are not finalized include the composition and valuation of intangible assets and working capital. The goodwill balance is primarily attributed to the assembled workforce, additional market opportunities from offering CredentialMyDoc products, and expected synergies from integrating CredentialMyDoc with other products or other combined functional areas within the Company. The goodwill balance is deductible for U.S. income tax purposes. The net tangible assets include deferred revenue, which was adjusted down from a book value at the acquisition date of $595,000 to an estimated fair value of $280,000. The $315,000 write-down of deferred revenue will result in lower revenues than would have otherwise been recognized for such services.

The following table sets forth the preliminary components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands):

	Preliminary Fair value		Useful life
Customer relationships	$	2,100	9 years
Developed technology		2,100	4 years
Non-compete		110	5 years
Trade name		30	3 years
Total intangible assets subject to amortization	$	4,340

The following unaudited pro forma financial information summarizes the results of operations of the Company and CredentialMyDoc as though the companies were combined as of January 1, 2019 (in thousands, except per share data):

	Three Months Ended March 31,
	2020		2019
Total revenues	$	61,703	$	65,678
Income from continuing operations	$	7,191	$	4,684
Net income	$	7,191	$	5,878
Net income per share - basic	$	0.22	$	0.18
Net income per share - diluted	$	0.22	$	0.18

These unaudited pro forma combined results of operations include certain adjustments arising from the acquisition, such as amortization of intangible assets, depreciation of property and equipment, and fair value adjustments of acquired deferred revenue balances. The unaudited pro forma combined results of operations is for informational purposes only and is not indicative of what the Company’s results of operations would have been had the transaction occurred at the beginning of the earliest period presented or to project the Company’s results of operations in any future period.

NurseGrid

On March 9, 2020, the Company acquired all of the outstanding stock of HcT2 Co. dba NurseGrid (“NurseGrid”), a Portland, Oregon-based healthcare technology company offering NurseGrid Mobile and its corollary application for nurse managers, NurseGrid Enterprise for net cash consideration of approximately $21.4 million, subject to a post-closing working capital adjustment. The Company accounted for this transaction as a business combination achieved in stages which required the Company to remeasure its previously existing minority ownership interest, which was accounted for as a non-marketable equity investment measured using the fair value alternative, to fair value at the acquisition date based on the total enterprise value, adjusting for a control premium. The fair value of the Company’s interest in NurseGrid was $3.6 million at closing, resulting in a gain of $1.2 million, recorded as a change in fair value of non-marketable equity investments in the Company’s Condensed Consolidated Statement of Income. Additionally, the Company’s previously recorded non-marketable equity investment in NurseGrid was de-recognized from the Company’s Condensed Consolidated Balance Sheet. The financial results of NurseGrid have been included in the Workforce Solutions segment from March 9, 2020.

A summary of the purchase price is as follows (in thousands):

Cash paid at closing	$	25,485
Cash acquired		(4,064	)
Net consideration paid		21,421
Fair value of existing equity interest in NurseGrid		3,594
Total purchase price	$	25,015

The following table summarizes the preliminary fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands):

Accounts and unbilled receivable, net	$	92
Prepaid and other current assets		145
Operating lease right-of-use assets		50
Deferred tax assets		2,119
Goodwill		21,087
Intangible assets		1,845
Accounts payable and accrued liabilities		(194	)
Deferred revenue		(78	)
Operating lease liabilities		(51	)
Net assets acquired	$	25,015

The following table sets forth the preliminary components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands):

	Preliminary Fair value		Useful life
Customer relationships	$	35	8 years
Developed technology		1,110	5 years
Trade name		700	Indefinite
Total intangible assets subject to amortization	$	1,845

The amounts of revenue and operating loss of NurseGrid included in the Company’s Consolidated Statement of Income since the date of acquisition of March 9, 2020 for the three months ended March 31, 2020 are as follows (in thousands):

Total revenues		$	28
Operating loss		$	(220	)

The following unaudited pro forma financial information summarizes the results of operations of the Company and NurseGrid as though the companies were combined as of January 1, 2019 (in thousands, except per share data):

