0000950170-22-002112 | 10-K | XBRL Viewer | Allscripts Healthcare Solutions INC

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CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 188,351	$ 531,104
Restricted cash	2,169	6,361
Accounts receivable, net of allowance of $29,943 and $31,596 as of December 31, 2021 and December 31, 2020, respectively	327,069	347,355
Contract assets, net of allowance of $1,068 as of December 31, 2021 and December 31, 2020	124,811	106,717
Income tax receivable	0	25,421
Prepaid expenses and other current assets	118,942	136,264
Total current assets	761,342	1,153,222
Fixed assets, net	47,902	72,162
Software development costs, net	172,104	193,202
Intangible assets, net	235,930	286,602
Goodwill	974,478	974,729
Deferred taxes, net	6,607	5,790
Contract assets - long-term, net of allowance of $2,273 and $4,273 as of December 31, 2021 and December 31, 2020, respectively	56,797	43,682
Right-of-use assets - operating leases	68,909	96,601
Other assets	101,160	91,628
Total assets	2,425,229	2,917,618
Current liabilities:
Accounts payable	16,836	35,905
Accrued expenses	92,525	100,262
Accrued compensation and benefits	92,222	118,771
Deferred revenue	325,900	334,764
Current operating lease liabilities	19,599	22,264
Current liabilities attributable to discontinued operations	0	322,811
Total current liabilities	547,082	934,777
Long-term debt	350,062	167,587
Deferred revenue	4,407	3,471
Deferred taxes, net	16,625	18,186
Long-term operating lease liabilities	64,822	93,463
Other liabilities	34,093	33,891
Total liabilities	1,017,091	1,251,375
Commitments and contingencies
Stockholders’ equity:
Preferred stock: $0.01 par value, 1,000 shares authorized, no shares issued and outstanding as of December 31, 2021 and December 31, 2020	0	0
Common stock: $0.01 par value, 349,000 shares authorized as of December 31, 2021 and December 31, 2020; 276,705 and 116,114 shares issued and outstanding as of December 31, 2021, respectively; 274,558 and 139,942 shares issued and outstanding as of December 31, 2020, respectively	2,766	2,745
Treasury stock: at cost, 160,591 and 134,616 shares as of December 31, 2021 and December 31, 2020, respectively	(1,321,805)	(870,558)
Additional paid-in capital	1,962,386	1,902,776
Retained earnings	767,556	633,118
Accumulated other comprehensive loss	(2,765)	(1,838)
Total stockholders’ equity	1,408,138	1,666,243
Total liabilities and stockholders’ equity	$ 2,425,229	$ 2,917,618

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 29,943	$ 31,596
Contract assets, allowance	1,068	1,068
Contract assets - long-term, allowance	$ 2,273	$ 4,273
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	276,705,000	274,558,000
Common stock, shares outstanding	116,114,000	139,942,000
Treasury stock at cost, shares	160,591,000	134,616,000

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)	12 Months Ended
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Revenue:
Revenue from contract with customers	$ 1,503,037,000	$ 1,502,700,000	$ 1,632,611,000
Cost of revenue:
Amortization of software development and acquisition-related assets	118,700,000	118,399,000	107,874,000
Total cost of revenue	57,885,000	102,730,000	100,089,000
Gross profit	619,565,000	565,695,000	610,287,000
Selling, general and administrative expenses	313,814,000	389,941,000	400,808,000
Research and development	193,671,000	206,061,000	245,443,000
Asset impairment charges	11,772,000	74,969,000	10,837,000
Goodwill impairment charge	0	0	25,700,000
Amortization of intangible and acquisition-related assets	23,109,000	25,604,000	27,188,000
Income (loss) from operations	77,199,000	(130,880,000)	(99,689,000)
Interest expense	(13,166,000)	(34,104,000)	(43,172,000)
Other income (loss), net	87,666,000	54,000	(138,904,000)
Gain on sale of businesses, net	8,370,000	0	0
Impairment of long-term investments	0	(1,575,000)	(651,000)
Equity in net income of unconsolidated investments	1,757,000	17,194,000	665,000
Income (loss) from continuing operations before income taxes	161,826,000	(149,311,000)	(281,751,000)
Income tax (provision) benefit	(27,851,000)	16,692,000	43,340,000
Income (loss) from continuing operations, net of tax	133,975,000	(132,619,000)	(238,411,000)
(Loss) income from discontinued operations	(15,000)	71,448,000	75,235,000
Gain on sale of discontinued operations	647,000	1,156,504,000	0
Income tax effect on discontinued operations	(169,000)	(394,926,000)	(19,426,000)
Income from discontinued operations, net of tax	463,000	833,026,000	55,809,000
Net income (loss)	134,438,000	700,407,000	(182,602,000)
Net loss attributable to non-controlling interests	0	0	424,000
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ 134,438,000	$ 700,407,000	$ (182,178,000)
Basic
Continuing operations	$ 1.03	$ (0.83)	$ (1.43)
Discontinued operations	0.00	5.23	0.33
Net earnings (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	1.03	4.40	(1.10)
Diluted
Continuing operations	0.97	(0.83)	(1.43)
Discontinued operations	0.00	5.23	0.33
Net earnings (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$ 0.97	$ 4.40	$ (1.10)
Software delivery, Support and Maintenance [Member]
Revenue:
Revenue from contract with customers	$ 916,186,000	$ 923,737,000	$ 1,010,993,000
Cost of revenue:
Total cost of revenue	278,551,000	287,954,000	319,140,000
Client services [Member]
Revenue:
Revenue from contract with customers	586,851,000	578,963,000	621,618,000
Cost of revenue:
Total cost of revenue	$ 486,221,000	$ 530,652,000	$ 595,310,000

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ 134,438	$ 700,407	$ (182,602)
Other comprehensive (loss) income:
Foreign currency translation adjustments	(69)	1,435	1,192
Change in fair value of derivatives qualifying as cash flow hedges	(1,157)	1,509	(262)
Other comprehensive (loss) income before income tax benefit (expense)	(1,226)	2,944	930
Income tax benefit (expense) related to items in other comprehensive (loss) income	299	(390)	67
Total other comprehensive (loss) income	(927)	2,554	997
Comprehensive income (loss)	133,511	702,961	(181,605)
Comprehensive loss attributable to non-controlling interests	0	0	424
Comprehensive income (loss), net	$ 133,511	$ 702,961	$ (181,181)

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock Issued [Member]	Treasury Stock [Member]	Additional Paid-In Capital [Member]	Retained Earnings (Accumulated Deficit) [Member]	Retained Earnings (Accumulated Deficit) [Member] Cumulative Effect Period Of Adoption Adjustment [Member] Revision Of Prior Period Accounting Standards Update Adjustment [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
Beginning Balance (ASU 2016-13 [Member]) at Dec. 31, 2018						$ 0
Stock-based compensation				38,713
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		1,654
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 16		(7,227)
Issuance of 0.875% Convertible Senior Notes				40,058
Capped call transactions				(17,222)
Allocation of discounts and debt issuance costs for issuance of 0.875%Convertible Senior Notes				(1,140)
Issuance of treasury stock, Shares			61
Issuance of treasury stock	701		$ 846	(144)
Purchase of treasury stock, Shares			(10,464)
Purchase of treasury stock			$ (111,460)
Accelerated share repurchase program, Shares			0
Accelerated share repurchase program			$ 0	0
Warrants issued				2,729
Acquisition of non-controlling interest				(29,913)				(28,890)
Net income (loss) less net loss attributable to non-controlling interests					(182,178)
Foreign currency translation adjustments, net	1,192						1,192
Unrecognized gain (loss) on derivatives qualifying as cash flow hedges, net of tax							(195)
Net loss attributable to non-controlling interests	(424)							(424)
Ending Balance, Shares at Dec. 31, 2019		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
Ending Balance (ASU 2016-13 [Member]) at Dec. 31, 2019						(17,953)
Stock-based compensation				34,036
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		1,949
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 20		(6,059)
Issuance of 0.875% Convertible Senior Notes				0
Capped call transactions				797
Allocation of discounts and debt issuance costs for issuance of 0.875%Convertible Senior Notes				0
Issuance of treasury stock, Shares			198
Issuance of treasury stock	752		$ 1,193	(440)
Purchase of treasury stock, Shares			(12,984)
Purchase of treasury stock			$ (134,863)
Accelerated share repurchase program, Shares			11,696
Accelerated share repurchase program			$ (165,731)	(34,269)
Warrants issued				1,363
Acquisition of non-controlling interest				0				0
Net income (loss) less net loss attributable to non-controlling interests					700,407
Foreign currency translation adjustments, net	1,435						1,435
Unrecognized gain (loss) on derivatives qualifying as cash flow hedges, net of tax							1,119
Net loss attributable to non-controlling interests	$ 0							0
Ending Balance, Shares at Dec. 31, 2020	274,558	274,558	(134,616)
Ending Balance at Dec. 31, 2020	$ 1,666,243	$ 2,745	$ (870,558)	1,902,776	633,118		(1,838)	0
Ending Balance (ASU 2016-13 [Member]) at Dec. 31, 2020						$ 0
Stock-based compensation				35,169
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		2,147
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 21		14,043
Issuance of 0.875% Convertible Senior Notes				0
Capped call transactions				0
Allocation of discounts and debt issuance costs for issuance of 0.875%Convertible Senior Notes				0
Issuance of treasury stock, Shares			33
Issuance of treasury stock	534		$ 465	68
Purchase of treasury stock, Shares			(12,862)
Purchase of treasury stock			$ (217,443)
Accelerated share repurchase program, Shares			(13,146)
Accelerated share repurchase program			$ 234,269	34,269
Warrants issued				4,147
Acquisition of non-controlling interest				0				0
Net income (loss) less net loss attributable to non-controlling interests					134,438
Foreign currency translation adjustments, net	(69)						69
Unrecognized gain (loss) on derivatives qualifying as cash flow hedges, net of tax							(858)
Net loss attributable to non-controlling interests	$ 0							0
Ending Balance, Shares at Dec. 31, 2021	276,705	276,705	(160,591)
Ending Balance at Dec. 31, 2021	$ 1,408,138	$ 2,766	$ (1,321,805)	$ 1,962,386	$ 767,556		$ (2,765)	$ 0

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Parenthetical)	Dec. 31, 2021	Dec. 31, 2020	Jun. 30, 2020	Dec. 31, 2019	Dec. 09, 2019
0.875% Convertible Senior Notes [Member]
Debt instrument interest rate	0.875%	0.875%	0.875%	0.875%	0.875%

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash flows from operating activities:
Net income (loss)	$ 134,438	$ 700,407	$ (182,602)
Less: Income from discontinued operations	463	833,026	55,809
Income (loss) from continuing operations	133,975	(132,619)	(238,411)
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:
Depreciation and amortization	176,137	192,269	198,226
Non-cash lease expense, net	(3,859)	1,454	(2,588)
Stock-based compensation expense	35,169	34,036	38,982
Deferred taxes	(2,099)	(3,275)	(37,970)
Impairment of assets and long-term investments	11,772	76,544	37,188
Equity in net income of unconsolidated investments	(1,757)	(17,194)	(665)
Gain on sale of businesses, net	(8,370)	0	0
Other (income) loss, net	(69,141)	(5,900)	10,042
Changes in operating assets and liabilities (net of businesses acquired):
Accounts receivable and contract assets, net	(5,002)	35,163	(9,430)
Prepaid expenses and other assets	17,794	(34,418)	(16,251)
Accounts payable	(18,729)	(66,987)	27,552
Accrued expenses	21,971	(3,064)	(3,894)
Accrued compensation and benefits	(26,034)	49,492	(32,764)
Deferred revenue	(13,692)	28,667	(92,067)
Other liabilities	205	5,334	(7,555)
Accrued DOJ settlement	0	(147,169)	145,000
Net cash provided by operating activities - continuing operations	248,340	12,333	15,395
Net cash (used in) provided by operating activities - discontinued operations	(323,768)	(119,048)	30,859
Net cash (used in) provided by operating activities	(75,428)	(106,715)	46,254
Cash flows from investing activities:
Capital expenditures	(5,295)	(17,025)	(16,450)
Capitalized software	(73,265)	(87,993)	(103,317)
Cash paid for business acquisitions, net of cash acquired	0	0	(23,443)
Sale of businesses and other investments, net of cash divested, and distributions received	68,806	1,734,967	1,044
Purchases of equity securities, other investments and related intangible assets, net	(2,421)	(7,097)	(8,235)
Other proceeds from investing activities	0	0	14
Net cash (used in) provided by investing activities - continuing operations	(12,175)	1,622,852	(150,387)
Net cash used in investing activities - discontinued operations	0	(7,664)	(10,669)
Net cash (used in) provided by investing activities	(12,175)	1,615,188	(161,056)
Cash flows from financing activities:
Taxes paid related to net share settlement of equity awards	(14,023)	(6,033)	(7,286)
Proceeds from issuance of 0.875% Convertible Senior Notes	0	0	218,000
Payments for issuance costs on 0.875% Convertible Senior Notes	0	(758)	(5,445)
Payments for capped call transaction on 0.875% Convertible Senior Notes	0	0	(17,222)
Repayment of Convertible Senior Notes	0	(352,361)	0
Credit facility payments	(75,000)	(1,315,000)	(220,000)
Credit facility borrowings, net of issuance costs	250,000	903,625	279,241
Repurchase of common stock	(417,443)	(334,863)	(111,460)
Payment of acquisition and other financing obligations	(2,400)	(4,369)	(14,685)
Purchases of subsidiary shares owned by non-controlling interest	0	0	(53,800)
Net cash (used in) provided by financing activities	(258,866)	(1,109,759)	67,343
Effect of exchange rate changes on cash and cash equivalents	(476)	1,212	203
Net (decrease) increase in cash and cash equivalents	(346,945)	399,926	(47,256)
Cash, cash equivalents and restricted cash, beginning of period	537,465	137,539	184,795
Cash, cash equivalents and restricted cash, end of period	$ 190,520	$ 537,465	$ 137,539

Basis of Presentation and Significant Accounting Policies

12 Months Ended

Dec. 31, 2021

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.

Use of Estimates

The preparation of consolidated financial statements in accordance with generally accepted accounting principles in the United States of America (“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 third quarter of 2021, we changed our reportable segments from Core Clinical and Financial Solutions and Data, Analytics and Care Coordination to Hospitals and Large Physician Practices and Veradigm. Certain business units reported within the historical segments have been reallocated into the new segments. Refer to Note 19 “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.

Cash and Cash Equivalents

We consider all highly liquid investments with an original maturity of three months or less, when purchased, to be cash equivalents. The fair values of these investments approximate their carrying values.

Other Financial Assets and Liabilities

We have investments in equity instruments for which it is not practicable to estimate fair value primarily because of their illiquidity and restricted marketability. Such investments are recorded initially at cost, less impairment and changes resulting from observable price changes and equity methods of accounting. Refer to Note 6, “Fair Value Measurements and Other Investments” for additional information about these investments.

Our long-term financial liabilities include amounts outstanding under our Senior Secured Credit Facility (as defined in Note 10, “Debt”), with carrying values that approximate fair value since the interest rates approximate current market rates. As of December 31, 2019, the carrying amount of the 1.25% Notes (as defined in Note 10, “Debt”) approximated fair value since the effective interest rate on the 1.25% Notes approximated current market rates. On July 1, 2020, the 1.25% Notes matured and were paid in full. See Note 10, “Debt” for further information regarding our long-term financial liabilities.

Derivative Financial Instruments

Derivative instruments are recognized as either assets or liabilities and are measured at fair value. The accounting for changes in the fair value of a derivative depends on the intended use of the derivative and the resulting designation. See Note 16, “Derivative Financial Instruments” for information regarding gains and losses from derivative instruments during the years ended December 31, 2021, 2020 and 2019.

Trade Accounts Receivable

Accounts receivable are recorded at the invoiced amounts and do not bear interest.

Contingent Liabilities

A liability is contingent if the amount is not presently known but may become known in the future as a result of the occurrence of some uncertain future event. We accrue a liability for an estimated loss if we determine that the potential loss is probable of occurring 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 assessment of contingent liabilities, including legal and income tax contingencies, involves the use of estimates, assumptions and judgments. Our estimates are based on our belief that future events will validate the current assumptions regarding the ultimate outcome of these exposures. However, there can be no assurance that future events, such as court decisions or Internal Revenue Service (“IRS”) positions, will not differ from our assessments.

Fixed Assets

Fixed assets are stated at cost. Depreciation and amortization are computed under the straight-line method over the estimated useful lives of the related assets. The depreciable life of leasehold improvements is the shorter of the lease term or the useful life. Upon asset retirement or other disposition, the fixed asset cost and the related accumulated depreciation or amortization are removed from the accounts, and any gain or loss is included in the consolidated statements of operations. Amounts incurred for repairs and maintenance are expensed as incurred.

Business Combinations

Goodwill as of the acquisition date is measured as the excess of consideration transferred over the net of the acquisition date fair values of the assets acquired and the liabilities assumed. While we use our best estimates and assumptions as a part of the purchase price allocation process to accurately value the assets acquired, including intangible assets, and the liabilities assumed at the acquisition date, our estimates are inherently uncertain and subject to refinement. As a result, during the measurement period, which may be up to one year from the acquisition date, we may record adjustments to the fair values of the assets acquired and the liabilities assumed, with a corresponding offset to goodwill. Upon the conclusion of the measurement period or final determination of the values of assets acquired or the liabilities assumed, whichever comes first, any subsequent adjustments are reflected in our consolidated statements of operations.

Goodwill and Intangible Assets

Goodwill and intangible assets acquired in a business combination and determined to have an indefinite useful life are not amortized but are tested for impairment annually or between annual tests when an impairment indicator exists. If an optional qualitative goodwill impairment assessment is not performed, we are required to determine the fair value of each reporting unit. If a reporting unit’s fair value is lower than the carrying value, an impairment loss equal to the excess will be recorded not to exceed the carrying amount of goodwill assigned to the reporting unit. The recoverability of indefinite-lived intangible assets is assessed by comparison of the carrying value of an asset to its estimated fair value. If we determine that the carrying value of an asset exceeds its estimated fair value, an impairment loss equal to the excess will be recorded.

The determination of the fair value of our reporting units is based on a combination of a market approach, which considers benchmark company market multiples, and an income approach, which utilizes discounted cash flows for each reporting unit and other Level 3 inputs. Under the income approach, we determine fair value based on the present value of the most recent cash flow projections for each reporting unit as of the date of the analysis and calculate a terminal value utilizing a terminal growth rate. The significant assumptions under this approach include, among others: income projections, which are dependent on sales to new and existing clients, new product introductions, client behavior, competitor pricing, operating expenses, the discount rate, and the terminal growth rate. The cash flows used to determine fair value are dependent on a number of significant management assumptions such as our expectations of future performance and the expected future economic environment, which are partly based upon our historical experience. Our estimates are subject to change given the inherent uncertainty in predicting future results. Additionally, the discount rate and the terminal growth rate are based on our judgment of the rates that would be utilized by a hypothetical market participant. As part of the goodwill impairment testing, we also consider our market capitalization in assessing the reasonableness of the combined fair values estimated for our reporting units.

In accordance with GAAP, definite-lived intangible assets are required to be amortized over their respective estimated useful lives and reviewed for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We estimate the useful lives of our intangible assets and ratably amortize their value over the estimated useful lives of those assets. If the estimates of the useful lives should change, we will amortize the remaining book value over the remaining useful lives or, if an asset is deemed to be impaired, a write-down of the value of the asset may be required at such time.

Long-Lived Assets and Long-Lived Assets to Be Disposed Of

We review our long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net cash flows expected to be generated by the asset. If assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the fair value of the assets.

Software Development Costs

We capitalize purchased software upon acquisition if it is accounted for as internal-use software or if it meets the future alternative use criteria. For software to be sold, we capitalize incurred labor costs for software development from the time technological feasibility of the software is established, or when the preliminary project phase is completed in the case of internal-use software, until the software is available for general release. Research and development costs and other computer software maintenance costs related to software development are expensed as incurred. We estimate the useful life of our capitalized software and amortize its value over that estimated life. If the actual useful life is determined to be shorter than our estimated useful life, we will amortize the remaining book value over the remaining useful life or the asset may be deemed to be impaired and, accordingly, a write-down of the value of the asset may be recorded as a charge to earnings. Upon the availability for general release, we commence amortization of the capitalized software costs on a product by product basis. Amortization of capitalized software is recorded using the greater of (i) the ratio of current revenues to total and anticipated future revenues for the applicable product or (ii) the straight-line method over the remaining estimated economic life, which is estimated to be three to five years.

At each balance sheet date, the unamortized capitalized costs of a software product are compared with the net realizable value of that product. The net realizable value is the estimated future gross revenues from that product reduced by the estimated future costs of completing and disposing of that product, including the costs of performing maintenance and client support required to satisfy our responsibility set forth at the time of sale. The amount by which the unamortized capitalized costs of a software product exceed the net realizable value of that asset is written off. If we determine that the value of the capitalized software could not be recovered, a write-down of the value of the capitalized software to its recoverable value is recorded as a charge to earnings.

