0001564590-20-035191 | 10-Q | XBRL Viewer | Allscripts Healthcare Solutions INC

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Document and Entity Information - shares	6 Months Ended
Document and Entity Information - shares	Jun. 30, 2020	Jul. 27, 2020
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q2
Trading Symbol	MDRX
Entity Registrant Name	ALLSCRIPTS HEALTHCARE SOLUTIONS, INC.
Entity Central Index Key	0001124804
Entity Current Reporting Status	Yes
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		162,969,271
Entity File Number	001-35547
Entity Tax Identification Number	36-4392754
Entity Address, Address Line One	222 Merchandise Mart
Entity Address, Address Line Two	Suite 2024
Entity Address, City or Town	Chicago
Entity Address, State or Province	IL
Entity Address, Postal Zip Code	60654
City Area Code	800
Local Phone Number	334-8534
Entity Interactive Data Current	Yes
Title of 12(b) Security	Common Stock, par value $0.01 per share
Security Exchange Name	NASDAQ
Entity Incorporation, State or Country Code	DE
Document Quarterly Report	true
Document Transition Report	false

CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 199,004	$ 129,668
Restricted cash	6,194	7,871
Accounts receivable, net of allowance of $36,972 and $23,879 as of June 30, 2020 and December 31, 2019, respectively	415,848	459,751
Contract assets, net of allowance of $1,068 and $0 as of June 30, 2020 and December 31, 2019, respectively	99,675	95,982
Prepaid expenses and other current assets	149,080	147,990
Total current assets	869,801	841,262
Fixed assets, net	75,728	88,339
Software development costs, net	253,442	243,929
Intangible assets, net	343,636	374,142
Goodwill	1,361,406	1,362,017
Deferred taxes, net	5,333	5,704
Contract assets - long-term, net of allowance of $4,273 and $0 as of June 30, 2020 and December 31, 2019, respectively	47,553	67,559
Right-of-use assets - operating leases	107,661	98,020
Other assets	124,278	124,767
Total assets	3,188,838	3,205,739
Current liabilities:
Accounts payable	75,552	104,014
Accrued expenses	190,645	270,662
Accrued compensation and benefits	82,097	68,569
Deferred revenue	366,378	379,843
Current maturities of long-term debt	374,538	364,465
Current operating lease liabilities	22,072	23,137
Total current liabilities	1,111,282	1,210,690
Long-term debt	661,703	551,004
Deferred revenue	12,055	12,337
Deferred taxes, net	23,940	21,038
Long-term operating lease liabilities	104,815	95,162
Other liabilities	32,114	30,320
Total liabilities	1,945,909	1,920,551
Commitments and contingencies
Stockholders’ equity:
Preferred stock: $0.01 par value, 1,000 shares authorized, no shares issued and outstanding as of June 30, 2020 and December 31, 2019	0	0
Common stock: $0.01 par value, 349,000 shares authorized as of June 30, 2020 and December 31, 2019; 274,463 and 162,969 shares issued and outstanding as of June 30, 2020, respectively; 272,609 and 162,475 shares issued and outstanding as of December 31, 2019, respectively	2,743	2,725
Treasury stock: at cost, 111,493 and 110,134 shares as of June 30, 2020 and December 31, 2019, respectively	(579,678)	(571,157)
Additional paid-in capital	1,920,645	1,907,348
Accumulated deficit	(95,248)	(49,336)
Accumulated other comprehensive loss	(5,533)	(4,392)
Total stockholders’ equity	1,242,929	1,285,188
Total liabilities and stockholders’ equity	$ 3,188,838	$ 3,205,739

CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Statement Of Financial Position [Abstract]
Accounts receivable, allowance	$ 36,972	$ 23,879
Contract assets, allowance	1,068	0
Contract assets - long-term, allowance	$ 4,273	$ 0
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	349,000,000	349,000,000
Common stock, shares issued	274,463,000	272,609,000
Common stock, shares outstanding	162,969,000	162,475,000
Treasury stock at cost, shares	111,493,000	110,134,000

CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Revenue:
Revenue from contract with customers	$ 406,223	$ 444,460	$ 822,936	$ 876,509
Cost of revenue:
Amortization of software development and acquisition-related assets	32,012	29,030	62,653	57,252
Total cost of revenue	241,739	260,338	501,491	518,292
Gross profit	164,484	184,122	321,445	358,217
Selling, general and administrative expenses	114,620	105,542	211,908	205,787
Research and development	48,282	63,414	110,437	127,724
Asset impairment charges	0	3,691	0	3,789
Amortization of intangible and acquisition-related assets	6,328	6,732	13,046	13,529
(Loss) income from operations	(4,746)	4,743	(13,946)	7,388
Interest expense	(11,395)	(10,424)	(23,618)	(20,608)
Other loss, net	(875)	(144,994)	(353)	(144,481)
(Impairment) recovery of long-term investments	(550)	0	(550)	1,045
Equity in net income (loss) of unconsolidated investments	16,834	218	17,034	154
Loss before income taxes	(732)	(150,457)	(21,433)	(156,502)
Income tax (provision) benefit	(6,873)	527	(6,526)	(1,405)
Net loss	(7,605)	(149,930)	(27,959)	(157,907)
Net loss attributable to non-controlling interests	0	0	0	424
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ (7,605)	$ (149,930)	$ (27,959)	$ (157,483)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share - Basic	$ (0.05)	$ (0.90)	$ (0.17)	$ (0.94)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share - Diluted	$ (0.05)	$ (0.90)	$ (0.17)	$ (0.94)
Software delivery, Support and Maintenance [Member]
Revenue:
Revenue from contract with customers	$ 256,021	$ 285,023	$ 519,633	$ 560,535
Cost of revenue:
Total cost of revenue	74,243	84,056	150,568	165,089
Client services [Member]
Revenue:
Revenue from contract with customers	150,202	159,437	303,303	315,974
Cost of revenue:
Total cost of revenue	$ 135,484	$ 147,252	$ 288,270	$ 295,951

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Statement Of Income And Comprehensive Income [Abstract]
Net loss	$ (7,605)	$ (149,930)	$ (27,959)	$ (157,907)
Other comprehensive income (loss):
Foreign currency translation adjustments	918	(156)	(1,594)	539
Change in fair value of derivatives qualifying as cash flow hedges	1,084	42	611	174
Other comprehensive income (loss) before income tax (expense) benefit	2,002	(114)	(983)	713
Income tax (expense) benefit related to items in other comprehensive income (loss)	(280)	(11)	(158)	(46)
Total other comprehensive income (loss)	1,722	(125)	(1,141)	667
Comprehensive income (loss)	(5,883)	(150,055)	(29,100)	(157,240)
Comprehensive loss attributable to non-controlling interests	0	0	0	424
Comprehensive income (loss), net	$ (5,883)	$ (150,055)	$ (29,100)	$ (156,816)

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Unaudited) - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock Issued [Member]	Treasury Stock [Member]	Additional Paid-In Capital [Member]	Retained Earnings (Accumulated Deficit) [Member]	Accumulated Other Comprehensive Loss [Member]	Non-Controlling Interest [Member]
Beginning Balance, Shares at Dec. 31, 2018		270,955	(99,731)
Beginning Balance at Dec. 31, 2018	$ 1,580,427	$ 2,709	$ (460,543)	$ 1,881,494	$ 132,842	$ (5,389)	$ 29,314
Stock-based compensation				21,523
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		1,517
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 15		(6,711)
Capped call transactions				0
Issuance of treasury stock	701		$ 846	(144)
Issuance of treasury stock, Shares			61
Purchase of treasury stock, Shares			(6,148)
Purchase of treasury stock			$ (65,070)
Warrants issued				1,364
Acquisition of non-controlling interest				(29,913)			(28,890)
Net loss less net loss attributable to non-controlling interests					(157,483)
ASU implementation and ASC tax adjustments \| ASU 2016-13					0
Foreign currency translation adjustments, net	539					539
Unrecognized gain on derivatives qualifying as cash flow hedges,net of tax						128
Net loss attributable to non-controlling interests	(424)						(424)
Ending Balance, Shares at Jun. 30, 2019		272,472	(105,818)
Ending Balance at Jun. 30, 2019	1,316,207	$ 2,724	$ (524,767)	1,867,613	(24,641)	(4,722)	0
Beginning Balance, Shares at Dec. 31, 2018		270,955	(99,731)
Beginning Balance at Dec. 31, 2018	$ 1,580,427	$ 2,709	$ (460,543)	1,881,494	132,842	(5,389)	29,314
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares	1,700
Ending Balance, Shares at Dec. 31, 2019	272,609	272,609	(110,134)
Ending Balance at Dec. 31, 2019	$ 1,285,188	$ 2,725	$ (571,157)	1,907,348	(49,336)	(4,392)	0
Beginning Balance, Shares at Mar. 31, 2019		272,013	(105,879)
Beginning Balance at Mar. 31, 2019	1,456,117	$ 2,719	$ (525,613)	1,858,319	125,289	(4,597)	0
Stock-based compensation				10,129
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		459
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 5		(1,373)
Capped call transactions				0
Issuance of treasury stock			$ 846	(144)
Issuance of treasury stock, Shares			61
Purchase of treasury stock, Shares			0
Purchase of treasury stock			$ 0
Warrants issued				682
Acquisition of non-controlling interest				0			0
Net loss less net loss attributable to non-controlling interests					(149,930)
ASU implementation and ASC tax adjustments \| ASU 2016-13					0
Foreign currency translation adjustments, net	(156)					(156)
Unrecognized gain on derivatives qualifying as cash flow hedges,net of tax						31
Net loss attributable to non-controlling interests	0						0
Ending Balance, Shares at Jun. 30, 2019		272,472	(105,818)
Ending Balance at Jun. 30, 2019	$ 1,316,207	$ 2,724	$ (524,767)	1,867,613	(24,641)	(4,722)	0
Beginning Balance, Shares at Dec. 31, 2019	272,609	272,609	(110,134)
Beginning Balance at Dec. 31, 2019	$ 1,285,188	$ 2,725	$ (571,157)	1,907,348	(49,336)	(4,392)	0
Stock-based compensation				17,120
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares	1,900	1,854
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 18		(5,544)
Capped call transactions				797
Issuance of treasury stock	$ 752		$ 1,193	(440)
Issuance of treasury stock, Shares			90
Purchase of treasury stock, Shares			(1,449)
Purchase of treasury stock			$ (9,714)
Warrants issued				1,364
Acquisition of non-controlling interest				0			0
Net loss less net loss attributable to non-controlling interests					(27,959)
ASU implementation and ASC tax adjustments \| ASU 2016-13					(17,953)
Foreign currency translation adjustments, net	(1,594)					(1,594)
Unrecognized gain on derivatives qualifying as cash flow hedges,net of tax						453
Net loss attributable to non-controlling interests	$ 0						0
Ending Balance, Shares at Jun. 30, 2020	274,463	274,463	(111,493)
Ending Balance at Jun. 30, 2020	$ 1,242,929	$ 2,743	$ (579,678)	1,920,645	(95,248)	(5,533)	0
Beginning Balance, Shares at Mar. 31, 2020		273,484	(111,583)
Beginning Balance at Mar. 31, 2020	1,241,780	$ 2,733	$ (580,871)	1,914,816	(87,643)	(7,255)	0
Stock-based compensation				7,166
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		979
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 10		(2,376)
Capped call transactions				797
Issuance of treasury stock			$ 1,193	(440)
Issuance of treasury stock, Shares			90
Purchase of treasury stock, Shares			0
Purchase of treasury stock			$ 0
Warrants issued				682
Acquisition of non-controlling interest				0			0
Net loss less net loss attributable to non-controlling interests					(7,605)
ASU implementation and ASC tax adjustments \| ASU 2016-13					0
Foreign currency translation adjustments, net	918					918
Unrecognized gain on derivatives qualifying as cash flow hedges,net of tax						804
Net loss attributable to non-controlling interests	$ 0						0
Ending Balance, Shares at Jun. 30, 2020	274,463	274,463	(111,493)
Ending Balance at Jun. 30, 2020	$ 1,242,929	$ 2,743	$ (579,678)	$ 1,920,645	$ (95,248)	$ (5,533)	$ 0

CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Cash flows from operating activities:
Net loss	$ (27,959)	$ (157,907)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	104,524	100,603
Operating right-of-use asset amortization	10,872	11,007
Stock-based compensation expense	17,120	21,790
Deferred taxes	3,132	(1,506)
Asset impairment charges	0	3,789
Impairment (recovery) of long-term investments	550	(1,045)
Equity in net (income) loss of unconsolidated investments	(17,034)	(154)
Other (income) loss, net	(57)	1,992
Changes in operating assets and liabilities (net of businesses acquired):
Accounts receivable and contract assets, net	47,853	42,256
Prepaid expenses and other assets	(10,905)	(16,691)
Accounts payable	(27,631)	16,285
Accrued expenses	1,973	1,841
Accrued compensation and benefits	13,603	(47,284)
Deferred revenue	(15,371)	(77,342)
Other liabilities	1,615	(2,670)
Operating leases	(10,327)	(11,874)
Accrued DOJ settlement	(73,020)	145,000
Net cash provided by operating activities - continuing operations	18,938	28,090
Net cash (used in) provided by operating activities - discontinued operations	0	(30,000)
Net cash provided by (used in) operating activities	18,938	(1,910)
Cash flows from investing activities:
Capital expenditures	(4,860)	(9,429)
Capitalized software	(55,277)	(55,222)
Cash paid for business acquisitions, net of cash acquired	0	(11,718)
Sales (purchases) of equity securities, other investments and related intangible assets, net	19,431	(1,159)
Other proceeds from investing activities	0	9
Net cash used in investing activities	(40,706)	(77,519)
Cash flows from financing activities:
Taxes paid related to net share settlement of equity awards	(5,533)	(6,695)
Repayment of Convertible Senior Notes	(7,361)	0
Payments for issuance costs on 0.875% Convertible Senior Notes	(758)	0
Credit facility payments	(167,500)	(10,000)
Credit facility borrowings, net of issuance costs	285,000	180,000
Repurchase of common stock	(9,714)	(65,070)
Payment of acquisition and other financing obligations	(4,369)	(1,541)
Purchases of subsidiary shares owned by non-controlling interest	0	(54,064)
Net cash provided by financing activities	89,765	42,630
Effect of exchange rate changes on cash and cash equivalents	(338)	143
Net increase (decrease) in cash and cash equivalents	67,659	(36,656)
Cash, cash equivalents and restricted cash, beginning of period	137,539	184,795
Cash, cash equivalents and restricted cash, end of period	$ 205,198	$ 148,139

Basis of Presentation and Significant Accounting Policies

6 Months Ended

Jun. 30, 2020

Accounting Policies [Abstract]

Basis of Presentation and Significant Accounting Policies

1. Basis of Presentation and Significant Accounting Policies

Principles of Consolidation

The consolidated financial statements include the accounts of Allscripts Healthcare Solutions, Inc. (“Allscripts”) and its wholly-owned subsidiaries and controlled affiliates. All significant intercompany balances and transactions have been eliminated. Each of the terms “we,” “us,” “our” or the “Company” as used herein refers collectively to Allscripts Healthcare Solutions, Inc. and its wholly-owned subsidiaries and controlled affiliates, unless otherwise stated.

Unaudited Interim Financial Information

The unaudited interim consolidated financial statements as of and for the three and six months ended June 30, 2020 and 2019 have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim financial reporting. These interim consolidated financial statements are unaudited and, in the opinion of our management, include all adjustments, consisting of normal recurring adjustments and accruals, necessary to present fairly the consolidated financial statements for the periods presented in accordance with generally accepted accounting principles in the United States of America (“GAAP”). The consolidated results of operations for the three and six months ended June 30, 2020 are not necessarily indicative of the results to be expected for the full year ending December 31, 2020.

Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted in accordance with the SEC's rules and regulations for interim reporting. The Company believes that the disclosures made are adequate to make these unaudited interim consolidated financial statements not misleading. They should be read in conjunction with the consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2019 (our “Form 10-K”).

Use of Estimates

The preparation of consolidated financial statements in accordance with GAAP requires us to make estimates and assumptions that affect the amounts reported and disclosed in the consolidated financial statements and the accompanying notes. Our estimates and assumptions consider the economic implications of COVID-19 on our critical and significant accounting estimates. Actual results could differ materially from these estimates.

Change in Presentation

During the first quarter of 2020, we changed our reportable segments from Provider, Veradigm and Unallocated to Core Clinical and Financial Solutions, Data, Analytics and Care Coordination, and Unallocated. The business units reported within the historical segments have been reallocated into the new segments. Refer to Note 15 “Business Segments” for further discussion on the impact of the change.

Certain reclassifications were made to prior period amounts in order to conform to the current period presentation. These reclassifications had no impact on the reported consolidated prior period financial results.

Significant Accounting Policies

We adopted Accounting Standards Update No. 2016-13, “Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments” (“ASU 2016-13”) on January 1, 2020 using the cumulative-effect adjustment transition method. The guidance in ASU 2016-13 replaces the incurred loss impairment methodology under current GAAP. The new impairment model requires immediate recognition of estimated credit losses expected to occur for most financial assets and certain other instruments. For available-for-sale debt securities with unrealized losses, the losses will be recognized as allowances rather than reductions in the amortized cost of the securities. ASU 2016-13 is effective for annual periods beginning after December 15, 2019, and interim periods within those annual periods. Refer to Note 2 “Revenue from Contracts with Customers” and Note 3 “Accounts Receivable” for further discussion on the impact of adoption.