	Three Months Ended March 31,
	2020		2019
Total revenues	$	61,644	$	65,375
Income from continuing operations	$	6,515	$	3,876
Net income	$	6,515	$	5,071
Net income per share - basic	$	0.20	$	0.16
Net income per share - diluted	$	0.20	$	0.16

These unaudited pro forma combined results of operations include certain adjustments arising from the acquisition, such as amortization of intangible assets, depreciation of property and equipment, interest expense related to NurseGrid’s previously outstanding debt, and fair value adjustments of acquired deferred revenue balances. The unaudited pro forma combined results of operations is for informational purposes only and is not indicative of what the Company’s results of operations would have been had the transaction occurred at the beginning of the earliest period presented or to project the Company’s results of operations in any future period.

Business Segments

3 Months Ended

Mar. 31, 2020

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 (Workforce Solutions) and provider credentialing, privileging, and enrollment products and services (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, and depreciation. The Unallocated component below includes corporate functions, such as accounting, human resources, legal, investor relations, information systems, 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 for the three months ended March 31, 2020 and 2019 and as of March 31, 2020 and December 31, 2019 (in thousands).

	Three Months Ended March 31,
Revenues, net:	2020			2019
Workforce Solutions	$	49,824		$	54,295
Provider Solutions		11,748			10,892
Total revenues, net	$	61,572		$	65,187
Operating income from continuing operations:
Workforce Solutions	$	13,370		$	11,529
Provider Solutions		1,197			1,436
Unallocated		(7,323	)		(7,596	)
Total operating income from continuing operations	$	7,244		$	5,369

Segment assets *	March 31, 2020		December 31, 2019
Workforce Solutions	$	146,895	$	118,382
Provider Solutions		143,842		148,398
Unallocated		190,774		222,764
Total assets	$	481,511	$	489,544

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, marketable securities, non-marketable equity investments, and certain ROU assets are not allocated to individual segments and are included within Unallocated. A significant portion of property and equipment assets are included within Unallocated.

Discontinued Operations

3 Months Ended

Mar. 31, 2020

Discontinued Operations And Disposal Groups [Abstract]

Discontinued Operations

10. DISCONTINUED OPERATIONS

Patient Experience

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 $20.5 million, of which $19.0 million was recorded during the year ended December 31, 2018 and $1.5 million was recorded during the year ended December 31, 2019. This sale of the PX business resulted in the divestiture of the Company’s patient experience solutions business segment. The Company has classified the gain on sale of its PX business segment as discontinued operations in its Condensed Consolidated Statements of Income for all periods presented.

Debt

3 Months Ended

Mar. 31, 2020

Debt Disclosure [Abstract]

Debt

11. DEBT

Revolving Credit Facility

On December 31, 2018, the Company entered into a Second Amendment to its Revolving Credit Agreement, dated as of November 24, 2014 (as amended, the “Revolving Credit Facility”), with SunTrust Bank (“SunTrust”), which extended 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 Revolving Credit Facility), 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 March 31, 2020, the Company was in compliance with all covenants. There were no balances outstanding on the Revolving Credit Facility as of or during the three months ended March 31, 2020.

Non-Marketable Equity Investments

3 Months Ended

Mar. 31, 2020

Investments Debt And Equity Securities [Abstract]

Non-Marketable Equity Investments

12. NON-MARKETABLE EQUITY INVESTMENTS

Non-marketable equity investments where the Company is not able to exercise significant influence over the investee are accounted for using the measurement alternative for equity investments that do not have readily determinable fair values. ASU 2016-01, Financial Instruments – Overall (Subtopic 825-10) 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 aggregate carrying amount of all non-marketable equity investments was $3.0 million and $5.4 million as of March 31, 2020 and December 31, 2019, respectively, which carrying value we evaluate for impairment at each reporting period. During the three months ended March 31, 2020, the Company recorded a $1.2 million upward adjustment to the carrying value of our non-marketable equity investment in NurseGrid due to a change in fair value based on the consideration paid upon our acquisition of NurseGrid on March 9, 2020 (See Note 8). Cumulatively, the Company has recorded $0.1 million in downward adjustments to the carrying value of non-marketable equity investments. Such is the combination of cumulative downward adjustments of $1.3 million offset by cumulative upward adjustments of $1.2 million. These adjustments are the result of changes in fair value based on observable prices from orderly transactions for similar investments made in investees. The fair value of non-marketable equity investments 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.