The unamortized balances of capitalized software were as follows:


	December 31,
(In thousands)	2021			2020
Software development costs	$	338,677		$	327,519
Less: accumulated amortization		(166,573	)		(134,317	)
Software development costs, net	$	172,104		$	193,202

Capitalized software development costs, divestitures, write-offs included in asset impairment changes and amortization of capitalized software development costs included in cost of revenue are illustrated in the following table:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Capitalized software development costs	$	73,265	$	87,993	$	103,317
Write-offs and divestitures of capitalized software development costs	$	3,105	$	31,214	$	0
Amortization of capitalized software development costs	$	91,258	$	86,269	$	72,840

Income Taxes

We account for income taxes using the liability method, which requires the recognition of deferred tax assets or liabilities for the tax-effected temporary differences between the financial reporting and tax bases of our assets and liabilities and for net operating loss and tax credit carryforwards. The objectives of accounting for income taxes are to recognize the amount of taxes payable or refundable for the current year and deferred tax liabilities and assets for the future tax consequences of events that have been recognized in an entity’s financial statements or tax returns. Judgment is required in addressing the future tax consequences of events that have been recognized in our consolidated financial statements or tax returns. The deferred tax assets are recorded net of a valuation allowance when, based on the weight of available evidence, we believe it is more likely than not that some portion or all of the recorded deferred tax assets will not be realized in future periods. We consider many factors when assessing the likelihood of future realization of our deferred tax assets, including recent cumulative earnings experience, expectations of future taxable income, the ability to carryback losses and other relevant factors.

In addition, we are subject to the continuous examination of our income tax returns by the IRS and other tax authorities. A change in the assessment of the outcomes of such matters could materially impact our consolidated financial statements.

The calculation of tax liabilities involves dealing with uncertainties in the application of complex tax regulations. We recognize liabilities for anticipated tax audit issues based on our estimate of whether, and the extent to which, additional taxes may be required. If we ultimately determine that payment of these amounts is unnecessary, then we reverse the liability and recognize a tax benefit during the period in which we determine that the liability is no longer necessary. We also recognize tax benefits to the extent that it is more likely than not that our positions will be sustained if challenged by the taxing authorities. To the extent we prevail in matters for which liabilities have been established or are required to pay amounts in excess of our liabilities, our effective tax rate in a given period may be materially affected. An unfavorable tax settlement would require cash payments and may result in an increase in our effective tax rate in the year of resolution. A favorable tax settlement would be recognized as a reduction in our effective tax rate in the year of resolution. We report interest and penalties related to uncertain income tax positions in the income tax (provision) benefit line of our consolidated statements of operations.

We file income tax returns in the United States federal jurisdiction, numerous states in the United States and multiple countries outside of the United States.

Stock-Based Compensation

We account for stock-based compensation in accordance with GAAP, which requires the measurement and recognition of compensation expense for all share-based payment awards made to employees and non-employee directors based on their estimated fair value. We measure stock-based compensation cost at the grant date based on the fair value of the award and recognize the expense over the requisite service period typically on a straight-line basis, net of estimated forfeitures. 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 restricted stock units and restricted stock awards is measured at their underlying closing share price on the date of grant. The fair value of market-based restricted stock units is measured using the Monte Carlo pricing model. The net proceeds from stock-based compensation activities are reflected as a financing activity within the accompanying consolidated statements of cash flows. We settle employee stock option exercises and stock awards with newly issued common shares. Refer to Note 12, “Stock Award Plan” for detailed discussion about our stock-based incentive plan.

Employee Benefit Plans

We provide employees with defined contribution savings plans. We recognize expense for our contributions to the savings plans at the time employees make contributions to the plans and we contributed the following amounts to these plans:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Company contributions to employee benefit plans	$	19,511	$	21,143	$	23,998

Foreign Currency

The determination of the functional currency of our foreign subsidiaries is made based on the appropriate economic and management indicators. Our foreign subsidiaries use the local currency of their respective countries as the functional currency, with the exception of our operating subsidiaries in India and Israel which use the United States dollar as a functional currency. The assets and liabilities of foreign subsidiaries whose functional currency is the local currency are translated into United States dollars at the exchange rates in effect at the consolidated balance sheet date, while revenues and expenses are translated at the average rates of exchange during the year. Translation gains and losses are not included in determining net income or loss but are included as a separate component of accumulated other comprehensive loss. Gains and losses resulting from foreign currency transactions are included in determining net income or loss and have not been material in any years presented in the accompanying consolidated statements of operations. We periodically enter into non-deliverable forward foreign currency exchange contracts in order 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. See Note 16, “Derivative Financial Instruments,” for information regarding these foreign currency exchange contracts.

Concentrations of Credit Risk

Financial instruments that potentially subject us to a concentration of credit risk consist of cash, cash equivalents, marketable securities and trade receivables. We primarily maintain our cash balances with one major commercial bank domestically and several commercial banks internationally.

We sell our products and services to healthcare providers. Credit risk with respect to trade receivables is generally diversified due to the large number of clients and their geographic dispersion. To reduce credit risk, we perform ongoing credit evaluations of significant clients and their payment histories. In general, we do not require collateral from our clients, but we do enter into advance deposit agreements, if appropriate.

The majority of our revenue is derived from clients located in the United States. The majority of long-lived assets are also located in the United States. For the years ended December 31, 2021 and 2020, we had one client that accounted for 12.5% and 12%, respectively, of our revenue. Other than this one client, no single client accounted for more than 10% of our revenue in the years ended December 31, 2021, 2020 and 2019. No client represented more than 10% of accounts receivable as of December 31, 2021 and 2020.

Recently Adopted Accounting Pronouncements

In December 2019, the Financial Accounting Standards Board (“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. We adopted ASU 2019-12 on January 1, 2021, and the adoption did not have a significant impact on our consolidated financial statements.

Accounting Pronouncements Not Yet Adopted

In August 2020, the FASB issued Accounting Standards Update No. 2020-06, “Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity” (“ASU 2020-06”). The amendments in ASU 2020-06 simplify the accounting for convertible instruments by removing major separation models required under current GAAP. ASU 2020-06 removes certain settlement conditions that are required for equity contracts to qualify for the derivative scope exceptions and also simplifies the diluted earnings per share calculation in certain areas. The standard is effective for public business entities, excluding entities eligible to be smaller reporting companies as defined by the SEC, for fiscal years and interim periods within those fiscal years, beginning after December 15, 2021. We plan to adopt ASU 2020-06 on January 1, 2022 and we expect the adoption to impact our consolidated financial statements.

Revenue from Contracts with Customers

12 Months Ended

Dec. 31, 2021

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.

Costs to Obtain or Fulfill a Contract

Capitalized costs to obtain or fulfill a contract are amortized over periods ranging from two to six years which represent the initial contract term or a longer period, if renewals are expected and the renewal commission, if any, is not commensurate with the initial commission. We classify such capitalized costs as current or non-current based on the expected timing of expense recognition. The current and non-current portions are included in Prepaid expenses and other current assets, and Other assets, respectively, in our consolidated balance sheets.

At December 31, 2021 and 2020, we had capitalized costs to obtain or fulfill a contract of $16.5 million and $16.8 million, respectively, in Prepaid and other current assets and $27.0 million and $27.9 million, respectively, in Other assets. During the year ended December 31, 2021 and 2020, we recognized $20.5 million and $23.6 million, respectively, of amortization expense related to such capitalized costs, which is included in Selling, general and administrative expense within our consolidated statements of operations.

Contract Balances

The timing of revenue recognition, billings and cash collections results in billed and unbilled accounts receivables, 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.

In general, with the exception of fixed fee project-based client service offerings (such as implementation services), we sell our software solutions on date-based milestone events where control transfers and use of the software occurs on the delivery date but the associated payments for the software license occur on future milestone dates. In such instances, unbilled amounts are included in contract assets since our right to receive payment is conditional upon the continued functionality of the software and the provision of ongoing support and maintenance. Our fixed fee project-based client service offerings typically require us to provide the services with either a significant portion or all amounts due prior to service completion. Since our right to payment is not unconditional, amounts associated with work prior to the completion date are also deemed to be contract assets.

Performance Obligations

A performance obligation is a promise in a contract to transfer a distinct product or service to a customer and is the unit of account under the FASB Accounting Standards Codification 606, Revenue from Contracts with Customers (“ASC 606”). A performance obligation is considered distinct when both (i) a customer can benefit from the product or service either on its own or together with other resources that are readily available to the customer and (ii) the promised product or service is separately identifiable from other promises in the contract. Activities related to the fulfillment of a contract that do not transfer products or services to a customer, such as contract preparation or legal review of contract terms, are not deemed to be performance obligations.

We generally sell our solutions through contracts with multiple performance obligations where we provide the customer with (1) software licenses, (2) support and maintenance, (3) embedded content such as third-party software and (4) client services. Incremental solutions, such as hardware and managed services are also provided based upon a customer’s preferences and requirements. We deem that a customer is typically able to benefit from a product or service on its own or together with readily available resources when we sell such product or service on a standalone basis. We have historically sold the majority of our performance obligations, with the exception of software licenses, on a standalone basis. Incremental solutions, such as hardware, client services and managed services, are often negotiated and fulfilled on an independent sales order basis as customer needs and requirements change over the course of a relationship period. In addition, support and maintenance and embedded content are provided on a stand-alone basis through the renewal process.

Our support and maintenance obligations include multiple discrete performance obligations, with the two largest being unspecified product upgrades or enhancements, and technical support, which can be offered at various points during a contract period. We believe that the multiple discrete performance obligations within our overall support and maintenance obligations can be viewed as a single performance obligation since both the unspecified product upgrades and technical support are activities to fulfill the maintenance performance obligation and are rendered concurrently.

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


(In thousands)	Three Months Ended March 31, 2021		Three Months Ended June 30, 2021		Three Months Ended September 30, 2021		Three Months Ended December 31, 2021
Revenue related to deferred revenue balance at beginning of period	$	137,848	$	151,857	$	144,696	$	151,763
Revenue related to new performance obligations satisfied during the period		173,316		158,910		159,149		171,345
Revenue recognized under "right-to-invoice" expedient		56,811		62,422		64,820		68,089
Reimbursed travel expenses, shipping and other revenue		377		525		607		502
Total revenue	$	368,352	$	373,714	$	369,272	$	391,699


(In thousands)	Three Months Ended March 31, 2020		Three Months Ended June 30, 2020		Three Months Ended September 30, 2020		Three Months Ended December 31, 2020
Revenue related to deferred revenue balance at beginning of period	$	105,366	$	119,545	$	118,300	$	138,279
Revenue related to new performance obligations satisfied during the period		216,580		195,308		192,658		182,690
Revenue recognized under "right-to-invoice" expedient		58,059		54,082		54,313		65,108
Reimbursed travel expenses, shipping and other revenue		1,359		369		347		337
Total revenue	$	381,364	$	369,304	$	365,618	$	386,414


(In thousands)	Three Months Ended March 31, 2019		Three Months Ended June 30, 2019		Three Months Ended September 30, 2019		Three Months Ended December 31, 2019
Revenue related to deferred revenue balance at beginning of period	$	93,602	$	113,288	$	116,812	$	136,460
Revenue related to new performance obligations satisfied during the period		248,126		233,293		227,954		214,952
Revenue recognized under "right-to-invoice" expedient		55,923		62,245		61,814		60,826
Reimbursed travel expenses, shipping and other revenue		1,467		2,057		1,700		2,092
Total revenue	$	399,118	$	410,883	$	408,280	$	414,330

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 $3.8 billion as of December 31, 2021, of which we expect to recognize approximately 34% over the next 12 months, and the remaining 66% thereafter.

Transaction price and allocation

Our contracts with customers often include multiple distinct performance obligations such as software licenses, software support and maintenance, hardware, client services, private cloud hosting and Software-as-a-Service. We adjust the transaction price on a contract-by-contract basis for (i) the effect of the time value of money when a contract has a significant financing component and/or (ii) customer discounts and incentives deemed to be variable consideration. We then allocate the contract transaction price to the distinct performance obligations in the contract. Such allocation is based on the stand-alone selling price (“SSP”) of each distinct performance obligation. The transaction price allocated to each distinct performance obligation is adjusted for discounts offered to customers that are outside of the Company’s established sufficiently narrow ranges for distinct performance obligations’ SSPs on a relative SSP basis.

We use observable stand-alone pricing to determine the SSP for each distinct performance obligation. Such observable SSPs are based upon our listed sales prices and consider discounts offered to customers. In instances where SSP is not directly observable because we do not sell the product or service separately, we determine the SSP through the residual approach or cost-plus margin models using information that includes market conditions and other observable inputs. Such instances primarily relate to sales of new products and service offerings and our acute suite of software licenses. Our acute suite of software licenses is sold to a diverse set of customers for a broad range of amounts and, therefore, SSP is not discernible from past transactions due to the high variability of selling prices.

Our products and services are generally not sold with a right of return, except for certain hardware sales, which are not material to our consolidated revenue. We may provide credits or incentives on a contract-by-contract basis which are accounted for either as a material right or as variable consideration, respectively, when allocating the transaction price. Such credits and incentives have historically not been significant. We do not provide additional warranties to clients above and beyond warranties that the solutions purchased will perform in accordance with the agreed-upon specifications. On rare occasions, when additional warranties are granted, we evaluate on a case-by-case basis whether the additional warranty granted represents a separate performance obligation.

Accounting Policy Elections and Practical Expedients

We have elected to exclude from the measurement of the transaction price any contractual indexing (e.g. consumer price index), shipping costs and all taxes (e.g., sales, use, value-added) assessed by government authorities and collected from a customer. Therefore, revenue is recognized net of such taxes.

We contract with customers to deliver and ship tangible products within the normal course of business, such as computer hardware. The control of the products transfers to the customer when the product reaches the shipper based on free on board (FOB) shipping clauses in these situations. We have elected to use the practical expedient allowed under ASC 606 to account for shipping and handling activities that occur after the customer has obtained control of a promised good as fulfillment costs rather than as an additional promised service and, therefore, we do not allocate a portion of the transaction price to a shipping service obligation. We record as revenue any amounts billed to customers for shipping and handling costs and record as cost of revenue the actual shipping costs incurred.

Our standard contract terms allow for the reimbursement by a customer for certain travel expenses necessary to provide on-site services to the customer, such as implementation and training. Such reimbursed travel expenses are reported on a gross basis. Since such reimbursed travel expenses do not represent a distinct good or service nor incremental value provided to a customer, a performance obligation is deemed not to exist. In certain situations, however, when the allowable reimbursable expenses amount is capped, we believe that such cap represents the most likely amount of variable consideration and the capped amount is included in the total contract transaction price.

In accordance with ASC 606, if an entity has a right to consideration from a customer in an amount that corresponds directly with the value to the customer of the entity’s performance completed to date, the entity may recognize revenue in the amount to which the entity has a right to invoice (“right-to-invoice” practical expedient). We have elected to utilize this expedient as it relates to transaction-based services (such as revenue cycle management) and electronic data interchange transactions.

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. The following table summarizes the pattern of revenue recognition for our most significant performance obligations:


Performance Obligation	Revenue Type	Recurring or Non-recurring Nature	Revenue Recognition Pattern	Measure of progress
Support and maintenance ("SMA")	Software delivery, support and maintenance	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Software as a service ("SaaS")	Software delivery, support and maintenance	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Private cloud hosting	Client services	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Client/Education services	Client services	Non-recurring	Over time	Input method (cost to cost) – revenue is recognized proportionally over the service implementation based on hours
Outsourcing services	Client services	Recurring	Over time	Input method (cost to cost) – revenue is recognized proportionally over the outsourcing period
Payerpath (transaction volume)	Software delivery, support and maintenance	Recurring	Over time	Output method ("right-to-invoice" practical expedient) – value transferred to the customer is reflected on invoicing.
Software licenses	Software delivery, support and maintenance	Non-recurring	Point in time	Upon electronic delivery
Hardware	Software delivery, support and maintenance	Non-recurring	Point in time	Upon shipment
Consulting Services	Client services	Non-recurring	Over time	Output method ("right-to-invoice" practical expedient) – value transferred to the customer is reflected on invoicing.

Recurring software delivery, support and maintenance revenue consists of recurring subscription-based software sales, support and maintenance revenue, and recurring transaction-related revenue. Non-recurring software delivery, support and maintenance revenue consists of perpetual software licenses sales, resale of hardware and non-recurring transaction-related revenue. Recurring client services revenue consists of revenue from managed services solutions, such as outsourcing, private cloud hosting and revenue cycle management. Non-recurring client services revenue consists of project-based client services revenue.

SMA, SaaS and private cloud hosting performance obligations are deemed to be performance obligations satisfied evenly over time as these are fulfilled as stand-ready obligations to perform. Client services, such as those relating to implementation, consulting, training or education, are generally not fulfilled evenly over the contract period, but rather over a shorter timeline where work effort can increase, or decline based upon stages of the project work effort. These client services are typically quoted to a customer as a fixed fee amount that covers the implementation effort. Delivery progress for these services is measured by establishing an approved cost budget with labor hour inputs utilized to gauge percentage of completion of the work effort. Therefore, revenue for our client, education and outsourcing services is recognized proportionally with the progress of the implementation work effort.

Payerpath transaction volume and other transaction-based service obligations, such as revenue cycle management services, are fulfilled over time but are not provided evenly over the contract period and reliable inputs are not available to track progress of completion. We determined that value is provided to the customer throughout the contract period and the pricing charged to the customer varies on a monthly basis, based upon the volume of the customer’s transactions processed in that respective period. The invoiced amount to the customer represents this value and, accordingly, the practical expedient to recognize revenue based upon invoicing is most appropriate.

We considered the specific implementation guidance for accounting for licenses of intellectual property (“IP”) to determine if point in time or over time recognition was more appropriate. The first step in the licensing framework is to determine whether the license is distinct or combined with other goods and services. Our software licensing products are distinct from the implementation services. Significant contracts are reviewed to determine if the software requires significant customizations or interfaces. In all instances, we determined that we are offering functional IP as compared with a symbolic IP. Functional IP is a right to use IP because the IP has standalone functionality and a customer can use the IP as it exists at a point in time.

Disaggregation of Revenue

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:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Revenue:
Recurring revenue	$	1,209,746	$	1,222,731	$	1,278,456
Non-recurring revenue		293,291		279,969		354,155
Total revenue	$	1,503,037	$	1,502,700	$	1,632,611


	Year Ended December 31, 2021
(In thousands)	Hospitals and Large Physician Practices		Veradigm		Unallocated Amounts		Total
Software delivery, support and maintenance	$	446,309	$	452,933	$	16,944	$	916,186
Client services		481,281		99,275		6,295		586,851
Total revenue	$	927,590	$	552,208	$	23,239	$	1,503,037


	Year Ended December 31, 2020
(In thousands)	Hospitals and Large Physician Practices		Veradigm		Unallocated Amounts		Total
Software delivery, support and maintenance	$	472,130	$	432,009	$	19,598	$	923,737
Client services		478,025		95,959		4,979		578,963
Total revenue	$	950,155	$	527,968	$	24,577	$	1,502,700


	Year Ended December 31, 2019
(In thousands)	Hospitals and Large Physician Practices		Veradigm		Unallocated Amounts		Total
Software delivery, support and maintenance	$	541,904	$	448,380	$	20,709	$	1,010,993
Client services		510,363		106,530		4,725		621,618
Total revenue	$	1,052,267	$	554,910	$	25,434	$	1,632,611

Contract Assets – Estimate of Credit Losses

We adopted ASU 2016-13 on January 1, 2020 using the cumulative-effect adjustment transition method. The guidance required the recognition of lifetime estimated credit losses expected to occur for contract assets and trade receivables. 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. Refer to Note 3, "Accounts Receivable", for the adoption impact related to trade receivables.

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 were aligned with management’s review of financial performance at the time. In the fourth quarter of 2020, we used each customer’s primary business unit in our pooling determination. This assessment provides additional information of the customer including size, segment and industry. Using this perspective, we added one new pool. We reallocated pools and loss rates accordingly and noted slight shifts in each pool. The new pools are aligned with management’s review of financial performance. For the year ended December 31, 2021, no other adjustments to the pools were 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 and anticipated future 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 December 31, 2021 analysis resulted in a reduction to the ending estimate of credit losses.

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


	Year Ended December 31,
(In thousands)	2021			2020
Beginning Balance	$	5,341		$	5,341
Current period provision		(2,000	)		0
Ending Balance	$	3,341		$	5,341
Less: Contract assets, short-term		1,068			1,068
Total contract assets, long-term	$	2,273		$	4,273

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-URI http://asc.fasb.org/topic&trid=49130388

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
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-Section 50
-Paragraph 10
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130551-203045

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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-Section 50
-Paragraph 13
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
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-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
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-Section 50
-Paragraph 12
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 15
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130558-203045

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

+ Details

Accounts Receivable

12 Months Ended

Dec. 31, 2021

Receivables [Abstract]

Accounts Receivable

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 guidance required the recognition of lifetime estimated credit losses expected to occur for trade accounts receivable, which resulted in the recording of a debit to retained earnings of $12.6 million as of January 1, 2020. Refer to Note 2, "Revenue from Contracts with Customers" for additional information regarding the adoption of ASU 2016-13. No adjustments were made to the pools or historical loss rate data for trade accounts receivable during the year ended December 31, 2021.

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


	Year Ended December 31,
(In thousands)	2021			2020
Beginning Balance	$	31,596		$	33,256
Current period provision		6,818			8,726
Write-offs		(9,191	)		(10,484	)
Recoveries		720			98
Ending Balance	$	29,943		$	31,596

Leases

12 Months Ended

Dec. 31, 2021

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 term 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 comprise of executory costs, and the practical expedient allows for 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 7 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)	Year Ended December 31,
	2021			2020
Operating lease cost (1)	$	22,343		$	25,394
Less: Sublease income		(314	)		(1,121	)
Total operating lease costs	$	22,029		$	24,273

(1)

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

Supplemental information for operating leases is as follows:


(In thousands)	Year Ended December 31,
	2021		2020
Operating cash flows from operating leases	$	24,141	$	26,638
Right-of-use assets obtained in exchange for operating lease obligations	$	3,252	$	21,770

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


(In thousands, except lease term and discount rate)	December 31, 2021			December 31, 2020
Right-of-use assets - operating leases	$	68,909		$	96,601
Current operating lease liabilities	$	19,599		$	22,264
Long-term operating lease liabilities	$	64,822		$	93,463
Weighted average remaining lease term (in years)		5			6
Weighted average discount rate		3.3	%		3.6	%

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 December 31, 2021.


