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Health Catalyst, Inc. (HCAT)

Q1 2024 Earnings Call· Thu, May 9, 2024

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Transcript

Operator

Operator

Good afternoon, everyone, and welcome to the Health Catalyst First Quarter 2024 Earnings Conference Call. [Operator Instructions] I would now like to turn the conference over to Jack Knight, Vice President of Investor Relations. Please go ahead, sir.

Jack Knight

Analyst

Good afternoon, and welcome to Health Catalyst's earnings conference call for the first quarter of 2024, which ended on March 31, 2024. My name is Jack Knight. I'm the Vice President of Investor Relations for Health Catalyst. And with me on the call is Dan Burton, our Chief Executive Officer; and Jason Alger, our Chief Financial Officer. A complete disclosure of our results can be found in our press release issued today as well as in our related Form 8-K furnished to the SEC, both of which are available on the Investor Relations section of our website at ir.healthcatalyst.com. As a reminder, today's call is being recorded, and a replay will be available following the conclusion of the call. During today's call, we will make forward-looking statements pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995 regarding our future growth and our financial outlook for the second quarter and full year of 2024. Our ability to attract new clients and retain and expand our relationships with existing clients, trends, strategies, the impact of the macroeconomic challenges, including the impact of inflation and the interest rate environment, the tight labor market, bookings, our pipeline conversion rates, the demand for deployment and development of our data and analytics platform and the general anticipated performance of our business. These forward-looking statements are based on management's current views and expectations as of today and should not be relied upon as representing our views as of any subsequent date. We disclaim any obligation to update any forward-looking statements or outlook. Actual results may materially differ. Please refer to the risk factors in our Form 10-K for the full year 2023 filed with the SEC on February 22, 2024, and our Form 10-Q for the first quarter 2024 that will be filed with the SEC. We will also refer to certain non-GAAP financial measures to provide additional information to investors. Non-GAAP financial information is presented for supplemental informational purposes only, has limitations as an analytical tool and should not be considered in isolation or as a substitute for financial information presented in accordance with GAAP. A reconciliation of non-GAAP financial measures for the first quarters of 2024 and 2023 to their most comparable GAAP measures is provided in our press release. However, we have not provided forward-looking guidance for professional services gross margin, the most directly comparable GAAP measure to adjusted professional services gross margin we will discuss later. Technology gross margin, the most directly comparable GAAP measure to our adjusted technology gross margin we will discuss later or net cash from operating activities, the most comparable GAAP measure to adjusted free cash flow we will discuss later. And therefore, not provided related reconciliations of these non-GAAP measures to their most comparable GAAP measures because there are items that are not within our control or cannot be reasonably forecasted. With that, I will turn the call over to Dan. Dan?

Daniel Burton

Analyst

Thank you, Jack, and thank you to everyone who has joined us this afternoon. We are pleased to share our first quarter 2024 financial performance, along with additional highlights from the quarter. I will begin today's call with summary commentary on our first quarter 2024 results. We are encouraged by our first quarter 2024 financial results, including total revenue of $74.7 million and adjusted EBITDA of $3.4 million, with these results above the midpoint of our most recent guidance on each metric. Additional financial highlights from the first quarter include our adjusted gross margin of 68% for technology and 22% for professional services. Both of these metrics represent improvement compared to Q4, 2023. Now let me highlight some additional items from the quarter. You will recall from our previous earnings calls that we measure our company's performance in the 3 strategic objective categories of improvement, growth and scale. And we'll discuss our quarterly results with you in each of these categories. The first category: improvement, is focused on evaluating our ability to enable our clients to realize massive, measurable improvements while also maintaining industry-leading client and team member engagement. Let me begin by sharing a couple of examples of improvements from recently published success stories. First, many health care organizations grapple with the challenges of labor-intensive chart abstraction and registry submission. These processes are costly and time-consuming and demand expertise in clinical and electronic health record systems, compounded by the industry's imperative to reduce expenses, these burdens underscore the need for innovative solutions. Our tech-enabled managed services solution for chart abstraction leverages our technology and expertise, inclusive of Generative AI and process improvement methodologies to establish substantially more efficient abstraction. Our solution enables improved timeliness, accuracy and quality of submission, all at a meaningfully lower cost. Data exists in structured…