Contractual Adjustment

3 Months Ended

Mar. 31, 2020

Contractual Adjustment [Abstract]

Contractual Adjustment

13. CONTRACTUAL ADJUSTMENT

In June 2018, a contract with one of our royalty partners expired and was not renewed. However, the contract required continued royalty payments for any subscriptions that extended beyond the contract termination date. Following the contract termination, there was a mutual disagreement related to various elements of this past partnership, and the Company accrued but did not pay royalties to the partner following the contract expiration. During the first quarter of 2020, the Company received a release of liability from the partner associated with this contract, resulting in no royalties to be paid to the partner. The de-recognition of this royalty liability and related expense was recorded as a $3.4 million reduction to cost of revenues in the first quarter of 2020.

Recent Accounting Pronouncements (Policies)

3 Months Ended

Mar. 31, 2020

Accounting Changes And Error Corrections [Abstract]

Accounting Standards Recently Adopted

Revenue Recognition and Sales Commissions (Tables)

3 Months Ended

Mar. 31, 2020

Revenue From Contract With Customer [Abstract]

Schedule of Revenues Included in Continuing Operations from Contracts with Customers Disaggregated by Revenue Source

The following table represents revenues disaggregated by revenue source for the three months ended March 31, 2020 and 2019 (in thousands). Sales taxes are excluded from revenues.

	Three Months Ended March 31, 2020						Three Months Ended March 31, 2019
Business Segments	Workforce Solutions		Provider Solutions		Consolidated		Workforce Solutions		Provider Solutions		Consolidated
Subscription services	$	48,717	$	9,627	$	58,344	$	52,805	$	9,080	$	61,885
Professional services		1,107		2,121		3,228		1,490		1,812		3,302
Total revenues, net	$	49,824	$	11,748	$	61,572	$	54,295	$	10,892	$	65,187

Shareholders' Equity (Tables)

3 Months Ended

Mar. 31, 2020

Equity [Abstract]

Stock Based Compensation Expense Recognized in Condensed Consolidated Statements of Income

Total stock based compensation expense recognized for the three months ended March 31, 2020 and 2019 in the Condensed Consolidated Statements of Income is as follows (in thousands):

	Three Months Ended March 31,
	2020		2019
Cost of revenues (excluding depreciation and amortization)	$	7	$	1
Product development		81		53
Sales and marketing		49		56
Other general and administrative		413		406
Total stock based compensation expense	$	550	$	516

Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2020

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 months ended March 31, 2020 and 2019 (in thousands, except per share data):

	Three Months Ended March 31,
	2020		2019
Numerator:
Income from continuing operations	$	7,092	$	4,780
Income from discontinued operations		—		1,194
Net income	$	7,092	$	5,974
Denominator:
Weighted-average shares outstanding		32,334		32,337
Effect of dilutive shares		23		40
Weighted-average diluted shares		32,357		32,377

Net income per share - basic:
Continuing operations	$	0.22	$	0.15
Discontinued operations		—		0.03
Net income per share - basic	$	0.22	$	0.18

Net income per share - diluted:
Continuing operations	$	0.22	$	0.15
Discontinued operations		—		0.03
Net income per share - diluted	$	0.22	$	0.18

Marketable Securities (Tables)

3 Months Ended

Mar. 31, 2020

Investments Debt And Equity Securities [Abstract]

Fair Value of Available for Sale Marketable Securities

At March 31, 2020 and December 31, 2019, the fair value of marketable securities, which were all classified as available for sale, included the following (in thousands):

	March 31, 2020
	Adjusted Cost		Unrealized Gains		Unrealized Losses			Fair Value
Level 2:
Corporate debt securities	$	34,686	$	—	$	(101	)	$	34,585
Total	$	34,686	$	—	$	(101	)	$	34,585