	December 31, 2021
(In thousands)	Operating Leases
2022	$	22,093
2023		20,285
2024		14,805
2025		13,438
2026		12,105
Thereafter		8,655
Total lease liabilities		91,381
Less: Amount representing interest		(6,960	)
Less: Short-term lease liabilities		(19,599	)
Total long-term lease liabilities	$	64,822

Business Combinations and Divestitures

12 Months Ended

Dec. 31, 2021

Business Combinations [Abstract]

Business Combinations and Divestitures

5. Business Combinations and Divestitures

2021 Divestitures

On August 23, 2021, we completed the sale of substantially all of the assets of our 2bPrecise business to a third party for a non-controlling interest in the combined entity. We realized a pre-tax gain upon the sale of $8.4 million, which was included in the Gain on sale of businesses, net line in our consolidated statements of operations for the year ended December 31, 2021. The 2bPrecise business was previously reported within our Data, Analytics and Care Coordination segment. However, due to the reportable segment changes in the third quarter of 2021, the historical 2bPrecise business is now presented in our “Unallocated Amounts” category. Refer to Note 19, “Business Segments” for additional information.

2020 Divestitures

On December 31, 2020, we completed the sale of substantially all of the assets of our CarePort business to a subsidiary of WellSky Corp., a Delaware corporation (“WellSky”), pursuant to a purchase agreement (the “CarePort Purchase Agreement”). The total consideration for CarePort was $1.35 billion, which was subject to certain adjustments for liabilities assumed by WellSky and net working capital as described in the CarePort Purchase Agreement. We realized a pre-tax gain upon the sale of $933.9 million, which was included in the Gain on sale of discontinued operations line in our consolidated statements of operations for the year ended December 31, 2020. For the year ended December 31, 2021, we recorded a $0.6 million gain that primarily related to net working capital adjustments in the Gain on sale of discontinued operations line in our consolidated statements of operations. The divestiture was treated as a discontinued operation as of December 31, 2020. Refer to Note 18, “Discontinued Operations” for additional information. On December 31, 2020, we repaid $161.0 million of the Term Loan (as defined below) as a result of the sale, which was a mandatory prepayment in accordance with the Second Amended Credit Agreement (as defined below).

On October 15, 2020, we completed the sale of substantially all of the assets of our EPSi business to Strata Decision Technology LLC, an Illinois limited liability company (“Strata”), and Roper Technologies, Inc., a Delaware corporation, pursuant to a purchase agreement (the “EPSi Purchase Agreement”). The total consideration for EPSi was $365.0 million, which was subject to certain adjustments for liabilities assumed by Strata and net working capital as described in the EPSi Purchase Agreement. We realized a pre-tax gain upon the sale of $222.6 million, which was included in the Gain on sale of discontinued operations line in our consolidated statements of operations for the year ended December 31, 2020. The divestiture was treated as a discontinued operation as of December 31, 2020. Refer to Note 18, “Discontinued Operations” for additional information. On October 29, 2020, we repaid $19.0 million of the Term Loan (as defined below) as a result of the sale, which was a mandatory prepayment in accordance with the Second Amended Credit Agreement (as defined below).

2019 Business Combinations

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 on July 2, 2019. 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. During the first quarter of 2021, we extended the ACC earnout agreement to June 30, 2021. In the second quarter of 2021, we paid $0.9 million related to the earnout agreement and accrued the remaining payment as contingent consideration within our consolidated financial statements. In the fourth quarter of 2021, we wrote off contingent consideration of $0.1 million and released the majority of the accrual. Refer to Note 6, "Fair Value Measurements and Long-term Investments" for additional information regarding the contingent consideration. The business is included in our Veradigm business segment.

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 on June 10, 2019. The drug platform and software will enable healthcare providers, pharmacists and payors to digitally interact with one another to fill a prescription. The business is included in our Veradigm business segment.

We acquired all of the outstanding minority interest in Pulse8, Inc. on March 1, 2019 for $53.8 million (subject to adjustments for net working capital and a contingency holdback), plus up to a $5.0 million earnout based upon revenue targets through 2019. Pulse8, Inc. is 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. 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 year ended December 31, 2019.

Fair Value Measurements and Other Investments

12 Months Ended

Dec. 31, 2021

Fair Value Disclosures [Abstract]

Fair Value Measurements and Other Investments

6. Fair Value Measurements and Other Investments

Fair value measurements are based upon observable and unobservable inputs. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our view of market participant assumptions in the absence of observable market information. We utilize valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs. The fair values of assets and liabilities required to be measured at fair value are categorized based upon the level of judgment associated with the inputs used to measure their value in one of the following three categories:

Level 1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities. We held no Level 1 financial instruments at December 31, 2021 or 2020.

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. Refer to Note 16, “Derivative Financial Instruments,” for further information regarding these derivative financial instruments.

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. Level 3 instruments include the estimated 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. Changes in fair value for contingent consideration adjustments are recorded in Other income (loss), net in the consolidated statements of operations. Level 3 instruments also included the 1.25% Call Option asset and the 1.25% embedded cash conversion option liability (together the “Call Spread Overlay” as further described in Note 10, “Debt”) that are not actively traded. These derivative instruments were designed with the intent that changes in their fair values would substantially offset, with limited net impact to our earnings. The sensitivity of changes in the unobservable inputs to the valuation pricing model used to value these instruments is not material to our consolidated results of operations. On July 1, 2020, these instruments matured and were repaid in full.

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	December 31, 2021								December 31, 2020
(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	$	352	$	0	$	352	$	0	$	1,509	$	0	$	1,509
Total assets		$	0	$	352	$	0	$	352	$	0	$	1,509	$	0	$	1,509

Contingent consideration - current	Accrued expenses	$	0	$	0	$	19	$	19	$	0	$	0	$	1,011	$	1,011
Total liabilities		$	0	$	0	$	19	$	19	$	0	$	0	$	1,011	$	1,011

The changes in Level 3 assets and liabilities measured at fair value on a recurring basis at December 31, 2021 are summarized as follows:


(In thousands)	Contingent Consideration			1.25% Notes Call Spread Overlay
Balance at December 31, 2019	$	19,515		$	(101	)
Additions		770			0
Payments/write-downs (1)		(19,274	)		0
Fair value adjustments		0			101
Balance at December 31, 2020	$	1,011		$	0
Payments		(858	)		0
Write-downs		(134	)		0
Balance at December 31, 2021	$	19		$	0

(1)

Payments and write-downs for the year ended December 31, 2020 primarily consisted of $4.0 million in payments for the ACC earnout and a $13.9 million write-down related to the Health Grid earnout.

The following table summarizes the quantitative information about our Level 3 fair value measurements at December 31, 2021:

December 31, 2021

(In thousands, except the discount rate)

Fair Value

Valuation Technique

Significant Unobservable Inputs

Ranges of Inputs

Weighted Average (1)

Financial instruments:

Contingent consideration

Probability Weighted Discounted cash flow

Discount rate

5.3% to 5.5%

5.4

Registry members

0 to 1,551

776

Patient data volume

0 to 52,845

26,422

Projected year of remaining payment

2022

Total financial instruments

(1)

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

Long-term Investments

The following table summarizes our other 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 December 31, 2021		Cost		December 31, 2021		December 31, 2020 (2)
Equity method investments (1)		4	$	7,099	$	12,260	$	10,744
Cost with adjustments		7		57,213		49,293		25,059
Total long-term equity investments		11	$	64,312	$	61,553	$	35,803

(1)

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

(2)

Amounts include investments that are no longer held as of December 31, 2021.

During the fourth quarter of 2021, we sold one of our third-party cost method investments. The sale resulted in a $60.9 million gain, which is included in the Other income (loss), net line in our consolidated statements of operations for the year ended December 31, 2021. During the third quarter of 2021, we divested one of our businesses to a new third-party in exchange for a non-controlling interest in the combined entity, which we now report as a cost method investment. The divestiture resulted in an $8.4 million gain, which is included in the Gain on sale of businesses, net line in our consolidated statements of operations for the year ended December 31, 2021. During the second quarter of 2021, one of our third-party cost method investments converted its notes and, we received 475 thousand shares of preferred stock in such third party as a result of the conversion. We also revalued our existing investment based on the note conversion share price. The note conversion and the revaluation of the existing investment resulted in a $9.7 million gain, which is included in the Other income (loss), net line in our consolidated statements of operations for the year ended December 31, 2021.

During 2020, we recorded a $16.8 million gain from the sale of a third-party equity-method investment. The gain is recognized in the Equity in net income of unconsolidated investments line in the consolidated statements of operations.

It is not practicable to estimate the fair value of our equity investments primarily because of their illiquidity and restricted marketability as of December 31, 2021. 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

Management performs a quarterly assessment of each of our investments on an individual basis to determine if there are any declines in fair value. In 2021, we determined no impairment charges of long-term investments were necessary. In the third quarter of 2020, we recognized a $1.0 million non-cash impairment charge related to one of our cost-method investments, which equaled the cost basis of our initial investment. In the second quarter of 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 non-cash impairment charge. We recognized non-cash impairment charges of $1.7 million during 2019 related to one of our long-term investments. We also recovered $1.0 million from a third-party cost-method investment that we had previously impaired. The non-cash impairment charges and the amount recovered are recognized in the Impairment of long-term investments line in the consolidated statements of operations for the years ended December 31, 2020 and 2019.

- 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

Fixed Assets

12 Months Ended

Dec. 31, 2021

Property, Plant and Equipment [Abstract]

Fixed Assets

7. Fixed Assets

Fixed assets consist of the following:


	Estimated	December 31,			December 31,
(Dollar amounts in thousands)	Useful Life	2021			2020
Computer equipment and software	3 to 10 years	$	310,153		$	329,564
Facility furniture, fixtures and equipment	5 to 7 years		23,325			25,932
Leasehold improvements	Shorter of 7 years or life of lease		36,858			40,115
Assets under finance leases	1 to 3 years		524			524
Fixed assets, gross			370,860			396,135
Less: Accumulated depreciation and amortization			(322,958	)		(323,973	)
Fixed assets, net		$	47,902		$	72,162

Accumulated amortization for assets under finance leases totaled $0.5 million as of December 31, 2021 and 2020.


	Year Ended December 31,
(In thousands)	2021		2020		2019
Fixed assets depreciation and amortization expense, including finance leases	$	26,847	$	32,324	$	46,705

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2021

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

8. Goodwill and Intangible Assets

Goodwill and intangible assets consist of the following:


	December 31, 2021							December 31, 2020
	Gross							Gross
	Carrying		Accumulated			Intangible		Carrying		Accumulated			Intangible
(In thousands)	Amount		Amortization			Assets, Net		Amount		Amortization			Assets, Net
Intangibles subject to amortization:
Proprietary technology	$	535,019	$	(492,681	)	$	42,338	$	535,092	$	(465,292	)	$	69,800
Customer contracts and relationships		674,078		(532,486	)		141,592		674,336		(509,534	)		164,802
Total	$	1,209,097	$	(1,025,167	)	$	183,930	$	1,209,428	$	(974,826	)	$	234,602

Intangibles not subject to amortization:
Registered trademarks						$	52,000						$	52,000
Goodwill							974,478							974,729
Total						$	1,026,478						$	1,026,729

During the third quarter of 2021, as a result of organizational change, we changed our reportable segments from Core Clinical and Financial Solutions and Data, Analytics and Care Coordination to Hospitals and Large Physician Practices and Veradigm. As a result of this change, our reporting units became Hospitals and Large Physician Practices, Veradigm and Unallocated. Refer to Note 19, “Business Segments,” for further discussion on the impact of the change to our reportable segments.

During 2021, as a result of the organizational change, we performed interim goodwill impairment tests as of September 30, 2021. The fair values of each reporting unit substantially exceeded its carrying value, before and after the change, and no indicators of impairment were identified.

We performed our annual 2021 goodwill impairment test as of October 1, 2021. The fair value of each reporting unit substantially exceeded its carrying value, and no indicators of impairment were identified.

During the first and second quarters of 2020, we changed our reportable segments due to certain organizational changes. As a result of these changes, we performed interim goodwill impairment tests as of January 1, 2020 and April 1, 2020. The fair value of each reporting unit substantially exceeded its carrying value, and no indicators of impairment were identified.

We performed our annual 2020 goodwill impairment test as of October 1, 2020. The fair value of each reporting unit substantially exceeded its carrying value, and no indicators of impairment were identified.

We performed our 2019 goodwill impairment test as of October 1, 2019. As a result of this test, we concluded that the carrying value of the historical Hospitals and Health Systems (“HHS”) reporting unit exceeded its fair value. As a result, we recognized a goodwill impairment charge of $25.7 million. This goodwill impairment charge is reflected on the Goodwill impairment charge line in our consolidated statements of operations. The historical HHS reporting unit is now reported within the Hospitals and Large Physician Practices reporting unit. The fair values of all other reporting units substantially exceeded their carrying values. As of December 31, 2019, the goodwill allocated to the historical HHS reporting unit was $485.5 million.

The determination of the fair value of our reporting units is based on a combination of a market approach, which considers benchmark company market multiples, and an income approach, which utilizes discounted cash flows for each reporting unit and other Level 3 inputs. We determine fair value based on the present value of the most recent cash flow projections for each reporting unit as of the date of the analysis and calculate a terminal value utilizing a terminal growth rate under the income approach. The significant assumptions under this approach include, among others: income projections, which are dependent on sales to new and existing clients, new product introductions, client behavior, competitor pricing, operating expenses, the discount rate, and the terminal growth rate. The cash flows used to determine fair value are dependent on a number of significant management assumptions such as our expectations of future performance and the expected future economic environment, which are partly based upon our historical experience. Our estimates are subject to change given the inherent uncertainty in predicting future results. The discount rate and the terminal growth rate are based on our judgment of the rates that would be utilized by a hypothetical market participant. We also consider our market capitalization in assessing the reasonableness of the combined fair values estimated for our reporting units as part of goodwill impairment testing.

We recognized an intangible asset impairment charge of $23.1 million relating to Health Grid’s remaining customer relationship intangible balance during 2020. We also recognized an intangible asset impairment charge of $8.1 million relating to NantHealth’s remaining customer relationship intangible balance during 2019. These impairment charges are included in the Asset impairment charges line in our consolidated statements of operations for the years ended December 31, 2020 and 2019.

As of December 31, 2021 and 2020, there were no accumulated impairment losses associated with goodwill. Accumulated impairment losses associated with goodwill totaled $39.2 million as of December 31, 2019. Changes in the carrying amounts of goodwill by reportable segment for the years ended December 31, 2021 and 2020 were as follows:


(In thousands)	Hospitals and Large Physician Practices			Veradigm		Unallocated		Total
Balance as of December 31, 2019	$	530,774		$	433,188	$	10,148	$	974,110
Foreign exchange translation		619			0		0		619
Balance as of December 31, 2020		531,393			433,188		10,148		974,729
Foreign exchange translation		(251	)		0		0		(251	)
Balance as of December 31, 2021	$	531,142		$	433,188	$	10,148	$	974,478

Additions to goodwill in 2019 resulted from the purchase of the Pinnacle and Diabetes Collaborative Registries and a prescription drug software company. Refer to Note 5, “Business Combinations and Divestitures” for additional information regarding these transactions. As stated above, we also recognized a goodwill impairment charge in 2019 for $25.7 million related to the historical HHS reporting unit.

Intangible assets are being amortized over their estimated useful lives, and amortization expense related to intangible assets was as follows:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Proprietary technology amortization included in cost of revenue	$	27,443	$	32,130	$	35,034
Intangible amortization included in operating expenses		23,109		25,604		27,188
Total intangible amortization expense	$	50,552	$	57,734	$	62,222

Future amortization expense for the intangible assets as of December 31, 2021, based on foreign currency exchange rates in effect as of such date, is as follows:



Year Ended December 31,	(In thousands)
2022	$	44,117
2023		27,905
2024		23,765
2025		20,177
2026		16,521
Thereafter		51,445
Total	$	183,930

Asset Impairment Charges

12 Months Ended

Dec. 31, 2021

Asset Impairment Charges [Abstract]

Asset Impairment Charges

9. Asset Impairment Charges

We incurred $11.8 million of non-cash asset impairment charges during the year ended December 31, 2021. Non-cash asset impairment charges totaling $11.3 million were due to the write-off of deferred costs related to our private cloud hosting operations. The write-offs were driven by the termination of our previous agreement with a private cloud hosting partner as part of a transition to another partner.

During the year ended December 31, 2020, we recorded several non-cash asset impairment charges. We recorded a non-cash asset impairment charge of $23.1 million related to the write-off of the remaining Health Grid acquired customer relationship intangible balance. This was partially offset by the write-off of $13.9 million related to the Health Grid contingent consideration accrual. We recorded $31.2 million of non-cash asset impairment charges related to the write-off of capitalized software due to the asset values exceeding the product’s net realizable value. The write-off was primarily related to one product in which we determined it would no longer be placed into service. We also recorded a $34.3 million non-cash asset impairment charge due to the write-off of deferred costs related to our private cloud hosting operations. The write-off was driven by the expectation of improved efficiencies in the utilization of our contract compared with historical deferred costs, which was identified through our broader cost reduction initiatives. Impairment of long-term investments during the year ended December 31, 2020 consisted of $1.6 million, which included $1.0 million related to one of our cost-method investments and $0.6 million related to one of our third-party equity-method investments. Refer to Note 6, “Fair Value Measurements and Other Investments” for further information regarding the long-term investment impairments.

Asset impairment charges incurred during the year ended December 31, 2019 were primarily the result of impairing the remaining NantHealth acquired customer relationship intangible balance of $8.1 million. We also recognized non-cash impairment charges of $2.7 million on the retirement of certain hosting assets due to data center migrations. Impairment of long-term investments during the year ended December 31, 2019 consisted of an impairment of $1.7 million associated with one of our long-term equity investments. We also recovered $1.0 million from one of our long-term equity investments that we had previously impaired. We also recorded a goodwill impairment charge of $25.7 million related to our historical HHS reporting unit. Refer to Note 8, “Goodwill and Intangible Assets” for further information regarding this impairment.

The following table summarizes the non-cash asset impairment charges recorded during the periods indicated and where they appear in the corresponding consolidated statements of operations:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Asset impairment charges	$	11,772	$	74,969	$	10,837
Goodwill impairment charge	$	0	$	0	$	25,700
Impairment of long-term investments	$	0	$	1,575	$	651

Debt

12 Months Ended

Dec. 31, 2021

Debt Disclosure [Abstract]

Debt

10. Debt

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


	December 31, 2021							December 31, 2020
(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	$	(9,057	)	$	176,910	$	167,853	$	(3,166	)	$	171,019
Senior Secured Credit Facility		175,000		1,848			173,152		0		3,432			(3,432	)
Total debt	$	342,853	$	(7,209	)	$	350,062	$	167,853	$	266		$	167,587

(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 consisted of the following:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Interest expense	$	5,691	$	18,113	$	26,648
Amortization of discounts and debt issuance costs		7,475		15,991		16,524
Total interest expense	$	13,166	$	34,104	$	43,172

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


	Year Ended December 31,
(In thousands)	2021		2020		2019
Coupon interest	$	1,819	$	4,016	$	4,429
Amortization of discounts and debt issuance costs		5,891		13,484		14,926
Total interest expense related to the convertible notes	$	7,710	$	17,500	$	19,355

Allscripts 0.875% Convertible Senior Notes

On December 9, 2019, we issued $200.0 million aggregate principal amount of Allscripts’ 0.875% Convertible Senior Notes due 2027 (the “0.875% Notes”) in a private offering. The 0.875% Notes are Allscripts’ senior, unsecured obligations that bear interest at a rate of 0.875% per year, payable semiannually in arrears on January 1 and July 1 of each year, commencing on July 1, 2020. The 0.875% Notes will mature on January 1, 2027, unless earlier repurchased by us or converted in accordance with their terms prior to such date.

The 0.875% Notes are convertible at the option of the holders (in whole or in part) at any time prior to the close of business on the business day immediately preceding July 1, 2026 only under the following circumstances: (1) during any calendar quarter commencing after the calendar quarter ending on December 31, 2019 (and only during such calendar quarter), if the last reported sale price of Allscripts’ common stock for at least 20 trading days (whether or not consecutive) during the period of 30 consecutive trading days ending on and including the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day (the “Trading Price Trigger”); (2) during the five business day period after any five consecutive trading day period (the “measurement period”) in which the trading price per $1,000 principal amount of 0.875% Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of Allscripts’ common stock and the conversion rate on each such trading day; or (3) upon the occurrence of certain corporate events as specified in the indenture governing the 0.875% Notes (the “0.875% Notes Indenture”). On or after July 1, 2026 until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert all or any portion of their 0.875% Notes at any time, regardless of the foregoing conditions. Upon conversion, Allscripts will pay or deliver, as the case may be, cash, shares of Allscripts’ common stock, or a combination of cash and shares of Allscripts’ common stock, at Allscripts’ election, in amounts determined in the manner set forth in the 0.875% Notes Indenture. During the quarter ended December 31, 2021, the Trading Price Trigger occurred; as a result, holders of the 0.875% Notes are entitled to convert the 0.875% Notes into common stock at their option at any time during the quarter ending March 31, 2022.

The initial conversion rate for the 0.875% Notes will be 75.0962 shares of Allscripts’ common stock per $1,000 principal amount of the 0.875% Notes, which is equivalent to an initial conversion price of approximately $13.32 per share of Allscripts’ common stock. The initial conversion price of the 0.875% Notes represents a premium of approximately 32.5% to $10.05 per share last reported sale price of Allscripts’ common stock on December 4, 2019. The conversion rate will be subject to adjustment upon the occurrence of certain specified events, but will not be adjusted for any accrued and unpaid interest. In addition, upon the occurrence of a “make-whole fundamental change” (as defined in Section 1.01 of the 0.875% Notes Indenture), Allscripts’ will, in certain circumstances, increase the conversion rate by a number of additional shares of Allscripts’ common stock for a holder that elects to convert its 0.875% Notes in connection with such make-whole fundamental change. We may not redeem the 0.875% Notes prior to the maturity date, and no sinking fund is provided for the 0.875% Notes.

