R1 RCM Inc. announced unaudited consolidated earnings results for the fourth quarter and full year ended December 31, 2017. For the quarter, the company reported net services revenue of $140.3 million against $106.2 million for the same period a year ago. Loss from operations was $3.7 million against income from operations of $27.6 million for the same period a year ago. Loss before income tax provision was $3.6 million against profit before income tax provision of $27.7 million for the same period a year ago. Net loss was $40.2 million against net income of $13.2 million for the same period a year ago. Basic and diluted loss per share was $0.44 against basic and diluted earnings per share of $0.65 for the same period a year ago. Adjusted EBITDA (non-GAAP) was $5.7 million against $35.9 million for the same period a year ago. The sequential improvement was driven by EBITDA contribution from Ascension Phase-1 and Phase-2 additional booked ministries. The company also generated another quarter of sequential revenue growth, driven by the contribution from the Wisconsin business.

For the year, the company reported net services revenue of $449.8 million against $592.6 million for the same period a year ago. Loss from operations was $27.5 million against income from operations of $297.9 million for the same period a year ago. Loss before income tax provision was $27.3 million against profit before income tax provision of $298.2 million for the same period a year ago. Net loss was $58.8 million against net income of $177.1 million for the same period a year ago. Basic and diluted loss per share was $0.75 against basic and diluted earnings per share of $0.65 for the same period a year ago. Net cash provided by operating activities was $20.9 million against net cash used in operating activities of $86.9 million for the same period a year ago. Purchases of property, equipment, and software were $33.6 million against $12.6 million for the same period a year ago. Adjusted EBITDA (non-GAAP) was $4.1 million against $357.0 million for the same period a year ago. This substantial improvement in adjusted EBITDA was a function of revenue growth and cost efficiencies delivered from onboarded businesses as well as a reduction in SG&A expense. Revenue was up more than $241 million relative to gross cash generated from contracting activities in the prior year, driven in large part by the onboarding of new business.

The company provided earnings guidance for the year 2018. For the year, the company expects to generate revenue of $850 million to $900 million, GAAP operating loss of $30 million to $55 million and adjusted EBITDA of $50 million to $55 million. The company expects depreciation and amortization expense of $25 million to $30 million, amortization of intangibles of $15 million to $30 million. This guidance contemplates the Intermedix transaction closing in the second quarter and no major changes from the adoption of ASC 606 for Intermedix.

The company expect a modest sequential increase in revenue in the first quarter of 2018, followed by a meaningful step up in the second quarter of 2018 as the company's onboard Intermountain and assuming a mid-quarter closed for Intermedix.

In the third quarter of 2018, the company expects a further step up in revenue due to a full quarter of Intermedix contribution and revenue from onboarding Presence Health and Ascension Medical Group.

The company expects a modest sequential increase in revenue in the fourth quarter of 2018.