	December 31, 2019
	Adjusted Cost		Unrealized Gains		Unrealized Losses			Fair Value
Level 2:
Corporate debt securities	$	37,325	$	7	$	(5	)	$	37,327
Government-sponsored enterprise debt securities		4,001		—		—			4,001
Total	$	41,326	$	7	$	(5	)	$	41,328

Business Combinations (Tables)

3 Months Ended

Mar. 31, 2020

CredentialMyDoc [Member]

Summary of Purchase Price

A summary of the purchase price is as follows (in thousands):

Cash paid at closing	$	7,920
Cash held in escrow		1,080
Total consideration paid	$	9,000

Summary of Preliminary Fair Value of Assets Acquired and Liabilities Assumed

The following table summarizes the preliminary fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands):

Accounts and unbilled receivable, net	$	216
Prepaid and other current assets		3
Operating lease right-of-use assets		30
Deferred tax assets		71
Goodwill		4,657
Intangible assets		4,340
Accounts payable and accrued liabilities		(7	)
Deferred revenue		(280	)
Operating lease liabilities		(30	)
Net assets acquired	$	9,000

Summary of Preliminary Components of Identifiable Intangible Assets and Estimated Useful Lives

The following table sets forth the preliminary components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands):

	Preliminary Fair value		Useful life
Customer relationships	$	2,100	9 years
Developed technology		2,100	4 years
Non-compete		110	5 years
Trade name		30	3 years
Total intangible assets subject to amortization	$	4,340

Summary of Unaudited Pro Forma Financial Information

	Three Months Ended March 31,
	2020		2019
Total revenues	$	61,703	$	65,678
Income from continuing operations	$	7,191	$	4,684
Net income	$	7,191	$	5,878
Net income per share - basic	$	0.22	$	0.18
Net income per share - diluted	$	0.22	$	0.18

NurseGrid [Member]

Summary of Purchase Price

A summary of the purchase price is as follows (in thousands):

Cash paid at closing	$	25,485
Cash acquired		(4,064	)
Net consideration paid		21,421
Fair value of existing equity interest in NurseGrid		3,594
Total purchase price	$	25,015

Summary of Preliminary Fair Value of Assets Acquired and Liabilities Assumed

The following table summarizes the preliminary fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands):

Accounts and unbilled receivable, net	$	92
Prepaid and other current assets		145
Operating lease right-of-use assets		50
Deferred tax assets		2,119
Goodwill		21,087
Intangible assets		1,845
Accounts payable and accrued liabilities		(194	)
Deferred revenue		(78	)
Operating lease liabilities		(51	)
Net assets acquired	$	25,015

Summary of Preliminary Components of Identifiable Intangible Assets and Estimated Useful Lives

The following table sets forth the preliminary components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands):

	Preliminary Fair value		Useful life
Customer relationships	$	35	8 years
Developed technology		1,110	5 years
Trade name		700	Indefinite
Total intangible assets subject to amortization	$	1,845

Summary of Unaudited Pro Forma Financial Information

	Three Months Ended March 31,
	2020		2019
Total revenues	$	61,644	$	65,375
Income from continuing operations	$	6,515	$	3,876
Net income	$	6,515	$	5,071
Net income per share - basic	$	0.20	$	0.16
Net income per share - diluted	$	0.20	$	0.16

Summary of Revenue and Operating Loss Included in Company's Consolidated Statement of Income since the Date of Acquisition

Total revenues		$	28
Operating loss		$	(220	)

Business Segments (Tables)

3 Months Ended

Mar. 31, 2020

Segment Reporting [Abstract]

Business Segment Information Based on Net Revenues and Operating Income

The following is the Company’s business segment information for the three months ended March 31, 2020 and 2019 and as of March 31, 2020 and December 31, 2019 (in thousands).