Recently Adopted Accounting Pronouncements

In August 2018, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2018-13, “Fair Value Measurement (Topic 820) – Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement” (“ASU 2018-13”), which eliminates, adds and modifies certain disclosure requirements for fair value measurements. Entities will no longer be required to disclose the amount of and reasons for transfers between Level 1 and Level 2 of the fair value hierarchy, but public companies will be required to disclose the range and weighted-average of significant unobservable inputs used to develop Level 3 fair value measurements. ASU 2018-13 will be effective for all entities for interim and annual periods beginning after December 15, 2019, with early adoption permitted. We adopted ASU 2018-13 on January 1, 2020, and the adoption had no impact on our consolidated financial statements.

In March 2020, the FASB issued Accounting Standards Update No. 2020-04, “Reference Rate Reform (Topic 848) – Facilitation of the Effects of Reference Rate Reform on Financial Reporting” (“ASU 2020-04”), which provides optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The amendments in ASU 2020-04 apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. ASU 2020-04 will be effective for all entities as of March 12, 2020 through December 31, 2022. We adopted ASU 2020-04 on March 12, 2020, and the adoption had no impact on our consolidated financial statements.

Accounting Pronouncements Not Yet Adopted

In December 2019, the FASB issued Accounting Standards Update No. 2019-12, “Income Taxes (Topic 740)” (“ASU 2019-12”), which is part of the FASB’s overall simplification initiative to reduce the costs and complexity of applying accounting standards while maintaining or improving the usefulness of the information provided to users of financial statements. ASU 2019-12 simplifies accounting guidance for intraperiod allocations, deferred tax liabilities, year-to-date losses in interim periods, franchise taxes, step-up in tax basis of goodwill, separate entity financial statements and interim recognition of tax laws or rate changes. ASU 2019-12 is effective for public business entities for annual reporting periods beginning after December 15, 2020, with early adoption permitted. We are currently evaluating the impact of this accounting guidance.

We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, will have a material impact on our consolidated financial statements.

Revenue from Contracts with Customers

6 Months Ended

Jun. 30, 2020

Revenue From Contract With Customer [Abstract]

Revenue from Contracts with Customers

2. Revenue from Contracts with Customers

Our two primary revenue streams are (i) software delivery, support and maintenance and (ii) client services. Software delivery, support and maintenance revenue consists of all of our proprietary software sales (either under a perpetual or term license delivery model), subscription-based software sales, transaction-related revenue, the resale of hardware and third-party software and revenue from post-contract client support and maintenance services, which include telephone support services, maintaining and upgrading software and ongoing enhanced maintenance. Client services revenue consists of revenue from managed services solutions, such as private cloud hosting, outsourcing and revenue cycle management, as well as other client services and project-based revenue from implementation, training and consulting services. For some clients, we host the software applications licensed from us using our own or third-party servers. For other clients, we offer an outsourced service in which we assume partial to total responsibility for a healthcare organization’s IT operations using our employees.

At June 30, 2020 and December 31, 2019, we had capitalized costs to obtain or fulfill a contract of $19.2 million and $20.8 million, respectively, in Prepaid and other current assets and $34.1 million and $32.9 million, respectively, in Other assets. During the three months ended June 30, 2020 and 2019, we recognized $6.6 million and $7.4 million, respectively, of amortization expense related to such capitalized costs. During the six months ended June 30, 2020 and 2019, we recognized $14.1 million and $15.0 million, respectively, of amortization expense related to such capitalized costs. The amortization of these capitalized costs to obtain a contract are included in Selling, general and administrative expense within our consolidated statements of operations.

The timing of revenue recognition, billings and cash collections results in billed and unbilled accounts receivable, contract assets and customer advances and deposits. Accounts receivable, net includes both billed and unbilled amounts where the right to receive payment is unconditional and only subject to the passage of time. Contract assets include amounts where revenue recognized exceeds the amount billed to the customer and the right to payment is not solely subject to the passage of time. Deferred revenue includes advanced payments and billings in excess of revenue recognized. Our contract assets and deferred revenue are reported in a net position on an individual contract basis at the end of each reporting period. Contract assets are classified as current or long-term based on the timing of when we expect to complete the related performance obligations and bill the customer. Deferred revenue is classified as current or long-term based on the timing of when we expect to recognize revenue.

The breakdown of revenue recognized based on the origination of performance obligations and elected accounting expedients is presented in the table below:

(In thousands)	Three Months Ended March 31, 2020		Three Months Ended June 30, 2020
Revenue related to deferred revenue balance at beginning of period	$	140,132	$	155,616
Revenue related to new performance obligations satisfied during the period		216,990		196,110
Revenue recognized under "right-to-invoice" expedient		58,059		54,082
Reimbursed travel expenses, shipping and other revenue		1,532		415
Total revenue	$	416,713	$	406,223

(In thousands)	Three Months Ended March 31, 2019		Three Months Ended June 30, 2019
Revenue related to deferred revenue balance at beginning of period	$	126,184	$	146,150
Revenue related to new performance obligations satisfied during the period		248,221		233,696
Revenue recognized under "right-to-invoice" expedient		55,923		62,245
Reimbursed travel expenses, shipping and other revenue		1,721		2,369
Total revenue	$	432,049	$	444,460

The aggregate amount of contract transaction price related to remaining unsatisfied performance obligations (commonly referred to as “backlog”) represents contracted revenue that has not yet been recognized and includes both deferred revenue and amounts that will be invoiced and recognized as revenue in future periods. Total backlog equaled $4.4 billion as of June 30, 2020, of which we expect to recognize approximately 33% over the next 12 months, and the remaining 67% thereafter.

Revenue Recognition

We recognize revenue only when we satisfy an identified performance obligation (or bundle of obligations) by transferring control of a promised product or service to a customer. We consider a product or service to be transferred when a customer obtains control because a customer has sole possession of the right to use (or the right to direct the use of) the product or service for the remainder of its economic life or to consume the product or service in its own operations. We evaluate the transfer of control primarily from the customer’s perspective as this reduces the risk that revenue is recognized for activities that do not transfer control to the customer.

The majority of our revenue is recognized over time because a customer continuously and simultaneously receives and consumes the benefits of our performance. The exceptions to this pattern are our sales of perpetual and term software licenses, and hardware, where we determined that a customer obtains control of the asset upon granting of access, delivery or shipment.

We disaggregate our revenue from contracts with customers based on the type of revenue and nature of revenue stream, as we believe those categories best depict how the nature, amount, timing and uncertainty of our revenue and cash flows are affected by economic factors. The below tables summarize revenue by type and nature of revenue stream as well as by our reportable segments:

	Three Months Ended June 30,				Six Months Ended June 30,
(In thousands)	2020		2019		2020		2019
Revenue:
Recurring revenue	$	335,088	$	350,113	$	676,307	$	698,749
Non-recurring revenue		71,135		94,347		146,629		177,760
Total revenue	$	406,223	$	444,460	$	822,936	$	876,509

	Three Months Ended June 30, 2020
(In thousands)	Core Clinical and Financial Solutions		Data, Analytics and Care Coordination		Unallocated Amounts		Total
Software delivery, support and maintenance	$	167,219	$	81,856	$	6,946	$	256,021
Client services		143,880		3,305		3,017		150,202
Total revenue	$	311,099	$	85,161	$	9,963	$	406,223

	Three Months Ended June 30, 2019
(In thousands)	Core Clinical and Financial Solutions		Data, Analytics and Care Coordination		Unallocated Amounts		Total
Software delivery, support and maintenance	$	194,053	$	84,947	$	6,023	$	285,023
Client services		153,729		3,038		2,670		159,437
Total revenue	$	347,782	$	87,985	$	8,693	$	444,460

	Six Months Ended June 30, 2020
(In thousands)	Core Clinical and Financial Solutions		Data, Analytics and Care Coordination		Unallocated Amounts		Total
Software delivery, support and maintenance	$	341,302	$	165,796	$	12,535	$	519,633
Client services		290,129		7,723		5,451		303,303
Total revenue	$	631,431	$	173,519	$	17,986	$	822,936

	Six Months Ended June 30, 2019
(In thousands)	Core Clinical and Financial Solutions		Data, Analytics and Care Coordination		Unallocated Amounts		Total
Software delivery, support and maintenance	$	383,435	$	164,455	$	12,645	$	560,535
Client services		304,759		5,936		5,279		315,974
Total revenue	$	688,194	$	170,391	$	17,924	$	876,509

Contract Assets – Estimate of Credit Losses

We adopted ASU 2016-13 on January 1, 2020 using the cumulative-effect adjustment transition method. The new guidance required the recognition of lifetime estimated credit losses expected to occur for contract assets. The guidance also required that we pool assets with similar risk characteristics and consider current economic conditions when estimating losses. The adoption of ASU 2016-13 for contract assets was recorded as a debit to retained earnings of $5.3 million as of January 1, 2020.

At adoption, we segmented the contract asset population into pools based on their risk assessment. Risks related to contract assets are a customer’s inability to pay or bankruptcy. Each pool was defined by their internal credit assessment, and business size. The pools are aligned with management’s review of financial performance. For the six months ended June 30, 2020, no adjustment to the pools was necessary.

We utilized a loss-rate method to measure expected credit loss for each pool. The loss rate is calculated using a twenty-four-month lookback period of credit memos and adjustments divided by the average contract asset balance for each pool during that period. We considered current economic conditions, including how the COVID-19 pandemic is impacting the global economy, internal forecasts, cash collection and credit memos written during the current period when assessing loss rates. We reviewed these factors and concluded that no adjustments should be made to the historical loss rate data. The June 30, 2020 analysis resulted in no change in the ending estimate of credit losses.

Changes in the estimate of credit losses for contract assets are presented in the table below.

(In thousands)	Total
Balance at January 1, 2020	$	5,341
Current period provision		0
Balance at June 30, 2020	$	5,341
Less: Contract assets, short-term		1,068
Total contract assets, long-term	$	4,273

Accounts Receivables

6 Months Ended

Jun. 30, 2020

Receivables [Abstract]

Accounts Receivables

3. Accounts Receivable

Trade Accounts Receivable – Estimate of Credit Losses

We adopted ASU 2016-13 on January 1, 2020 using the cumulative-effect adjustment transition method. The new guidance required the recognition of lifetime estimated credit losses expected to occur for trade accounts receivable. The guidance also required that we pool assets with similar risk characteristics and consider current economic conditions when estimating losses. The adoption of ASU 2016-13 for trade accounts receivable was recorded as a debit to retained earnings of $12.6 million as of January 1, 2020.

At adoption, we segmented the accounts receivable population into pools based on their risk assessment. Risks related to trade accounts receivable are a customer’s inability to pay or bankruptcy. Each pool was defined by their internal credit assessment, and business size. The pools are aligned with management’s review of financial performance. For the six months ended June 30, 2020, no adjustment to the pools was necessary.

We utilized a loss-rate method to measure expected credit loss for each pool. The loss rate is calculated using a twelve-month lookback period of credit memos and adjustments divided by the average accounts receivable balance for each pool during that period. We considered current economic conditions, including how the COVID-19 pandemic is impacting the global economy, internal forecasts, cash collection and credit memos written during the current period when assessing loss rates. We reviewed these factors and concluded that no adjustments should be made to the historical loss rate data.

Changes in the estimate of credit losses for trade accounts receivable are presented in the tables below.

(In thousands)	Total
Balance at January 1, 2020	$	36,490
Current period provision		4,261
Write-offs		(3,811	)
Recoveries		32
Balance at June 30, 2020	$	36,972

Leases

6 Months Ended

Jun. 30, 2020

Lessee Disclosure [Abstract]

Leases

4. Leases

We determine whether an arrangement is a lease at inception. Assets leased under an operating lease arrangement are recorded in Right-of-use assets – operating leases and the associated lease liabilities are included in Current operating lease liabilities and Long-term operating lease liabilities within the consolidated balance sheets. Assets leased under finance lease arrangements are recorded within fixed assets and the associated lease liabilities are recorded within Accrued expenses and Other liabilities within the consolidated balance sheets.

Right-of-use assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease right-of-use assets and liabilities are recognized at commencement date based on the present value of lease payments over the expected lease term. Since our lease arrangements do not provide an implicit rate, we use our incremental borrowing rate in conjunction with the market swap rate for the expected remaining lease team at commencement date for new leases in determining the present value of future lease payments. Our expected lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Operating lease expense is recognized on a straight-line basis over the lease term.

We have elected the group of practical expedients under ASU 2016-02 to forego assessing upon adoption: (1) whether any expired contracts are or contain leases; (2) the lease classification for any existing or expired leases and (3) any indirect costs that would have qualified for capitalization for any existing leases. We have lease agreements with lease and non-lease components, which are generally accounted for separately except for real estate and vehicle leases, which we have elected to combine through a practical expedient under ASU 2016-02. Non-lease components for our leases typically consist of executory costs, and the practical expedient allows for all executory costs to be recorded as lease payments. Additionally, for certain equipment leases, we apply a portfolio approach to effectively record right-of-use assets and liabilities.

Our operating leases mainly include office leases and our finance leases include office and computer equipment leases. Our finance leases are not significant. Our leases have remaining lease terms up to 8 years, some of which include options to extend the leases for up to 5 years, which may include options to terminate the leases within 1 year. Operating costs associated with leased assets are as follows:

(In thousands)	Three Months Ended June 30,						Six Months Ended June 30,
	2020			2019			2020			2019
Operating lease cost ⁽¹⁾	$	6,439		$	7,051		$	13,361		$	13,768
Less: Sublease income		(166	)		(778	)		(769	)		(1,580	)
Total operating lease costs	$	6,273		$	6,273		$	12,592		$	12,188

⁽¹⁾	Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statements of operations.

Supplemental information for operating leases is as follows:

(In thousands)	Six Months Ended June 30,
	2020		2019
Operating cash flows from operating leases	$	14,283	$	14,688
Right-of-use assets obtained in exchange for operating lease obligations	$	23,056	$	128,664

The balance sheet location and balances for operating leases are as follows:

(In thousands, except lease term and discount rate)	June 30, 2020			December 31, 2019
Right-of-use assets - operating leases	$	107,661		$	98,020
Current operating lease liabilities	$	22,072		$	23,137
Long-term operating lease liabilities	$	104,815		$	95,162
Weighted average remaining lease term (in years)		6			6
Weighted average discount rate		3.6	%		4.4	%

The future maturities of our leasing arrangements including lease and non-lease components are shown in the below table. The maturities are calculated using foreign currency exchange rates in effect as of June 30, 2020.

	June 30, 2020
(In thousands)	Operating Leases
Remainder of 2020	$	13,254
2021		26,469
2022		24,914
2023		22,732
2024		17,188
Thereafter		36,462
Total lease liabilities		141,019
Less: Amount representing interest		(14,132	)
Less: Short-term lease liabilities		(22,072	)
Total long-term lease liabilities	$	104,815

Business Combinations

6 Months Ended

Jun. 30, 2020

Business Combinations [Abstract]

Business Combinations

5. Business Combinations

On July 2, 2019, we acquired the Pinnacle and Diabetes Collaborative Registries from the American College of Cardiology (“ACC”) as part of our broader strategic partnership with the ACC. The total purchase price was $19.7 million, consisting of an initial payment of $11.7 million plus up to an aggregate of $8.0 million pending the attainment certain milestones over the next 18 months. The contingent consideration of up to $8.0 million was valued at $5.0 million at the time of closing. As part of this partnership, we operate Pinnacle and Diabetes Collaborative Registries, which extends our EHR-enabled ambulatory network to create a large-scale chronic disease network. The business is included in our Data, Analytics and Care Coordination business segment.

On June 10, 2019, we acquired the assets of a business engaged in the development, implementation, customization, marketing, licensing and sale of a specialty prescription drug platform, including software that collects, saves and transmits information required to fill a prescription. The drug platform and software enables healthcare providers, pharmacists and payors to digitally interact with one another to fill a prescription. The business is included in our Data, Analytics and Care Coordination business segment.

On March 1, 2019, we acquired all of the outstanding minority interests in Pulse8, Inc., a healthcare analytics and technology company that provides business intelligence software solutions for health plans and at-risk providers to enable them to analyze their risk adjustment and quality management programs, for $53.8 million (subject to adjustments for net working capital and a contingency holdback). We initially acquired a controlling stake in Pulse 8, Inc. on September 8, 2016. This transaction was treated as an equity transaction, and the cash payment is reported as part of cash flow from financing activities in the consolidated statement of cash flows for the six months ended June 30, 2019.

Fair Value Measurements and Long-term Investments

6 Months Ended

Jun. 30, 2020

Fair Value Disclosures [Abstract]

Fair Value Measurements and Long-term Investments

6. Fair Value Measurements and Long-term Investments

Fair value measurements are based upon observable and unobservable inputs.

Level 1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities at the measurement date.

Level 2: Quoted prices for similar instruments in active markets with inputs that are observable, either directly or indirectly. Our Level 2 derivative financial instruments include foreign currency forward contracts valued based upon observable values of spot and forward foreign currency exchange rates.