Jason Alger

Analyst

Thank you, Dan. Before diving into our quarterly financial results, I want to echo what Dan shared and say that I am pleased with our first quarter performance. I will now comment on our strategic objective category of scale. For the first quarter of 2024, we generated $74.7 million in total revenue. This total represents a slight outperformance relative to the midpoint of our quarterly guidance and it is an increase of 1% year-over-year. Technology revenue for the first quarter of 2024 was $47 million, roughly flat compared to Q1, 2023. Professional services revenue for Q1, 2024 was $27.8 million, representing a 4% increase relative to the same period last year. This year-over-year performance was primarily due to revenue recognition ramping from the tech-enabled managed services contracts that were signed in the second half of 2023, partially offset by some down selling from our higher-margin consulting services. For the first quarter 2024, total adjusted gross margin was 51%, representing a decrease of approximately 70 basis points year-over-year. In the Technology segment, our Q1 2024 adjusted technology gross margin was 68%, a decrease of approximately 140 basis points relative to the same period last year. This year-over-year performance was expected and mainly driven by costs associated with migrating a subset of our client base to Health Catalyst Ignite, our next-generation multi-tenant, Snowflake and Databricks enabled data and analytics platform environment. In the Professional Services segment, our Q1 2024 adjusted professional services gross margin was 22%, representing an increase of approximately 190 basis points year-over-year. and an increase of approximately 1,040 basis points relative to Q4 2023. This quarterly performance was ahead of the expectations we shared on our last earnings call, mainly driven by our recent reduction in force that primarily occurred late in the fourth quarter of 2023. In Q1…

Daniel Burton

Analyst

Thanks, Jason. In conclusion, I would like to recognize and thank our committed and mission-aligned clients and our highly engaged team members for their dedication and contributions to these results and this progress as well as express my optimism for the future. And with that, I will turn the call back to the operator for questions.

Operator

Operator

[Operator Instructions] We'll go first this afternoon to Jared Haase of William Blair.

Jared Haase

Analyst

This is Jared on for Ryan Daniels. Dan, maybe just since you mentioned in the prepared remarks, M&A, I'll ask one around that. I'm curious, could you just maybe remind us kind of any particular product areas or sort of value propositions that might make sense for you guys to look to do a deal around just in terms of that build versus buy question? And then I guess also related to that, could you kind of run through what you typically look for or how we should think about the type of deal size or financial profile?

Daniel Burton

Analyst

Yes. Absolutely, Jared. So when we think about M&A, first, as we mentioned in the prepared remarks, we look for a really strong strategic fit. And specifically, we are focused in those 5 key areas. There's 2 horizontal areas around the data and analytics platform and then the measures and registries capability that are more horizontal in nature. And so we focus on ensuring that we're strategically really strong there. Most of our data and analytics platform investments are -- and improvements come through R&D and less about the M&A opportunities. But I would say in the measures and registry space and then in the 3 use case areas of focus for us, those are areas where we're conscious of the opportunities that might exist in buy versus partner versus build specific spaces. And a few of our recent -- most recent acquisitions are good examples of that, where we have accelerated our capabilities in measures and registries, for example, through the most recent acquisition of ERS or the ARMUS acquisition before that. So we'll continue to be focused, I think, more in that use case area and the apps layer, and we'll continue to be really financially disciplined as well in the way that we think about these. I do believe that the acquisition opportunities that we'll focus on will be much like those more recent acquisitions over the last few years where they're more tuck-in acquisitions, they're more tech-focused acquisitions that just allow us to accelerate our product road map and accelerate our offering to our clients. But likely more in those use case areas and more specifically skewing towards technology tuck-ins. Anything, Jason, you would add?