	Three Months Ended March 31,
Revenues, net:	2020			2019
Workforce Solutions	$	49,824		$	54,295
Provider Solutions		11,748			10,892
Total revenues, net	$	61,572		$	65,187
Operating income from continuing operations:
Workforce Solutions	$	13,370		$	11,529
Provider Solutions		1,197			1,436
Unallocated		(7,323	)		(7,596	)
Total operating income from continuing operations	$	7,244		$	5,369

Business Segment Information Based on Assets

Segment assets *	March 31, 2020		December 31, 2019
Workforce Solutions	$	146,895	$	118,382
Provider Solutions		143,842		148,398
Unallocated		190,774		222,764
Total assets	$	481,511	$	489,544

Revenue Recognition and Sales Commissions - Schedule of Revenues Included in Continuing Operations Disaggregated by Revenue Source (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Disaggregation Of Revenue [Line Items]
Total revenues, net	$ 61,572	$ 65,187
Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	49,824	54,295
Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	11,748	10,892
Subscription Services [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	58,344	61,885
Subscription Services [Member] \| Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	48,717	52,805
Subscription Services [Member] \| Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	9,627	9,080
Professional Services [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	3,228	3,302
Professional Services [Member] \| Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	1,107	1,490
Professional Services [Member] \| Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	$ 2,121	$ 1,812

Revenue Recognition and Sales Commissions - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Revenue Recognition and Sales Commissions [Line Items]
Revenues recognized in period, included in deferred revenue at beginning of the period	$ 31,600,000	$ 31,200,000
Estimated revenue expected to be recognized in future under contract with customers	$ 402,000,000
Description of sales commission plan	Sales commissions earned by our sales force are considered incremental and recoverable costs of obtaining a contract with a customer. The sales commission plan for 2020 typically includes two payments; the initial payment is due in the period a customer contract is obtained and the final payment is due 60 days after product implementation is completed. The sales commission plan for 2019 typically included an initial payment in the period a customer contract was obtained and subsequent payments either 15 or 27 months after the initial payment depending on the contract term.
Sales Commissions, amortization term description	Non-commensurate commissions are amortized over the greater of the contract term or technological obsolescence period of approximately three years.
Sales Commissions, amortization period	3 years
Amortization of deferred commissions	$ 2,159,000	2,121,000
Customer Contracts [Member]
Revenue Recognition and Sales Commissions [Line Items]
Impairment losses on receivables and contract asset	$ 288,000	$ 2,000

Revenue Recognition and Sales Commissions - Additional Information (Detail 1) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2020-04-01	Mar. 31, 2020
Revenue Recognition and Sales Commissions [Line Items]
Percentage of remaining performance obligations expects revenue	47.00%
Estimated revenue, expected recognition period	12 months

Income Taxes - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Income Taxes Disclosure [Line Items]
Income tax provision	$ 1,858,000	$ 1,411,000
Effective tax rate for continuing operations	21.00%	23.00%
Additional income tax expense for tax deficiencies associated with stock based awards	$ 26,000
Reduction in income tax expense for excess tax benefits associated with stock based awards		$ 83,000
NurseGrid [Member]
Income Taxes Disclosure [Line Items]
Income tax provision	(300,000)
Change in fair value of non-marketable equity investments	$ 1,200,000

Shareholders' Equity - Additional Information (Detail) - USD ($)		3 Months Ended
	Mar. 13, 2020	Mar. 31, 2020	Mar. 31, 2019	Jun. 30, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock repurchase program, authorized amount	$ 30,000,000.0
Stock repurchase program, termination date	Mar. 12, 2021
Share repurchased, shares		438,142
Share repurchased, fair value		$ 9,876,000
Share repurchased, average price per share		$ 22.52
RSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued		111,510	86,220
Weighted average grant date fair value, restricted share unit		$ 22.96	$ 27.39
Performance-based RSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued		14,000		70,000
Weighted average grant date fair value, restricted share unit		$ 22.96
Restricted share units vesting period				5 years
Restricted share units, incremental performance percentage, year 2018				10.00%
Restricted share units, incremental performance percentage, year 2019				15.00%
Restricted share units, incremental performance percentage, year 2020				20.00%
Restricted share units, incremental performance percentage, year 2021				25.00%
Restricted share units, incremental performance percentage, year 2022				30.00%
Performance-based RSUs [Member] \| 2020 Performance [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued				14,000
Performance-based RSUs [Member] \| Performance Criteria Not Yet Determined [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued				38,500
Performance-based RSUs [Member] \| 2018 and 2019 Performance [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued		17,500,000