Level 3: Unobservable inputs are significant to the fair value of the asset or liability, and include situations where there is little, if any, market activity for the asset or liability. Our Level 3 instruments include the 1.25% Call Option asset and the 1.25% embedded cash conversion option liability that are not actively traded. The changes in unobservable inputs to the valuation pricing model used to value these instruments is not material to our consolidated results of operations. Level 3 instruments also include the fair value of contingent consideration related to completed acquisitions. The fair values are based on discounted cash flow analyses reflecting the likelihood of achieving specified performance measures or events and captures the contractual nature of the contingencies, commercial risk or time value of money.

The following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates:

	Balance Sheet	June 30, 2020								December 31, 2019
(In thousands)	Classifications	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Foreign exchange derivative assets	Prepaid expenses and other current assets	$	0	$	611	$	0	$	611	$	0	$	0	$	0	$	0
1.25% Call Option	Other assets		0		0		0		0		0		0		84		84
Total assets		$	0	$	611	$	0	$	611	$	0	$	0	$	84	$	84

Contingent consideration - current	Accrued expenses	$	0	$	0	$	13,699	$	13,699	$	0	$	0	$	17,116	$	17,116
Contingent consideration - long-term	Other liabilities		0		0		2,415		2,415		0		0		2,415		2,415
1.25% Embedded cash conversion option	Other liabilities		0		0		0		0		0		0		185		185
Total liabilities		$	0	$	0	$	16,114	$	16,114	$	0	$	0	$	19,716	$	19,716

The changes in Level 3 assets and liabilities measured at fair value on a recurring basis at June 30, 2020 are summarized as follows:

(In thousands)	Contingent Consideration			1.25% Notes Call Spread Overlay
Balance at December 31, 2019	$	19,531		$	(101	)
Additions		772			0
Payments/write-downs		(4,189	)		0
Fair value adjustments		0			101
Balance at June 30, 2020	$	16,114		$	0

The following table summarizes the quantitative information about our Level 3 fair value measurements at June 30, 2020:

June 30, 2020

(In thousands, except the discount rate)

Fair Value

Valuation Technique

Significant Unobservable Inputs

Ranges of Inputs

Weighted Average ⁽¹⁾

Financial instruments:

Contingent consideration

16,114

Probability Weighted Discounted cash flow

Discount rate

4% to 5%

Revenue

$0 to $62,500

31,250

Registry members

0 to 1,551

776

Patient data volume

0 to 52,845

26,422

Projected year of payment

2020 to 2021

Total financial instruments

16,114

⁽¹⁾	The weighted average is calculated based upon the absolute fair value of the instruments.

Long-term Investments

The following table summarizes our long-term equity investments which are included in Other assets in the accompanying consolidated balance sheets:

	Number of Investees		Original		Carrying Value at
(In thousands, except for number of investees)	at June 30, 2020		Cost		June 30, 2020		December 31, 2019
Equity method investments ⁽¹⁾		3	$	7,099	$	10,667	$	11,332
Cost less impairment		8		37,568		27,766		32,462
Total long-term equity investments		11	$	44,667	$	38,433	$	43,794

⁽¹⁾	Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

During the six months ended June 30, 2020, we recorded a $16.8 million gain from the sale of a third-party equity method investment.

As of June 30, 2020, it is not possible to estimate the fair value of our non-marketable cost and equity method investments, primarily because of their illiquidity and restricted marketability. The factors we considered in trying to determine fair value include, but are not limited to, available financial information, the issuer’s ability to meet its current obligations, the issuer’s subsequent or planned raises of capital and observable price changes in orderly transactions.

Impairment and Recovery of Long-term Investments

During the six months ended June 30, 2020, we reached a settlement agreement with one of our third-party equity-method investments, which resulted in the recognition of a $0.6 million impairment charge. During the six months ended June 30, 2019, we recovered $1.0 million from a third-party cost-method investment that we had previously impaired. The impairment charge and the amount recovered are recognized in the (Impairment) recovery of long-term investments.

Long-term Financial Liabilities

Our long-term financial liabilities include amounts outstanding under our senior secured credit facility (as described in Note 10, “Debt”), with carrying values that approximate fair value since the interest rates approximate current market rates. The carrying amount of our 1.25% Cash Convertible Senior Notes (the “1.25% Notes”) approximates fair value as of June 30, 2020, since the effective interest rate on the 1.25% Notes approximates current market rates. Refer to Note 10, “Debt,” for further information regarding our long-term financial liabilities.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Stockholders' Equity

6 Months Ended

Jun. 30, 2020

Equity [Abstract]

Stockholders' Equity

7. Stockholders' Equity

Stock-based Compensation Expense

Stock-based compensation expense recognized during the three and six months ended June 30, 2020 and 2019 is included in our consolidated statements of operations as shown in the below table. Stock-based compensation expense includes both non-cash expense related to grants of stock-based awards as well as cash expense related to the employee discount applied to purchases of our common stock under our employee stock purchase plan. No stock-based compensation costs were capitalized during the three and six months ended June 30, 2020 and 2019.

	Three Months Ended June 30,				Six Months Ended June 30,
(In thousands)	2020		2019		2020		2019
Cost of revenue:
Software delivery, support and maintenance	$	343	$	614	$	918	$	1,127
Client services		808		1,163		1,899		2,256
Total cost of revenue		1,151		1,777		2,817		3,383
Selling, general and administrative expenses		5,081		6,831		12,123		15,156
Research and development		1,428		2,571		3,823		5,448
Total stock-based compensation expense	$	7,660	$	11,179	$	18,763	$	23,987

Allscripts Long-Term Incentive Plan

We measure stock-based compensation expense at the grant date based on the fair value of the award. We recognize the expense for service-based share awards over the requisite service period on a straight-line basis, net of estimated forfeitures. We recognize the expense for performance-based and market-based share awards over the vesting period under the accelerated attribution method, net of estimated forfeitures. In addition, we recognize stock-based compensation cost for awards with performance conditions if and when we conclude that it is probable that the performance conditions will be achieved.

The fair value of service-based and performance-based restricted stock units is measured at the underlying closing share price of our common stock on the date of grant. The fair value of market-based restricted stock units is measured using the Monte Carlo pricing model. No stock options were granted during the three and six months ended June 30, 2020 and 2019.

We granted stock-based awards as follows:

	Three Months Ended June 30, 2020				Six Months Ended June 30, 2020
			Weighted-Average				Weighted-Average
			Grant Date				Grant Date
(In thousands, except per share amounts)	Shares		Fair Value		Shares		Fair Value
Service-based restricted stock units		4,021	$	6.21		4,418	$	6.39
Market-based restricted stock units with a service condition		0	$	0.00		595	$	9.98
		4,021	$	6.21		5,013	$	6.82

During the six months ended June 30, 2020 and the year ended December 31, 2019, 1.9 million and 1.7 million shares of common stock, respectively, were issued in connection with the exercise of options and the release of restrictions on stock awards.

Net Share-settlements

Upon vesting, restricted stock units are generally net share-settled to cover the required withholding tax, and the remaining amount is converted into an equivalent number of shares of common stock. The majority of restricted stock units and awards that vested during the six months ended June 30, 2020 and 2019 were net-share settled such that we withheld shares with fair value equivalent to the employees’ minimum statutory obligation for the applicable income and other employment taxes and remitted the cash to the appropriate taxing authorities. Total payments for the employees' minimum statutory tax obligations to the taxing authorities are reflected as a financing activity within the accompanying consolidated statements of cash flows. The total shares withheld for the six months ended June 30, 2020 and 2019 were 764 thousand and 651 thousand, respectively, and were based on the value of the restricted stock units on their vesting date as determined by our closing stock price. These net-share settlements had the effect of share repurchases by us as they reduced the number of shares that would have otherwise been issued as a result of the vesting.

Stock Repurchases

On August 2, 2018, we announced that our Board of Directors approved a stock purchase program (the “2018 Program”) under which we may repurchase up to $250 million of our common stock through December 31, 2020. We repurchased 1.5 million shares of our common stock under the 2018 Program for a total of $9.7 million during the six months ended June 30, 2020. We repurchased no shares during the three months ended June 30, 2020. The approximate dollar value of shares that may yet be purchased under the 2018 Program is $92.1 million as of June 30, 2020. We repurchased 6.1 million shares of our common stock under the 2018 Program for a total of $64.9 million during the six months ended June 30, 2019. We repurchased no shares during the three months ended June 30, 2019. Any future stock repurchase transactions may be made through open market transactions, block trades, privately negotiated transactions (including accelerated share repurchase transactions) or other means, subject to market conditions. Any repurchase activity will depend on many factors such as our working capital needs, cash requirements for investments, debt repayment obligations, economic and market conditions at the time, including the price of our common stock, and other factors that we consider relevant. Our stock repurchase program may be accelerated, suspended, delayed or discontinued at any time.

Earnings (Loss) Per Share

6 Months Ended

Jun. 30, 2020

Earnings Per Share [Abstract]

Earnings (Loss) Per Share

8. Earnings (Loss) Per Share

Basic earnings (loss) per share is computed by dividing net income (loss) by the weighted-average shares of common stock outstanding. For purposes of calculating diluted earnings (loss) per share, the denominator includes both the weighted-average shares of common stock outstanding and dilutive common stock equivalents. Dilutive common stock equivalents consist of stock options, restricted stock unit awards and warrants calculated under the treasury stock method.

The calculations of earnings (loss) per share are as follows:

	Three Months Ended June 30,						Six Months Ended June 30,
(In thousands, except per share amounts)	2020			2019			2020			2019
Basic earnings (loss) per Common Share:
Net loss	$	(7,605	)	$	(149,930	)	$	(27,959	)	$	(157,907	)
Net loss attributable to non-controlling interests		0			0			0			424
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(7,605	)	$	(149,930	)	$	(27,959	)	$	(157,483	)

Weighted-average common shares outstanding		162,682			166,522			162,571			168,230
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(0.05	)	$	(0.90	)	$	(0.17	)	$	(0.94	)

Diluted earnings (loss) per Common Share:
Net loss	$	(7,605	)	$	(149,930	)	$	(27,959	)	$	(157,907	)
Net loss attributable to non-controlling interests		0			0			0			424
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(7,605	)	$	(149,930	)	$	(27,959	)	$	(157,483	)

Weighted-average common shares outstanding		162,682			166,522			162,571			168,230
Plus: Dilutive effect of stock options, restricted stock unit awards and warrants		0			0			0			0
Weighted-average common shares outstanding assuming dilution		162,682			166,522			162,571			168,230
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(0.05	)	$	(0.90	)	$	(0.17	)	$	(0.94	)

Due to the net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders for the three and six months ended June 30, 2020 and 2019, we used basic weighted-average common shares outstanding in the calculation of diluted loss per share for those periods, since the inclusion of any stock equivalents would be anti-dilutive.

The following stock options, restricted stock unit awards and warrants are not included in the computation of diluted earnings (loss) per share as the effect of including such stock options, restricted stock unit awards and warrants in the computation would be anti-dilutive:

Three Months Ended June 30,

Six Months Ended June 30,

(In thousands)

2020

2019

2020

2019

Shares subject to anti-dilutive stock options, restricted stock

unit awards and warrants excluded from calculation

50,988

29,720

49,304

27,358

Goodwill and Intangible Assets

6 Months Ended

Jun. 30, 2020

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

9. Goodwill and Intangible Assets

Goodwill and intangible assets consist of the following:

	June 30, 2020							December 31, 2019
	Gross							Gross
	Carrying		Accumulated			Intangible		Carrying		Accumulated			Intangible
(In thousands)	Amount		Amortization			Assets, Net		Amount		Amortization			Assets, Net
Intangibles subject to amortization:
Proprietary technology	$	546,094	$	(454,615	)	$	91,479	$	546,373	$	(437,640	)	$	108,733
Customer contracts and relationships		701,651		(501,494	)		200,157		702,034		(488,625	)		213,409
Total	$	1,247,745	$	(956,109	)	$	291,636	$	1,248,407	$	(926,265	)	$	322,142

Intangibles not subject to amortization:
Registered trademarks						$	52,000						$	52,000
Goodwill							1,361,406							1,362,017
Total						$	1,413,406						$	1,414,017

Changes in the carrying amounts of goodwill by reportable segment for the six months ended June 30, 2020 were as follows:

(In thousands)	Core Clinical and Financial Solutions			Data, Analytics and Care Coordination		Unallocated Amounts		Total
Balance as of December 31, 2019		734,883			552,471		74,663		1,362,017
Foreign exchange translation		(611	)		0		0		(611	)
Balance as of June 30, 2020	$	734,272		$	552,471	$	74,663	$	1,361,406

There are $39.2 million in accumulated impairment losses associated with our goodwill as of June 30, 2020 and December 31, 2019.

Debt

6 Months Ended

Jun. 30, 2020

Debt Disclosure [Abstract]

Debt

10. Debt

Debt outstanding, excluding lease obligations, consists of the following:

	June 30, 2020							December 31, 2019
(In thousands)	Principal Balance		Unamortized Discount and Debt Issuance Costs			Net Carrying Amount		Principal Balance		Unamortized Discount and Debt Issuance Costs		Net Carrying Amount
0.875% Convertible Senior Notes ⁽¹⁾	$	167,853	$	(258	)	$	168,111	$	177,942	$	4,697	$	173,245
1.25% Cash Convertible Senior Notes		345,000		0			345,000		345,000		7,552		337,448
Senior Secured Credit Facility		527,500		4,370			523,130		410,000		5,224		404,776
Total debt	$	1,040,353	$	4,112		$	1,036,241	$	932,942	$	17,473	$	915,469
Less: Debt payable within one year		375,000		462			374,538		364,653		188		364,465
Total long-term debt, less current maturities	$	665,353	$	3,650		$	661,703	$	568,289	$	17,285	$	551,004

⁽¹⁾	Principal balance is $207,911 thousand; $167,853 thousand is recognized in debt and $40,058 thousand is recognized in additional paid-in capital

Interest expense consists of the following:

	Three Months Ended June 30,				Six Months Ended June 30,
(In thousands)	2020		2019		2020		2019
Interest expense	$	5,680	$	6,434	$	12,187	$	12,663
Amortization of discounts and debt issuance costs		5,715		3,990		11,431		7,945
Total interest expense	$	11,395	$	10,424	$	23,618	$	20,608

Interest expense related to the 0.875% Convertible Senior Notes and the 1.25% Cash Convertible Senior Notes, included in the table above, consisted of the following:

	Three Months Ended June 30,				Six Months Ended June 30,
(In thousands)	2020		2019		2020		2019
Coupon interest	$	1,555	$	1,078	$	3,110	$	2,156
Amortization of discounts and debt issuance costs		5,288		3,614		10,576		7,191
Total interest expense related to the convertible notes	$	6,843	$	4,692	$	13,686	$	9,347

Allscripts Senior Secured Credit Facility

On February 15, 2018, Allscripts and Healthcare LLC entered into a Second Amended and Restated Credit Agreement (the “Second Amended Credit Agreement”), with JPMorgan Chase Bank, N.A., as administrative agent. The Second Amended Credit Agreement provides for a $400 million senior secured term loan (the “Term Loan”) and a $900 million senior secured revolving facility (the “Revolving Facility”), each with a five-year term. The Term Loan is repayable in quarterly installments, which began on June 30, 2018. A total of up to $50 million of the Revolving Facility is available for the issuance of letters of credit, up to $10 million of the Revolving Facility is available for swingline loans, and up to $100 million of the Revolving Facility could be borrowed under certain foreign currencies.

As of June 30, 2020, $317.5 million under the Term Loan, $210.0 million under the Revolving Facility, and $1.0 million in letters of credit were outstanding under the Second Amended Credit Agreement.

As of June 30, 2020, the interest rate on the borrowings under the Second Amended Credit Agreement was LIBOR plus 2.00%, which totaled 2.18%. We were in compliance with all covenants under the Second Amended Credit Agreement as of June 30, 2020.

On August 7, 2019, we entered into a First Amendment to the Second Amended Credit Agreement in order to remain compliant with the covenants of our Second Amended Credit Agreement. The First Amendment provided the financial flexibility to settle the U.S. Department of Justice’s investigations as discussed in Note 14, “Contingencies” while maintaining our compliance with the covenants of our Second Amended Credit Agreement. None of the original terms of our Second Amended Credit Agreement relating to scheduled future principal payments, applicable interest rates and margins or borrowing capacity under our Revolving Facility were amended. In connection with this amendment, we incurred fees and other costs totaling $0.8 million, of which a majority was capitalized.

As of June 30, 2020, we had $689.0 million available, net of outstanding letters of credit, under our Revolving Facility. There can be no assurance that we will be able to draw on the full available balance of our Revolving Facility if the financial institutions that have extended such credit commitments become unwilling or unable to fund such borrowings or if we are unable to maintain compliance with applicable covenants.