Jason Alger

Analyst

Yes. The only thing I would add is from a financial profile standpoint, profitability is extremely important to us. So we'll be focused on adjusted EBITDA that these deals are primarily adjusted EBITDA neutral to adjusted EBITDA positive. There could be trades that we might consider in certain deals, but profitability is very important.

Operator

Operator

We'll go next now to Elizabeth Anderson of Evercore ISI.

Elizabeth Anderson

Analyst

I guess one of the things that was interesting to me was just obviously the strong gross margin in the professional services. If we think about the kind of like the -- maybe separate out the impact of the TEMs deals ramping versus maybe what [indiscernible], gross margins outside of that. Can you just talk through maybe the non-TEMs ramping portion of it, just so we kind of understand like multiple moving pieces there?

Daniel Burton

Analyst

Yes, absolutely. I'll share a few thoughts, Elizabeth and then, Jason, please feel free to add as well. So separating out the mix dynamic of TEMs deals where they ramp from a low gross margin to a little bit higher gross margin over time. I think the main factor that really helped us was really getting into greater balance from a supply/demand perspective through the workforce reduction that Jason had alluded to in the prepared remarks, that in those higher-margin consulting services, I think we now have rightsized the right size of staff and team with the right level of demand, and that had a meaningful positive gross margin impact.

Jason Alger

Analyst

Yes. The only thing I would add there, Elizabeth, is that we do expect our revenue to ramp in the second half of the year. Some of that ramp will be new TEMs bills. Those TEMs bills will put a bit of pressure on our professionals -- on our adjusted professional services gross margin. We're very pleased with the progress that we made in Q1 and expect to continue to make progress, but do expect to see a bit of pressure in the second half, which is where we set our expectation at the high teens from an adjusted professional services gross margin level on the year.

Elizabeth Anderson

Analyst

Got it. That's super helpful color. And then maybe just as a follow-up, can you talk a little bit more about the 2Q and maybe it's that you have the visibility into the 4Q booking season. Just sort of what are you seeing? How is the change in appetite in terms of like making commitments, sort of mix of things that potential customers and current customers are interested in? Any other color on that would be helpful.

Daniel Burton

Analyst

Yes, absolutely. Thanks for the question, Elizabeth. So we started with a strong Q1, where our performance was consistent with our expectations, and that's always a good sign. As we mentioned in the prepared remarks, we do see some meaningful overall positive trends as it relates to our end market and operating margins. Now there's a spectrum of experiences across our client base and that still includes some on that spectrum really struggling. Many of you may have seen some of the recent announcements as it relates to Steward Health Care, which does include a part of our client base that still is struggling. But at an overarching level, I think we're encouraged to see those trend lines. Now specific to Steward Health, given their financial challenges and their announcement around the bankruptcy proceedings that they are working their way through, as you might expect from keeping a close eye on that situation, and this is recent information and the situation is continuing to evolve, and expect that we'll learn a lot more in the weeks and months ahead. We've been an active frequent and direct communication with senior leaders at the C-suite level at Steward, including even as recently as over the last few days. And as a reminder, even with the announcements that Steward has been sharing, each of the more than 30 hospitals, medical centers and physician offices within Steward Health Care are open. They're caring for patients on a daily basis. And we're also actively providing our solutions in the support of that care on a daily basis. Senior leaders at Steward have communicated with us that they view us and our solutions as critical to their ongoing operations, and the solutions that we provide are critical, and they have meaningful hard dollar financial benefits associated with those ongoing solutions. And as such, our default assumption in this specific scenario is that these solutions will continue in 2024 and beyond, including in various asset sales scenarios. We've been receiving regular payments from Steward, and we anticipate that during the bankruptcy proceedings, Steward will continue to pay for active contracts like those that we are continuing with them. We're actively seeking to collect all of the outstanding payments that are due to help catalysts. But of course, we acknowledge that there are challenges with respect to collection of prepetition debt in any bankruptcy situation. And there's some uncertainty around collectibility of prepetition amounts. Therefore, we've made some meaningful provision for the possibility that we may not collect all of the prepetition amount owed.