Shareholders' Equity - Stock Based Compensation Expense Recognized in Condensed Consolidated Statements of Income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	$ 550	$ 516
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	7	1
Product Development [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	81	53
Sales and Marketing [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	49	56
Other General and Administrative [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	$ 413	$ 406

Earnings Per Share - Additional Information (Detail) - shares	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Earnings Per Share [Abstract]
Total number of common equivalent shares excluded from the calculations of diluted earnings per share	106,000	136,000

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Numerator:
Income from continuing operations	$ 7,092	$ 4,780
Income from discontinued operations		1,194
Net income	$ 7,092	$ 5,974
Denominator:
Weighted-average shares outstanding	32,334	32,337
Effect of dilutive shares	23	40
Weighted-average diluted shares	32,357	32,377
Net income per share - basic:
Continuing operations	$ 0.22	$ 0.15
Discontinued operations		0.03
Net income per share - basic	0.22	0.18
Net income per share - diluted:
Continuing operations	0.22	0.15
Discontinued operations		0.03
Net income per share - diluted	$ 0.22	$ 0.18

Marketable Securities - Fair Value of Available for Sale Marketable Securities (Detail) - Level 2 [Member] - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Schedule of Available-for-sale Securities [Line Items]
Available for sale securities, Adjusted Cost	$ 34,686	$ 41,326
Available for sale securities, Unrealized Gains		7
Available for sale securities, Unrealized Losses	(101)	(5)
Available for sale securities, Fair Value	34,585	41,328
Corporate Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Available for sale securities, Adjusted Cost	34,686	37,325
Available for sale securities, Unrealized Gains		7
Available for sale securities, Unrealized Losses	(101)	(5)
Available for sale securities, Fair Value	$ 34,585	37,327
Government-Sponsored Enterprises Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Available for sale securities, Adjusted Cost		4,001
Available for sale securities, Fair Value		$ 4,001

Marketable Securities - Additional Information (Detail)	Mar. 31, 2020 USD ($)
Amortized Cost And Fair Value Debt Securities [Abstract]
Available for sale debt securities, allowance for credit impairments	$ 0

Business Combinations - Additional Information (Detail) - USD ($)	Mar. 09, 2020	Dec. 16, 2019
CredentialMyDoc [Member]
Business Acquisition [Line Items]
Consideration paid for acquisition in cash		$ 9,000,000
Net tangible assets include deferred revenue book value at acquisition date		595,000
Net tangible assets include deferred revenue fair value at acquisition date		280,000
Write-down of deferred revenue		$ 315,000
CredentialMyDoc [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Preliminary purchase price allocation measurement period from acquisition date		1 year
CredentialMyDoc [Member] \| Recovery of Working Capital Adjustment and Certain Potential Indemnification Claims [Member]
Business Acquisition [Line Items]
Purchase price held in escrow		$ 1,100,000
NurseGrid [Member]
Business Acquisition [Line Items]
Consideration paid for acquisition in cash	$ 21,400,000
Net tangible assets include deferred revenue book value at acquisition date	157,000
Net tangible assets include deferred revenue fair value at acquisition date	78,000
Write-down of deferred revenue	78,000
Fair value of existing equity interest	3,594,000
Gain recognized from remeasurement of equity interest	$ 1,200,000
NurseGrid [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Preliminary purchase price allocation measurement period from acquisition date	1 year

Business Combinations - Summary of Purchase Price (Detail) - USD ($) $ in Thousands	Mar. 09, 2020	Dec. 16, 2019
CredentialMyDoc [Member]
Business Acquisition [Line Items]
Total consideration paid		$ 9,000
CredentialMyDoc [Member] \| Cash Paid at Closing [Member]
Business Acquisition [Line Items]
Total consideration paid		7,920
CredentialMyDoc [Member] \| Cash Held in Escrow [Member]
Business Acquisition [Line Items]
Total consideration paid		$ 1,080
NurseGrid [Member]
Business Acquisition [Line Items]
Total consideration paid	$ 21,400
Cash acquired	(4,064)
Net consideration paid	21,421
Fair value of existing equity interest in NurseGrid	3,594
Total purchase price	25,015
NurseGrid [Member] \| Cash Paid at Closing [Member]
Business Acquisition [Line Items]
Total consideration paid	$ 25,485