0.875% Convertible Senior Notes

The issuance in December 2019 of the combined $218.0 million aggregate principal amount of the 0.875% Convertible Senior Notes resulted in $0.7 million in debt issuance costs, which were paid in January 2020. We have separately recorded liability and equity components of the 0.875% Convertible Senior Notes, including any discounts and issuance costs, by allocating the proceeds from the issuance between the liability component and the embedded conversion option, or equity component. This allocation was completed by first estimating an interest rate at the time of issuance for similar notes that do not include an embedded conversion option. The interest rate of 1.95% was used to compute the initial fair value of the liability component, which totaled $177.9 million at the time of issuance. The excess of the initial proceeds received from the 0.875% Convertible Senior Notes and the $177.9 million liability component was allocated to the equity component, which totaled $40.1 million at the time of issuance before deducting any paid capped call fees. The equity component of $40.1 million, the $17.2 million in paid capped call fees and an allocation of $1.1 million in combined discounts and issuance costs were recorded in Additional paid-in capital within the consolidated balance sheets in December 2019. These were recorded as a discount that will be accreted into interest expense through January 1, 2027 using the interest method. In June 2020, we paid $7.7 million to repurchase $10.1 million of the aggregate principal amount of the 0.875% Convertible Senior Notes, which resulted in a $0.5 million gain. In connection with the repurchase, the capped call transaction was partially terminated, and we received $0.3 million, which resulted in a recognition of $0.8 million in equity to offset the capped call fees and a $0.5 million loss. The remaining principal amount of the 0.875% Convertible Senior Notes at June 30, 2020 totaled $207.9 million. The carrying value of the combined equity component, net of capped call fees, issuance costs and accretion, at June 30, 2020 totaled $18.7 million.

1.25% Cash Convertible Senior Notes

As of June 30, 2020, the if-converted value of the 1.25% Notes did not exceed the 1.25% Notes’ principal amount.

The following table summarizes future debt payment obligations as of June 30, 2020:


(In thousands)	Total		Remainder of 2020		2021		2022		2023		2024		Thereafter
0.875% Convertible Senior Notes ⁽¹⁾	$	207,911	$	0	$	0	$	0	$	0	$	0	$	207,911
1.25% Cash Convertible Senior Notes ⁽²⁾		345,000		345,000		0		0		0		0		0
Term Loan		317,500		15,000		30,000		37,500		235,000		0		0
Revolving Facility ⁽³⁾		210,000		0		0		0		210,000		0		0
Total debt	$	1,080,411	$	360,000	$	30,000	$	37,500	$	445,000	$	0	$	207,911

⁽¹⁾	Amount represents face value of the 0.875% Convertible Senior Notes, which includes both the liability and equity portion.

⁽²⁾	Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.

⁽³⁾	Assumes no additional borrowings after June 30, 2020, payment of any required periodic installments of principal and that all drawn amounts are repaid upon maturity.

Income Taxes

6 Months Ended

Jun. 30, 2020

Income Tax Disclosure [Abstract]

Income Taxes

11. Income Taxes

We account for income taxes under FASB Accounting Standards Codification 740, “Income Taxes” (“ASC 740”). We calculate the quarterly tax provision consistent with the guidance provided by ASC 740, whereby we forecast the estimated annual effective tax rate and then apply that rate to the year-to-date pre-tax book (loss) income. The effective tax rate may be subject to fluctuations during the year as new information is obtained, which may affect the assumptions used to estimate the annual effective rate, including factors such as the valuation allowances against deferred tax assets, the recognition or de-recognition of tax benefits related to uncertain tax positions, or changes in or the interpretation of tax laws in jurisdictions where the Company conducts business. There is no tax benefit recognized on certain of the net operating losses incurred due to insufficient evidence supporting the Company’s ability to use these losses in the future. The effective tax rates were as follows:

	Three Months Ended June 30,						Six Months Ended June 30,
(In thousands, except effective tax rate)	2020			2019			2020			2019
Loss before income taxes	$	(732	)	$	(150,457	)	$	(21,433	)	$	(156,502	)
Income tax (provision) benefit	$	(6,873	)	$	527		$	(6,526	)	$	(1,405	)
Effective tax rate		(938.9	%)		0.4	%		(30.4	%)		(0.9	%)

Our provision for income taxes differs from the tax computed at the U.S. federal statutory income tax rate primarily due to permanent differences, income attributable to foreign jurisdictions taxed at different rates, state taxes, tax credits and certain discrete items. Our effective tax rate for the three and six months ended June 30, 2020, compared with the prior year comparable periods, differs primarily due to the fact that the permanent items, credits and the impact of foreign earnings had less impact on the pre-tax loss of $0.7 million and $21.4 million in the three and six months ended June 30, 2020, respectively, compared to the impacts of these items on a pre-tax loss of $150.5 million and $156.5 million for the three and six months ended June 30, 2019, respectively.

In evaluating our ability to recover our deferred tax assets within the jurisdictions from which they arise, we consider all available evidence, including scheduled reversals of deferred tax liabilities, tax-planning strategies, and results of recent operations. In evaluating the objective evidence that historical results provide, we consider three years of cumulative operating income (loss). During the six months ended June 30, 2020, we recorded valuation allowances of $1.1 million related to U.S. and foreign net operating loss carryforwards.

Our unrecognized income tax benefits were $21.6 million and $20.6 million as of June 30, 2020 and December 31, 2019, respectively. If any portion of our unrecognized tax benefits is recognized, it could impact our effective tax rate. The tax reserves are reviewed periodically and adjusted considering changing facts and circumstances, such as progress of tax audits, lapse of applicable statutes of limitations and changes in tax law.

Derivative Financial Instruments

6 Months Ended

Jun. 30, 2020

Derivative Instruments And Hedging Activities Disclosure [Abstract]

Derivative Financial Instruments

12. Derivative Financial Instruments

The following tables provide information about the fair values of our derivative financial instruments as of the respective balance sheet dates:

June 30, 2020

Asset Derivatives

Liability Derivatives

(In thousands)

Balance Sheet Location

Fair Value

Balance Sheet Location

Fair Value

Derivatives qualifying as cash flow hedges:

Foreign exchange contracts

Prepaid expenses and

other current assets

611

Accrued expenses

Derivatives not subject to hedge accounting:

1.25% Call Option

Other assets

N/A

1.25% Embedded cash conversion option

N/A

Other liabilities

Total derivatives

611

December 31, 2019

Asset Derivatives

Liability Derivatives

(In thousands)

Balance Sheet Location

Fair Value

Balance Sheet Location

Fair Value

Derivatives qualifying as cash flow hedges:

Foreign exchange contracts

Prepaid expenses and

other current assets

Accrued expenses

Derivatives not subject to hedge accounting:

1.25% Call Option

Other assets

N/A

1.25% Embedded cash conversion option

N/A

Other liabilities

185

Total derivatives

185

N/A – We define “N/A” as disclosure not being applicable

Foreign Exchange Contracts

We have entered into non-deliverable forward foreign currency exchange contracts with reputable banking counterparties to hedge a portion of our forecasted future Indian Rupee-denominated (“INR”) expenses against foreign currency fluctuations between the United States dollar and the INR. These forward contracts cover a percentage of forecasted monthly INR expenses over time. As of June 30, 2020, there were 12 forward contracts outstanding that were staggered to mature monthly starting in July 2020 and ending in June 2021. In the future, we may enter into additional forward contracts to increase the amount of hedged monthly INR expenses or initiate hedges for monthly periods beyond July 2021. As of June 30, 2020, the notional amount for each of the outstanding forward contracts ranged from 225 to 280 million INR, or the equivalent of $3.0 million to $3.7 million, based on the exchange rate between the United States dollar and the INR in effect as of June 30, 2020. These amounts also approximate the forecasted future INR expenses we target to hedge in any one month in the future. As of June 30, 2020, we estimate that $0.6 million of net unrealized derivative gains included in accumulated other comprehensive income (“AOCI”) will be reclassified into income within the next twelve months.

The following tables show the impact of derivative instruments designated as cash flow hedges on the consolidated statements of operations and the consolidated statements of comprehensive loss:

	Amount of Gain (Loss) Recognized in OCI					Amount of Gain (Loss) Reclassified from AOCI into Income
(In thousands)	Three Months Ended June 30, 2020		Six Months Ended June 30, 2020		Location of Gain (Loss) Reclassified from AOCI into Income	Three Months Ended June 30, 2020			Six Months Ended June 30, 2020
Foreign exchange contracts	$	991	$	518	Cost of Revenue	$	(36	)	$	(36	)
					Selling, general and administrative expenses		(18	)		(18	)
					Research and development	$	(38	)	$	(38	)

	Amount of Gain (Loss) Recognized in OCI					Amount of Gain (Loss) Reclassified from AOCI into Income
(In thousands)	Three Months Ended June 30, 2019		Six Months Ended June 30, 2019		Location of Gain (Loss) Reclassified from AOCI into Income	Three Months Ended June 30, 2019		Six Months Ended June 30, 2019
Foreign exchange contracts	$	189	$	340	Cost of Revenue	$	53	$	60
					Selling, general and administrative expenses		36		41
					Research and development	$	59	$	66

1.25% Call Option

In June 2013, concurrent with the issuance of the 1.25% Notes, we entered into privately negotiated hedge transactions with certain of the initial purchasers of the 1.25% Notes (collectively, the “1.25% Call Option”). Assuming full performance by the counterparties, the 1.25% Call Option is intended to offset cash payments in excess of the principal amount due upon any conversion of the 1.25% Notes.

The 1.25% Call Option, which is indexed to our common stock, is a derivative asset that requires mark-to-market accounting treatment (due to the cash settlement features) until the 1.25% Call Option settles or expires. The 1.25% Call Option is measured and reported at fair value on a recurring basis, within Level 3 of the fair value hierarchy.

The 1.25% Call Option does not qualify for hedge accounting treatment. Therefore, the change in fair value of these instruments is recognized immediately in our consolidated statements of operations in Other income, net. Because the terms of the 1.25% Call

Option are substantially similar to those of the 1.25% Notes embedded cash conversion option, discussed below, we expect the net effect of those two derivative instruments on our earnings to be minimal.

1.25% Notes Embedded Cash Conversion Option

The embedded cash conversion option within the 1.25% Notes is required to be separated from the 1.25% Notes and accounted for separately as a derivative liability, with changes in fair value reported in our consolidated statements of operations in Other income, net until the cash conversion option settles or expires. The initial fair value liability of the embedded cash conversion option was $82.8 million, which simultaneously reduced the carrying value of the 1.25% Notes (effectively an original issuance discount). The embedded cash conversion option is measured and reported at fair value on a recurring basis, within Level 3 of the fair value hierarchy.

The following table shows the net impact of the changes in fair values of the 1.25% Call Option and the 1.25% Notes’ embedded cash conversion option in the consolidated statements of operations:

	Three Months Ended June 30,					Six Months Ended June 30,
(In thousands)	2020		2019			2020			2019
1.25% Call Option	$	0	$	3,379		$	(84	)	$	(2,695	)
1.25% Embedded cash conversion option		1		(3,840	)		185			2,609
Net income included in Other income, net	$	1	$	(461	)	$	101		$	(86	)

Other Comprehensive Income

6 Months Ended

Jun. 30, 2020

Equity [Abstract]

Other Comprehensive Income

13. Other Comprehensive Income

Accumulated Other Comprehensive Loss

Changes in the balances of each component included in AOCI are presented in the tables below. All amounts are net of tax and exclude non-controlling interest.

(In thousands)	Foreign Currency Translation Adjustments			Unrealized Net Gains on Foreign Exchange Contracts		Total
Balance as of December 31, 2019⁽¹⁾	$	(4,392	)	$	0	$	(4,392	)
Other comprehensive loss (income) before reclassifications		(1,594	)		384		(1,210	)
Net losses (gains) reclassified from accumulated other comprehensive loss		0			69		69
Net other comprehensive (loss) income		(1,594	)		453		(1,141	)
Balance as of June 30, 2020⁽²⁾	$	(5,986	)	$	453	$	(5,533	)

⁽¹⁾ Net of taxes of $149 thousand arising from the revaluation of tax effects included in AOCI.

⁽²⁾ Net of taxes of $158 thousand for unrealized net gains on foreign exchange contract derivatives.

(In thousands)	Foreign Currency Translation Adjustments			Unrealized Net Gains on Foreign Exchange Contracts			Total
Balance as of December 31, 2018⁽¹⁾	$	(5,584	)	$	195		$	(5,389	)
Other comprehensive income (loss) before reclassifications		539			252			791
Net (gains) losses reclassified from accumulated other comprehensive loss		0			(124	)		(124	)
Net other comprehensive income		539			128			667
Balance as of June 30, 2019⁽²⁾	$	(5,045	)	$	323		$	(4,722	)

⁽¹⁾ Net of taxes of $68 thousand for unrealized net gains on foreign exchange contract derivatives and $149 thousand arising from the revaluation of tax effects included in AOCI.

⁽²⁾ Net of taxes of $113 thousand for unrealized net losses on foreign exchange contract derivatives.

Income Tax Effects Related to Components of Other Comprehensive Income (Loss)

The following tables reflect the tax effects allocated to each component of other comprehensive income (loss) (“OCI”):

	Three Months Ended June 30,
	2020							2019
(In thousands)	Before-Tax Amount		Tax Effect			Net Amount		Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	918	$	0		$	918	$	(156	)	$	0		$	(156	)
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		991		(256	)		735		189			(49	)		140
Net losses (gains) reclassified into income		93		(24	)		69		(147	)		38			(109	)
Net change in unrealized gains (losses) on foreign exchange contracts		1,084		(280	)		804		42			(11	)		31
Net gain (loss) on cash flow hedges		1,084		(280	)		804		42			(11	)		31
Other comprehensive income (loss)	$	2,002	$	(280	)	$	1,722	$	(114	)	$	(11	)	$	(125	)

Contingencies

6 Months Ended

Jun. 30, 2020

Commitments And Contingencies Disclosure [Abstract]

Contingencies

14. Contingencies

In addition to commitments and obligations in the ordinary course of business, we are currently subject to various legal proceedings and claims that have not been fully adjudicated. We intend to vigorously defend ourselves, as appropriate, in these matters.

No less than quarterly, we review the status of each significant matter and assess our potential financial exposure. We accrue a liability for an estimated loss if the potential loss from any legal proceeding or claim is considered probable and the amount can be reasonably estimated. Significant judgment is required in both the determination of probability and the determination as to whether the amount of an exposure is reasonably estimable, and accruals are based only on the information available to our management at the time the judgment is made.

The outcome of legal proceedings is inherently uncertain, and we may incur substantial defense costs and expenses defending any of these matters. In the opinion of our management, except as set forth below with respected to the resolution of the Practice Fusion investigations, the ultimate disposition of pending legal proceedings or claims will not have a material adverse effect on our consolidated financial position, liquidity or results of operations. However, if one or more of these additional legal proceedings were resolved against or settled by us in a reporting period for amounts in excess of our management’s expectations, our consolidated financial statements for that and subsequent reporting periods could be materially adversely affected. Additionally, the resolution of a legal proceeding against us could prevent us from offering our products and services to current or prospective clients or cause us to incur increased compliance costs, either of which could further adversely affect our operating results.

The Enterprise Information Solutions business (the “EIS Business”) acquired from McKesson Corporation (“McKesson”) on October 2, 2017 is subject to a May 2017 civil investigative demand (“CID”) from the U.S. Attorney’s Office for the Eastern District of New York. The CID requests documents and information related to the certification McKesson obtained for Horizon Clinicals in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program. In August 2018, McKesson received an additional CID seeking similar information for Paragon. McKesson has agreed, with respect to the CIDs, to indemnify Allscripts for amounts paid or payable to the government (or any private relator) involving any products or services marketed, sold or licensed by the EIS Business as of or prior to the closing of the acquisition.

Practice Fusion, acquired by Allscripts on February 13, 2018, received in March 2017 a request for documents and information from the U.S. Attorney’s Office for the District of Vermont pursuant to a CID. Between April 2018 and June 2019, Practice Fusion received from the U.S. Department of Justice (the “DOJ”) seven additional requests for documents and information through four additional CIDs and three Health Insurance Portability and Accountability Act (“HIPAA”) subpoenas. The document and information requests received by Practice Fusion related to both the certification Practice Fusion obtained in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program and Practice Fusion’s compliance with the Anti-Kickback Statute (“AKS”) and HIPAA as it relates to certain business practices engaged in by Practice Fusion. In March 2019, Practice Fusion received a grand jury subpoena in connection with a criminal investigation related to Practice Fusion’s compliance with the AKS. On August 6, 2019, Practice Fusion reached an agreement in principle with the DOJ to resolve all of the DOJ’s outstanding civil and criminal investigations, including the investigation by the U.S. Attorney’s Office for the District of Vermont, and we announced that on January 27, 2020, Practice Fusion entered into a deferred prosecution agreement and various civil settlement agreements, including with the Medicaid programs for each U.S. state, the District of Columbia and Puerto Rico (collectively, the “Settlement Agreements”) resolving the investigations conducted by the DOJ and the U.S. Attorney’s Office. The Settlement Agreements require Practice Fusion to, among other matters, pay a criminal fine of $25.3 million, a forfeiture payment of $959,700 and a civil settlement of $118.6 million, which includes $5.2 million designated for the state Medicaid program expenditures. The terms of Settlement Agreements resolved, among other things, allegations that Practice Fusion, long before its acquisition by Allscripts and concerning conduct about which Allscripts was unaware at the time of the acquisition, violated the AKS through the manner by which a sponsored Clinical Decision Support arrangement was sold to an opioid manufacturer and other AKS allegations made by the DOJ against Practice Fusion, as well as False Claims Act allegations pertaining to Meaningful Use payments the federal government made to users of Practice Fusion’s EHR system. In April 2020, Practice Fusion amended its civil settlement agreement with the DOJ by revising the timing of certain of the payments required to be made by Practice Fusion. Pursuant to the amendment, the Federal settlement amounts that were otherwise owed in the Company’s second and third fiscal quarters were reduced by half, and the balance of the Federal settlement amount owed by Practice Fusion will become due in January 2021.