Upon the occurrence of a “fundamental change” (as defined in Section 1.01 of the 0.875% Notes Indenture), holders of the 0.875% Notes may require us to repurchase all or any portion of their 0.875% Notes in principal amounts of $1,000 or an integral multiple thereof at a fundamental change repurchase price in cash equal to 100% of the principal amount of the 0.875% Notes to be repurchased, plus any accrued and unpaid interest, if any, to, but excluding, the fundamental change repurchase date.

The 0.875% Notes Indenture contains customary terms and covenants, including that upon certain events of default, including cross acceleration to certain other indebtedness of Allscripts and its subsidiaries, either the trustee under the 0.875% Notes Indenture or the holders of not less than 25% in aggregate principal amount of the 0.875% Notes then outstanding may declare the unpaid principal of the 0.875% Notes and accrued and unpaid interest, if any, thereon immediately due and payable.

In December 2019, in connection with the 0.875% Notes offering, we entered into privately negotiated capped call transactions with JPMorgan Chase Bank, National Association, New York Branch, Wells Fargo Bank, National Association, Bank of America, N.A. and Deutsche Bank AG, London Branch (the “option counterparties”). The capped call transactions are expected generally to reduce the potential dilution to Allscripts’ common stock upon any conversion of 0.875% Notes and/or offset any cash payments Allscripts is required to make in excess of the principal amount of the converted 0.875% Notes upon conversion of the 0.875% Notes, as the case may be, in the event that the market price of Allscripts’ common stock is greater than the strike price of the capped call transactions (which initially corresponds to the initial conversion price of the 0.875% Notes of approximately $13.32 per share of Allscripts’ common stock and is subject to certain adjustments under the terms of the capped call transactions), with such reduction and/or offset subject to a cap based on the cap price of the capped call transactions. The cap price of the capped call transactions is initially $17.5875 per share, representing a premium of 75% above the last reported sale price of $10.05 per share of Allscripts’ common stock on December 4, 2019, and is subject to certain adjustments under the terms of the capped call transactions. The capped call transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the 0.875% Notes, the number of shares of Allscripts’ common stock that underlie the 0.875% Notes. The capped call transactions are not part of the terms of the 0.875% Notes and will not affect any holder’s rights under the 0.875% Notes. Holders of the 0.875% Notes will not have any rights with respect to the capped call transactions.

The aggregate net proceeds of the 0.875% Notes were $195.0 million after deducting $5.0 million for the initial purchasers’ discount but before deducting other estimated expenses. On December 9, 2019, we used $15.8 million of the net proceeds to pay the cost of the capped call transactions and the remainder of $179.2 million to repay outstanding borrowings under our senior secured revolving credit facility.

On December 18, 2019, the initial purchasers notified us of the partial exercise of their option to purchase additional 0.875% Notes. On December 20, 2019 we issued an additional $18.0 million in aggregate principal amount of the 0.875% Notes (the “Option Notes”) pursuant to a partial exercise of the initial purchasers’ option to purchase additional 0.875% Notes. The Option Notes have the same terms as the 0.875% Notes previously described and are issued pursuant to the same 0.875% Notes Indenture. The net proceeds from the sale of the Option Notes totaled $17.5 million after deducting $0.5 million in debt issuance costs. In connection with the initial purchasers’ exercise of their option to purchase the Option Notes, we entered into additional privately negotiated capped call transactions (the “additional capped call transactions”) with each of the option counterparties. On December 20, 2019, we used $1.4 million of the net proceeds to pay the cost of additional capped call transactions and the remainder to repay additional outstanding borrowings under our senior secured revolving credit facility.

The issuance in December 2019 of the combined $218.0 million aggregate purchase amount of the 0.875% Notes and the Option Notes (collectively, the “0.875% Convertible Senior Notes”) incurred $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 semi-annual 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 December 31, 2021 totaled $207.9 million. The carrying value of the combined equity component, net of capped call fees, issuance costs and accretion, at December 31, 2021 totaled $10.9 million.

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. Collectively, the Term Loan and the Revolving Facility are referred to herein as the “Senior Secured Credit Facility.” The Term Loan is repayable in quarterly installments, which commenced on June 30, 2018. We repaid the Term Loan in full on December 31, 2020. 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.

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 provides the financial flexibility to settle the U.S. Department of Justice’s investigations as discussed in Note 22, “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.

On July 20, 2020, we entered into a Second Amendment to the 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 $1.4 million, of which a majority was capitalized.

The proceeds of the Revolving Facility can be used to finance Allscripts’ working capital needs and for general corporate purposes, including, without limitation, for financing permitted acquisitions, and for share repurchases. Allscripts is also permitted to add one or more incremental revolving and/or term loan facilities in an aggregate amount of up to $600 million, subject to certain conditions.

The initial applicable interest rate margin for Base Rate borrowings is 1.00%, and for Eurocurrency Rate borrowings is 2.00%. On and after December 31, 2021, the interest rate margins will be determined from a pricing table and will depend upon Allscripts’ total leverage ratio. The applicable margins for Base Rate borrowings under the Second Amended Credit Agreement range from 0.50% to 1.25% depending on Allscripts’ total leverage ratio range. The applicable margins for Eurocurrency Rate loans range from 1.50% to 2.25%, depending on Allscripts’ total leverage ratio.

Subject to certain agreed upon exceptions, all obligations under the Senior Secured Credit Facility remain guaranteed by each of our existing and future direct and indirect material domestic subsidiaries other than Coniston Exchange LLC and certain domestic subsidiaries owned by our foreign subsidiaries (the “Guarantors”) pursuant to a related Guarantee and Collateral Agreement among Allscripts Healthcare Solutions, Inc., Allscripts Healthcare, LLC, certain of our other subsidiaries, and JPMorgan Chase Bank, N.A., as administrative agent. Our obligations under the Senior Secured Credit Facility, any swap agreements and any cash management arrangements provided by any lender, remain secured, subject to permitted liens and other agreed upon exceptions, by a perfected first priority security interest in all of the tangible and intangible assets (including, without limitation, intellectual property, material owned real property and all of the capital stock of each Guarantor and, in the case of foreign subsidiaries, up to 65% of the capital stock of first tier material foreign subsidiaries) of Allscripts Healthcare Solutions, Inc. and certain of our subsidiary guarantors.

The Second Amended Credit Agreement requires us to maintain a minimum interest coverage ratio of 3.5 to 1.0 and a maximum total net leverage ratio of 4.25 to 1.0. The minimum interest coverage ratio is calculated by dividing earnings before interest expense, income tax expense, depreciation and amortization expense by cash interest expense, subject to various agreed upon adjustments. The total net leverage ratio is calculated by dividing total indebtedness reduced by a portion of domestic unrestricted cash, by earnings before interest expense, income tax expense, depreciation and amortization expense, subject to various agreed upon adjustments. The Second Amended Credit Agreement also provides that during the four-quarter period following permitted acquisitions that are financed in whole or in part with indebtedness and the consideration paid by us is $100 million or more, we are required to maintain a maximum total leverage ratio of 4.5 to 1.0. In addition, the Second Amended Credit Agreement requires mandatory prepayments of the debt outstanding under the Senior Secured Credit Facility in certain specific circumstances, and contains a number of covenants which, among other things, restrict our ability to incur additional indebtedness, engage in mergers, or declare dividends or other payments in respect of our capital stock.

The Second Amended Credit Agreement also contains certain customary events of default, including relating to non-payment, breach of covenants, cross-default, bankruptcy and change of control.

In connection with the sale of substantially all of the assets of our EPSi business on October 15, 2020, which is further discussed in Note 5, “Business Combinations and Divestitures”, the terms of our Second Amended and Restated Credit Agreement required us to make a mandatory prepayment of our Term Loan in the amount of $19.0 million on October 29, 2020.

In connection with the sale of substantially all of the assets of our CarePort business on December 31, 2020, which is further discussed in Note 5, “Business Combinations and Divestitures”, the terms of our Second Amended and Restated Credit Agreement required us to make a mandatory prepayment of our Term Loan in the amount of $161.0 million on December 31, 2020.

As of December 31, 2021, $175.0 million under the Revolving Facility and $1.0 million in letters of credit were outstanding under the Second Amended Credit Agreement.

As of December 31, 2021, the interest rate on the Senior Secured Credit Facility was LIBOR plus 1.50%, which totaled 1.60%. We were in compliance with all financial covenants under the Second Amended Credit Agreement as of December 31, 2021.

As of December 31, 2021, we had $724.0 million available borrowing capacity, net of outstanding letters of credit, under the Revolving Facility. There can be no assurance that we will be able to draw on the full available balance of the 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.

Allscripts 1.25% Cash Convertible Senior Notes and Call Spread Overlay

On June 18, 2013, we issued $345.0 million aggregate principal amount of Allscripts' 1.25% Cash Convertible Senior Notes due 2020 (the “1.25% Notes”). Concurrent with the issuance of the 1.25% Notes, we entered into privately negotiated hedge transactions (collectively, the “1.25% Call Option”) and warrant transactions (collectively, the “1.25% Warrants”), with certain of the initial purchasers of the 1.25% Notes (collectively, the “Call Spread Overlay”). The aggregate net proceeds of the 1.25% Notes were $305.1 million, after payment of the net cost of the Call Spread Overlay and transaction costs. Refer to Note 10, “Debt,” in our consolidated financial statements included in Part II, Item 8, “Financial Statements and Supplementary Data” of the 2020 Form 10-K for further details regarding the 1.25% Notes and Call Spread Overlay transactions. The 1.25% Call Option was a derivative financial instrument and is discussed further in Note 16, “Derivative Financial Instruments.” The 1.25% Warrants were equity instruments and are further discussed in Note 13, “Stockholders’ Equity.”

Future Debt Payments

The following table summarizes future debt payments as of December 31, 2021:



(In thousands)	Total		2022		2023		2024		2025		2026		Thereafter
0.875% Convertible Senior Notes (1)	$	207,911	$	0	$	0	$	0	$	0	$	0	$	207,911
Revolving Facility (2)		175,000		0		175,000		0		0		0		0
Total debt	$	382,911	$	0	$	175,000	$	0	$	0	$	0	$	207,911

(1)

Amount represents the face value of the 0.875% Convertible Senior Notes, which includes both the liability and equity portions.

(2)

Assumes no additional borrowings after December 31, 2021, payment of any required periodic installments of principal when due and that all drawn amounts are repaid upon maturity.

Income Taxes

12 Months Ended

Dec. 31, 2021

Income Tax Disclosure [Abstract]

Income Taxes

11. Income Taxes

The following is a geographic breakdown of income (loss) from continuing operations before income tax provision (benefit):


	Year Ended December 31,
(In thousands)	2021		2020			2019
United States	$	141,367	$	(148,174	)	$	(287,088	)
Foreign		20,459		(1,137	)		5,337
Income (loss) from continuing operations before income taxes	$	161,826	$	(149,311	)	$	(281,751	)

The following is a summary of the components of the provision (benefit) for income taxes:


	Year Ended December 31,
(In thousands)	2021			2020			2019
Current tax provision (benefit)
Federal	$	17,179		$	(19,346	)	$	(8,232	)
State		507			(219	)		(1,809	)
Foreign		7,998			3,803			5,054
		25,684			(15,762	)		(4,987	)
Deferred tax provision (benefit)
Federal		3,341			2,931			(28,732	)
State		(34	)		(2,981	)		(8,763	)
Foreign		(1,140	)		(880	)		(858	)
		2,167			(930	)		(38,353	)
Income tax provision (benefit)	$	27,851		$	(16,692	)	$	(43,340	)

Taxes computed at the statutory federal income tax rate of 21% for the years ended December 31, 2021, 2020 and 2019 are reconciled to the provision for income taxes as follows:


	Year Ended December 31,
(In thousands)	2021			2020			2019
United States federal tax at statutory rate	$	33,983		$	(31,355	)	$	(59,170	)
Items affecting federal income tax rate
Non-deductible acquisition and reorganization expenses		0			0			31
Non-deductible portion of Department of Justice Settlement		(1,050	)		0			18,546
Research credits		(5,000	)		(6,500	)		(6,126	)
Change in unrecognized tax benefits		2,007			3,204			1,046
State income taxes, net of federal benefit		7,161			(2,940	)		(7,411	)
Compensation		(1,103	)		5,314			4,664
Meals and entertainment		7			118			549
Impact of foreign operations		2,579			1,443			3,079
Provision-to-Return adjustments		(9,544	)		(2,362	)		(383	)
Deemed Dividends		208			352			473
Federal, state and local rate changes		0			0			(630	)
US Tax reform impact		0			0			(2,972	)
Goodwill impairment		0			0			5,397
Non-deductible items		66			28			43
Valuation allowance		(1,504	)		16,949			922
Other		41			(943	)		(1,398	)
Income tax provision (benefit)	$	27,851		$	(16,692	)	$	(43,340	)

Significant components of our deferred tax assets and liabilities consist of the following:


	December 31,
(In thousands)	2021			2020
Deferred tax assets
Accruals and reserves, net	$	11,689		$	18,260
Allowance for doubtful accounts		8,750			9,571
Stock-based compensation, net		9,869			8,428
Deferred revenue		42,672			35,016
Operating and finance lease liabilities		15,612			22,902
Net operating loss carryforwards		33,231			35,695
Research and development tax credit		432			251
Other		0			4,519
Less: Valuation Allowance		(34,339	)		(35,491	)
Total deferred tax assets		87,916			99,151

Deferred tax liabilities
Prepaid expense		(4,272	)		(4,329	)
Property and equipment, net		(88	)		(2,062	)
Acquired intangibles, net		(80,273	)		(86,841	)
Operating and finance right-of-use assets		(11,840	)		(18,315	)
Other		(1,461	)		0
Total deferred tax liabilities		(97,934	)		(111,547	)
Net deferred tax liabilities	$	(10,018	)	$	(12,396	)

The deferred tax assets (liabilities) are classified in the consolidated balance sheets as follows:


	December 31,
(In thousands)	2021			2020
Non-current deferred tax assets, net	$	6,607		$	5,790
Non-current deferred tax liabilities, net		(16,625	)		(18,186	)
Net deferred tax liabilities	$	(10,018	)	$	(12,396	)

We had federal net operating loss (“NOL”) carryforwards of $151 million and $164 million as of December 31, 2021, and 2020, respectively. The federal NOL carryforward includes U.S. NOL carryovers of $12.5 million and Israeli NOL carryovers of $47 million that do not expire. The NOL carryforwards expire in various amounts starting in 2031 for federal purposes. The utilization of the federal NOL carryforwards is subject to limitation under the rules regarding changes in stock ownership as determined by the Internal Revenue Code.

For federal purposes, 2018 to 2021 tax years remain subject to income tax examination by federal authorities. For our state tax jurisdictions, 2016 to 2021 tax years remain open to income tax examination by state tax authorities. Tax years remain open in various foreign jurisdictions beginning in 2016. We have a subsidiary in India that is entitled to a tax holiday that allows for tax-free operations during such tax holiday. This tax holiday for the subsidiary began to partially expire in 2012 and fully expired in 2017. Tax savings realized from this holiday totaled $0.4 million for the year ended December 31, 2017, which reduced our loss per share by less than $0.01 through 2017. There is a potential for a partial tax holiday for 5 years beginning on April 1, 2017, which is contingent upon a certain level of capital expenditure spending, among other conditions. Tax savings impact of $0.3 million has been recorded for this potential tax holiday for the year ended December 31, 2021, which impacted our diluted earnings per share by less than $0.01 in this year.

GAAP principles prescribe a threshold of more-likely-than-not to be sustained upon examination for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. These principles also provide guidance on de-recognition, classification, interest and penalties, accounting in interim periods, disclosure and transition.

Changes in the amounts of unrecognized tax benefits were as follows:


	Year Ended December 31,
(In thousands)	2021			2020			2019
Beginning balance as of January 1	$	28,885		$	20,604		$	19,821
Increases for tax positions related to the current year		1,000			8,053			1,240
Decreases for tax positions related to prior years		(276	)		0			0
Increases for tax positions related to prior years		685			427			95
Foreign currency translation		0			2			3
Reductions due to lapsed statute of limitations		0			(201	)		(555	)
Ending balance as of December 31	$	30,294		$	28,885		$	20,604

We had gross unrecognized tax benefits of $30.3 million and $28.9 million as of December 31, 2021 and 2020, respectively. If the current gross unrecognized tax benefits were recognized, the result would be an increase in our income tax benefit of $33.5 million and $30.8 million, for 2021 and 2020, respectively. These amounts are net of accrued interest and penalties relating to unrecognized tax benefits of $3.2 million and $2.0 million, respectively. We believe that it is reasonably possible that $18.2 million of our currently remaining unrecognized tax benefits may be recognized by the end of 2022, as a result of a lapse of the applicable statute of limitations.

We recognized interest and penalties related to uncertain tax positions in our consolidated statements of operations as follows:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Interest and penalties included in the provision for income taxes	$	1,172	$	1,620	$	229

The amount of interest and penalties included in our consolidated balance sheets is as follows:


	December 31,
(In thousands)	2021		2020
Interest and penalties included in the liability for uncertain tax positions	$	3,220	$	2,048

During the year ended December 31, 2021, we recorded a valuation allowance of $0.4 million related to the unvested stock compensation of covered officers due to the potential deduction limitations under Section 162(m) provisions. We released $1.9 million against deferred tax assets of certain U.S. and foreign deferred tax assets. In evaluating our ability to recover our deferred tax assets within the jurisdiction from which they arise, we consider all available positive and negative 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). The Company continually evaluates the realization of its U.S. deferred tax assets and based on historical trends and current activity; we may release the remaining U.S. valuation allowance in 2022.

We file income tax returns in the United States federal jurisdiction, numerous states in the United States and multiple countries outside of the United States. We are subject to the continuous examination of our income tax returns by the IRS and other tax authorities. A change in the assessment of the outcomes of such matters could materially impact our consolidated financial statements.

We intend to indefinitely reinvest the undistributed earnings of our foreign subsidiaries as a general rule, as most of our foreign subsidiaries have third party customers, as well as formal sales proposals that could require significant resources. Specifically, our subsidiary in India may repatriate all current 2021 earnings at the discretion of management. As of December 31, 2021, we have no other plans to repatriate any other funds at this time. A Netherlands holding company currently holds all of our foreign subsidiaries. Our holding company makes it more efficient for us to share resources between the respective foreign subsidiaries. As we have determined that the earnings of these subsidiaries are not required as a source of funding for our U.S. operations, such earnings are not planned to be distributed to the United States in the foreseeable future. Determination of the amount of unrecognized income tax liability related to these undistributed foreign subsidiary earnings, if repatriated, is currently not practicable.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32705-109319

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
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-URI http://asc.fasb.org/extlink&oid=6424409&loc=d3e44925-109338

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
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-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

Stock Award Plan

12 Months Ended

Dec. 31, 2021

Share-based Payment Arrangement [Abstract]

Stock Award Plan

12. Stock Award Plan

Total recognized stock-based compensation expense is included in our consolidated statements of operations as shown in the table below. 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.


	Year Ended December 31,
(In thousands)	2021		2020		2019
Cost of revenue:
Software delivery, support and maintenance	$	1,529	$	1,640	$	2,075
Client services		4,086		4,421		4,067
Total cost of revenue		5,615		6,061		6,142
Selling, general and administrative expenses		31,661		25,002		27,348
Research and development		6,287		7,827		9,200
Total stock-based compensation expense	$	43,563	$	38,890	$	42,690

The estimated income tax benefit of stock-based compensation expense included in the provision for income taxes for the year ended December 31, 2021 is approximately $4.9 million. No stock-based compensation costs were capitalized during the years ended December 31, 2021, 2020 and 2019. The calculation of stock-based compensation expenses includes an estimate for forfeitures at the time of grant. This estimate can be revised in subsequent periods if actual forfeitures differ from those estimates, which are based on historical trends. Total unrecognized stock-based compensation expense related to non-vested awards and options was $58.8 million as of December 31, 2021, and this expense is expected to be recognized over a weighted-average period of 2.3 years.

Allscripts Long-Term Incentive Plan

Allscripts adopted the 2019 Stock Incentive Plan (the “Plan”), which became effective May 23, 2019. The Plan provides for the granting of stock options, service-based share awards, performance-based share awards and market-based share awards, among other equity awards. The maximum number of shares available for awards under the Plan is 5.5 million, plus the number of available shares of common stock under the Amended and Restated 2011 Stock Incentive plan as of the effective date of the Plan. As of December 31, 2021, there were 6.5 million shares of common stock reserved for issuance under future share-based awards to be granted to any of Allscripts employees, officers, directors or independent consultants at terms and prices to be determined by our Board, and subject to the terms of the Plan.

We issue service-based, performance-based and market-based awards in the form of restricted stock units or stock options. A description of each category of awards is presented below.

Service-based Share Awards

Service-based share awards include stock options and restricted stock units, and typically vest over a four-year period commencing on the date of grant subject to continued service with the Company. Upon termination of an employee’s employment, any unvested service-based share awards are forfeited unless otherwise provided in an employee’s employment agreement. Share units are awarded to directors and vest within one year. We recognize the expense for service-based share awards over the requisite service period on a straight-line basis, net of estimated forfeitures.

There was $45.4 million of total estimated unrecognized stock-based compensation expense related to the service-based share awards as of December 31, 2021, which is expected to be recognized over a weighted-average period of 2.5 years.