Operator

Operator

We go next now to Stephanie Davis with Barclays.

Anna Kruszenski

Analyst

This is Anna Kruszenski on for Stephanie. The first one I wanted to ask on is just if you could talk maybe a bit about the push-pull of the change outage, but then also the improving operating margins and how maybe that's impacting TEM decision-making?

Daniel Burton

Analyst

Yes, absolutely. So in general, we've been grateful to see no major disruption from the perspective of our business as it relates to the challenges of the changed health care situation. There is one case where with regards to a meaningful tech-enabled managed services opportunity that has been progressing in our pipeline. One particular existing client asked us to just press pause while they dealt with the near-term operational challenges over the last couple of months related to the changed health care situation. We're grateful to see meaningful progress there. And even as early -- as recently as just over the last week or so, that systems are becoming operational once again. So that was the only major example of some specific pipeline-related delay related to that one tech enabled managed services opportunity. But in other parts of our pipeline, both on the new client side and on the existing client side, we have not experienced any specific interruption or challenges related to that. It is important to note that we have a very different business model and solution than what change health care provides. And that solution continues to be in demand with our clients, and we continue to be really vigilant and focused on information security Health Catalyst as evidenced by our high trust certification, our SOC2 certifications and state ramp certifications, and we'll continue to be vigilant and focused in that really important area. Anything you'd add, Jason?

Jason Alger

Analyst

I think you covered it well, Dan. Thanks.

Anna Kruszenski

Analyst

Awesome. And then just one other one. I was wondering if you could talk about the expansion with Saudi German Health. I'm just curious how much of that book is international.

Daniel Burton

Analyst

Yes, absolutely. So that is all international opportunity for us. We're excited to see a meaningful expansion in that relationship. And I would say, this is a good example of something that we've talked a little bit about earlier which is, as we saw more and more technology-oriented growth opportunities, both with existing clients and new clients as the end market improved, we have proactively shifted more of our growth resources to focus on those technology opportunities. And Saudi German expansion is a good example of that where much of the expansion is technology expansion, which obviously is higher gross margin and contributes more to our profitable growth expectations and our forecast. So we're really excited to see that kind of meaningfully technology-heavy expansion, which is also encouraging to see in the international segment of our business.

Operator

Operator

We go next now to John Ransom with Raymond James.

John Ransom

Analyst

Just kind of stepping back and asking more of a macro question. You've had to come through the end of the free money era, the coming and waning of COVID, you had some pivots in your strategy. But when you kind of think about Health Catalyst in 2024 versus the Health Catalyst that came public in 2019, what's -- what do you think the major changes are, the major lessons learned? What did you learn from all this? And how do we think about the company differently than maybe the company that existed a few years ago?

Daniel Burton

Analyst

Yes. Great question, John. The company is very different than what it was 5 years ago. I would characterize this as more of an adolescent 5 years ago as a company. We were about 1/3 of our current revenue size and we had less than 1/5 of the total number of clients that we have today. We were also meaningfully unprofitable from an adjusted EBITDA perspective. And I think one of the anticipated benefits of the company going public was the discipline and the rigor that it would require of us and the consistency of performance that it would require of us. And as we approach our 5-year anniversary here in just another 2 months or so, I really feel grateful for that discipline and that capacity for consistency that Health Catalyst has developed through that experience of being a publicly traded company. We're now 3x our size from a revenue perspective. We've shifted from meaningful negative EBITDA to meaningful positive EBITDA, and we're excited as we think forward to the next number of years that we'll continue to mature as more of a grown-up company that has meaningful predictability, has meaningful consistency. Now what we didn't anticipate in 2019 was, that within 7 or 8 months of going public, we would have a global once-in-a-century pandemic to deal with. So that was interesting. And it's massive and disproportionate impact on our end market in health care and health care providers, in particular, and that, that would be followed by a very brief respite in 2021 and then an incredibly disruptive and challenging financial environment due to the inflation impacts in 2022, 2023, that really hit our end market, our health system end market really, really hard. And for the vast majority of that time in 2022 and in most…