Business Segments

6 Months Ended

Jun. 30, 2020

Segment Reporting [Abstract]

Business Segments

15. Business Segments

We primarily derive our revenues from sales of our proprietary software (either as a direct license sale or under a subscription delivery model), which also serves as the basis for our recurring service contracts for software support and maintenance and certain transaction-related services. In addition, we provide various other client services, including installation, and managed services such as outsourcing, private cloud hosting and revenue cycle management.

During the first quarter of 2020, we realigned our reporting structure to organize the Company around strategic business units to maximize delivery of client commitments, operational effectiveness and competitiveness. As a result, we have three operating segments, (i) Core Clinical and Financial Solutions, (ii) Data, Analytics and Care Coordination and (iii) EPSi^TM. The Core Clinical and Financial Solutions and Data, Analytics and Care Coordination operating segments are the equivalent to the reportable segments.

During the second quarter of 2020, (i) certain operations were moved between Core Clinical and Financial Solutions, and Data, Analytics and Care Coordination and (ii) a transfer price allocation was recorded between Core Clinical and Financial Solutions, and Data, Analytics and Care Coordination. In addition, the (i) corporate general and administrative expenses (including marketing expenses) and (ii) revenue and the associated cost from the resale of certain ancillary products, primarily hardware that were previously in the “Unallocated Amounts” have been allocated between the three operating segments.

The new reportable segments are (i) Core Clinical and Financial Solutions and (ii) Data, Analytics and Care Coordination. The new Core Clinical and Financial Solutions segment derives its revenue from the sale of patient engagement, integrated clinical software applications and financial management solutions, which primarily include EHR-related software, financial and practice management software, related installation, support and maintenance, outsourcing, private cloud hosting and revenue cycle management. The new Data, Analytics and Care Coordination segment derives its revenue from the sale of care coordination, practice reimbursement and payer and life sciences solutions, which are mainly targeted at hospitals, health systems, other care facilities, payers, life sciences companies and other key healthcare stakeholders. These solutions enable clients to transition, analyze, coordinate care and improve the quality, efficiency and value of healthcare delivery across the entire care community. The EPSi^TM operating segment is included in the “Unallocated Amounts” category as it does not meet the requirements to be a reportable segment nor the criteria to be aggregated into the two reportable segments. The segment disclosures below for the three and six months ended June 30, 2019 have been revised to conform to the current year presentation.

Our Chief Operating Decision Maker (“CODM”) uses segment revenues, gross profit and (loss) income from operations as measures of performance and to make decisions about the allocation of resources. We do not track our assets by segment.

	Three Months Ended June 30,						Six Months Ended June 30,
(In thousands)	2020			2019			2020			2019
Revenue:
Core Clinical and Financial Solutions	$	311,099		$	347,782		$	631,431		$	688,194
Data, Analytics and Care Coordination		85,161			87,985			173,519			170,391
Unallocated Amounts		9,963			8,693			17,986			17,924
Total revenue	$	406,223		$	444,460		$	822,936		$	876,509

Gross profit:
Core Clinical and Financial Solutions	$	108,522		$	122,322		$	208,856		$	242,447
Data, Analytics and Care Coordination		49,032			55,676			100,697			103,406
Unallocated Amounts		6,930			6,124			11,892			12,364
Total gross profit	$	164,484		$	184,122		$	321,445		$	358,217

(Loss) income from operations:
Core Clinical and Financial Solutions	$	(16,033	)	$	(11,734	)	$	(36,745	)	$	(17,258	)
Data, Analytics and Care Coordination		7,267			12,534			16,932			16,854
Unallocated Amounts		4,020			3,943			5,867			7,792
Total (loss) income from operations	$	(4,746	)	$	4,743		$	(13,946	)	$	7,388

Supplemental Disclosures

6 Months Ended

Jun. 30, 2020

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Supplemental Disclosures

16. Supplemental Disclosures

Supplemental Consolidated Statements of Cash Flows Information

The majority of the restricted cash balance as of June 30, 2020 and 2019 represents the remaining balance of the escrow account established as part of the acquisition of Netsmart in 2016, to be used by Netsmart to facilitate the integration of Allscripts’ former Homecare^TMbusiness.

	June 30,
(In thousands)	2020		2019
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$	199,004	$	138,903
Restricted cash		6,194		9,236
Total cash, cash equivalents and restricted cash	$	205,198	$	148,139

	Six Months Ended June 30,
(In thousands)	2020		2019
Supplemental non-cash information:
Issuance of treasury stock to commercial partner	$	752	$	701

Subsequent Events

6 Months Ended

Jun. 30, 2020

Subsequent Events [Abstract]

Subsequent Events

17. Subsequent Events

On July 1, 2020, the 1.25% Cash Convertible Senior Notes matured. We borrowed $345.0 million from our senior secured revolving credit facility to repay the 1.25% Notes in full.

On July 30, 2020, we signed an asset purchase agreement with Strata Decision Technology LLC, an Illinois limited liability company (“Strata”), and Roper Technologies, Inc., a Delaware corporation (the “EPSi Purchase Agreement”), pursuant to which Strata has agreed to purchase substantially all of the assets of our EPSi^TM business for $365.0 million, subject to adjustment and upon the terms and conditions set forth in the EPSi Purchase Agreement. The transactions contemplated by the EPSi Purchase Agreement are subject to customary closing conditions, including the applicable waiting period (and any extensions thereof) under the Hart-Scott-Rodino Antitrust Improvements Act having expired or otherwise having been terminated.

Basis of Presentation and Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation The consolidated financial statements include the accounts of Allscripts Healthcare Solutions, Inc. (“Allscripts”) and its wholly-owned subsidiaries and controlled affiliates. All significant intercompany balances and transactions have been eliminated. Each of the terms “we,” “us,” “our” or the “Company” as used herein refers collectively to Allscripts Healthcare Solutions, Inc. and its wholly-owned subsidiaries and controlled affiliates, unless otherwise stated.
Unaudited Interim Financial Information	Unaudited Interim Financial Information The unaudited interim consolidated financial statements as of and for the three and six months ended June 30, 2020 and 2019 have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim financial reporting. These interim consolidated financial statements are unaudited and, in the opinion of our management, include all adjustments, consisting of normal recurring adjustments and accruals, necessary to present fairly the consolidated financial statements for the periods presented in accordance with generally accepted accounting principles in the United States of America (“GAAP”). The consolidated results of operations for the three and six months ended June 30, 2020 are not necessarily indicative of the results to be expected for the full year ending December 31, 2020. Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted in accordance with the SEC's rules and regulations for interim reporting. The Company believes that the disclosures made are adequate to make these unaudited interim consolidated financial statements not misleading. They should be read in conjunction with the consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2019 (our “Form 10-K”).
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in accordance with GAAP requires us to make estimates and assumptions that affect the amounts reported and disclosed in the consolidated financial statements and the accompanying notes. Our estimates and assumptions consider the economic implications of COVID-19 on our critical and significant accounting estimates. Actual results could differ materially from these estimates.
Change in Presentation	Change in Presentation During the first quarter of 2020, we changed our reportable segments from Provider, Veradigm and Unallocated to Core Clinical and Financial Solutions, Data, Analytics and Care Coordination, and Unallocated. The business units reported within the historical segments have been reallocated into the new segments. Refer to Note 15 “Business Segments” for further discussion on the impact of the change. Certain reclassifications were made to prior period amounts in order to conform to the current period presentation. These reclassifications had no impact on the reported consolidated prior period financial results.
Recently Adopted Accounting Pronouncements	Significant Accounting Policies We adopted Accounting Standards Update No. 2016-13, “Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments” (“ASU 2016-13”) on January 1, 2020 using the cumulative-effect adjustment transition method. The guidance in ASU 2016-13 replaces the incurred loss impairment methodology under current GAAP. The new impairment model requires immediate recognition of estimated credit losses expected to occur for most financial assets and certain other instruments. For available-for-sale debt securities with unrealized losses, the losses will be recognized as allowances rather than reductions in the amortized cost of the securities. ASU 2016-13 is effective for annual periods beginning after December 15, 2019, and interim periods within those annual periods. Refer to Note 2 “Revenue from Contracts with Customers” and Note 3 “Accounts Receivable” for further discussion on the impact of adoption. Recently Adopted Accounting Pronouncements In August 2018, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2018-13, “Fair Value Measurement (Topic 820) – Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement” (“ASU 2018-13”), which eliminates, adds and modifies certain disclosure requirements for fair value measurements. Entities will no longer be required to disclose the amount of and reasons for transfers between Level 1 and Level 2 of the fair value hierarchy, but public companies will be required to disclose the range and weighted-average of significant unobservable inputs used to develop Level 3 fair value measurements. ASU 2018-13 will be effective for all entities for interim and annual periods beginning after December 15, 2019, with early adoption permitted. We adopted ASU 2018-13 on January 1, 2020, and the adoption had no impact on our consolidated financial statements. In March 2020, the FASB issued Accounting Standards Update No. 2020-04, “Reference Rate Reform (Topic 848) – Facilitation of the Effects of Reference Rate Reform on Financial Reporting” (“ASU 2020-04”), which provides optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The amendments in ASU 2020-04 apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. ASU 2020-04 will be effective for all entities as of March 12, 2020 through December 31, 2022. We adopted ASU 2020-04 on March 12, 2020, and the adoption had no impact on our consolidated financial statements.
Accounting Pronouncements Not Yet Adopted	Accounting Pronouncements Not Yet Adopted In December 2019, the FASB issued Accounting Standards Update No. 2019-12, “Income Taxes (Topic 740)” (“ASU 2019-12”), which is part of the FASB’s overall simplification initiative to reduce the costs and complexity of applying accounting standards while maintaining or improving the usefulness of the information provided to users of financial statements. ASU 2019-12 simplifies accounting guidance for intraperiod allocations, deferred tax liabilities, year-to-date losses in interim periods, franchise taxes, step-up in tax basis of goodwill, separate entity financial statements and interim recognition of tax laws or rate changes. ASU 2019-12 is effective for public business entities for annual reporting periods beginning after December 15, 2020, with early adoption permitted. We are currently evaluating the impact of this accounting guidance. We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, will have a material impact on our consolidated financial statements.
Revenue Recognition	Revenue Recognition We recognize revenue only when we satisfy an identified performance obligation (or bundle of obligations) by transferring control of a promised product or service to a customer. We consider a product or service to be transferred when a customer obtains control because a customer has sole possession of the right to use (or the right to direct the use of) the product or service for the remainder of its economic life or to consume the product or service in its own operations. We evaluate the transfer of control primarily from the customer’s perspective as this reduces the risk that revenue is recognized for activities that do not transfer control to the customer. The majority of our revenue is recognized over time because a customer continuously and simultaneously receives and consumes the benefits of our performance. The exceptions to this pattern are our sales of perpetual and term software licenses, and hardware, where we determined that a customer obtains control of the asset upon granting of access, delivery or shipment.

Revenue from Contracts with Customers (Tables)

6 Months Ended

Jun. 30, 2020

Summary of Revenue Recognized on Various Performance Obligations and Elected Accounting Expedients

The breakdown of revenue recognized based on the origination of performance obligations and elected accounting expedients is presented in the table below:

(In thousands)	Three Months Ended March 31, 2020		Three Months Ended June 30, 2020
Revenue related to deferred revenue balance at beginning of period	$	140,132	$	155,616
Revenue related to new performance obligations satisfied during the period		216,990		196,110
Revenue recognized under "right-to-invoice" expedient		58,059		54,082
Reimbursed travel expenses, shipping and other revenue		1,532		415
Total revenue	$	416,713	$	406,223

(In thousands)	Three Months Ended March 31, 2019		Three Months Ended June 30, 2019
Revenue related to deferred revenue balance at beginning of period	$	126,184	$	146,150
Revenue related to new performance obligations satisfied during the period		248,221		233,696
Revenue recognized under "right-to-invoice" expedient		55,923		62,245
Reimbursed travel expenses, shipping and other revenue		1,721		2,369
Total revenue	$	432,049	$	444,460

Summary of Revenue by Type and Nature of Revenue Stream by Reportable Segments

The below tables summarize revenue by type and nature of revenue stream as well as by our reportable segments:

	Three Months Ended June 30,				Six Months Ended June 30,
(In thousands)	2020		2019		2020		2019
Revenue:
Recurring revenue	$	335,088	$	350,113	$	676,307	$	698,749
Non-recurring revenue		71,135		94,347		146,629		177,760
Total revenue	$	406,223	$	444,460	$	822,936	$	876,509

Summary of Changes in Estimate of Credit Losses for Contract Assets

Changes in the estimate of credit losses for contract assets are presented in the table below.

(In thousands)	Total
Balance at January 1, 2020	$	5,341
Current period provision		0
Balance at June 30, 2020	$	5,341
Less: Contract assets, short-term		1,068
Total contract assets, long-term	$	4,273

Revenue by Segment [Member]

Summary of Revenue by Type and Nature of Revenue Stream by Reportable Segments

	Three Months Ended June 30, 2020
(In thousands)	Core Clinical and Financial Solutions		Data, Analytics and Care Coordination		Unallocated Amounts		Total
Software delivery, support and maintenance	$	167,219	$	81,856	$	6,946	$	256,021
Client services		143,880		3,305		3,017		150,202
Total revenue	$	311,099	$	85,161	$	9,963	$	406,223

	Three Months Ended June 30, 2019
(In thousands)	Core Clinical and Financial Solutions		Data, Analytics and Care Coordination		Unallocated Amounts		Total
Software delivery, support and maintenance	$	194,053	$	84,947	$	6,023	$	285,023
Client services		153,729		3,038		2,670		159,437
Total revenue	$	347,782	$	87,985	$	8,693	$	444,460

	Six Months Ended June 30, 2020
(In thousands)	Core Clinical and Financial Solutions		Data, Analytics and Care Coordination		Unallocated Amounts		Total
Software delivery, support and maintenance	$	341,302	$	165,796	$	12,535	$	519,633
Client services		290,129		7,723		5,451		303,303
Total revenue	$	631,431	$	173,519	$	17,986	$	822,936

	Six Months Ended June 30, 2019
(In thousands)	Core Clinical and Financial Solutions		Data, Analytics and Care Coordination		Unallocated Amounts		Total
Software delivery, support and maintenance	$	383,435	$	164,455	$	12,645	$	560,535
Client services		304,759		5,936		5,279		315,974
Total revenue	$	688,194	$	170,391	$	17,924	$	876,509

Accounts Receivables (Tables)

6 Months Ended

Jun. 30, 2020

Trade Accounts Receivable [Member]

Accounts Notes And Loans Receivable [Line Items]

Schedule of Changes in Estimate of Credit Losses for Trade Accounts Receivable

Changes in the estimate of credit losses for trade accounts receivable are presented in the tables below.

(In thousands)	Total
Balance at January 1, 2020	$	36,490
Current period provision		4,261
Write-offs		(3,811	)
Recoveries		32
Balance at June 30, 2020	$	36,972

Leases (Tables)

6 Months Ended

Jun. 30, 2020

Lessee Disclosure [Abstract]

Summary of Operating Costs Associated with Leased Assets

Operating costs associated with leased assets are as follows:

(In thousands)	Three Months Ended June 30,						Six Months Ended June 30,
	2020			2019			2020			2019
Operating lease cost ⁽¹⁾	$	6,439		$	7,051		$	13,361		$	13,768
Less: Sublease income		(166	)		(778	)		(769	)		(1,580	)
Total operating lease costs	$	6,273		$	6,273		$	12,592		$	12,188

⁽¹⁾	Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statements of operations.

Supplemental Information for Operating Leases

Supplemental information for operating leases is as follows:

(In thousands)	Six Months Ended June 30,
	2020		2019
Operating cash flows from operating leases	$	14,283	$	14,688
Right-of-use assets obtained in exchange for operating lease obligations	$	23,056	$	128,664

Summary of Balance Sheet Location and Balances for Operating Leases

The balance sheet location and balances for operating leases are as follows:

(In thousands, except lease term and discount rate)	June 30, 2020			December 31, 2019
Right-of-use assets - operating leases	$	107,661		$	98,020
Current operating lease liabilities	$	22,072		$	23,137
Long-term operating lease liabilities	$	104,815		$	95,162
Weighted average remaining lease term (in years)		6			6
Weighted average discount rate		3.6	%		4.4	%

Summary of Future Maturities of Lease and Non-Lease Components

	June 30, 2020
(In thousands)	Operating Leases
Remainder of 2020	$	13,254
2021		26,469
2022		24,914
2023		22,732
2024		17,188
Thereafter		36,462
Total lease liabilities		141,019
Less: Amount representing interest		(14,132	)
Less: Short-term lease liabilities		(22,072	)
Total long-term lease liabilities	$	104,815

Fair Value Measurements and Long-term Investments (Tables)

6 Months Ended

Jun. 30, 2020

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis

The following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates:

	Balance Sheet	June 30, 2020								December 31, 2019
(In thousands)	Classifications	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Foreign exchange derivative assets	Prepaid expenses and other current assets	$	0	$	611	$	0	$	611	$	0	$	0	$	0	$	0
1.25% Call Option	Other assets		0		0		0		0		0		0		84		84
Total assets		$	0	$	611	$	0	$	611	$	0	$	0	$	84	$	84

Contingent consideration - current	Accrued expenses	$	0	$	0	$	13,699	$	13,699	$	0	$	0	$	17,116	$	17,116
Contingent consideration - long-term	Other liabilities		0		0		2,415		2,415		0		0		2,415		2,415
1.25% Embedded cash conversion option	Other liabilities		0		0		0		0		0		0		185		185
Total liabilities		$	0	$	0	$	16,114	$	16,114	$	0	$	0	$	19,716	$	19,716

Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis

The changes in Level 3 assets and liabilities measured at fair value on a recurring basis at June 30, 2020 are summarized as follows:

(In thousands)	Contingent Consideration			1.25% Notes Call Spread Overlay
Balance at December 31, 2019	$	19,531		$	(101	)
Additions		772			0
Payments/write-downs		(4,189	)		0
Fair value adjustments		0			101
Balance at June 30, 2020	$	16,114		$	0

Summary of Quantitative Information About Fair Value Measurements

The following table summarizes the quantitative information about our Level 3 fair value measurements at June 30, 2020:

June 30, 2020

(In thousands, except the discount rate)

Fair Value

Valuation Technique

Significant Unobservable Inputs

Ranges of Inputs

Weighted Average ⁽¹⁾

Financial instruments:

Contingent consideration

16,114

Probability Weighted Discounted cash flow

Discount rate

4% to 5%

Revenue

$0 to $62,500

31,250

Registry members

0 to 1,551

776

Patient data volume

0 to 52,845

26,422

Projected year of payment

2020 to 2021

Total financial instruments

16,114

⁽¹⁾	The weighted average is calculated based upon the absolute fair value of the instruments.