Performance-based Share Awards

Performance-based share awards include restricted stock units. The purpose of such awards is to align management’s compensation with our financial performance and other operational objectives and, in certain cases, to retain key employees over a specified performance period. Awards granted under this category are based on the achievement of various targeted financial measures as defined by the Plan. The awards are earned based on actual results achieved compared to targeted amounts. Stock-based compensation expense related to these awards is recognized over a three-year vesting period under the accelerated attribution method if and when we conclude that it is probable that the performance conditions will be achieved.

There was $8.2 million of total estimated unrecognized stock-based compensation expense as of December 31, 2021, assuming various target attainments related to the performance-based share awards, which is expected to be recognized over a weighted-average period of 1.8 years.

Market-based Share Awards

Market-based share awards include restricted stock units. The purpose of such awards is to align management’s compensation with the performance of our common stock relative to the market. Awards granted under this category are dependent on our total shareholder returns relative to a specified peer group of companies over three-year performance periods with vesting based on three annual performance segments from the grant dates. Fair values of the awards were estimated at the date of the grants using the Monte Carlo pricing model. The Compensation Committee of our Board determines the number of awards that will vest considering overall performance over the three-year performance period following the completion of a performance period. Stock-based compensation expense related to these awards is recognized over the three-year vesting periods under the accelerated attribution method.

There was $5.2 million of total estimated unrecognized stock-based compensation expense as of December 31, 2021, which is expected to be recognized over a weighted-average period of 1.7 years.

Restricted Stock Units

The following table summarizes the activity for restricted stock units during the periods presented:


				Weighted-Average
(In thousands, except per share amounts)	Shares			Grant Date Fair Value
Unvested restricted stock units as of December 31, 2018		7,950		$	12.81
Awarded		4,777			10.15
Vested		(2,360	)		12.62
Forfeited		(1,453	)		12.20
Unvested restricted stock units as of December 31, 2019		8,914			11.53
Awarded		5,607			6.88
Vested		(2,756	)		11.69
Forfeited		(2,097	)		10.79
Unvested restricted stock units as of December 31, 2020		9,668			8.95
Awarded		3,010			15.50
Vested		(3,051	)		9.52
Forfeited		(1,407	)		11.63
Unvested restricted stock units as of December 31, 2021		8,220		$	10.68

Net Share-settlements

Upon vesting, restricted stock units are generally net share-settled upon vesting 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 that vested during the years ended December 31, 2021, 2020 and 2019 were net-share settled such that we withheld shares with value equivalent to the employees’ minimum statutory tax obligations for the applicable income and other employment taxes and remitted the equivalent amount of cash to the appropriate taxing authorities. Total payments for the employees’ minimum statutory tax obligations are reflected as a financing activity within the accompanying consolidated statements of cash flows. The total shares withheld during the years ended December 31, 2021, 2020 and 2019 were 904 thousand, 808 thousand and 705 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 at the vesting date.

The following activity occurred under the Plan:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Total fair value of share awards vested	$	29,045	$	32,218	$	29,793

Stock Options

The following table summarizes the status of stock options outstanding and the changes during the periods presented:


	Options			Weighted-Average		Options		Weighted-Average
(In thousands, except per share amounts)	Outstanding			Exercise Price		Exercisable		Exercise Price
Balance as of December 31, 2018		1,332		$	13.69		1,332	$	13.69
Options granted		0			0.00
Options exercised		0			0.00
Options forfeited		(98	)		14.01
Balance as of December 31, 2019		1,234			13.67		1,234		13.67
Options granted		0			0.00
Options exercised		0			0.00
Options forfeited		(1,234	)		13.67
Balance as of December 31, 2020		0			0.00		0		0.00
Options granted		0			0.00
Options exercised		0			0.00
Options forfeited		0			0.00
Balance as of December 31, 2021		0		$	0.00		0	$	0.00

We estimated the fair value of our service-based stock option awards on the date of grant using the Black-Scholes-Merton option-pricing model. Option valuation models, including the Black-Scholes-Merton option-pricing model, require the input of certain assumptions that involve judgment. Changes in the input assumptions can materially affect the fair value estimates and, ultimately, how much we recognize as stock-based compensation expense. Our stock options had a contractual term of 7 years.

The aggregate intrinsic value of stock options outstanding or exercisable as of December 31, 2021 was zero, as all outstanding stock options were forfeited as of December 31, 2020. The intrinsic value of stock options outstanding represents the amount that would have been received by the option holders had all option holders exercised their stock options as of that date.

Allscripts Employee Stock Purchase Plan

Our Employee Stock Purchase Plan (the “ESPP”) allows eligible employees to authorize payroll deductions of up to 20% of their base salary to be applied toward the purchase of full shares of common stock on the last business day of each offering period. Offering periods under the ESPP are three months in duration and begin on each March 1st, June 1st, September 1st, and December 1st. Shares are purchased on the last day of each offering period at a discount of 15% to the fair market value of our common stock as reported on Nasdaq based on the lower of the closing price either on the first or last business day of each offering period. Employees are limited to purchasing shares under the ESPP having a collective fair market value no greater than $25,000 in any one calendar year. The shares available for purchase under the ESPP may be drawn from either authorized but previously unissued shares of common stock or from reacquired shares of common stock, including shares purchased by us in the open market and held as treasury shares.

We treat the ESPP as a compensatory plan in accordance with GAAP. For the years ended December 31, 2021 and 2020, we purchased 0.9 million and 2.0 million shares, respectively, under the ESPP.

Stockholders' Equity

12 Months Ended

Dec. 31, 2021

Equity [Abstract]

Stockholders' Equity

13. Stockholders’ Equity

Stock Repurchases

On August 2, 2018, we announced that our Board approved a stock purchase program (the “2018 Program”) under which we could repurchase up to $250 million of our common stock through December 31, 2020. During 2020, we repurchased 10.6 million shares of our common stock under the 2018 Program for a total of $102.0 million.

On November 18, 2020, we announced that our Board approved a stock purchase program (the “2020 Program”) under which we could repurchase up to $300 million of our common stock through December 31, 2021. The 2020 Program replaced the 2018 Program, and we fully utilized all remaining authorization under the 2020 Program by May of 2021. During 2021, we repurchased 5.6 million shares of our common stock under the 2020 Program, which was inclusive of the shares we received at final settlement of the accelerated share repurchase program we entered into on November 30, 2020, described below. During the fourth quarter of 2020, we repurchased 14.1 million of our common stock under the 2020 Program, which was inclusive of the initial shares repurchased through the accelerated share repurchase program we entered into on November 30, 2020, described below.

On May 26, 2021, we announced that our Board approved a new stock purchase program (the "2021 Program") under which we may repurchase up to $350 million of our common stock, with no termination date. The 2021 Program replaced the 2020 Program, and we fully utilized all remaining authorization under the 2021 Program by December 31, 2021. During 2021, we repurchased 20.4 million shares of our common stock under the 2021 Program. This is inclusive of the shares we received at initial and final settlement of the accelerated share repurchase program we entered into on June 14, 2021, described below.

On November 30, 2020, we entered into separate Master Confirmations (each, a “Master Confirmation”) and Supplemental Confirmations (each, together with the related Master Confirmation, an “ASR Agreement”), with JPMorgan Chase Bank, National Association and Wells Fargo Bank, National Association (each, an “ASR Counterparty”, or collectively, the “ASR Counterparties”), to purchase shares of our common stock for a total payment of $200.0 million (the “Prepayment Amount”). Under the terms of the ASR Agreements, on November 30, 2020, we paid the Prepayment Amount to the ASR Counterparties and received on December 2, 2020 an initial delivery of approximately 11.7 million shares of our common stock, which is approximately 80% of the total number of shares that could be repurchased under the ASR Agreements if the final purchase price per share equaled the closing price of our common stock on November 30, 2020. These repurchased shares became treasury shares and were recorded as a $165.7 million reduction to shareholder’s equity. The remaining $34.3 million of the Prepayment Amount was recorded as a reduction to shareholders’ equity as an unsettled forward contract indexed to our common stock. The total number of shares received under the ASR Agreements, after final settlement, was based on the average daily volume weighted average price of our common stock during the repurchase period, less an agreed upon discount. Final settlement of the ASR Agreements occurred in May 2021, resulting in the receipt of 1.6 million additional shares, which yielded a weighted-average share repurchase price of approximately $15.07.

On June 14, 2021, we entered into Supplemental Confirmations (each, a “June 2021 Supplemental Confirmation”) to the Master Confirmations dated November 30, 2020 (each, as supplemented by the corresponding June 2021 Supplemental Confirmation, a “June 2021 ASR Agreement”), with each of the ASR Counterparties, to purchase shares of our common stock for a total payment of $200.0 million (the “June 2021 Prepayment Amount”). Under the terms of the June 2021 ASR Agreements, on June 14, 2021, we paid the June 2021 Prepayment Amount to the ASR Counterparties and received on June 16, 2021 an initial delivery of approximately 9.1 million shares of our common stock, which is approximately 80% of the total number of shares that could be repurchased under the June 2021 ASR Agreements if the final purchase price per share equaled the closing price of our common stock on June 14, 2021. These repurchased shares became treasury shares and were recorded as a $161.2 million reduction to stockholders’ equity. The remaining $38.8 million of the June 2021 Prepayment Amount was recorded as a reduction to stockholders’ equity as an unsettled forward contract indexed to our common stock. The total number of shares received under the June 2021 ASR Agreements, after final settlement, was based on the average daily volume weighted average price of our common stock during the repurchase period, less an agreed upon discount. Final settlement of the June 2021 ASR Agreements occurred in August 2021, resulting in the receipt of 2.4 million additional shares, which yielded a weighted-average share repurchase price of approximately $17.28.

On January 24, 2022, we announced that our Board approved a new stock purchase program (the "2022 Program") under which we may repurchase up to $250 million of our common stock. The 2022 Program replaced the 2021 Program and has no termination date. 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 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.

Issuance of Common Stock and Warrants

On December 31, 2020, we completed the issuance of a warrant to a commercial partner, as part of a new and expanded commercial relationship, pursuant to which the warrant holder has the right to purchase 1.5 million shares of our common stock at an exercise price of $9.82 per share (the closing price of the Company’s common stock on the date definitive agreements with respect to the new and expanded commercial relationship were executed), subject to customary anti-dilution adjustments. The warrant vests in four equal annual installments of 375 thousand shares beginning on December 31, 2020 with each additional installment vesting annually thereafter. The warrant expires on December 31, 2026 and becomes void if certain specified changes to the parties’ commercial relationship occur. The warrant was issued and sold in reliance upon an exemption from registration under the Securities Act of 1933, as amended (the “Securities Act”), afforded by Section 4(a)(2) of the Securities Act and rules promulgated thereunder and corresponding provisions of state securities laws. The commercial partner is an “accredited investor” as defined in Rule 501(a) under the Securities Act. The warrant is not actively traded and was valued based on an option pricing model that used observable and unobservable market data for inputs. The warrant was valued at $12.4 million and is being amortized into earnings over the three-year vesting period. The amortization of the warrant value is included in stock-based compensation expense in the accompanying consolidated statements of cash flows. As of December 31, 2021, the vested installments of the warrant have not been exercised.

On June 30, 2016, we issued to a commercial partner, as part of an overall commercial relationship, unregistered warrants to purchase (i) 900,000 shares of our common stock, par value $0.01 per share, at a price per share of $12.47, (ii) 1,000,000 shares of our common stock at a price per share of $14.34 and (iii) 1,100,000 shares of our common stock at a price per share of $15.59, in each case subject to customary anti-dilution adjustments. The warrants vested in four equal annual installments of 750 thousand shares beginning in June 2017 and expire in June 2026. Our issuance of the warrants was a private placement exempt from registration pursuant to Section 4(a)(2) under the Securities Act. These warrants are not actively traded and were valued based on an option pricing model that used observable and unobservable market data for inputs. The warrants were valued at $11 million and were amortized into earnings over the four-year vesting period. The amortization expense is included as a reduction to revenue in the accompanying consolidated statements of operations. On December 30, 2020, the commercial partner exercised its warrants to purchase 900,000 shares on a cashless basis. Based on a price per share of $14.18, which was calculated in accordance with the agreement, it resulted in a delivery of 108 thousand shares. As of December 31, 2021, no additional warrants have been exercised.

In June 2013, in connection with the issuance of the 1.25% Notes, we issued the 1.25% Warrants exercisable for 20.1 million shares of our common stock (subject to anti-dilution adjustments under certain circumstances) with an initial exercise price of $23.135 per share, subject to customary adjustments. The net proceeds from the sale of the 1.25% Warrants of $51.2 million are included as additional paid in capital in the accompanying consolidated balance sheets as of December 31, 2021 and 2020. The 1.25% Warrants began to expire on October 1, 2020, with expiration continuing to expire over the next 70 trading days. The 1.25% Warrants are exercisable only upon expiration. All of the 1.25% Warrants expired by the end of the first quarter in 2021, and none were exercised.

Issuance of 0.875% Convertible Senior Notes

In December 2019, we issued the 0.875% Convertible Senior Notes that, at the option of the holders, may be converted into cash, Allscripts’ common stock or a combination of cash and Allscripts’ common stock. The issuance of the 0.875% Convertible Senior Notes generated a $40.1 million equity component for the embedded conversion option, which was recorded as Additional paid-in capital within the consolidated balance sheets as a discount that will be accreted into interest expense through January 1, 2027 using the interest method. The carrying value of the embedded conversion option was $10.9 million as of December 31, 2021. Refer to Note 10, “Debt” for further information regarding the 0.875% Convertible Senior Notes and embedded conversion option, including the Trading Price Trigger.

Earnings (Loss) Per Share

12 Months Ended

Dec. 31, 2021

Earnings Per Share [Abstract]

Earnings (Loss) Per Share

14. 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 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:


	Year Ended December 31,
(In thousands, except per share amounts)	2021		2020			2019
Basic earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax	$	133,975	$	(132,619	)	$	(238,411	)
Net loss attributable to non-controlling interests		0		0			424
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		133,975		(132,619	)		(237,987	)
Income from discontinued operations, net of tax		463		833,026			55,809
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	134,438	$	700,407		$	(182,178	)

Weighted-average common shares outstanding		130,140		159,281			166,306

Basic earnings (loss) from continuing operations per Common Share	$	1.03	$	(0.83	)	$	(1.43	)
Basic earnings from discontinued operations per Common Share	$	0.00	$	5.23		$	0.33
Net earnings (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	1.03	$	4.40		$	(1.10	)

Diluted earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax	$	133,975	$	(132,619	)	$	(238,411	)
Net loss attributable to non-controlling interests		0		0			424
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		133,975		(132,619	)		(237,987	)
Income from discontinued operations, net of tax		463		833,026			55,809
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	134,438	$	700,407		$	(182,178	)

Weighted-average common shares outstanding		130,140		159,281			166,306
Plus: Dilutive effect of stock options, restricted stock unit awards and warrants		8,518		0			0
Weighted-average common shares outstanding assuming dilution		138,658		159,281			166,306

Diluted earnings (loss) from continuing operations per Common Share	$	0.97	$	(0.83	)	$	(1.43	)
Diluted earnings from discontinued operations per Common Share	$	0.00	$	5.23		$	0.33
Net earnings (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	0.97	$	4.40		$	(1.10	)

As a result of the loss from continuing operations, net of tax for the years ended December 31, 2020 and 2019, we used basic weighted-average common shares outstanding in the calculation of diluted earnings (loss) per share, 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:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Shares subject to anti-dilutive stock options, restricted stock unit awards and warrants excluded from calculation		0		42,845		27,945

Accumulated Other Comprehensive Loss

12 Months Ended

Dec. 31, 2021

Equity [Abstract]

Accumulated Other Comprehensive Loss

15. Accumulated Other Comprehensive Loss

Accumulated Other Comprehensive Loss

Changes in the balances of each component included in accumulated other comprehensive loss (“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 (Losses) on Foreign Exchange Contracts			Total
Balance as of December 31, 2018 (1)		(5,584	)		195			(5,389	)
Other comprehensive income (loss) before reclassifications		1,192			61			1,253
Net (gains) losses reclassified from accumulated other comprehensive loss		0			(256	)		(256	)
Net other comprehensive income (loss)		1,192			(195	)		997
Balance as of December 31, 2019 (1)		(4,392	)		0			(4,392	)
Other comprehensive income (loss) before reclassifications		1,435			1,587			3,022
Net (gains) losses reclassified from accumulated other comprehensive loss		0			(468	)		(468	)
Net other comprehensive income (loss)		1,435			1,119			2,554
Balance as of December 31, 2020 (2)		(2,957	)		1,119			(1,838	)
Other comprehensive (loss) income before reclassifications		(69	)		351			282
Net (gains) losses reclassified from accumulated other comprehensive loss		0			(1,209	)		(1,209	)
Net other comprehensive (loss) income		(69	)		(858	)		(927	)
Balance as of December 31, 2021 (3)	$	(3,026	)	$	261		$	(2,765	)

(1)

Tax effects for the years ended December 31, 2019 and 2018 include $149 thousand arising from the revaluations of tax effects included in accumulated other comprehensive income.

(2)

Net of taxes of $390 thousand for unrealized net gains on foreign exchange contract derivatives.

(3)

Net of taxes of $91 thousand for unrealized net gains on foreign exchange contract derivatives.

Income Tax Effects Related to Components of Other Comprehensive Loss

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


	Year Ended December 31, 2021
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	(69	)	$	0		$	(69	)
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		473			(122	)		351
Net (gains) losses reclassified into income		(1,630	)		421			(1,209	)
Net change in unrealized (losses) gains on foreign exchange contracts		(1,157	)		299			(858	)
Other comprehensive (loss) income	$	(1,226	)	$	299		$	(927	)


	Year Ended December 31, 2020
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	1,435		$	0		$	1,435
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		2,139			(552	)		1,587
Net (gains) losses reclassified into income		(630	)		162			(468	)
Net change in unrealized gains (losses) on foreign exchange contracts		1,509			(390	)		1,119
Other comprehensive income (loss)	$	2,944		$	(390	)	$	2,554


	Year Ended December 31, 2019
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	1,192		$	0		$	1,192
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		82			(21	)		61
Net (gains) losses reclassified into income		(344	)		88			(256	)
Net change in unrealized (losses) gains on foreign exchange contracts		(262	)		67			(195	)
Other comprehensive income	$	930		$	67		$	997

Derivative Financial Instruments

12 Months Ended

Dec. 31, 2021

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Derivative Financial Instruments

16. Derivative Financial Instruments

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


	December 31, 2021
	Asset Derivatives
(In thousands)	Balance Sheet Location	Fair Value
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts	Prepaid expenses and other current assets	$	352
Total derivatives		$	352


	December 31, 2020
	Asset Derivatives
(In thousands)	Balance Sheet Location	Fair Value
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts	Prepaid expenses and other current assets	$	1,509
Total derivatives		$	1,509

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 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 December 31, 2021, there were 12 forward contracts outstanding that when entered into were staggered to mature monthly starting in January 2022 and ending in December 2022. 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 December 2022. As of December 31, 2021, the notional amount for each of the outstanding forward contracts ranged from 50 to 250 million INR, or the equivalent of $0.7 million to $3.4 million, based on the exchange rate between the United States dollar and the INR in effect as of December 31, 2021. These amounts also approximate the forecasted future INR expenses we target to hedge in any one month in the future. As of December 31, 2021, we estimate that $0.4 million of net unrealized derivative gains included in accumulated other comprehensive income will be reclassified into income within the next 12 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 income (loss):


	Amount of Gain (Loss) Recognized in OCI						Location of Gain (Loss) Reclassified from AOCI into Income	Amount of Gain (Loss) Reclassified from AOCI into Income
	Year Ended December 31,							Year Ended December 31,
(In thousands)	2021		2020		2019			2021		2020		2019
Foreign exchange contracts	$	473	$	2,139	$	82	Cost of Revenue	$	611	$	249	$	124
							Selling, general and administrative expenses		351		122		83
							Research and development		668		259		137

1.25% Call Option

In June 2013, concurrent with the issuance of the 1.25% Notes, we entered into the 1.25% Call Option with certain of the initial purchasers of the 1.25% Notes (the “Option Counterparties”). Assuming full performance by the Option Counterparties, the 1.25% Call Option was intended to offset cash payments in excess of the principal amount due upon any conversion of the 1.25% Notes. On July 1, 2020, the 1.25% Notes matured and were repaid in full, and the 1.25% Call Option expired.

Aside from the initial payment of a premium to the Option Counterparties of $82.8 million for the 1.25% Call Option, we were not required to make any cash payments to the Option Counterparties under the 1.25% Call Option, and, subject to the terms and conditions thereof, would have been entitled to receive from the Option Counterparties an amount of cash, generally equal to the amount by which the market price per share of our common stock exceeded the strike price of the 1.25% Call Option during the relevant valuation period. The strike price under the 1.25% Call Option was equal to the conversion price of the 1.25% Notes of $17.19 per share of our common stock.

The 1.25% Call Option, which was indexed to our common stock, was a derivative asset that required mark-to-market accounting treatment, due to the cash settlement features, until the 1.25% Call Option settled or expired. The 1.25% Call Option was measured and reported at fair value on a recurring basis within Level 3 of the fair value hierarchy. For further discussion of the inputs used to determine the fair value of the 1.25% Call Option, refer to Note 6, “Fair Value Measurements and Other Investments.”

The 1.25% Call Option did not qualify for hedge accounting treatment. Therefore, the change in fair value of this instrument was recognized immediately in our consolidated statements of operations in Other income (loss), net. Because the terms of the 1.25% Call Option were substantially similar to those of the 1.25% Notes embedded cash conversion option, discussed next, we expected the net effect of those two derivative instruments on our results of operations to be minimal.