Jason Alger

Analyst

Yes. The one thing that I would add, and this is reiterating some of what Dan mentioned is, one lesson learned is the importance of being able to be agile and really meet our clients where they are. We have went through some challenging macroeconomic times, and I'm grateful that we did have an offering that could support our clients through those times and allow for financial savings and hard dollar ROI identification. So we've seen some swings on the pendulum where, at times, we were tech-focused. At times, we were more service-focused. Moving into 2024, we are taking a bit more of a balanced approach. We're focused on profitable growth but also focused on our TEMs offering and being thoughtful around growing through TEMs as well.

John Ransom

Analyst

So my other question is you've hit on this a little bit. But as you think about the end market healing, you look at companies selling into the hospital space, and they hit this sort of inevitable top line growth that mirrors the growth of their end market. And you can think of all the mature vendors and some of the public that sell into the hospital industry. And then you also look at HCIT and HCIT companies or software companies tend to hit the wall at $300 million of revenue according to McKinsey or somebody. But so how do you -- when you think about the long term, how do you avoid falling into the trap of either just growing at the rate of your end market or also just hitting the wall as a software company that -- and I don't really frankly understand the gravity of why $300 million is the number, but I'm just curious if you thought about that. And just how do you long term avoid those 2 traps?

Daniel Burton

Analyst

Yes, great question, John. So I'll try to be a little more brief in this answer, but that was an opportunity for reflection over the last 5 years. So I appreciate you asking the first question. So as it relates to the end market and us moving forward as a company, I think implied in your question is, what is it that gives us confidence that we will see a reacceleration from single-digit percentage growth to double-digit growth like we've forecasted, as we shared in our most recent earnings call. I think there's a few dynamics that really help us. First, remember that we provide both technology and services. And it's a relatively large proportion of both. And so we see meaningful growth opportunities from a technology perspective. We also see meaningful growth opportunities from a services perspective and tech enablement and services kind of blends both. And part of what we've seen is, as our end market continues to need to drive more and more efficiency, they also -- there also is a trend line of consolidation to fewer and fewer vendors than our strategic partners. And those fewer vendors do have the opportunity to continue to grow at a faster pace than the industry as they consolidate and provide more to these existing clients. And there have been examples like that. EPIC is a good example of that, where they have continued to grow even though they're at more -- around $4 billion of revenue, and yet they're still growing at a double-digit pace because partners -- their client partners are choosing to consolidate and do more with EPIC. We see a similar pattern with our client base where they're choosing to do more and more with Health Catalysts. And one example of that is the amount that…

Operator

Operator

We'll go next now to Daniel Grosslight with Citi.

Unknown Analyst

Analyst

This is [ Louis ] on for Daniel. I just had a question. How should we think about the cadence of tech margins as you migrate clients from on the new system?

Daniel Burton

Analyst

Yes, great question. I'll share a few thoughts and then, Jason, please add anything as well. So as in all things, there are put and there are takes. In the near term, as Jason shared in the prepared remarks, there are some near-term migration expenses that we have incorporated into our 2024 operating plan, and that will be part of the next couple of years as we migrate the vast majority of our existing clients onto the Ignite platform. So that's a negative. However, that's offset and one of the reasons why even with some of those incremental migration costs, you've seen our technology gross margins essentially stay flat, is that the underlying profile from a gross margin perspective of our next-gen Ignite platform is a higher gross margin profile. It's more efficient offering, a much more scalable offering as well. So we do anticipate over the longer term, after we get through those migrations over the next 2, 3 years to see about a total of around a 10-point improvement in terms of the technology gross margin at the data and analytics platform layer. But that will take a few years to play out as we still have those migration-related costs that are pulling that increased gross margin down a little bit. Anything you'd add, Jason?

Jason Alger

Analyst

Yes. The only thing I would add is that with the wind down in our major investment in Health Catalyst Ignite, we do expect our R&D line to be down in absolute dollars compared to 2023. So we do expect to make some progress there as well.

Operator

Operator

We'll go next now to David Larsen with BTIG.

Jenny Shen

Analyst

This is Jenny Shen on for Dave Larsen. Congrats on the quarter. I just wanted to build off of an earlier question on selling into hospitals in that dynamic. And also another question on M&A to expand your solutions suite. So it's always made a lot of sense to us for you guys to expand your offerings and sell into like med tech companies, life sciences companies, even payers. Is that something that you're considering? And if so, what opportunity do you see there? And if you're not considering that, what are some reasons why?

Daniel Burton

Analyst

Thank you, Jenny. We might have missed a little bit of your question, but I think you were focused on asking about adjacent markets like med tech or life sciences or payers and how do we evaluate that? Did I capture your question accurately?

Jenny Shen

Analyst

Yes.

Daniel Burton

Analyst

Okay. Wonderful. So we do recognize the strategic trades and the strategic importance of being focused as a company and simplifying our focus. And that has been an important part of the last few years of Health Catalyst's existence. And I think we benefited from that focus on those 5 key areas of opportunity. But we're also mindful that there are some meaningful and logical adjacent opportunities for us. And in fact, in many ways, the progress that we've made, for example, with our next-generation data and analytics platform, our Ignite platform, it may well open up not only great opportunities for our core market within the provider space, but the standardization of data elements that come with these updated data models in the NextGen Ignite platform, also may well be really useful and improved infrastructure as it relates to some adjacent market and use case opportunities. You may recall that a few years ago, we decided to press pause on some of our life sciences investments. And one of the reasons we pressed pause was we were lacking the infrastructure and the standardization of that infrastructure from a data perspective to really be well positioned to provide meaningful solutions for certain life sciences use cases. Now we're still early in the process, and our primary focus is absolutely on our core market. And I think that's really important for us to continue. But we're also mindful of the meaningful leverage and often, there can be profitable leverage of a core capability into an adjacent market. And that could include in the future us reevaluating and considering areas like life sciences use cases, though I think we would benefit from some of the learnings of the past by being very focused on just a very small subset of use cases where we were convinced we could have a differentiated offering, and we have the right infrastructure. Likewise, in the payer space, we still do provide solutions to some part of the payer market. But we've there, again, tried to be focused and really thoughtful and be convinced and persuaded that we have a truly differentiated offering before we make significant investments. International is one more example where that's an adjacency that we've tried to be thoughtful, focused and opportunistic in targeting just a few areas where we were persuaded that we can leverage our existing strength, provide a differentiated offering. And I think the recent Saudi German announcement is a good example of us meaningfully tapping into and leveraging those core strengths in ways that they're, again, skew a little bit more towards technology growth, which obviously supports our overall goals for profitable growth moving forward.

Operator

Operator

We go next now to Jack Wallace with Guggenheim.

Unknown Analyst

Analyst

This is Mitchell on for Jack. So AI was a big topic. It has a few months ago. Do you have anything to share on that front and anything incremental on the progress with how you're utilizing AI over the past few months since then?

Daniel Burton

Analyst

Yes. Thanks for the question, Mitchell. We are excited about some advances that we were thrilled to share at the Healthcare Analytics Summit. And really, we have -- there'll be 3 tangible use case areas of focus. One of them we mentioned, as one of the success stories in my prepared remarks, around using AI, using Generative AI as it relates to chart abstraction. And as I mentioned in the prepared remarks, we are seeing about a 24% efficiency improvement through the use of Generative AI to help automate the process of hunting and gathering the data that's necessary for registry submission. And we still keep the chart abstractor who's clinically trained in the driver's seat. But we found that we're over 90% accurate in our AI and it improves and learns along the way. And as chart abstraction is a meaningful growth area for Health Catalyst where that is a meaningful tech-enabled managed service for us, obviously, the more efficiency gains, the better. The more that we can perhaps share some of those efficiency gains with our clients, and build an even more profitable sustainable business. So that's the first use case, and we'll continue to actively and proactively test out other AI use cases that might apply to other TEMs areas as well. The second area that we talked about it has is version 2.0 of healthcare.ai, which is a fantastic capability, incredibly relevant for us as an analytics company, where we enable on a daily basis, thousands of dashboards and visualizations that the primary benefit of healthcare.ai, is to help interpret the data more accurately through the benefits of AI where AI can help us read a graph much more accurately. We find a step function improvement in humans' ability to interpret data through version 1.0 of…

Operator

Operator

And our final question will come from Stan Berenshteyn of Wells Fargo.