Long-Term Equity and Cost Method Investments [Member]

Summary of Long-term Equity Investments Included in Other Assets

The following table summarizes our long-term equity investments which are included in Other assets in the accompanying consolidated balance sheets:

	Number of Investees		Original		Carrying Value at
(In thousands, except for number of investees)	at June 30, 2020		Cost		June 30, 2020		December 31, 2019
Equity method investments ⁽¹⁾		3	$	7,099	$	10,667	$	11,332
Cost less impairment		8		37,568		27,766		32,462
Total long-term equity investments		11	$	44,667	$	38,433	$	43,794

⁽¹⁾	Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Stockholders' Equity (Tables)

6 Months Ended

Jun. 30, 2020

Equity [Abstract]

Share-Based Compensation Expense

	Three Months Ended June 30,				Six Months Ended June 30,
(In thousands)	2020		2019		2020		2019
Cost of revenue:
Software delivery, support and maintenance	$	343	$	614	$	918	$	1,127
Client services		808		1,163		1,899		2,256
Total cost of revenue		1,151		1,777		2,817		3,383
Selling, general and administrative expenses		5,081		6,831		12,123		15,156
Research and development		1,428		2,571		3,823		5,448
Total stock-based compensation expense	$	7,660	$	11,179	$	18,763	$	23,987

Share-Based Awards Granted

We granted stock-based awards as follows:

	Three Months Ended June 30, 2020				Six Months Ended June 30, 2020
			Weighted-Average				Weighted-Average
			Grant Date				Grant Date
(In thousands, except per share amounts)	Shares		Fair Value		Shares		Fair Value
Service-based restricted stock units		4,021	$	6.21		4,418	$	6.39
Market-based restricted stock units with a service condition		0	$	0.00		595	$	9.98
		4,021	$	6.21		5,013	$	6.82

Earnings (Loss) Per Share (Tables)

6 Months Ended

Jun. 30, 2020

Earnings Per Share [Abstract]

Calculations of Earnings (Loss) Per Share

The calculations of earnings (loss) per share are as follows:

	Three Months Ended June 30,						Six Months Ended June 30,
(In thousands, except per share amounts)	2020			2019			2020			2019
Basic earnings (loss) per Common Share:
Net loss	$	(7,605	)	$	(149,930	)	$	(27,959	)	$	(157,907	)
Net loss attributable to non-controlling interests		0			0			0			424
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(7,605	)	$	(149,930	)	$	(27,959	)	$	(157,483	)

Weighted-average common shares outstanding		162,682			166,522			162,571			168,230
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(0.05	)	$	(0.90	)	$	(0.17	)	$	(0.94	)

Diluted earnings (loss) per Common Share:
Net loss	$	(7,605	)	$	(149,930	)	$	(27,959	)	$	(157,907	)
Net loss attributable to non-controlling interests		0			0			0			424
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(7,605	)	$	(149,930	)	$	(27,959	)	$	(157,483	)

Weighted-average common shares outstanding		162,682			166,522			162,571			168,230
Plus: Dilutive effect of stock options, restricted stock unit awards and warrants		0			0			0			0
Weighted-average common shares outstanding assuming dilution		162,682			166,522			162,571			168,230
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(0.05	)	$	(0.90	)	$	(0.17	)	$	(0.94	)

Anti-Dilutive Stock Options, Restricted Stock Unit Awards and Warrants Excluded from Computation of Diluted Earnings (Loss) Per Share

Three Months Ended June 30,

Six Months Ended June 30,

(In thousands)

2020

2019

2020

2019

Shares subject to anti-dilutive stock options, restricted stock

unit awards and warrants excluded from calculation

50,988

29,720

49,304

27,358

Goodwill and Intangible Assets (Tables)

6 Months Ended

Jun. 30, 2020

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

Goodwill and intangible assets consist of the following:

	June 30, 2020							December 31, 2019
	Gross							Gross
	Carrying		Accumulated			Intangible		Carrying		Accumulated			Intangible
(In thousands)	Amount		Amortization			Assets, Net		Amount		Amortization			Assets, Net
Intangibles subject to amortization:
Proprietary technology	$	546,094	$	(454,615	)	$	91,479	$	546,373	$	(437,640	)	$	108,733
Customer contracts and relationships		701,651		(501,494	)		200,157		702,034		(488,625	)		213,409
Total	$	1,247,745	$	(956,109	)	$	291,636	$	1,248,407	$	(926,265	)	$	322,142

Intangibles not subject to amortization:
Registered trademarks						$	52,000						$	52,000
Goodwill							1,361,406							1,362,017
Total						$	1,413,406						$	1,414,017

Changes in Carrying Amount of Goodwill

Changes in the carrying amounts of goodwill by reportable segment for the six months ended June 30, 2020 were as follows:

(In thousands)	Core Clinical and Financial Solutions			Data, Analytics and Care Coordination		Unallocated Amounts		Total
Balance as of December 31, 2019		734,883			552,471		74,663		1,362,017
Foreign exchange translation		(611	)		0		0		(611	)
Balance as of June 30, 2020	$	734,272		$	552,471	$	74,663	$	1,361,406

Debt (Tables)

6 Months Ended

Jun. 30, 2020

Debt Instrument [Line Items]

Debt Outstanding Excluding Lease Obligations

Debt outstanding, excluding lease obligations, consists of the following:

	June 30, 2020							December 31, 2019
(In thousands)	Principal Balance		Unamortized Discount and Debt Issuance Costs			Net Carrying Amount		Principal Balance		Unamortized Discount and Debt Issuance Costs		Net Carrying Amount
0.875% Convertible Senior Notes ⁽¹⁾	$	167,853	$	(258	)	$	168,111	$	177,942	$	4,697	$	173,245
1.25% Cash Convertible Senior Notes		345,000		0			345,000		345,000		7,552		337,448
Senior Secured Credit Facility		527,500		4,370			523,130		410,000		5,224		404,776
Total debt	$	1,040,353	$	4,112		$	1,036,241	$	932,942	$	17,473	$	915,469
Less: Debt payable within one year		375,000		462			374,538		364,653		188		364,465
Total long-term debt, less current maturities	$	665,353	$	3,650		$	661,703	$	568,289	$	17,285	$	551,004

⁽¹⁾	Principal balance is $207,911 thousand; $167,853 thousand is recognized in debt and $40,058 thousand is recognized in additional paid-in capital

Interest Expense

Interest expense consists of the following:

	Three Months Ended June 30,				Six Months Ended June 30,
(In thousands)	2020		2019		2020		2019
Interest expense	$	5,680	$	6,434	$	12,187	$	12,663
Amortization of discounts and debt issuance costs		5,715		3,990		11,431		7,945
Total interest expense	$	11,395	$	10,424	$	23,618	$	20,608

Summary of Future Debt Payment Obligations

The following table summarizes future debt payment obligations as of June 30, 2020:


(In thousands)	Total		Remainder of 2020		2021		2022		2023		2024		Thereafter
0.875% Convertible Senior Notes ⁽¹⁾	$	207,911	$	0	$	0	$	0	$	0	$	0	$	207,911
1.25% Cash Convertible Senior Notes ⁽²⁾		345,000		345,000		0		0		0		0		0
Term Loan		317,500		15,000		30,000		37,500		235,000		0		0
Revolving Facility ⁽³⁾		210,000		0		0		0		210,000		0		0
Total debt	$	1,080,411	$	360,000	$	30,000	$	37,500	$	445,000	$	0	$	207,911

⁽¹⁾	Amount represents face value of the 0.875% Convertible Senior Notes, which includes both the liability and equity portion.

⁽²⁾	Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.

⁽³⁾	Assumes no additional borrowings after June 30, 2020, payment of any required periodic installments of principal and that all drawn amounts are repaid upon maturity.

0.875% Convertible Senior Notes and the 1.25% Cash Convertible Senior Notes [Member]

Debt Instrument [Line Items]

Interest Expense Related to 0.875% Convertible Senior Notes and 1.25% Cash Convertible Senior Notes

Interest expense related to the 0.875% Convertible Senior Notes and the 1.25% Cash Convertible Senior Notes, included in the table above, consisted of the following:

	Three Months Ended June 30,				Six Months Ended June 30,
(In thousands)	2020		2019		2020		2019
Coupon interest	$	1,555	$	1,078	$	3,110	$	2,156
Amortization of discounts and debt issuance costs		5,288		3,614		10,576		7,191
Total interest expense related to the convertible notes	$	6,843	$	4,692	$	13,686	$	9,347

Income Taxes (Tables)

6 Months Ended

Jun. 30, 2020

Income Tax Disclosure [Abstract]

Effective Tax Rates

The effective tax rates were as follows:

	Three Months Ended June 30,						Six Months Ended June 30,
(In thousands, except effective tax rate)	2020			2019			2020			2019
Loss before income taxes	$	(732	)	$	(150,457	)	$	(21,433	)	$	(156,502	)
Income tax (provision) benefit	$	(6,873	)	$	527		$	(6,526	)	$	(1,405	)
Effective tax rate		(938.9	%)		0.4	%		(30.4	%)		(0.9	%)

Derivative Financial Instruments (Tables)

6 Months Ended

Jun. 30, 2020

Derivative Instruments And Hedging Activities Disclosure [Abstract]

Fair Value and Balance Sheet Locations

The following tables provide information about the fair values of our derivative financial instruments as of the respective balance sheet dates:

June 30, 2020

Asset Derivatives

Liability Derivatives

(In thousands)

Balance Sheet Location

Fair Value

Balance Sheet Location

Fair Value

Derivatives qualifying as cash flow hedges:

Foreign exchange contracts

Prepaid expenses and

other current assets

611

Accrued expenses

Derivatives not subject to hedge accounting:

1.25% Call Option

Other assets

N/A

1.25% Embedded cash conversion option

N/A

Other liabilities

Total derivatives

611

December 31, 2019

Asset Derivatives

Liability Derivatives

(In thousands)

Balance Sheet Location

Fair Value

Balance Sheet Location

Fair Value

Derivatives qualifying as cash flow hedges:

Foreign exchange contracts

Prepaid expenses and

other current assets

Accrued expenses

Derivatives not subject to hedge accounting:

1.25% Call Option

Other assets

N/A

1.25% Embedded cash conversion option

N/A

Other liabilities

185

Total derivatives

185

N/A – We define “N/A” as disclosure not being applicable

Derivatives Instruments Designated as Cash Flow Hedges

The following tables show the impact of derivative instruments designated as cash flow hedges on the consolidated statements of operations and the consolidated statements of comprehensive loss:

	Amount of Gain (Loss) Recognized in OCI					Amount of Gain (Loss) Reclassified from AOCI into Income
(In thousands)	Three Months Ended June 30, 2020		Six Months Ended June 30, 2020		Location of Gain (Loss) Reclassified from AOCI into Income	Three Months Ended June 30, 2020			Six Months Ended June 30, 2020
Foreign exchange contracts	$	991	$	518	Cost of Revenue	$	(36	)	$	(36	)
					Selling, general and administrative expenses		(18	)		(18	)
					Research and development	$	(38	)	$	(38	)

	Amount of Gain (Loss) Recognized in OCI					Amount of Gain (Loss) Reclassified from AOCI into Income
(In thousands)	Three Months Ended June 30, 2019		Six Months Ended June 30, 2019		Location of Gain (Loss) Reclassified from AOCI into Income	Three Months Ended June 30, 2019		Six Months Ended June 30, 2019
Foreign exchange contracts	$	189	$	340	Cost of Revenue	$	53	$	60
					Selling, general and administrative expenses		36		41
					Research and development	$	59	$	66

Net Impact of Changes in Fair Value of Call Option and Embedded Cash Conversion Option

The following table shows the net impact of the changes in fair values of the 1.25% Call Option and the 1.25% Notes’ embedded cash conversion option in the consolidated statements of operations:

	Three Months Ended June 30,					Six Months Ended June 30,
(In thousands)	2020		2019			2020			2019
1.25% Call Option	$	0	$	3,379		$	(84	)	$	(2,695	)
1.25% Embedded cash conversion option		1		(3,840	)		185			2,609
Net income included in Other income, net	$	1	$	(461	)	$	101		$	(86	)

Other Comprehensive Income (Tables)

6 Months Ended

Jun. 30, 2020

Equity [Abstract]

Components of Accumulated Other Comprehensive Loss

Changes in the balances of each component included in AOCI are presented in the tables below. All amounts are net of tax and exclude non-controlling interest.

(In thousands)	Foreign Currency Translation Adjustments			Unrealized Net Gains on Foreign Exchange Contracts		Total
Balance as of December 31, 2019⁽¹⁾	$	(4,392	)	$	0	$	(4,392	)
Other comprehensive loss (income) before reclassifications		(1,594	)		384		(1,210	)
Net losses (gains) reclassified from accumulated other comprehensive loss		0			69		69
Net other comprehensive (loss) income		(1,594	)		453		(1,141	)
Balance as of June 30, 2020⁽²⁾	$	(5,986	)	$	453	$	(5,533	)

⁽¹⁾ Net of taxes of $149 thousand arising from the revaluation of tax effects included in AOCI.

⁽²⁾ Net of taxes of $158 thousand for unrealized net gains on foreign exchange contract derivatives.

(In thousands)	Foreign Currency Translation Adjustments			Unrealized Net Gains on Foreign Exchange Contracts			Total
Balance as of December 31, 2018⁽¹⁾	$	(5,584	)	$	195		$	(5,389	)
Other comprehensive income (loss) before reclassifications		539			252			791
Net (gains) losses reclassified from accumulated other comprehensive loss		0			(124	)		(124	)
Net other comprehensive income		539			128			667
Balance as of June 30, 2019⁽²⁾	$	(5,045	)	$	323		$	(4,722	)

⁽¹⁾ Net of taxes of $68 thousand for unrealized net gains on foreign exchange contract derivatives and $149 thousand arising from the revaluation of tax effects included in AOCI.

⁽²⁾ Net of taxes of $113 thousand for unrealized net losses on foreign exchange contract derivatives.