1.25% Notes Embedded Cash Conversion Option

The embedded cash conversion option within the 1.25% Notes was required to be separated from the 1.25% Notes and accounted for separately as a derivative liability, with changes in fair value recognized immediately in our consolidated statements of operations in Other income (loss), net until the cash conversion option settled or expired. The cash conversion option expired without ever having required settlement prior to the maturity of the 1.25% Notes. 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 was measured and reported at fair value on a recurring basis within Level 3 of the fair value hierarchy. For further discussion of the inputs used to determine the fair value of the embedded cash conversion option, refer to Note 6, “Fair Value Measurements and Other Investments.”

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


	Year Ended December 31,
(In thousands)	2021		2020			2019
1.25% Call Option	$	0	$	(84	)	$	(9,020	)
1.25% Embedded cash conversion option		0		185			9,789
Net income included in Other income (loss), net	$	0	$	101		$	769

Commitments

12 Months Ended

Dec. 31, 2021

Commitments and Contingencies Disclosure [Abstract]

Commitments

17. Commitments

Commitment with Strategic Partner

In October 2021, we completed renegotiations with Atos to improve the operating cost structure of our private cloud hosting operations from the previous agreement in 2019. The new agreement has changed from a base fee plus volume-based services to a fully volume-based services agreement with minimal fixed fees currently projected using volumes estimated based on historical actuals and forecasted projections. Given that the new agreement does not require a base fee, we no longer have a commitment to our private cloud hosting partner. The expenses under our agreements with Atos are included in cost of revenue in our consolidated statements of operations. Expenses related to our agreements with Atos, prior to the new agreement with no commitments, are as follows:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Expenses incurred under Atos agreements with base fees	$	57,885	$	102,730	$	100,089

Discontinued Operations

12 Months Ended

Dec. 31, 2021

Discontinued Operations and Disposal Groups [Abstract]

Discontinued Operations

18. Discontinued Operations

EPSi and CarePort Discontinued Operations

During 2020, we implemented a strategic initiative to sell two of our businesses, EPSi and CarePort. Since both businesses were part of the same strategic initiative and were sold within the same period, the combined sale of EPSi and CarePort represented a strategic shift that had a major effect on our operations and financial results. These businesses are reported together as discontinued operations for all periods presented.

On October 15, 2020, we completed the sale of our EPSi business in exchange for $365.0 million, which was subject to certain adjustments for liabilities assumed by Strata and net working capital as described in the EPSi Purchase Agreement. Prior to the sale, EPSi was part of the former Unallocated category as it did not meet the requirements to be a reportable segment nor the criteria to be aggregated into our two reportable segments. On its own, the divestiture of the EPSi business did not represent a strategic shift that had a major effect on our operations and financial results. However, the combined sale of EPSi and CarePort represented a strategic shift that had a major effect on our operations and financial results. Therefore, EPSi was treated as a discontinued operation. Refer to Note 5, “Business Combinations and Divestitures” for additional information about this transaction.

On December 31, 2020, we completed the sale of our CarePort business in exchange for $1.35 billion, which was subject to certain adjustments for liabilities assumed by WellSky and net working capital as described in the CarePort Purchase Agreement. Prior to the sale, CarePort was part of the former Data, Analytics and Care Coordination reportable segment. On its own, the divestiture of the CarePort business represented a strategic shift that had a major effect on our operations and financial results. Refer to Note 5, “Business Combinations and Divestitures” for additional information about this transaction.

The following table summarizes the major classes of assets and liabilities of EPSi and CarePort, as reported on the consolidated balance sheets as of December 31, 2021 and 2020:


(In thousands)	December 31, 2021		December 31, 2020
Carrying amounts of major classes of liabilities associated with EPSi and CarePort included as part of discontinued operations:
Accrued expenses	$	0	$	6,669
Income tax payable		0		316,142
Total current liabilities attributable to discontinued operations	$	0	$	322,811

The following table summarizes the major income and expense line items of EPSi and CarePort as reported in the consolidated statement of operations for the years ended December 31, 2021, 2020 and 2019. The activity during 2021 relates to certain adjustments made in connection with the sale of EPSi and CarePort, which primarily relate to net working capital adjustments that impacted the gain on the sale of the discontinued operations.


	Year ended December 31,
(In thousands)	2021			2020			2019
Major income and expense line items related to EPSi and CarePort:
Revenue:
Software delivery, support and maintenance	$	6		$	122,791		$	122,268
Client services		0			14,030			16,763
Total revenue		6			136,821			139,031
Cost of revenue:
Software delivery, support and maintenance		(178	)		11,424			12,482
Client services		154			15,585			15,124
Amortization of software development and acquisition-related assets		0			9,053			8,166
Total cost of revenue		(24	)		36,062			35,772
Gross profit		30			100,759			103,259
Selling, general and administrative expenses		79			15,539			18,964
Research and development		(32	)		8,269			9,065
Amortization of intangible assets		0			29			29
(Loss) income from discontinued operations for EPSi and CarePort		(17	)		76,922			75,201
Interest expense		0			(5,241	)		0
Other income (loss), net		2			(192	)		2
Gain on sale of discontinued operations		647			1,156,504			0
Income from discontinued operations for EPSi and CarePort before income taxes		632			1,227,993			75,203
Income tax provision (1)		(169	)		(394,926	)		(19,417	)
Income from discontinued operations, net of tax for EPSi and CarePort (2)	$	463		$	833,067		$	55,786

(1)

Income tax provision does not agree to the consolidated statement of operations for the year ended December 31, 2019 due to residual amounts related to Netsmart (as defined below). Refer to Note 20, "Supplemental Disclosures" for additional information.

(2)

Income from discontinued operations, net of tax for EPSi and CarePort does not agree to the consolidated statement of operations for the years ended December 31, 2020 and 2019 due to residual amounts related to Netsmart (as defined below). Refer to Note 20, "Supplemental Disclosures" for additional information.

Business Segments

12 Months Ended

Dec. 31, 2021

Segment Reporting [Abstract]

Business Segments

19. 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 third quarter of 2021, we realigned our reporting structure due to certain organizational changes. As a result, we had three operating segments: (i) Hospitals and Large Physician Practices, (ii) Veradigm and (iii) Certain Products (as defined below). The Hospitals and Large Physician Practices and Veradigm operating segments are the equivalent to the two current reportable segments described below.

The new reportable segments are (i) Hospitals and Large Physician Practices and (ii) Veradigm. The new Hospitals and Large Physician Practices segment derives its revenue from the sale of integrated clinical and financial management solutions, which primarily include EHR-related software, related installation, support and maintenance, outsourcing and private cloud hosting. The new Veradigm segment derives its revenue from payer and life sciences solutions, which are mainly targeted at payers, life sciences companies and other key healthcare stakeholders. Additionally, revenue is derived from software applications for patient engagement and the sale of EHR software to single-specialty and small and mid-sized physician practices, including related clinical, financial, administrative and operational solutions. 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 “Unallocated Amounts” category consists of the 2bPrecise business, certain products that were shifted from the previous Core Clinical and Financial Solutions reportable segment due to the organizational changes (“Certain Products”), transfer pricing revenues and certain corporate-related expenses. The amounts included in the “Unallocated Amounts” category for 2bPrecise and Certain Products do not meet the requirements to be reportable segments nor the criteria to be aggregated into the two reportable segments. The segment disclosures below for the years ended December 31, 2020 and 2019 have been revised to conform to the current year presentation.

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


	Year Ended December 31,
(In thousands)	2021			2020			2019
Revenue:
Hospitals and Large Physician Practices	$	927,590		$	950,155		$	1,052,267
Veradigm		552,208			527,968			554,910
Unallocated Amounts		23,239			24,577			25,434
Total revenue	$	1,503,037		$	1,502,700		$	1,632,611

Gross profit:
Hospitals and Large Physician Practices	$	330,720		$	293,672		$	317,776
Veradigm		272,540			254,631			274,103
Unallocated Amounts		16,305			17,392			18,408
Total gross profit	$	619,565		$	565,695		$	610,287

Income (loss) from operations:
Hospitals and Large Physician Practices	$	(7,231	)	$	(154,315	)	$	(132,593	)
Veradigm		81,456			38,338			51,195
Unallocated Amounts		2,974			(14,903	)		(18,291	)
Total income (loss) from operations	$	77,199		$	(130,880	)	$	(99,689	)

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Supplemental Disclosures

12 Months Ended

Dec. 31, 2021

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Supplemental Disclosures

20. Supplemental Disclosures

The majority of the restricted cash balance as of December 31, 2021 represents lease deposits. The majority of the restricted cash balance as of December 31, 2020 represents lease deposits and an escrow account established as part of the acquisition of Netsmart LLC ("Netsmart") in 2016, to be used by Netsmart to facilitate the integration of Allscripts' former HomecareTM business.


	December 31,
(In thousands)	2021		2020
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$	188,351	$	531,104
Restricted cash		2,169		6,361
Total cash, cash equivalents and restricted cash	$	190,520	$	537,465


	Year Ended December 31,
(In thousands)	2021		2020		2019
Cash paid during the period for:
Interest, including convertible senior notes	$	4,993	$	24,616	$	23,917
Income taxes paid, net of tax refunds	$	330,473	$	76,595	$	42,972
Non-cash transactions:
Sale of 2bPrecise business in exchange for a non-controlling interest in the combined entity	$	11,768	$	0	$	0
Issuance of treasury stock to commercial partner	$	534	$	752	$	701

Accrued expenses consist of the following:


	December 31,
(In thousands)	2021		2020
Royalties, certain third-party product costs and licenses	$	39,146	$	37,841
Other		53,379		62,421
Total Accrued expenses	$	92,525	$	100,262

Other consists of various accrued expenses and no individual item accounted for more than 5% of the current liabilities balance at the respective balance sheet dates.

Prepaid and other current assets consists of the following:


	December 31,
(In thousands)	2021		2020
Prepaid assets	$	116,640	$	132,944
Other current assets		2,302		3,320
Total Prepaid and other current assets	$	118,942	$	136,264

Other assets consist of the following:


	December 31,
(In thousands)	2021		2020
Long-term deferred hosting fees	$	0	$	11,025
Long-term prepaid commissions		27,031		27,882
Investments in non-marketable securities		61,553		35,805
Long-term deposits and other assets		12,576		16,916
Total Other assets	$	101,160	$	91,628

Geographic Information

12 Months Ended

Dec. 31, 2021

Segment Reporting [Abstract]

Geographic Information

21. Geographic Information

Revenues are attributed to geographic regions based on the location where the sale originated. Our revenues by geographic area are summarized below:


	Year Ended December 31,
(In thousands)	2021		2020		2019
United States	$	1,433,301	$	1,439,737	$	1,562,107
Canada		16,013		15,624		16,495
Other international		53,723		47,339		54,009
Total	$	1,503,037	$	1,502,700	$	1,632,611

A summary of our long-lived assets, comprised of fixed assets by geographic area, is presented below:


	December 31,
(In thousands)	2021		2020
United States	$	40,183	$	62,016
India		4,628		5,876
Israel		1,958		2,611
Canada		127		187
Other international		1,006		1,472
Total	$	47,902	$	72,162

Contingencies

12 Months Ended

Dec. 31, 2021

Commitments and Contingencies Disclosure [Abstract]

Contingencies

22. 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, 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 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”) related to the Horizon Clinicals software from the U.S. Attorney’s Office for the Eastern District of New York. In August 2018, McKesson received an additional CID (together with the May 2017 CID, the “McKesson CIDs”), which relates to the Paragon software. The McKesson CIDs request documents and information related to the certification McKesson obtained in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program. 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. In October 2021, Allscripts received a CID seeking information about its acquisition of the EIS Business from McKesson and the Horizon Clinicals software. McKesson has agreed to assume defense of this CID.

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 (the “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. See risk factor entitled “The failure by Practice Fusion to comply with the terms of its settlement agreements with the DOJ could have a material and adverse impact on our business, results of operations and financial condition, and, even if Practice Fusion complies with those settlement agreements, the costs and burdens of compliance could be significant, and we may face additional investigations and proceedings from other governmental entities or third parties related to the same or similar conduct underlying the agreements with the DOJ.” 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. The Settlement Agreements also required Practice Fusion to pay a criminal fine of $25.3 million, a forfeiture payment of $959,700 and a civil settlement of $118.6 million, which included $5.2 million designated for the state Medicaid program expenditures, all of which, as of December 31, 2020, have been paid in full. The Deferred Prosecution Agreement required Practice Fusion to retain an Oversight Organization to oversee the Practice Fusion’s implementation of certain compliance measures and ongoing compliance efforts. On August 17, 2021, Practice Fusion’s initial Oversight Organization resigned, and on August 25, 2021, Practice Fusion received a notice from the U.S. Attorney’s Office for the District of Vermont stating Practice Fusion was in breach of the Deferred Prosecution Agreement due to such resignation. On September 17, 2021, Practice Fusion engaged a new Oversight Organization, and in February 2022, Practice Fusion reached an agreement in principle with the U.S. Attorney's Office for the District of Vermont to resolve the matter without finding of a breach.

Schedule II-Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2020

SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]

Schedule II-Valuation and Qualifying Accounts

Schedule II—Valuation and Qualifying Accounts

Charged to

Balance at

Expenses/

Write-Offs,

Balance at

Beginning of

Against

Net of

End of

(In thousands)

Year

Revenue

Recoveries

Year

Allowance for doubtful accounts and sales credits

Year ended December 31, 2019

25,826

3,467

(7,288

)

22,005

All other schedules are omitted, since the required information is not applicable or is not present in amounts sufficient to require submission of the schedule, or because the information required is included in the consolidated financial statements and notes thereto.

Basis of Presentation and Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2021

Accounting Policies [Abstract]

Principles of Consolidation

Use of Estimates

Change in Presentation

Cash and Cash Equivalents

Other Financial Assets and Liabilities

Derivative Financial Instruments

Trade Accounts Receivable

Accounts receivable are recorded at the invoiced amounts and do not bear interest.

Contingent Liabilities

Fixed Assets

Business Combinations

Goodwill and Intangible Assets

Long-Lived Assets and Long-Lived Assets to Be Disposed Of

Software Development Costs

The unamortized balances of capitalized software were as follows:


	December 31,
(In thousands)	2021			2020
Software development costs	$	338,677		$	327,519
Less: accumulated amortization		(166,573	)		(134,317	)
Software development costs, net	$	172,104		$	193,202


	Year Ended December 31,
(In thousands)	2021		2020		2019
Capitalized software development costs	$	73,265	$	87,993	$	103,317
Write-offs and divestitures of capitalized software development costs	$	3,105	$	31,214	$	0
Amortization of capitalized software development costs	$	91,258	$	86,269	$	72,840

Income Taxes

We file income tax returns in the United States federal jurisdiction, numerous states in the United States and multiple countries outside of the United States.

Stock-Based Compensation

Employee Benefit Plans


	Year Ended December 31,
(In thousands)	2021		2020		2019
Company contributions to employee benefit plans	$	19,511	$	21,143	$	23,998

Foreign Currency

Concentrations of Credit Risk

Recently Adopted Accounting Pronouncements

Accounting Pronouncements Not Yet Adopted

Revenue Recognition


Performance Obligation	Revenue Type	Recurring or Non-recurring Nature	Revenue Recognition Pattern	Measure of progress
Support and maintenance ("SMA")	Software delivery, support and maintenance	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Software as a service ("SaaS")	Software delivery, support and maintenance	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Private cloud hosting	Client services	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Client/Education services	Client services	Non-recurring	Over time	Input method (cost to cost) – revenue is recognized proportionally over the service implementation based on hours
Outsourcing services	Client services	Recurring	Over time	Input method (cost to cost) – revenue is recognized proportionally over the outsourcing period
Payerpath (transaction volume)	Software delivery, support and maintenance	Recurring	Over time	Output method ("right-to-invoice" practical expedient) – value transferred to the customer is reflected on invoicing.
Software licenses	Software delivery, support and maintenance	Non-recurring	Point in time	Upon electronic delivery
Hardware	Software delivery, support and maintenance	Non-recurring	Point in time	Upon shipment
Consulting Services	Client services	Non-recurring	Over time	Output method ("right-to-invoice" practical expedient) – value transferred to the customer is reflected on invoicing.

Basis of Presentation and Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2021

Accounting Policies [Abstract]

Unamortized Balances of Capitalized Software

The unamortized balances of capitalized software were as follows:


	December 31,
(In thousands)	2021			2020
Software development costs	$	338,677		$	327,519
Less: accumulated amortization		(166,573	)		(134,317	)
Software development costs, net	$	172,104		$	193,202

Capitalized Software Development Costs, divestitures, Write Offs and Amortization of Capitalized Software Development Costs


	Year Ended December 31,
(In thousands)	2021		2020		2019
Capitalized software development costs	$	73,265	$	87,993	$	103,317
Write-offs and divestitures of capitalized software development costs	$	3,105	$	31,214	$	0
Amortization of capitalized software development costs	$	91,258	$	86,269	$	72,840

Company Contributions to Employee Benefit Plan


	Year Ended December 31,
(In thousands)	2021		2020		2019
Company contributions to employee benefit plans	$	19,511	$	21,143	$	23,998

Revenue from Contracts with Customers (Tables)

12 Months Ended

Dec. 31, 2021

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 tables below:


(In thousands)	Three Months Ended March 31, 2021		Three Months Ended June 30, 2021		Three Months Ended September 30, 2021		Three Months Ended December 31, 2021
Revenue related to deferred revenue balance at beginning of period	$	137,848	$	151,857	$	144,696	$	151,763
Revenue related to new performance obligations satisfied during the period		173,316		158,910		159,149		171,345
Revenue recognized under "right-to-invoice" expedient		56,811		62,422		64,820		68,089
Reimbursed travel expenses, shipping and other revenue		377		525		607		502
Total revenue	$	368,352	$	373,714	$	369,272	$	391,699


(In thousands)	Three Months Ended March 31, 2020		Three Months Ended June 30, 2020		Three Months Ended September 30, 2020		Three Months Ended December 31, 2020
Revenue related to deferred revenue balance at beginning of period	$	105,366	$	119,545	$	118,300	$	138,279
Revenue related to new performance obligations satisfied during the period		216,580		195,308		192,658		182,690
Revenue recognized under "right-to-invoice" expedient		58,059		54,082		54,313		65,108
Reimbursed travel expenses, shipping and other revenue		1,359		369		347		337
Total revenue	$	381,364	$	369,304	$	365,618	$	386,414


(In thousands)	Three Months Ended March 31, 2019		Three Months Ended June 30, 2019		Three Months Ended September 30, 2019		Three Months Ended December 31, 2019
Revenue related to deferred revenue balance at beginning of period	$	93,602	$	113,288	$	116,812	$	136,460
Revenue related to new performance obligations satisfied during the period		248,126		233,293		227,954		214,952
Revenue recognized under "right-to-invoice" expedient		55,923		62,245		61,814		60,826
Reimbursed travel expenses, shipping and other revenue		1,467		2,057		1,700		2,092
Total revenue	$	399,118	$	410,883	$	408,280	$	414,330

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:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Revenue:
Recurring revenue	$	1,209,746	$	1,222,731	$	1,278,456
Non-recurring revenue		293,291		279,969		354,155
Total revenue	$	1,503,037	$	1,502,700	$	1,632,611

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.


	Year Ended December 31,
(In thousands)	2021			2020
Beginning Balance	$	5,341		$	5,341
Current period provision		(2,000	)		0
Ending Balance	$	3,341		$	5,341
Less: Contract assets, short-term		1,068			1,068
Total contract assets, long-term	$	2,273		$	4,273

Revenue by Segment [Member]

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


	Year Ended December 31, 2021
(In thousands)	Hospitals and Large Physician Practices		Veradigm		Unallocated Amounts		Total
Software delivery, support and maintenance	$	446,309	$	452,933	$	16,944	$	916,186
Client services		481,281		99,275		6,295		586,851
Total revenue	$	927,590	$	552,208	$	23,239	$	1,503,037


	Year Ended December 31, 2020
(In thousands)	Hospitals and Large Physician Practices		Veradigm		Unallocated Amounts		Total
Software delivery, support and maintenance	$	472,130	$	432,009	$	19,598	$	923,737
Client services		478,025		95,959		4,979		578,963
Total revenue	$	950,155	$	527,968	$	24,577	$	1,502,700


	Year Ended December 31, 2019
(In thousands)	Hospitals and Large Physician Practices		Veradigm		Unallocated Amounts		Total
Software delivery, support and maintenance	$	541,904	$	448,380	$	20,709	$	1,010,993
Client services		510,363		106,530		4,725		621,618
Total revenue	$	1,052,267	$	554,910	$	25,434	$	1,632,611

Accounts Receivable (Tables)

12 Months Ended

Dec. 31, 2021

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 table below.


	Year Ended December 31,
(In thousands)	2021			2020
Beginning Balance	$	31,596		$	33,256
Current period provision		6,818			8,726
Write-offs		(9,191	)		(10,484	)
Recoveries		720			98
Ending Balance	$	29,943		$	31,596

Leases (Tables)

12 Months Ended

Dec. 31, 2021

Lessee Disclosure [Abstract]

Summary of Operating Costs Associated with Leased Assets

Operating costs associated with leased assets are as follows:


(In thousands)	Year Ended December 31,
	2021			2020
Operating lease cost (1)	$	22,343		$	25,394
Less: Sublease income		(314	)		(1,121	)
Total operating lease costs	$	22,029		$	24,273

(1)

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

Supplemental Information for Operating Leases

Supplemental information for operating leases is as follows:


(In thousands)	Year Ended December 31,
	2021		2020
Operating cash flows from operating leases	$	24,141	$	26,638
Right-of-use assets obtained in exchange for operating lease obligations	$	3,252	$	21,770

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)	December 31, 2021			December 31, 2020
Right-of-use assets - operating leases	$	68,909		$	96,601
Current operating lease liabilities	$	19,599		$	22,264
Long-term operating lease liabilities	$	64,822		$	93,463
Weighted average remaining lease term (in years)		5			6
Weighted average discount rate		3.3	%		3.6	%

Summary of Future Maturities of Lease and Non-Lease Components


	December 31, 2021
(In thousands)	Operating Leases
2022	$	22,093
2023		20,285
2024		14,805
2025		13,438
2026		12,105
Thereafter		8,655
Total lease liabilities		91,381
Less: Amount representing interest		(6,960	)
Less: Short-term lease liabilities		(19,599	)
Total long-term lease liabilities	$	64,822

Fair Value Measurements and Other Investments (Tables)

12 Months Ended

Dec. 31, 2021

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	December 31, 2021								December 31, 2020
(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	$	352	$	0	$	352	$	0	$	1,509	$	0	$	1,509
Total assets		$	0	$	352	$	0	$	352	$	0	$	1,509	$	0	$	1,509

Contingent consideration - current	Accrued expenses	$	0	$	0	$	19	$	19	$	0	$	0	$	1,011	$	1,011
Total liabilities		$	0	$	0	$	19	$	19	$	0	$	0	$	1,011	$	1,011

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 December 31, 2021 are summarized as follows:


(In thousands)	Contingent Consideration			1.25% Notes Call Spread Overlay
Balance at December 31, 2019	$	19,515		$	(101	)
Additions		770			0
Payments/write-downs (1)		(19,274	)		0
Fair value adjustments		0			101
Balance at December 31, 2020	$	1,011		$	0
Payments		(858	)		0
Write-downs		(134	)		0
Balance at December 31, 2021	$	19		$	0

(1)

Payments and write-downs for the year ended December 31, 2020 primarily consisted of $4.0 million in payments for the ACC earnout and a $13.9 million write-down related to the Health Grid earnout.

Summary of Quantitative Information About Fair Value Measurements

The following table summarizes the quantitative information about our Level 3 fair value measurements at December 31, 2021:

December 31, 2021

(In thousands, except the discount rate)

Fair Value

Valuation Technique

Significant Unobservable Inputs

Ranges of Inputs

Weighted Average (1)

Financial instruments:

Contingent consideration

Probability Weighted Discounted cash flow

Discount rate

5.3% to 5.5%

5.4

Registry members

0 to 1,551

776

Patient data volume

0 to 52,845

26,422

Projected year of remaining payment

2022

Total financial instruments

(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 Other Equity Investments Included in Other Assets

The following table summarizes our other 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 December 31, 2021		Cost		December 31, 2021		December 31, 2020 (2)
Equity method investments (1)		4	$	7,099	$	12,260	$	10,744
Cost with adjustments		7		57,213		49,293		25,059
Total long-term equity investments		11	$	64,312	$	61,553	$	35,803

(1)

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

(2)

Amounts include investments that are no longer held as of December 31, 2021.

Fixed Assets (Tables)

12 Months Ended

Dec. 31, 2021

Property, Plant and Equipment [Abstract]

Fixed Assets

Fixed assets consist of the following:


	Estimated	December 31,			December 31,
(Dollar amounts in thousands)	Useful Life	2021			2020
Computer equipment and software	3 to 10 years	$	310,153		$	329,564
Facility furniture, fixtures and equipment	5 to 7 years		23,325			25,932
Leasehold improvements	Shorter of 7 years or life of lease		36,858			40,115
Assets under finance leases	1 to 3 years		524			524
Fixed assets, gross			370,860			396,135
Less: Accumulated depreciation and amortization			(322,958	)		(323,973	)
Fixed assets, net		$	47,902		$	72,162

Depreciation and Amortization Expense


	Year Ended December 31,
(In thousands)	2021		2020		2019
Fixed assets depreciation and amortization expense, including finance leases	$	26,847	$	32,324	$	46,705

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2021

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

Goodwill and intangible assets consist of the following:


	December 31, 2021							December 31, 2020
	Gross							Gross
	Carrying		Accumulated			Intangible		Carrying		Accumulated			Intangible
(In thousands)	Amount		Amortization			Assets, Net		Amount		Amortization			Assets, Net
Intangibles subject to amortization:
Proprietary technology	$	535,019	$	(492,681	)	$	42,338	$	535,092	$	(465,292	)	$	69,800
Customer contracts and relationships		674,078		(532,486	)		141,592		674,336		(509,534	)		164,802
Total	$	1,209,097	$	(1,025,167	)	$	183,930	$	1,209,428	$	(974,826	)	$	234,602

Intangibles not subject to amortization:
Registered trademarks						$	52,000						$	52,000
Goodwill							974,478							974,729
Total						$	1,026,478						$	1,026,729

Changes in Carrying Amount of Goodwill

Changes in the carrying amounts of goodwill by reportable segment for the years ended December 31, 2021 and 2020 were as follows:


(In thousands)	Hospitals and Large Physician Practices			Veradigm		Unallocated		Total
Balance as of December 31, 2019	$	530,774		$	433,188	$	10,148	$	974,110
Foreign exchange translation		619			0		0		619
Balance as of December 31, 2020		531,393			433,188		10,148		974,729
Foreign exchange translation		(251	)		0		0		(251	)
Balance as of December 31, 2021	$	531,142		$	433,188	$	10,148	$	974,478

Amortization Expense Related to Intangible Assets

Intangible assets are being amortized over their estimated useful lives, and amortization expense related to intangible assets was as follows:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Proprietary technology amortization included in cost of revenue	$	27,443	$	32,130	$	35,034
Intangible amortization included in operating expenses		23,109		25,604		27,188
Total intangible amortization expense	$	50,552	$	57,734	$	62,222

Future Amortization Expense for Intangible Assets

Future amortization expense for the intangible assets as of December 31, 2021, based on foreign currency exchange rates in effect as of such date, is as follows:



Year Ended December 31,	(In thousands)
2022	$	44,117
2023		27,905
2024		23,765
2025		20,177
2026		16,521
Thereafter		51,445
Total	$	183,930

Asset Impairment Charges (Tables)

12 Months Ended

Dec. 31, 2021

Asset Impairment Charges [Abstract]

Summary of Non-Cash Asset Impairment Charges

The following table summarizes the non-cash asset impairment charges recorded during the periods indicated and where they appear in the corresponding consolidated statements of operations:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Asset impairment charges	$	11,772	$	74,969	$	10,837
Goodwill impairment charge	$	0	$	0	$	25,700
Impairment of long-term investments	$	0	$	1,575	$	651

Debt (Tables)

12 Months Ended

Dec. 31, 2021

Debt Instrument [Line Items]

Debt Outstanding Excluding Lease Obligations

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


	December 31, 2021							December 31, 2020
(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	$	(9,057	)	$	176,910	$	167,853	$	(3,166	)	$	171,019
Senior Secured Credit Facility		175,000		1,848			173,152		0		3,432			(3,432	)
Total debt	$	342,853	$	(7,209	)	$	350,062	$	167,853	$	266		$	167,587

(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 consisted of the following:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Interest expense	$	5,691	$	18,113	$	26,648
Amortization of discounts and debt issuance costs		7,475		15,991		16,524
Total interest expense	$	13,166	$	34,104	$	43,172

Summary of Future Debt Payments

The following table summarizes future debt payments as of December 31, 2021:



(In thousands)	Total		2022		2023		2024		2025		2026		Thereafter
0.875% Convertible Senior Notes (1)	$	207,911	$	0	$	0	$	0	$	0	$	0	$	207,911
Revolving Facility (2)		175,000		0		175,000		0		0		0		0
Total debt	$	382,911	$	0	$	175,000	$	0	$	0	$	0	$	207,911

(1)

Amount represents the face value of the 0.875% Convertible Senior Notes, which includes both the liability and equity portions.

(2)

Assumes no additional borrowings after December 31, 2021, payment of any required periodic installments of principal when due 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, which is included in total interest expense above, consisted of the following:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Coupon interest	$	1,819	$	4,016	$	4,429
Amortization of discounts and debt issuance costs		5,891		13,484		14,926
Total interest expense related to the convertible notes	$	7,710	$	17,500	$	19,355

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2021

Income Tax Disclosure [Abstract]

Geographic Breakdown of Income (Loss) From Continuing Operations Before Income Tax Provision (Benefits)

The following is a geographic breakdown of income (loss) from continuing operations before income tax provision (benefit):


	Year Ended December 31,
(In thousands)	2021		2020			2019
United States	$	141,367	$	(148,174	)	$	(287,088	)
Foreign		20,459		(1,137	)		5,337
Income (loss) from continuing operations before income taxes	$	161,826	$	(149,311	)	$	(281,751	)

Components of Provision (Benefit) for Income Taxes

The following is a summary of the components of the provision (benefit) for income taxes:


	Year Ended December 31,
(In thousands)	2021			2020			2019
Current tax provision (benefit)
Federal	$	17,179		$	(19,346	)	$	(8,232	)
State		507			(219	)		(1,809	)
Foreign		7,998			3,803			5,054
		25,684			(15,762	)		(4,987	)
Deferred tax provision (benefit)
Federal		3,341			2,931			(28,732	)
State		(34	)		(2,981	)		(8,763	)
Foreign		(1,140	)		(880	)		(858	)
		2,167			(930	)		(38,353	)
Income tax provision (benefit)	$	27,851		$	(16,692	)	$	(43,340	)

Taxes Computed at Statutory Federal Income Tax Rate Reconciled to Provision for Income Taxes

Taxes computed at the statutory federal income tax rate of 21% for the years ended December 31, 2021, 2020 and 2019 are reconciled to the provision for income taxes as follows:


	Year Ended December 31,
(In thousands)	2021			2020			2019
United States federal tax at statutory rate	$	33,983		$	(31,355	)	$	(59,170	)
Items affecting federal income tax rate
Non-deductible acquisition and reorganization expenses		0			0			31
Non-deductible portion of Department of Justice Settlement		(1,050	)		0			18,546
Research credits		(5,000	)		(6,500	)		(6,126	)
Change in unrecognized tax benefits		2,007			3,204			1,046
State income taxes, net of federal benefit		7,161			(2,940	)		(7,411	)
Compensation		(1,103	)		5,314			4,664
Meals and entertainment		7			118			549
Impact of foreign operations		2,579			1,443			3,079
Provision-to-Return adjustments		(9,544	)		(2,362	)		(383	)
Deemed Dividends		208			352			473
Federal, state and local rate changes		0			0			(630	)
US Tax reform impact		0			0			(2,972	)
Goodwill impairment		0			0			5,397
Non-deductible items		66			28			43
Valuation allowance		(1,504	)		16,949			922
Other		41			(943	)		(1,398	)
Income tax provision (benefit)	$	27,851		$	(16,692	)	$	(43,340	)

Components of Deferred Tax Assets and Liabilities

Significant components of our deferred tax assets and liabilities consist of the following:


	December 31,
(In thousands)	2021			2020
Deferred tax assets
Accruals and reserves, net	$	11,689		$	18,260
Allowance for doubtful accounts		8,750			9,571
Stock-based compensation, net		9,869			8,428
Deferred revenue		42,672			35,016
Operating and finance lease liabilities		15,612			22,902
Net operating loss carryforwards		33,231			35,695
Research and development tax credit		432			251
Other		0			4,519
Less: Valuation Allowance		(34,339	)		(35,491	)
Total deferred tax assets		87,916			99,151

Deferred tax liabilities
Prepaid expense		(4,272	)		(4,329	)
Property and equipment, net		(88	)		(2,062	)
Acquired intangibles, net		(80,273	)		(86,841	)
Operating and finance right-of-use assets		(11,840	)		(18,315	)
Other		(1,461	)		0
Total deferred tax liabilities		(97,934	)		(111,547	)
Net deferred tax liabilities	$	(10,018	)	$	(12,396	)

Schedule Of Deferred Tax Assets And Liabilities Classified In Consolidated Balance Sheets

The deferred tax assets (liabilities) are classified in the consolidated balance sheets as follows:


	December 31,
(In thousands)	2021			2020
Non-current deferred tax assets, net	$	6,607		$	5,790
Non-current deferred tax liabilities, net		(16,625	)		(18,186	)
Net deferred tax liabilities	$	(10,018	)	$	(12,396	)

Change in the Amount of Unrecognized Tax Benefits

Changes in the amounts of unrecognized tax benefits were as follows:


	Year Ended December 31,
(In thousands)	2021			2020			2019
Beginning balance as of January 1	$	28,885		$	20,604		$	19,821
Increases for tax positions related to the current year		1,000			8,053			1,240
Decreases for tax positions related to prior years		(276	)		0			0
Increases for tax positions related to prior years		685			427			95
Foreign currency translation		0			2			3
Reductions due to lapsed statute of limitations		0			(201	)		(555	)
Ending balance as of December 31	$	30,294		$	28,885		$	20,604

Recognized Interest and Penalties Related to Uncertain Tax Positions

We recognized interest and penalties related to uncertain tax positions in our consolidated statements of operations as follows:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Interest and penalties included in the provision for income taxes	$	1,172	$	1,620	$	229

Amount of Interest and Penalties Included in Consolidated Balance Sheets

The amount of interest and penalties included in our consolidated balance sheets is as follows:


	December 31,
(In thousands)	2021		2020
Interest and penalties included in the liability for uncertain tax positions	$	3,220	$	2,048

Stock Award Plan (Tables)

12 Months Ended

Dec. 31, 2021

Share-based Payment Arrangement [Abstract]

Stock-Based Compensation Expense


	Year Ended December 31,
(In thousands)	2021		2020		2019
Cost of revenue:
Software delivery, support and maintenance	$	1,529	$	1,640	$	2,075
Client services		4,086		4,421		4,067
Total cost of revenue		5,615		6,061		6,142
Selling, general and administrative expenses		31,661		25,002		27,348
Research and development		6,287		7,827		9,200
Total stock-based compensation expense	$	43,563	$	38,890	$	42,690

Activity for Restricted Stock Awards

The following table summarizes the activity for restricted stock units during the periods presented:


				Weighted-Average
(In thousands, except per share amounts)	Shares			Grant Date Fair Value
Unvested restricted stock units as of December 31, 2018		7,950		$	12.81
Awarded		4,777			10.15
Vested		(2,360	)		12.62
Forfeited		(1,453	)		12.20
Unvested restricted stock units as of December 31, 2019		8,914			11.53
Awarded		5,607			6.88
Vested		(2,756	)		11.69
Forfeited		(2,097	)		10.79
Unvested restricted stock units as of December 31, 2020		9,668			8.95
Awarded		3,010			15.50
Vested		(3,051	)		9.52
Forfeited		(1,407	)		11.63
Unvested restricted stock units as of December 31, 2021		8,220		$	10.68

Stock Options Outstanding

The following table summarizes the status of stock options outstanding and the changes during the periods presented:


	Options			Weighted-Average		Options		Weighted-Average
(In thousands, except per share amounts)	Outstanding			Exercise Price		Exercisable		Exercise Price
Balance as of December 31, 2018		1,332		$	13.69		1,332	$	13.69
Options granted		0			0.00
Options exercised		0			0.00
Options forfeited		(98	)		14.01
Balance as of December 31, 2019		1,234			13.67		1,234		13.67
Options granted		0			0.00
Options exercised		0			0.00
Options forfeited		(1,234	)		13.67
Balance as of December 31, 2020		0			0.00		0		0.00
Options granted		0			0.00
Options exercised		0			0.00
Options forfeited		0			0.00
Balance as of December 31, 2021		0		$	0.00		0	$	0.00

Stock Option Activity

The following activity occurred under the Plan:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Total fair value of share awards vested	$	29,045	$	32,218	$	29,793

Earnings (Loss) Per Share (Tables)

12 Months Ended

Dec. 31, 2021

Earnings Per Share [Abstract]

Calculations of Earnings (Loss) Per Share

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


	Year Ended December 31,
(In thousands, except per share amounts)	2021		2020			2019
Basic earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax	$	133,975	$	(132,619	)	$	(238,411	)
Net loss attributable to non-controlling interests		0		0			424
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		133,975		(132,619	)		(237,987	)
Income from discontinued operations, net of tax		463		833,026			55,809
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	134,438	$	700,407		$	(182,178	)

Weighted-average common shares outstanding		130,140		159,281			166,306

Basic earnings (loss) from continuing operations per Common Share	$	1.03	$	(0.83	)	$	(1.43	)
Basic earnings from discontinued operations per Common Share	$	0.00	$	5.23		$	0.33
Net earnings (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	1.03	$	4.40		$	(1.10	)

Diluted earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax	$	133,975	$	(132,619	)	$	(238,411	)
Net loss attributable to non-controlling interests		0		0			424
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		133,975		(132,619	)		(237,987	)
Income from discontinued operations, net of tax		463		833,026			55,809
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	134,438	$	700,407		$	(182,178	)

Weighted-average common shares outstanding		130,140		159,281			166,306
Plus: Dilutive effect of stock options, restricted stock unit awards and warrants		8,518		0			0
Weighted-average common shares outstanding assuming dilution		138,658		159,281			166,306

Diluted earnings (loss) from continuing operations per Common Share	$	0.97	$	(0.83	)	$	(1.43	)
Diluted earnings from discontinued operations per Common Share	$	0.00	$	5.23		$	0.33
Net earnings (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	0.97	$	4.40		$	(1.10	)

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


	Year Ended December 31,
(In thousands)	2021		2020		2019
Shares subject to anti-dilutive stock options, restricted stock unit awards and warrants excluded from calculation		0		42,845		27,945

Accumulated Other Comprehensive Loss (Tables)

12 Months Ended

Dec. 31, 2021

Equity [Abstract]

Components of Accumulated Other Comprehensive Loss


(In thousands)	Foreign Currency Translation Adjustments			Unrealized Net Gains (Losses) on Foreign Exchange Contracts			Total
Balance as of December 31, 2018 (1)		(5,584	)		195			(5,389	)
Other comprehensive income (loss) before reclassifications		1,192			61			1,253
Net (gains) losses reclassified from accumulated other comprehensive loss		0			(256	)		(256	)
Net other comprehensive income (loss)		1,192			(195	)		997
Balance as of December 31, 2019 (1)		(4,392	)		0			(4,392	)
Other comprehensive income (loss) before reclassifications		1,435			1,587			3,022
Net (gains) losses reclassified from accumulated other comprehensive loss		0			(468	)		(468	)
Net other comprehensive income (loss)		1,435			1,119			2,554
Balance as of December 31, 2020 (2)		(2,957	)		1,119			(1,838	)
Other comprehensive (loss) income before reclassifications		(69	)		351			282
Net (gains) losses reclassified from accumulated other comprehensive loss		0			(1,209	)		(1,209	)
Net other comprehensive (loss) income		(69	)		(858	)		(927	)
Balance as of December 31, 2021 (3)	$	(3,026	)	$	261		$	(2,765	)

(1)

Tax effects for the years ended December 31, 2019 and 2018 include $149 thousand arising from the revaluations of tax effects included in accumulated other comprehensive income.

(2)

Net of taxes of $390 thousand for unrealized net gains on foreign exchange contract derivatives.

(3)

Net of taxes of $91 thousand for unrealized net gains on foreign exchange contract derivatives.

Income Tax Effects Related to Components of Other Comprehensive Loss

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


	Year Ended December 31, 2021
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	(69	)	$	0		$	(69	)
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		473			(122	)		351
Net (gains) losses reclassified into income		(1,630	)		421			(1,209	)
Net change in unrealized (losses) gains on foreign exchange contracts		(1,157	)		299			(858	)
Other comprehensive (loss) income	$	(1,226	)	$	299		$	(927	)


	Year Ended December 31, 2020
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	1,435		$	0		$	1,435
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		2,139			(552	)		1,587
Net (gains) losses reclassified into income		(630	)		162			(468	)
Net change in unrealized gains (losses) on foreign exchange contracts		1,509			(390	)		1,119
Other comprehensive income (loss)	$	2,944		$	(390	)	$	2,554


	Year Ended December 31, 2019
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	1,192		$	0		$	1,192
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		82			(21	)		61
Net (gains) losses reclassified into income		(344	)		88			(256	)
Net change in unrealized (losses) gains on foreign exchange contracts		(262	)		67			(195	)
Other comprehensive income	$	930		$	67		$	997

Derivative Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2021

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:


	December 31, 2021
	Asset Derivatives
(In thousands)	Balance Sheet Location	Fair Value
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts	Prepaid expenses and other current assets	$	352
Total derivatives		$	352


	December 31, 2020
	Asset Derivatives
(In thousands)	Balance Sheet Location	Fair Value
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts	Prepaid expenses and other current assets	$	1,509
Total derivatives		$	1,509

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

Derivatives Instruments Designated as Cash Flow Hedges


	Amount of Gain (Loss) Recognized in OCI						Location of Gain (Loss) Reclassified from AOCI into Income	Amount of Gain (Loss) Reclassified from AOCI into Income
	Year Ended December 31,							Year Ended December 31,
(In thousands)	2021		2020		2019			2021		2020		2019
Foreign exchange contracts	$	473	$	2,139	$	82	Cost of Revenue	$	611	$	249	$	124
							Selling, general and administrative expenses		351		122		83
							Research and development		668		259		137

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 1.25% Notes’ embedded cash conversion option in the consolidated statements of operations:


	Year Ended December 31,
(In thousands)	2021		2020			2019
1.25% Call Option	$	0	$	(84	)	$	(9,020	)
1.25% Embedded cash conversion option		0		185			9,789
Net income included in Other income (loss), net	$	0	$	101		$	769

Commitments (Tables)

12 Months Ended

Dec. 31, 2021

Commitments and Contingencies Disclosure [Abstract]

Summary of Expense Incurred under Atos Agreement

Expenses related to our agreements with Atos, prior to the new agreement with no commitments, are as follows:


	Year Ended December 31,
(In thousands)	2021		2020		2019
Expenses incurred under Atos agreements with base fees	$	57,885	$	102,730	$	100,089

Discontinued Operations (Tables)

12 Months Ended

Dec. 31, 2021

EPSi and CarePort [Member]

Summary of Discontinued Operations in Financial Statements

The following table summarizes the major classes of assets and liabilities of EPSi and CarePort, as reported on the consolidated balance sheets as of December 31, 2021 and 2020:


(In thousands)	December 31, 2021		December 31, 2020
Carrying amounts of major classes of liabilities associated with EPSi and CarePort included as part of discontinued operations:
Accrued expenses	$	0	$	6,669
Income tax payable		0		316,142
Total current liabilities attributable to discontinued operations	$	0	$	322,811


	Year ended December 31,
(In thousands)	2021			2020			2019
Major income and expense line items related to EPSi and CarePort:
Revenue:
Software delivery, support and maintenance	$	6		$	122,791		$	122,268
Client services		0			14,030			16,763
Total revenue		6			136,821			139,031
Cost of revenue:
Software delivery, support and maintenance		(178	)		11,424			12,482
Client services		154			15,585			15,124
Amortization of software development and acquisition-related assets		0			9,053			8,166
Total cost of revenue		(24	)		36,062			35,772
Gross profit		30			100,759			103,259
Selling, general and administrative expenses		79			15,539			18,964
Research and development		(32	)		8,269			9,065
Amortization of intangible assets		0			29			29
(Loss) income from discontinued operations for EPSi and CarePort		(17	)		76,922			75,201
Interest expense		0			(5,241	)		0
Other income (loss), net		2			(192	)		2
Gain on sale of discontinued operations		647			1,156,504			0
Income from discontinued operations for EPSi and CarePort before income taxes		632			1,227,993			75,203
Income tax provision (1)		(169	)		(394,926	)		(19,417	)
Income from discontinued operations, net of tax for EPSi and CarePort (2)	$	463		$	833,067		$	55,786

(1)

(2)

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

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+ Details

Business Segments (Tables)

12 Months Ended

Dec. 31, 2021

Segment Reporting [Abstract]

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


	Year Ended December 31,
(In thousands)	2021			2020			2019
Revenue:
Hospitals and Large Physician Practices	$	927,590		$	950,155		$	1,052,267
Veradigm		552,208			527,968			554,910
Unallocated Amounts		23,239			24,577			25,434
Total revenue	$	1,503,037		$	1,502,700		$	1,632,611

Gross profit:
Hospitals and Large Physician Practices	$	330,720		$	293,672		$	317,776
Veradigm		272,540			254,631			274,103
Unallocated Amounts		16,305			17,392			18,408
Total gross profit	$	619,565		$	565,695		$	610,287

Income (loss) from operations:
Hospitals and Large Physician Practices	$	(7,231	)	$	(154,315	)	$	(132,593	)
Veradigm		81,456			38,338			51,195
Unallocated Amounts		2,974			(14,903	)		(18,291	)
Total income (loss) from operations	$	77,199		$	(130,880	)	$	(99,689	)

Supplemental Disclosures (Tables)

12 Months Ended

Dec. 31, 2021

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Supplemental Disclosures


	December 31,
(In thousands)	2021		2020
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$	188,351	$	531,104
Restricted cash		2,169		6,361
Total cash, cash equivalents and restricted cash	$	190,520	$	537,465


	Year Ended December 31,
(In thousands)	2021		2020		2019
Cash paid during the period for:
Interest, including convertible senior notes	$	4,993	$	24,616	$	23,917
Income taxes paid, net of tax refunds	$	330,473	$	76,595	$	42,972
Non-cash transactions:
Sale of 2bPrecise business in exchange for a non-controlling interest in the combined entity	$	11,768	$	0	$	0
Issuance of treasury stock to commercial partner	$	534	$	752	$	701

Accrued Expenses

Accrued expenses consist of the following:


	December 31,
(In thousands)	2021		2020
Royalties, certain third-party product costs and licenses	$	39,146	$	37,841
Other		53,379		62,421
Total Accrued expenses	$	92,525	$	100,262

Prepaid and other current assets

Prepaid and other current assets consists of the following:


	December 31,
(In thousands)	2021		2020
Prepaid assets	$	116,640	$	132,944
Other current assets		2,302		3,320
Total Prepaid and other current assets	$	118,942	$	136,264

Other Assets

Other assets consist of the following:


	December 31,
(In thousands)	2021		2020
Long-term deferred hosting fees	$	0	$	11,025
Long-term prepaid commissions		27,031		27,882
Investments in non-marketable securities		61,553		35,805
Long-term deposits and other assets		12,576		16,916
Total Other assets	$	101,160	$	91,628

Geographic Information (Tables)

12 Months Ended

Dec. 31, 2021

Segment Reporting [Abstract]

Revenues by Geographic Area

Revenues are attributed to geographic regions based on the location where the sale originated. Our revenues by geographic area are summarized below:


	Year Ended December 31,
(In thousands)	2021		2020		2019
United States	$	1,433,301	$	1,439,737	$	1,562,107
Canada		16,013		15,624		16,495
Other international		53,723		47,339		54,009
Total	$	1,503,037	$	1,502,700	$	1,632,611

Long-Lived Assets by Geographic Area

A summary of our long-lived assets, comprised of fixed assets by geographic area, is presented below:


	December 31,
(In thousands)	2021		2020
United States	$	40,183	$	62,016
India		4,628		5,876
Israel		1,958		2,611
Canada		127		187
Other international		1,006		1,472
Total	$	47,902	$	72,162

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail)		12 Months Ended
	Jul. 01, 2020	Dec. 31, 2021	Dec. 31, 2019	Jun. 18, 2013
Basis Of Presentation And Significant Accounting Policies [Line Items]
Maturity date		Jul. 01, 2020
Percentage of revenues		For the years ended December 31, 2021 and 2020, we had one client that accounted for 12.5% and 12%, respectively, of our revenue. Other than this one client, no single client accounted for more than 10% of our revenue in the years ended December 31, 2021, 2020 and 2019.
Customer concentration		No client represented more than 10% of accounts receivable as of December 31, 2021 and 2020.
Minimum [Member] \| Capitalized Software [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized software estimated economic life		3 years
Maximum [Member] \| Capitalized Software [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized software estimated economic life		5 years
1.25% Cash Convertible Senior Notes [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Interest rate	1.25%	1.25%	1.25%	1.25%
Maturity date	Jul. 01, 2020	Jul. 01, 2020

Basis of Presentation and Significant Accounting Policies - Unamortized Balances of Capitalized Software (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Software development costs	$ 338,677	$ 327,519
Less: accumulated amortization	(166,573)	(134,317)
Software development costs, net	$ 172,104	$ 193,202

Basis of Presentation and Significant Accounting Policies - Capitalized Software Development Costs, Divestitures, Write Offs and Amortization of Capitalized Software Development Costs (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Capitalized software development costs	$ 73,265	$ 87,993	$ 103,317
Write-offs and divestitures of capitalized software development costs	3,105	31,214	0
Amortization of capitalized software development costs	$ 91,258	$ 86,269	$ 72,840

Basis of Presentation and Significant Accounting Policies - Company Contributions to Employee Benefit Plan (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Company contributions to employee benefit plans	$ 19,511	$ 21,143	$ 23,998

Revenue from Contracts with Customers - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2021 USD ($) Revenue_Stream	Dec. 31, 2020 USD ($)	Jan. 01, 2020 USD ($)	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Number of primary revenue streams \| Revenue_Stream	2
Total backlog	$ 3,800,000
Total backlog, percentage, year one	34.00%
Total backlog, percentage after year one	66.00%
Cumulative impact on retained earnings (accumulated deficit)	$ 1,408,138	$ 1,666,243		$ 1,285,188	$ 1,580,427
Selling, General and Administrative Expense [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost Amortization	20,500	23,600
Prepaid Expenses and Other Current Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	16,500	16,800
Other Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	$ 27,000	$ 27,900
ASC 606 [Member] \| Minimum [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized cost, amortization period	2 years
ASC 606 [Member] \| Maximum [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized cost, amortization period	6 years
Accounting Standards Update 2016-13 [Member] \| Cumulative Effect Period Of Adoption Adjustment [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Cumulative impact on retained earnings (accumulated deficit)			$ (5,300)

Revenue from Contracts with Customers - Summary of Revenue Recognized on Various Performance Obligations and Elected Accounting Expedients (Detail) - USD ($) $ in Thousands	3 Months Ended												12 Months Ended
	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Revenue from Contract with Customer [Abstract]
Revenue related to deferred revenue balance at beginning of period	$ 151,763	$ 144,696	$ 151,857	$ 137,848	$ 138,279	$ 118,300	$ 119,545	$ 105,366	$ 136,460	$ 116,812	$ 113,288	$ 93,602
Revenue related to new performance obligations satisfied during the period	171,345	159,149	158,910	173,316	182,690	192,658	195,308	216,580	214,952	227,954	233,293	248,126
Revenue recognized under "right-to-invoice" expedient	68,089	64,820	62,422	56,811	65,108	54,313	54,082	58,059	60,826	61,814	62,245	55,923
Reimbursed travel expenses, shipping and other revenue	502	607	525	377	337	347	369	1,359	2,092	1,700	2,057	1,467
Total revenue	$ 391,699	$ 369,272	$ 373,714	$ 368,352	$ 386,414	$ 365,618	$ 369,304	$ 381,364	$ 414,330	$ 408,280	$ 410,883	$ 399,118	$ 1,503,037	$ 1,502,700	$ 1,632,611

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9031-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9038-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 4
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130543-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9054-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130545-203045

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 924
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-URI http://asc.fasb.org/extlink&oid=6472922&loc=d3e499488-122856

+ Details

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												12 Months Ended
	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Disaggregation Of Revenue [Line Items]
Recurring revenue													$ 1,209,746	$ 1,222,731	$ 1,278,456
Non-recurring revenue													293,291	279,969	354,155
Total revenue	$ 391,699	$ 369,272	$ 373,714	$ 368,352	$ 386,414	$ 365,618	$ 369,304	$ 381,364	$ 414,330	$ 408,280	$ 410,883	$ 399,118	1,503,037	1,502,700	1,632,611
Unallocated Amounts [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													23,239	24,577	25,434
Hospitals and Large Physician Practices [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													927,590	950,155	1,052,267
Hospitals and Large Physician Practices [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													927,590	950,155	1,052,267
Veradigm [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													552,208	527,968	554,910
Veradigm [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													552,208	527,968	554,910
Software delivery, Support and Maintenance [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													916,186	923,737	1,010,993
Software delivery, Support and Maintenance [Member] \| Unallocated Amounts [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													16,944	19,598	20,709
Software delivery, Support and Maintenance [Member] \| Hospitals and Large Physician Practices [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													446,309	472,130	541,904
Software delivery, Support and Maintenance [Member] \| Veradigm [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													452,933	432,009	448,380
Client services [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													586,851	578,963	621,618
Client services [Member] \| Unallocated Amounts [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													6,295	4,979	4,725
Client services [Member] \| Hospitals and Large Physician Practices [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													481,281	478,025	510,363
Client services [Member] \| Veradigm [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue													$ 99,275	$ 95,959	$ 106,530

Revenue from Contracts with Customers - Summary of Changes in Estimate of Credit Losses for Contract Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Revenue from Contract with Customer [Abstract]
Beginning Balance	$ 5,341	$ 5,341
Current period provision	(2,000)	0
Ending Balance	3,341	5,341
Contract assets, allowance	1,068	1,068
Total contract assets, long-term	$ 2,273	$ 4,273

Accounts Receivable - Additional Information (Detail) - Trade Accounts Receivable [Member] - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Jan. 01, 2020	Dec. 31, 2019
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, allowance for credit loss	$ 29,943	$ 31,596		$ 33,256
Accounting Standards Update 2016-13 [Member]
Accounts Notes And Loans Receivable [Line Items]
Accounts receivable, allowance for credit loss			$ 12,600

Accounts Receivable - Schedule of Changes in Estimate of Credit Losses for Trade Accounts Receivable (Detail) - Trade Accounts Receivable [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Accounts Notes And Loans Receivable [Line Items]
Beginning Balance	$ 31,596	$ 33,256
Current period provision	6,818	8,726
Write-offs	(9,191)	(10,484)
Recoveries	720	98
Ending Balance	$ 29,943	$ 31,596

Leases - Additional Information (Detail) - Maximum [Member]	12 Months Ended
	Dec. 31, 2021
Lessee Lease Description [Line Items]
Operating leases, remaining lease terms	7 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

12 Months Ended

Dec. 31, 2021

Dec. 31, 2020

Leases [Abstract]

Operating lease cost

^[1]

$ 22,343

$ 25,394

Less: Sublease income

(314)

(1,121)

Total operating lease costs

$ 22,029

$ 24,273

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

Leases - Supplemental Information for Operating Leases (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Leases [Abstract]
Operating cash flows from operating leases	$ 24,141	$ 26,638
Right-of-use assets obtained in exchange for operating lease obligations	$ 3,252	$ 21,770

Leases - Summary of Balance Sheet Location and Balances for Operating Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Leases [Abstract]
Right-of-use assets - operating leases	$ 68,909	$ 96,601
Current operating lease liabilities	19,599	22,264
Long-term operating lease liabilities	$ 64,822	$ 93,463
Weighted average remaining lease term (in years)	5 years	6 years
Weighted average discount rate	3.30%	3.60%

Leases - Summary of Future Maturities of Lease and Non-Lease Components (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Operating Leases [Abstract]
Operating Leases, 2022	$ 22,093
Operating Leases, 2023	20,285
Operating Leases, 2024	14,805
Operating Leases, 2025	13,438
Operating Leases, 2026	12,105
Operating Leases, Thereafter	8,655
Operating Leases, Total lease liabilities	91,381
Operating Leases, Less: Amount representing interest	(6,960)
Operating Leases, Less: Short-term lease liabilities	(19,599)	$ (22,264)
Operating Leases, Total long-term lease liabilities	$ 64,822	$ 93,463

Business Combinations and Divestitures - 2021 Divestitures - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended
	Aug. 23, 2021	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Gain on sale of businesses, net		$ 8,370	$ 0	$ 0
2bPrecise [Member]
Business Acquisition [Line Items]
Gain on sale of businesses, net	$ 8,400

Business Combinations and Divestitures - 2020 Divestitures - Additional Information (Detail) - USD ($) $ in Thousands					12 Months Ended
	Dec. 31, 2020	Dec. 30, 2020	Oct. 29, 2020	Oct. 15, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business					$ 8,370	$ 0	$ 0
CarePort Purchase Agreement [Member]
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business					$ 600
CarePort Purchase Agreement [Member] \| WellSky Corp [Member]
Business Acquisition [Line Items]
Sale of business unit		$ 1,350,000
Pre-tax gain (loss) on sale of business	$ 933,900
CarePort Purchase Agreement [Member] \| WellSky Corp [Member] \| Senior Secured Term Loan [Member] \| Second Amended Credit Agreement [Member]
Business Acquisition [Line Items]
Prepayment of debt	$ 161,000
EPSi Purchase Agreement [Member] \| Senior Secured Term Loan [Member] \| Second Amended Credit Agreement [Member]
Business Acquisition [Line Items]
Prepayment of debt			$ 19,000
EPSi Purchase Agreement [Member] \| Strata Decision Technology LLC [Member]
Business Acquisition [Line Items]
Sale of business unit				$ 365,000
Pre-tax gain (loss) on sale of business				$ 222,600
EPSi Purchase Agreement [Member] \| Strata Decision Technology LLC [Member] \| Senior Secured Term Loan [Member] \| Second Amended Credit Agreement [Member]
Business Acquisition [Line Items]
Prepayment of debt			$ 19,000

Business Combinations and Divestitures - 2019 Business Combinations - Additional Information (Detail) - USD ($)			3 Months Ended
	Jul. 02, 2019	Mar. 01, 2019	Dec. 31, 2021	Jun. 30, 2021
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
Payments related to earnout agreement				$ 900,000
Write off of contingent consideration			$ 100,000
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
Pulse8, Inc. [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Potential milestone/earnout payments		$ 5,000,000.0

Fair Value Measurements and Other Investments - Additional Information (Detail) - USD ($) shares in Thousands		3 Months Ended			12 Months Ended
	Jul. 01, 2020	Jun. 30, 2021	Sep. 30, 2020	Jun. 30, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Jun. 18, 2013
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Maturity date					Jul. 01, 2020
Conversion of notes into shares		475
Gain on sale of businesses					$ 8,370,000	$ 0	$ 0
Gain from sale of a third-party equity method investment						16,800,000
Total consideration for non marketable equity securities and convertible note					2,421,000	7,097,000	8,235,000
Impairment (recovery) of long-term investments					0	1,575,000	651,000
Gain on Sale of Businesses, Net [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Gain on sale of businesses					8,400,000
Other Income (Loss), Net [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Gain on note conversion and revaluation of existing investment					9,700,000
Gain on sale of businesses					$ 60,900,000
Cost Method Equity Investments [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Impairment (recovery) of long-term investments				$ 600,000
Long-term Equity Investments [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Impairment (recovery) of long-term investments						600,000	1,700,000
Cost Method Investment [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Impairment (recovery) of long-term investments			$ 1,000,000.0			$ 1,000,000.0	$ (1,000,000.0)
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%	1.25%
Maturity date	Jul. 01, 2020				Jul. 01, 2020
1.25% Call Option [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate					1.25%
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate					1.25%

Fair Value Measurements and Other Investments - Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	$ 118,942	$ 136,264
Total assets	352		$ 1,509
Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	352		1,509
Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	19	1,011
Total liabilities	19	1,011
Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	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
Total liabilities	0	0
Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	352		1,509
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	352		1,509
Level 2 [Member] \| Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	0	0
Total liabilities	0	0
Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	0		0
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	19	1,011
Total liabilities	$ 19	$ 1,011

Fair Value Measurements and Other Investments - Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2021

Dec. 31, 2020

Contingent Consideration [Member]

Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]

Balance

$ 1,011

$ 19,515

Additions

770

Payments/write-downs

^[1]

(19,274)

Payments

(858)

Write-downs

(134)

Fair value adjustments

Balance

1,011

1.25% Notes Call Spread Overlay [Member]

Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]

Balance

(0)

(101)

^[1]

Fair value adjustments

101

Balance

$ 0

$ (0)

[1]	Payments and write-downs for the year ended December 31, 2020 primarily consisted of $4.0 million in payments for the ACC earnout and a $13.9 million write-down related to the Health Grid earnout.

Fair Value Measurements and Other Investments - Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis (Parenthetical) (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2020 USD ($)
Health Grid [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Payments/write-downs	$ 13.9
ACC [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Payments/write-downs	$ 4.0

Fair Value Measurements and Other Investments - Summary of Quantitative Information About Fair Value Measurements (Detail)
$ in Thousands

12 Months Ended

Dec. 31, 2021

USD ($)

PatientDataVolume

RegistryMember

Level 3 [Member]

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

Total financial instruments | $

$ 19

Minimum [Member] | Level 3 [Member]

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

Projected year of remaining payment

2022

Registry Members [Member] | Minimum [Member] | Level 3 [Member]

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

Ranges of Inputs | RegistryMember

Registry Members [Member] | Maximum [Member] | Level 3 [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] | Level 3 [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] | Level 3 [Member]

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

Ranges of Inputs | PatientDataVolume

Patient Data Volume [Member] | Maximum [Member] | Level 3 [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] | Level 3 [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] | Level 3 [Member]

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

Total financial instruments | $

$ 19

Contingent Consideration [Member] | Probability Weighted Discounted Cash Flow [Member] | Discount Rate [Member] | Minimum [Member] | Level 3 [Member]

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

Ranges of Inputs

5.3

Contingent Consideration [Member] | Probability Weighted Discounted Cash Flow [Member] | Discount Rate [Member] | Maximum [Member] | Level 3 [Member]

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

Ranges of Inputs

5.5

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

5.4

^[1]

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

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

12 Months Ended

Dec. 31, 2021

USD ($)

Investment

Dec. 31, 2020

USD ($)

^[2]

Fair Value Disclosures [Abstract]

Equity method investments, Number of Investees | Investment

^[1]

Cost with adjustments, Number of investees | Investment

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

Equity method investments, Original Cost

^[1]

$ 7,099

Cost with adjustments, Original Cost

57,213

Total long-term equity investments, Original Cost

64,312

Equity method investments

^[1]

12,260

$ 10,744

Cost with adjustments, Carrying Value

49,293

25,059

Total long-term equity investments, Carrying Value

$ 61,553

$ 35,803

[1]	Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.
[2]	Amounts include investments that are no longer held as of December 31, 2021.

Fixed Assets - Fixed Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 370,860	$ 396,135
Less: Accumulated depreciation and amortization	(322,958)	(323,973)
Fixed assets, net	47,902	72,162
Computer Equipment and Software [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 310,153	329,564
Computer Equipment and Software [Member] \| Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	3 years
Computer Equipment and Software [Member] \| Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	10 years
Facility Furniture, Fixtures and Equipment [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 23,325	25,932
Facility Furniture, Fixtures and Equipment [Member] \| Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	5 years
Facility Furniture, Fixtures and Equipment [Member] \| Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	7 years
Leasehold Improvements [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 36,858	40,115
Estimated useful life (in years)	Shorter of 7 years or life of lease
Assets Under Finance Lease [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 524	524
Less: Accumulated depreciation and amortization	$ (500)	$ (500)
Assets Under Finance Lease [Member] \| Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	1 year
Assets Under Finance Lease [Member] \| Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	3 years

Fixed Assets - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Property Plant And Equipment [Line Items]
Accumulated depreciation and amortization	$ 322,958	$ 323,973
Assets Under Finance Lease [Member]
Property Plant And Equipment [Line Items]
Accumulated depreciation and amortization	$ 500	$ 500

Fixed Assets - