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We maintain our Neutral recommendation on Athenahealth (ATHN - Analyst Report). Its third-quarter 2012 earnings per share of 18 cents just beat the Zacks Consensus Estimate. Reported net income in the third quarter increased 17.6% year over year to $6.2 million (or 17 cents per share).

Revenues climbed 26% year over year to $105.9 million in the quarter. Revenues missed the Zacks Consensus Estimate of $109 million.

On a segment-wise basis, revenues from Business Services surged 26.8% year over year to $102.3 million while Implementation and Other revenues improved 17.1% to $3.6 million.

Utilization of athenaCollector by medical providers and physicians grew 20.4% and 20.2% respectively, year over year in the third quarter. Furthermore, the use of athenaClinical by medical providers and physicians jumped 72% and 74.7% respectively, year over year. The utilization of athenaCommunicator increased almost three fold to 12,149 medical providers (of whom 8,739 were physicians) from 4,117 medical providers (of whom 2,931 were physicians) in the year-ago period.   

Athenahealth’s web-based deployment provides a low-cost scalable service while its flexible rules engine leads to higher efficiency in claims settlement. The Software-as-a-Service (SaaS)-based approach allows for a more flexible delivery mechanism that is expected to help Athenahealth win deals. The company has traditionally enjoyed high customer satisfaction rates, which facilitates a larger number of referrals.

Athenahealth’s unique business model makes it a strong provider of RCM services (athenaCollector) designed for small physician practices. Its EHR product (athenaClinical) is a key player in ambulatory settings.

We believe that sales of athenaClinical are likely to remain robust. In addition, the company will harness its newer products, namely athenaCommunicator and athenaCoordinator.

The company should benefit from its extensive athenaCollector client base, as only a minority of its subscriber base also utilizes athenaClinical. Cross selling represents a real growth opportunity in the near term. In this regard, Athenahealth has made rapid strides in capturing the EHR business of physician practices. However, this segment is shrinking, as hospitals increasingly absorb physician’s medical practices.

Athenahealth is geared to enter the enterprise segment through its strategic alliance with Microsoft (MSFT - Analyst Report) and the acquisition of Proxsys, both completed in 2011. The company has recently signed on, and executed several enterprise-sized deals, which provide it with a credible and referenceable client base.

Though the federal stimulus will gradually wind down, the replacement market has been growing. Competition is fierce and larger competitors may benefit from the incumbency factor. Industry stalwarts such as Cerner (CERN - Analyst Report) offer long-standing seamless products integrating inpatient and ambulatory-care systems. Quality Systems (QSII - Analyst Report) and Allscripts Healthcare Solutions (MDRX - Analyst Report) are two other well-known competitors in a crowded field.

The stock carries a Zacks #4 Rank, which translates into a short-term Sell rating.

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