Income Tax Effects Related to Components of Other Comprehensive Income (Loss)

The following tables reflect the tax effects allocated to each component of other comprehensive income (loss) (“OCI”):

	Three Months Ended June 30,
	2020							2019
(In thousands)	Before-Tax Amount		Tax Effect			Net Amount		Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	918	$	0		$	918	$	(156	)	$	0		$	(156	)
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		991		(256	)		735		189			(49	)		140
Net losses (gains) reclassified into income		93		(24	)		69		(147	)		38			(109	)
Net change in unrealized gains (losses) on foreign exchange contracts		1,084		(280	)		804		42			(11	)		31
Net gain (loss) on cash flow hedges		1,084		(280	)		804		42			(11	)		31
Other comprehensive income (loss)	$	2,002	$	(280	)	$	1,722	$	(114	)	$	(11	)	$	(125	)

Business Segments (Tables)

6 Months Ended

Jun. 30, 2020

Segment Reporting [Abstract]

Revenues and Income from Operations Related to Segment Within Reconciliation to Consolidated Amounts

	Three Months Ended June 30,						Six Months Ended June 30,
(In thousands)	2020			2019			2020			2019
Revenue:
Core Clinical and Financial Solutions	$	311,099		$	347,782		$	631,431		$	688,194
Data, Analytics and Care Coordination		85,161			87,985			173,519			170,391
Unallocated Amounts		9,963			8,693			17,986			17,924
Total revenue	$	406,223		$	444,460		$	822,936		$	876,509

Gross profit:
Core Clinical and Financial Solutions	$	108,522		$	122,322		$	208,856		$	242,447
Data, Analytics and Care Coordination		49,032			55,676			100,697			103,406
Unallocated Amounts		6,930			6,124			11,892			12,364
Total gross profit	$	164,484		$	184,122		$	321,445		$	358,217

(Loss) income from operations:
Core Clinical and Financial Solutions	$	(16,033	)	$	(11,734	)	$	(36,745	)	$	(17,258	)
Data, Analytics and Care Coordination		7,267			12,534			16,932			16,854
Unallocated Amounts		4,020			3,943			5,867			7,792
Total (loss) income from operations	$	(4,746	)	$	4,743		$	(13,946	)	$	7,388

Supplemental Disclosures (Tables)

6 Months Ended

Jun. 30, 2020

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Supplemental Disclosures

	June 30,
(In thousands)	2020		2019
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$	199,004	$	138,903
Restricted cash		6,194		9,236
Total cash, cash equivalents and restricted cash	$	205,198	$	148,139

	Six Months Ended June 30,
(In thousands)	2020		2019
Supplemental non-cash information:
Issuance of treasury stock to commercial partner	$	752	$	701

Revenue from Contracts with Customers - Additional Information (Detail) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2020 USD ($)	Jun. 30, 2019 USD ($)	Jun. 30, 2020 USD ($) Revenue_Stream	Jun. 30, 2019 USD ($)	Jan. 01, 2020 USD ($)	Dec. 31, 2019 USD ($)
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Number of primary revenue streams \| Revenue_Stream			2
Total backlog	$ 4,400.0		$ 4,400.0
Total backlog, percentage, year one	33.00%		33.00%
Total backlog, percentage after year one	67.00%		67.00%
ASU 2016-13
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Effect of ASU on retained earnings					$ (5.3)
Selling, General and Administrative Expenses [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost Amortization	$ 6.6	$ 7.4	$ 14.1	$ 15.0
Prepaid Expenses and Other Current Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	19.2		19.2			$ 20.8
Other Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	$ 34.1		$ 34.1			$ 32.9

Revenue from Contracts with Customers - Summary of Revenue Recognized on Various Performance Obligations and Elected Accounting Expedients (Detail) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2020	Jun. 30, 2019
Revenue From Contract With Customer [Abstract]
Revenue related to deferred revenue balance at beginning of period	$ 155,616	$ 140,132	$ 146,150	$ 126,184
Revenue related to new performance obligations satisfied during the period	196,110	216,990	233,696	248,221
Revenue recognized under "right-to-invoice" expedient	54,082	58,059	62,245	55,923
Reimbursed travel expenses, shipping and other revenue	415	1,532	2,369	1,721
Total revenue	$ 406,223	$ 416,713	$ 444,460	$ 432,049	$ 822,936	$ 876,509

Revenue from Contracts with Customers - Summary of Revenue by Type and Nature of Revenue Stream by Reportable Segments (Detail) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2020	Jun. 30, 2019
Disaggregation Of Revenue [Line Items]
Recurring revenue	$ 335,088		$ 350,113		$ 676,307	$ 698,749
Non-recurring revenue	71,135		94,347		146,629	177,760
Total revenue	406,223	$ 416,713	444,460	$ 432,049	822,936	876,509
Unallocated Amounts [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	9,963		8,693		17,986	17,924
Core Clinical and Financial Solutions [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	311,099		347,782		631,431	688,194
Data Analytics and Care Coordination [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	85,161		87,985		173,519	170,391
Software delivery, Support and Maintenance [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	256,021		285,023		519,633	560,535
Software delivery, Support and Maintenance [Member] \| Unallocated Amounts [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	6,946		6,023		12,535	12,645
Software delivery, Support and Maintenance [Member] \| Core Clinical and Financial Solutions [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	167,219		194,053		341,302	383,435
Software delivery, Support and Maintenance [Member] \| Data Analytics and Care Coordination [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	81,856		84,947		165,796	164,455
Client services [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	150,202		159,437		303,303	315,974
Client services [Member] \| Unallocated Amounts [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	3,017		2,670		5,451	5,279
Client services [Member] \| Core Clinical and Financial Solutions [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	143,880		153,729		290,129	304,759
Client services [Member] \| Data Analytics and Care Coordination [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	$ 3,305		$ 3,038		$ 7,723	$ 5,936

Revenue from Contracts with Customers - Summary of Changes in Estimate of Credit Losses for Contract Assets (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Dec. 31, 2019
Revenue From Contract With Customer [Abstract]
Balance at January 1, 2020	$ 5,341
Current period provision	0
Balance at June 30, 2020	5,341
Contract assets, allowance	1,068	$ 0
Total contract assets, long-term	$ 4,273	$ 0

Accounts Receivables - Additional Information (Details) - Trade Accounts Receivable [Member] - USD ($) $ in Thousands	Jun. 30, 2020	Jan. 01, 2020	Dec. 31, 2019
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, allowance for credit loss	$ 36,972		$ 36,490
ASU 2016-13
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, allowance for credit loss		$ 12,600

Accounts Receivables - Schedule of Changes in Estimate of Credit Losses for Trade Accounts Receivable (Details) - Trade Accounts Receivable [Member] $ in Thousands	6 Months Ended
	Jun. 30, 2020 USD ($)
Accounts Notes And Loans Receivable [Line Items]
Balance at January 1, 2020	$ 36,490
Current period provision	4,261
Write-offs	(3,811)
Recoveries	32
Balance at June 30, 2020	$ 36,972

Leases - Additional Information (Detail) - Maximum [Member]	6 Months Ended
	Jun. 30, 2020
Lessee Lease Description [Line Items]
Operating leases, remaining lease terms	8 years
Operating leases, options to extend leases term	5 years
Operating leases, options to terminate leases term	1 year

Leases - Summary of Operating Costs Associated with Leased Assets (Detail) - USD ($)
$ in Thousands

3 Months Ended

6 Months Ended

Jun. 30, 2020

Jun. 30, 2019

Jun. 30, 2020

Jun. 30, 2019

Leases [Abstract]

Operating lease cost

^[1]

$ 6,439

$ 7,051

$ 13,361

$ 13,768

Less: Sublease income

(166)

(778)

(769)

(1,580)

Total operating lease costs

$ 6,273

$ 12,592

$ 12,188

[1]	Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statements of operations.

Leases - Supplemental Information for Operating Leases (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Leases [Abstract]
Operating cash flows from operating leases	$ 14,283	$ 14,688
Right-of-use assets obtained in exchange for operating lease obligations	$ 23,056	$ 128,664

Leases - Summary of Balance Sheet Location and Balances for Operating Leases (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Leases [Abstract]
Right-of-use assets - operating leases	$ 107,661	$ 98,020
Current operating lease liabilities	22,072	23,137
Long-term operating lease liabilities	$ 104,815	$ 95,162
Weighted average remaining lease term (in years)	6 years	6 years
Weighted average discount rate	3.60%	4.40%

Leases - Summary of Future Maturities of Lease and Non-Lease Components (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Operating Leases [Abstract]
Operating Leases, Remainder of 2020	$ 13,254
Operating Leases, 2021	26,469
Operating Leases, 2022	24,914
Operating Leases, 2023	22,732
Operating Leases, 2024	17,188
Operating Leases, Thereafter	36,462
Operating Leases, Total lease liabilities	141,019
Operating Leases, Less: Amount representing interest	(14,132)
Operating Leases, Less: Short-term lease liabilities	(22,072)	$ (23,137)
Operating Leases, Total long-term lease liabilities	$ 104,815	$ 95,162

Business Combinations - Additional Information (Detail) - USD ($)	Jul. 02, 2019	Mar. 01, 2019
ACC Pinnacle and Diabetes Collaborative Registries [Member]
Business Acquisition [Line Items]
Total purchase price	$ 19,700,000
Purchase price initial payment	11,700,000
Potential milestone/earnout payments	5,000,000.0
ACC Pinnacle and Diabetes Collaborative Registries [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Potential milestone/earnout payments	$ 8,000,000.0
Pulse8, Inc. [Member]
Business Acquisition [Line Items]
Acquisition of outstanding minority interest		$ 53,800,000

Fair Value Measurements and Long-term Investments - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Gain from sale of a third-party equity method investment			$ 16,800
Impairment (recovery) of long-term investments	$ 550	$ 0	$ 550	$ (1,045)
1.25% Cash Convertible Senior Notes [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%		1.25%
1.25% Call Option [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%		1.25%
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%		1.25%

Fair Value Measurements and Long-term Investments - Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	$ 149,080	$ 147,990
Total assets	611	84
Total liabilities	16,114	19,716
Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	611	0
Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	13,699	17,116
Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	2,415	2,415
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	185
Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	0	0
Total liabilities	0	0
Level 1 [Member] \| Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	0	0
Level 1 [Member] \| Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	0	0
Level 1 [Member] \| Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	0
Level 1 [Member] \| 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	0
Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	611	0
Total liabilities	0	0
Level 2 [Member] \| Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	611	0
Level 2 [Member] \| Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	0	0
Level 2 [Member] \| Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	0
Level 2 [Member] \| 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	0
Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	0	84
Total liabilities	16,114	19,716
Level 3 [Member] \| Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	0	0
Level 3 [Member] \| Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	13,699	17,116
Level 3 [Member] \| Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	2,415	2,415
Level 3 [Member] \| 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	185
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	84
1.25% Call Option [Member] \| Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
1.25% Call Option [Member] \| Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
1.25% Call Option [Member] \| Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	$ 0	$ 84

Fair Value Measurements and Long-term Investments - Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Parenthetical) (Detail)	Jun. 30, 2020
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Interest rate	1.25%
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Interest rate	1.25%

Fair Value Measurements and Long-term Investments - Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) $ in Thousands	6 Months Ended
	Jun. 30, 2020 USD ($)
Contingent Consideration [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance at December 31, 2019	$ 19,531
Additions	772
Payments/write-downs	(4,189)
Fair value adjustments	0
Balance at June 30, 2020	16,114
1.25% Notes Call Spread Overlay [Member]
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Balance at December 31, 2019	(101)
Additions	0
Payments/write-downs	0
Fair value adjustments	101
Balance at June 30, 2020	$ 0

Fair Value Measurements and Long-term Investments - Summary of Quantitative Information About Fair Value Measurements (Detail) - Level 3 [Member]

6 Months Ended

Jun. 30, 2020

USD ($)

RegistryMember

PatientDataVolume

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Total financial instruments

$ 16,114,000

Minimum [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Projected year of payment

2020

Maximum [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Projected year of payment

2021

Revenue [Member] | Minimum [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs

Revenue [Member] | Maximum [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs

62,500,000

Revenue [Member] | Weighted Average [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs

31,250,000

^[1]

Registry Members [Member] | Minimum [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs | RegistryMember

Registry Members [Member] | Maximum [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs | RegistryMember

1,551

Registry Members [Member] | Weighted Average [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs | RegistryMember

776

^[1]

Patient Data Volume [Member] | Minimum [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs | PatientDataVolume

Patient Data Volume [Member] | Maximum [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs | PatientDataVolume

52,845

Patient Data Volume [Member] | Weighted Average [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs | PatientDataVolume

26,422

^[1]

Contingent Consideration [Member] | Probability Weighted Discounted Cash Flow [Member] | Discount Rate [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Total financial instruments

$ 16,114,000

Contingent Consideration [Member] | Probability Weighted Discounted Cash Flow [Member] | Discount Rate [Member] | Minimum [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs

Contingent Consideration [Member] | Probability Weighted Discounted Cash Flow [Member] | Discount Rate [Member] | Maximum [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs

Contingent Consideration [Member] | Probability Weighted Discounted Cash Flow [Member] | Discount Rate [Member] | Weighted Average [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Ranges of Inputs

^[1]

[1]	The weighted average is calculated based upon the absolute fair value of the instruments.

Fair Value Measurements and Long-term Investments - Summary of Long-term Equity Investments Included in Other Assets (Detail)
$ in Thousands

6 Months Ended

Jun. 30, 2020

USD ($)

Investment

Dec. 31, 2019

USD ($)

Fair Value Disclosures [Abstract]

Equity method investments, Number of Investees | Investment

^[1]

Cost less impairments, Number of investees | Investment

Total long-term equity investments, Number of Investees | Investment

Equity method investments, Original Cost

^[1]

$ 7,099

Cost less impairment, Original Cost

37,568

Total long-term equity investments, Original Cost

44,667

Equity method investments, Carrying Value

^[1]

10,667

$ 11,332

Cost less impairment, Carrying Value

27,766

32,462

Total long-term equity investments, Carrying Value

$ 38,433

$ 43,794

[1]	Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Stockholders' Equity - Additional Information (Detail) - USD ($)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019	Aug. 02, 2018
Class Of Stock [Line Items]
Capitalized stock-based compensation costs	$ 0	$ 0	$ 0	$ 0
Stock options granted	0	0	0	0
Share issued, exercise of options and release of stock awards			1,900,000		1,700,000
Shares settled for tax withholding			764,000	651,000
Common stock repurchased, amount			$ 9,714,000	$ 65,070,000
August 2018 Stock Repurchase Program [Member]
Class Of Stock [Line Items]
Stock repurchase program, authorized amount						$ 250,000,000
Stock repurchase program, Value of shares yet to be purchased	$ 92,100,000		$ 92,100,000
Common stock repurchased, shares	0	0	1,500,000	6,100,000
Common stock repurchased, amount			$ 9,700,000	$ 64,900,000

Stock-Based Compensation Expense (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 7,660	$ 11,179	$ 18,763	$ 23,987
Cost of revenue [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	1,151	1,777	2,817	3,383
Cost of revenue [Member] \| Software delivery, Support and Maintenance [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	343	614	918	1,127
Cost of revenue [Member] \| Client services [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	808	1,163	1,899	2,256
Selling, General and Administrative Expenses [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	5,081	6,831	12,123	15,156
Research and development [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 1,428	$ 2,571	$ 3,823	$ 5,448

Stock-Based Awards Granted (Detail) - $ / shares shares in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted	4,021	5,013
Weighted-Average Grant Date Fair Value, granted	$ 6.21	$ 6.82
Service-Based Restricted Stock Units [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted	4,021	4,418
Weighted-Average Grant Date Fair Value, granted	$ 6.21	$ 6.39
Market-Based Restricted Stock Units with a Service Condition [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted	0	595
Weighted-Average Grant Date Fair Value, granted	$ 0.00	$ 9.98

Earnings (Loss) Per Share - Calculations of Earnings (Loss) Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Basic earnings (loss) per Common Share:
Net loss	$ (7,605)	$ (149,930)	$ (27,959)	$ (157,907)
Net loss attributable to non-controlling interests	0	0	0	424
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ (7,605)	$ (149,930)	$ (27,959)	$ (157,483)
Weighted-average common shares outstanding	162,682	166,522	162,571	168,230
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$ (0.05)	$ (0.90)	$ (0.17)	$ (0.94)
Diluted earnings (loss) per Common Share:
Net loss	$ (7,605)	$ (149,930)	$ (27,959)	$ (157,907)
Net loss attributable to non-controlling interests	0	0	0	424
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ (7,605)	$ (149,930)	$ (27,959)	$ (157,483)
Weighted-average common shares outstanding	162,682	166,522	162,571	168,230
Plus: Dilutive effect of stock options, restricted stock unit awards and warrants	0	0	0	0
Weighted-average common shares outstanding assuming dilution	162,682	166,522	162,571	168,230
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$ (0.05)	$ (0.90)	$ (0.17)	$ (0.94)

Earnings (Loss) Per Share - Anti-Dilutive Stock Options, Restricted Stock Unit Awards and Warrants Excluded from Computation of Diluted Earnings (Loss) Per Share (Detail) - shares shares in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Earnings Per Share [Abstract]
Shares subject to anti-dilutive stock options, restricted stock unit awards and warrants excluded from calculation	50,988	29,720	49,304	27,358

Goodwill and Intangible Assets - Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	$ 1,247,745	$ 1,248,407
Accumulated Amortization	(956,109)	(926,265)
Intangible Assets, Net	291,636	322,142
Registered trademarks	52,000	52,000
Goodwill	1,361,406	1,362,017
Total	1,413,406	1,414,017
Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	546,094	546,373
Accumulated Amortization	(454,615)	(437,640)
Intangible Assets, Net	91,479	108,733
Customer Contracts and Relationships [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	701,651	702,034
Accumulated Amortization	(501,494)	(488,625)
Intangible Assets, Net	$ 200,157	$ 213,409

Goodwill and Intangible Assets - Changes in Carrying Amount of Goodwill (Detail) $ in Thousands	6 Months Ended
	Jun. 30, 2020 USD ($)
Goodwill [Line Items]
Balance as of December 31, 2019	$ 1,362,017
Foreign exchange translation	(611)
Balance as of June 30, 2020	1,361,406
Unallocated Amounts [Member]
Goodwill [Line Items]
Balance as of December 31, 2019	74,663
Foreign exchange translation	0
Balance as of June 30, 2020	74,663
Core Clinical and Financial Solutions [Member] \| Operating Segments [Member]
Goodwill [Line Items]
Balance as of December 31, 2019	734,883
Foreign exchange translation	(611)
Balance as of June 30, 2020	734,272
Data Analytics and Care Coordination [Member] \| Operating Segments [Member]
Goodwill [Line Items]
Balance as of December 31, 2019	552,471
Foreign exchange translation	0
Balance as of June 30, 2020	$ 552,471

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Millions	Jun. 30, 2020	Dec. 31, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Accumulated impairment losses associated with goodwill	$ 39.2	$ 39.2