Business Combinations - Summary of Preliminary Fair Value of Assets Acquired and Liabilities Assumed (Detail) - USD ($)	Mar. 31, 2020	Mar. 09, 2020	Dec. 31, 2019	Dec. 16, 2019
Business Acquisition [Line Items]
Goodwill	$ 123,283,000		$ 102,196,000
CredentialMyDoc [Member]
Business Acquisition [Line Items]
Accounts and unbilled receivable, net				$ 216,000
Prepaid and other current assets				3,000
Operating lease right-of-use assets				30,000
Deferred tax assets				71,000
Goodwill				4,657,000
Intangible assets				4,340,000
Accounts payable and accrued liabilities				(7,000)
Deferred revenue				(280,000)
Operating lease liabilities				(30,000)
Net assets acquired				$ 9,000,000
NurseGrid [Member]
Business Acquisition [Line Items]
Accounts and unbilled receivable, net		$ 92,000
Prepaid and other current assets		145,000
Operating lease right-of-use assets		50,000
Deferred tax assets		2,119,000
Goodwill		21,087,000
Intangible assets		1,845,000
Accounts payable and accrued liabilities		(194,000)
Deferred revenue		(78,000)
Operating lease liabilities		(51,000)
Net assets acquired		$ 25,015,000

Business Combinations - Summary of Preliminary Components of Identifiable Intangible Assets and Estimated Useful Lives (Detail) - USD ($) $ in Thousands	Mar. 09, 2020	Dec. 16, 2019
CredentialMyDoc [Member]
Business Acquisition [Line Items]
Preliminary Fair value		$ 4,340
CredentialMyDoc [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Preliminary Fair value		$ 2,100
Useful life		9 years
CredentialMyDoc [Member] \| Developed Technology [Member]
Business Acquisition [Line Items]
Preliminary Fair value		$ 2,100
Useful life		4 years
CredentialMyDoc [Member] \| Non-Compete [Member]
Business Acquisition [Line Items]
Preliminary Fair value		$ 110
Useful life		5 years
CredentialMyDoc [Member] \| Trade Name [Member]
Business Acquisition [Line Items]
Preliminary Fair value		$ 30
Useful life		3 years
NurseGrid [Member]
Business Acquisition [Line Items]
Preliminary Fair value	$ 1,845
NurseGrid [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Preliminary Fair value	$ 35
Useful life	8 years
NurseGrid [Member] \| Developed Technology [Member]
Business Acquisition [Line Items]
Preliminary Fair value	$ 1,110
Useful life	5 years
NurseGrid [Member] \| Trade Name [Member]
Business Acquisition [Line Items]
Preliminary Fair value	$ 700

Business Combinations - Summary of Unaudited Pro Forma Financial Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
CredentialMyDoc [Member]
Business Acquisition [Line Items]
Total revenues	$ 61,703	$ 65,678
Income from continuing operations	7,191	4,684
Net income	$ 7,191	$ 5,878
Net income per share - basic	$ 0.22	$ 0.18
Net income per share - diluted	$ 0.22	$ 0.18
NurseGrid [Member]
Business Acquisition [Line Items]
Total revenues	$ 61,644	$ 65,375
Income from continuing operations	6,515	3,876
Net income	$ 6,515	$ 5,071
Net income per share - basic	$ 0.20	$ 0.16
Net income per share - diluted	$ 0.20	$ 0.16

Business Combinations - Summary of Revenue and Operating Loss Included in Company's Consolidated Statement of Income since the Date of Acquisition (Detail) - NurseGrid [Member] $ in Thousands	Mar. 09, 2020 USD ($)
Business Acquisition [Line Items]
Total revenues	$ 28
Operating loss	$ (220)