Stanislav Berenshteyn

Analyst

Maybe sticking on the tech side. So 2024 guidance reflects expectations for year-on-year improvement in both the number of DOS client wins as well as the size of the contracts. Can you just walk us through what's incremental this year that is yielding these improvement expectations within bookings?

Daniel Burton

Analyst

Yes, absolutely, Stan. So happy to share a few thoughts about our 2024 bookings guidance and how that impacts 2025. And as usual, there are some puts and takes there. As it relates to the positives that are contributing to that meaningful reacceleration to double-digit growth. I think if you think about the building blocks, including what's going on with our new clients and then what's going on with our existing clients and the retention and expansion. The positives that we see there are more activity, more pipeline in the new client space. We had a solid Q1 as it relates to new client activities. We're excited about the growing pipeline that we see in the new client space. We're also excited about the new client as a building block because that skews a little bit more towards technology. So that's certainly encouraging. And that informed our guidance expectation that we shared last quarter of both an increase in the number of net new DOS subscription clients to the mid-teens from 11 last year and our expectation that the average ARR per new client addition would be higher in 2024 than it was in 2023. So that's the first building block. The second building block is with existing client retention and expansion. And here, again, we see some positives that are general positives. And I want to -- I do want to come back to one specific element that we are watching specific to Steward Health, as one example of something that we're trying to be thoughtful about. But on the positive side, we're seeing some positive trend lines as it relates to client retention that, that continues to improve, and that was true in Q1, and that's certainly encouraging to see across the board that retention improving and strengthening.…

Stanislav Berenshteyn

Analyst

Appreciate the color. That's very helpful. Maybe just a quick follow-up. Tangentially speaking about the sales pipeline, you had your summit in February this year typically has been in the third quarter. Would just love to get your impressions of the calendar change had any impact on pipeline formation or on the sales cycle more broadly?

Daniel Burton

Analyst

Yes. Great question. So one thing that has remained consistent, whether the summit was in February or in the fall like it's traditionally been is the help and the accelerant that it is to the developing and the deepening of our relationships, whether that's more on the developing side with new clients or prospective clients, whether they're deepening with existing clients. This was an extremely successful summit in that regard. As I mentioned in the prepared remarks, we had 115 face-to-face meetings of senior leaders at existing clients and prospective clients, and I and other senior leaders participated in almost all of those. That's just a tremendous concentrated opportunity. And that may have been the most meetings we've had at Healthcare Analytics Summit ever. So in that regard, it was fantastic. I think it's also really helpful to have that earlier in the year so that we benefit from that acceleration throughout the year. There were some other challenges not related to the sales cycle, where logistically holding a summit in the wintertime where there can be all kinds of weather-related issues proved to be pretty darn challenging. And so we are planning to actually move back to the fall time frame. But from a sales enablement and a bookings enablement and a pipeline acceleration perspective, I was really pleased with the summit and we'll continue to find it a very, very helpful sales accelerant for the company.

Operator

Operator

And we have no further questions at this time. Mr. Burton, I'd like to turn things back to you for any closing comments.

Daniel Burton

Analyst

Thank you again for your time, for your interest in Health Catalyst. And we look forward to staying in touch in the future. Take care, everyone.

Operator

Operator

Thank you, Mr. Burton. Ladies and gentlemen, this concludes today's Health Catalyst First Quarter 2024 Earnings Call. Please disconnect your lines at this time, and have a wonderful day.