Debt - Debt Outstanding Excluding Lease Obligations (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Principal Balance	$ 1,040,353	$ 932,942
Unamortized Discount and Debt Issuance Costs	4,112	17,473
Net Carrying Amount	1,036,241	915,469
Principal Balance, Current	375,000	364,653
Unamortized Discount and Debt Issuance Costs, Current	462	188
Net Carrying Amount, Current	374,538	364,465
Principal Balance, Noncurrent	665,353	568,289
Unamortized Discount and Debt Issuance Costs, Noncurrent	3,650	17,285
Net Carrying Amount, Noncurrent	661,703	551,004
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Principal Balance	167,853	177,942
Unamortized Discount and Debt Issuance Costs	(258)	4,697
Net Carrying Amount	168,111	173,245
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Principal Balance	345,000	345,000
Unamortized Discount and Debt Issuance Costs	0	7,552
Net Carrying Amount	345,000	337,448
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Principal Balance	527,500	410,000
Unamortized Discount and Debt Issuance Costs	4,370	5,224
Net Carrying Amount	$ 523,130	$ 404,776

Debt - Debt Outstanding Excluding Lease Obligations (Parenthetical) (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Debt recognized	$ 1,040,353	$ 932,942
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument principal amount	207,911	218,000
Debt recognized	167,853	177,942
Additional Paid-In Capital [Member] \| 0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Additional paid-in capital recognized	$ 40,058	$ 40,058

Debt - Interest Expense (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
Debt - Interest Expense (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Debt Instrument [Line Items]
Total interest expense	$ 11,395	$ 10,424	$ 23,618	$ 20,608
Convertible Senior Notes and Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Interest expense	5,680	6,434	12,187	12,663
Amortization of discounts and debt issuance costs	5,715	3,990	11,431	7,945
Total interest expense	$ 11,395	$ 10,424	$ 23,618	$ 20,608

Debt - Interest Expense Related to 0.875% Convertible Senior Notes and 1.25% Cash Convertible Senior Notes (Detail) - 0.875% Convertible Senior Notes and the 1.25% Cash Convertible Senior Notes [Member] - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Debt Instrument [Line Items]
Coupon interest	$ 1,555	$ 1,078	$ 3,110	$ 2,156
Amortization of discounts and debt issuance costs	5,288	3,614	10,576	7,191
Total interest expense related to the convertible notes	$ 6,843	$ 4,692	$ 13,686	$ 9,347

Debt - Additional Information (Detail) - USD ($)			1 Months Ended		6 Months Ended
Debt - Additional Information (Detail) - USD ($)	Aug. 07, 2019	Feb. 15, 2018	Jun. 30, 2020	Dec. 31, 2019	Jun. 30, 2020	Jun. 30, 2019
Debt Instrument [Line Items]
Debt instrument principal amount			$ 1,040,353,000	$ 932,942,000	$ 1,040,353,000
Debt issuance costs					758,000	$ 0
Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Credit facility, amount available			689,000,000.0		689,000,000.0
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Debt instrument principal amount			527,500,000	410,000,000	527,500,000
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument principal amount			167,853,000	177,942,000	167,853,000
Debt instrument principal amount			$ 207,911,000	$ 218,000,000.0	$ 207,911,000
Interest rate			0.875%	0.875%	0.875%
Debt issuance costs				$ 700,000
Percentage of interest rate used to to compute the initial fair value of the liability component				1.95%
Debt instrument, initial fair value of liability component				$ 177,900,000
Debt instrument, net carrying value of equity component			$ 18,700,000		$ 18,700,000
Payments for repurchase debt instrument			7,700,000		7,700,000
Debt instrument aggregate principal amount repurchased			10,100,000		10,100,000
Gain on repurchase of debt instrument			500,000
Proceeds due to termination of capped call transaction			300,000
Reduction to capped call fees			800,000
Loss in capped call			500,000
0.875% Convertible Senior Notes [Member] \| Additional Paid-In Capital [Member]
Debt Instrument [Line Items]
Debt instrument, equity component amount			40,058,000	40,058,000	40,058,000
Payments of capped call fees				17,200,000
Debt discounts and issuance costs				1,100,000
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument principal amount			$ 345,000,000	$ 345,000,000	$ 345,000,000
Interest rate			1.25%		1.25%
Letter of Credit [Member]
Debt Instrument [Line Items]
Portion of facility available for issuance		$ 50,000,000
Swing Loans [Member]
Debt Instrument [Line Items]
Portion of facility available for issuance		10,000,000
Foreign Currencies [Member]
Debt Instrument [Line Items]
Portion of facility available for issuance		100,000,000
Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity		$ 400,000,000
Senior secured credit facilities term, years		5 years
Line of credit facility, frequency of payments					The Term Loan is repayable in quarterly installments, which began on June 30, 2018.
Second Amended Credit Agreement [Member] \| Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument principal amount			$ 317,500,000		$ 317,500,000
Second Amended Credit Agreement [Member] \| Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Debt instrument principal amount			$ 210,000,000.0		$ 210,000,000.0
Second Amended Credit Agreement [Member] \| Senior Secured Revolving Facility [Member] \| United States dollars [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate, effective percentage			2.18%		2.18%
Second Amended Credit Agreement [Member] \| Senior Secured Revolving Facility [Member] \| LIBOR Rate [Member]
Debt Instrument [Line Items]
Debt instrument, variable interest rate					2.00%
Second Amended Credit Agreement [Member] \| Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Letters of credit outstanding			$ 1,000,000.0		$ 1,000,000.0
Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity		$ 900,000,000
Senior secured credit facilities term, years		5 years
Fees and other costs, incurred	$ 800,000

Debt - Summary of Future Debt Payment Obligations (Detail) $ in Thousands	Jun. 30, 2020 USD ($)
Debt Instrument [Line Items]
Total	$ 1,080,411
Remainder of 2020	360,000
2021	30,000
2022	37,500
2023	445,000
2024	0
Thereafter	207,911
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Total	207,911
Remainder of 2020	0
2021	0
2022	0
2023	0
2024	0
Thereafter	207,911
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Total	345,000
Remainder of 2020	345,000
2021	0
2022	0
2023	0
2024	0
Thereafter	0
Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Total	317,500
Remainder of 2020	15,000
2021	30,000
2022	37,500
2023	235,000
2024	0
Thereafter	0
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Total	210,000
Remainder of 2020	0
2021	0
2022	0
2023	210,000
2024	0
Thereafter	$ 0

Debt - Summary of Future Debt Payment Obligations (Parenthetical) (Detail)	Jun. 18, 2013
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Maturity date	Jul. 01, 2020

Effective Tax Rates (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
Effective Tax Rates (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Income Tax Disclosure [Abstract]
Loss before income taxes	$ (732)	$ (150,457)	$ (21,433)	$ (156,502)
Income tax (provision) benefit	$ (6,873)	$ 527	$ (6,526)	$ (1,405)
Effective tax rate	(938.90%)	0.40%	(30.40%)	(0.90%)

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Pre-tax loss	$ 732	$ 150,457	$ 21,433	$ 156,502
Cumulative operating income loss period considered			3 years
Unrecognized income tax benefits	$ 21,600		$ 21,600		$ 20,600
U.S. and Foreign Net Operating Loss Carryforwards [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Valuation allowance			$ 1,100

Derivative Financial Instruments - Fair Value and Balance Sheet Locations - (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Derivatives Fair Value [Line Items]
Derivative asset, fair value	$ 611	$ 84
Derivative liability, fair value	0	185
Designated as Hedging Instrument [Member] \| Foreign Exchange Contract [Member] \| Prepaid Expenses and Other Current Assets [Member]
Derivatives Fair Value [Line Items]
Derivative asset, fair value	611	0
Designated as Hedging Instrument [Member] \| Foreign Exchange Contract [Member] \| Accrued expenses [Member]
Derivatives Fair Value [Line Items]
Derivative liability, fair value	0	0
Not Designated as Hedging Instrument [Member] \| 1.25% Call Option [Member] \| Other Assets [Member]
Derivatives Fair Value [Line Items]
Derivative asset, fair value	0	84
Not Designated as Hedging Instrument [Member] \| 1.25% Embedded Cash Conversion Option [Member] \| Other Liabilities [Member]
Derivatives Fair Value [Line Items]
Derivative liability, fair value	$ 0	$ 185

Derivative Financial Instruments - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2020 USD ($) Derivative	Jun. 30, 2020 INR (₨) Derivative	Jun. 18, 2013 USD ($)
1.25% Call Option [Member]
Derivative [Line Items]
Debt instrument interest rate	1.25%	1.25%
Foreign Exchange Forward Contracts [Member]
Derivative [Line Items]
Number of contracts \| Derivative	12	12
Unrealized derivatives gains included in accumulated other comprehensive (loss) income reclassified into income	$ 600,000
Estimated period of unrealized losses included in AOCI reclassified into income	12 months
Foreign Exchange Forward Contracts [Member] \| Minimum [Member]
Derivative [Line Items]
Date of contracts mature	Jul. 31, 2020
Derivative notional amount outstanding	$ 3,000,000.0	₨ 225,000,000
Foreign Exchange Forward Contracts [Member] \| Maximum [Member]
Derivative [Line Items]
Date of contracts mature	Jun. 30, 2021
Derivative notional amount outstanding	$ 3,700,000	₨ 280,000,000
1.25% Notes Embedded Cash Conversion Option [Member]
Derivative [Line Items]
Debt instrument interest rate	1.25%	1.25%
1.25% Notes Embedded Cash Conversion Option [Member] \| Level 3 [Member] \| Fair Value Measurements, Recurring [Member]
Derivative [Line Items]
Fair value liability of embedded cash conversion option			$ 82,800,000

Derivative Financial Instruments - Derivatives Instruments Designated as Cash Flow Hedges - (Detail) - Cash Flow Hedging [Member] - Foreign Exchange Contract [Member] - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Recognized in OCI	$ 991	$ 189	$ 518	$ 340
Cost of revenue [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income	(36)	53	(36)	60
Selling, General and Administrative Expenses [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income	(18)	36	(18)	41
Research and development [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income	$ (38)	$ 59	$ (38)	$ 66

Derivative Financial Instruments - Net Impact of Changes in Fair Value of Call Option and Embedded Cash Conversion Option - (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Derivative Instruments Gain Loss [Line Items]
Net (loss) income included in Other income, net	$ 1	$ (461)	$ 101	$ (86)
1.25% Call Option [Member]
Derivative Instruments Gain Loss [Line Items]
Net (loss) income included in Other income, net	0	3,379	(84)	(2,695)
1.25% Notes Embedded Cash Conversion Option [Member]
Derivative Instruments Gain Loss [Line Items]
Net (loss) income included in Other income, net	$ 1	$ (3,840)	$ 185	$ 2,609

Other Comprehensive Income - Components of Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period			$ 1,285,188
Other comprehensive loss (income) before reclassifications			(1,210)	$ 791
Net losses (gains) reclassified from accumulated other comprehensive loss			69	(124)
Total other comprehensive income (loss)	$ 1,722	$ (125)	(1,141)	667
Balance at the end of the period	1,242,929		1,242,929
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period			(4,392)	(5,584)
Other comprehensive loss (income) before reclassifications			(1,594)	539
Net losses (gains) reclassified from accumulated other comprehensive loss			0	0
Total other comprehensive income (loss)			(1,594)	539
Balance at the end of the period	(5,986)	(5,045)	(5,986)	(5,045)
Derivatives Qualifying as Cash Flow Hedges [Member] \| Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period			0	195
Other comprehensive loss (income) before reclassifications			384	252
Net losses (gains) reclassified from accumulated other comprehensive loss			69	(124)
Total other comprehensive income (loss)			453	128
Balance at the end of the period	453	323	453	323
Accumulated Other Comprehensive Loss [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period			(4,392)	(5,389)
Balance at the end of the period	$ (5,533)	$ (4,722)	$ (5,533)	$ (4,722)

Other Comprehensive Income - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) - Foreign Exchange Contract [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Jun. 30, 2020	Jun. 30, 2019
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized net gains (losses), taxes (benefits)		$ 68	$ 158	$ (113)
Revaluation of tax effects	$ 149	$ 149

Other Comprehensive Income - Income Tax Effects Related to Components of Other Comprehensive Income (Loss) (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Accumulated Other Comprehensive Income Loss [Line Items]
Foreign currency translation adjustments, Before-Tax Amount	$ 918	$ (156)	$ (1,594)	$ 539
Other comprehensive income (loss), Before Tax Amount	2,002	(114)	(983)	713
Foreign currency translation adjustments, Tax Effect	0	0	0	0
Other comprehensive income (loss), Tax effect	(280)	(11)	(158)	(46)
Foreign currency translation adjustments, Net	918	(156)	(1,594)	539
Other comprehensive income (loss)	1,722	(125)	(1,141)	667
Derivatives Qualifying as Cash Flow Hedges [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Derivatives qualifying as cash flow hedges, net gain (loss), Before-Tax Amount	1,084	42	611	174
Derivatives qualifying as cash flow hedges, net gain (loss), Tax Effect	(280)	(11)	(158)	(46)
Derivatives qualifying as cash flow hedges, net gain (loss), Net	804	31	453	128
Derivatives Qualifying as Cash Flow Hedges [Member] \| Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Before-Tax, Amount	991	189	518	340
Derivatives qualifying as cash flow hedges, net losses (gains) reclassified into income, Before-Tax Amount	93	(147)	93	(166)
Derivatives qualifying as cash flow hedges, net gain (loss), Before-Tax Amount	1,084	42	611	174
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Tax Effect	(256)	(49)	(134)	(89)
Derivatives qualifying as cash flow hedges, net losses (gains) reclassified into income, Tax Effect	(24)	38	(24)	43
Derivatives qualifying as cash flow hedges, net gain (loss), Tax Effect	(280)	(11)	(158)	(46)
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Net	735	140	384	251
Derivatives qualifying as cash flow hedges, net losses (gains) reclassified into income, Net	69	(109)	69	(123)
Derivatives qualifying as cash flow hedges, net gain (loss), Net	$ 804	$ 31	453	128
Other comprehensive income (loss)			$ 453	$ 128

Contingencies - Additional Information (Detail) - Practice Fusion, Inc. [Member] - US Department of Justice and US Attorney [Member]	6 Months Ended
	Jun. 30, 2020 USD ($)
Criminal Fine [Member]
Loss Contingencies [Line Items]
Litigation settlement, amount	$ 25,300,000
Forfeiture Payment [Member]
Loss Contingencies [Line Items]
Litigation settlement, amount	959,700
Civil Settlements [Member]
Loss Contingencies [Line Items]
Litigation settlement, amount	118,600,000
State Medicaid Program Expenditures [Member]
Loss Contingencies [Line Items]
Litigation settlement, amount	$ 5,200,000

Business Segments - Additional Information (Detail)	6 Months Ended
Business Segments - Additional Information (Detail)	Jun. 30, 2020 Segment
Segment Reporting [Abstract]
Number of operating segments	3
Number of reportable segments	2

Business Segments - Revenues and Income from Operations Related to Segment Within Reconciliation to Consolidated Amounts (Detail) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2020	Jun. 30, 2019
Segment Reporting Information [Line Items]
Revenue	$ 406,223	$ 416,713	$ 444,460	$ 432,049	$ 822,936	$ 876,509
Gross profit	164,484		184,122		321,445	358,217
(Loss) income from operations	(4,746)		4,743		(13,946)	7,388
Unallocated Amounts [Member]
Segment Reporting Information [Line Items]
Revenue	9,963		8,693		17,986	17,924
Gross profit	6,930		6,124		11,892	12,364
(Loss) income from operations	4,020		3,943		5,867	7,792
Core Clinical and Financial Solutions [Member] \| Operating Segments [Member]
Segment Reporting Information [Line Items]
Revenue	311,099		347,782		631,431	688,194
Gross profit	108,522		122,322		208,856	242,447
(Loss) income from operations	(16,033)		(11,734)		(36,745)	(17,258)
Data Analytics and Care Coordination [Member] \| Operating Segments [Member]
Segment Reporting Information [Line Items]
Revenue	85,161		87,985		173,519	170,391
Gross profit	49,032		55,676		100,697	103,406
(Loss) income from operations	$ 7,267		$ 12,534		$ 16,932	$ 16,854

Supplemental Disclosures - Supplemental Disclosures (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$ 199,004	$ 138,903	$ 129,668
Restricted cash	6,194	9,236	$ 7,871
Total cash, cash equivalents and restricted cash	205,198	148,139
Supplemental non-cash information:
Issuance of treasury stock to commercial partner	$ 752	$ 701

Subsequent Events - Additional Information (Detail) - USD ($) $ in Thousands	Jul. 30, 2020	Jul. 01, 2020	Jun. 18, 2013	Jun. 30, 2020	Dec. 31, 2019
Subsequent Event [Line Items]
Debt instrument principal amount				$ 1,040,353	$ 932,942
1.25% Cash Convertible Senior Notes [Member]
Subsequent Event [Line Items]
Interest rate				1.25%
Debt instrument principal amount				$ 345,000	345,000
Maturity date			Jul. 01, 2020
Senior Secured Credit Facility [Member]
Subsequent Event [Line Items]
Debt instrument principal amount				$ 527,500	$ 410,000
Subsequent Event [Member] \| EPSi Purchase Agreement [Member] \| Strata Decision Technology LLC [Member]
Subsequent Event [Line Items]
Sale of business unit	$ 365,000
Subsequent Event [Member] \| 1.25% Cash Convertible Senior Notes [Member]
Subsequent Event [Line Items]
Interest rate		1.25%
Maturity date		Jul. 01, 2020
Subsequent Event [Member] \| Senior Secured Credit Facility [Member]
Subsequent Event [Line Items]
Debt instrument principal amount		$ 345,000