Business Segments - Business Segment Information Based on Net Revenues and Operating Income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Revenues, net:
Revenues, net	$ 61,572	$ 65,187
Operating income from continuing operations:
Operating income from continuing operations	7,244	5,369
Workforce Solutions [Member]
Revenues, net:
Revenues, net	49,824	54,295
Provider Solutions [Member]
Revenues, net:
Revenues, net	11,748	10,892
Operating Segments [Member] \| Workforce Solutions [Member]
Revenues, net:
Revenues, net	49,824	54,295
Operating income from continuing operations:
Operating income from continuing operations	13,370	11,529
Operating Segments [Member] \| Provider Solutions [Member]
Revenues, net:
Revenues, net	11,748	10,892
Operating income from continuing operations:
Operating income from continuing operations	1,197	1,436
Unallocated [Member]
Operating income from continuing operations:
Operating income from continuing operations	$ (7,323)	$ (7,596)

Business Segments - Business Segment Information Based on Assets (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Segment Reporting Information [Line Items]
Total assets	$ 481,511	$ 489,544
Operating Segments [Member] \| Workforce Solutions [Member]
Segment Reporting Information [Line Items]
Total assets	146,895	118,382
Operating Segments [Member] \| Provider Solutions [Member]
Segment Reporting Information [Line Items]
Total assets	143,842	148,398
Unallocated [Member]
Segment Reporting Information [Line Items]
Total assets	$ 190,774	$ 222,764

Discontinued Operations - Additional Information (Detail) - Patient Experience Solutions [Member] - USD ($) $ in Millions		12 Months Ended
	Feb. 12, 2018	Dec. 31, 2019	Dec. 31, 2018
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Consideration received	$ 65.2
Gain on sale of business, net of tax	$ 20.5	$ 1.5	$ 19.0

Debt - Additional Information (Detail) - SunTrust Bank [Member]	3 Months Ended
	Mar. 31, 2020 USD ($)
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.
Minimum [Member]
Line of Credit Facility [Line Items]
Commitment fee paid per annum	0.20%
Maximum [Member]
Line of Credit Facility [Line Items]
Commitment fee paid per annum	0.30%
Revolving Credit Facility [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	$ 50,000,000.0
Increase in revolving credit facility	25,000,000.0
Principal payments prior to maturity	0
Outstanding balance on revolving credit facility	0
Revolving Credit Facility [Member] \| Swing Line Sub Facility [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity under credit facility	5,000,000.0
Revolving Credit Facility [Member] \| Letter of Credit Subfacility [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity under credit facility	$ 5,000,000.0
Revolving Credit Facility [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] \| Base Rate [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility, Interest Rate During Period	1.00%
Revolving Credit Facility [Member] \| Minimum [Member]
Line of Credit Facility [Line Items]
Interest coverage ratio	300.00%
Revolving Credit Facility [Member] \| Minimum [Member] \| Base Rate [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	0.50%
Revolving Credit Facility [Member] \| Minimum [Member] \| Eurodollar [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	1.50%
Revolving Credit Facility [Member] \| Maximum [Member]
Line of Credit Facility [Line Items]
Debt leverage ratio	300.00%
Revolving Credit Facility [Member] \| Maximum [Member] \| Base Rate [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	1.50%
Revolving Credit Facility [Member] \| Maximum [Member] \| Eurodollar [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	2.00%

Non-Marketable Equity Investments - Additional Information (Detail) - USD ($) $ in Thousands		3 Months Ended	12 Months Ended
	Mar. 09, 2020	Mar. 31, 2020	Dec. 31, 2018	Dec. 31, 2019
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Aggregate carrying amount of non-marketable equity investments		$ 3,000		$ 5,400
Changes in adjustment to carrying value of non-marketable equity investment due to change in fair value		(1,152)	$ 1,300
Cumulative downward adjustments to carrying value of non-marketable equity investments		$ 100
NurseGrid [Member]
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Changes in adjustment to carrying value of non-marketable equity investment due to change in fair value	$ (1,200)

Contractual Adjustment - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2020 USD ($)
Contractual Adjustment [Abstract]
Cost of goods and services sold, derecognized	$ 3.4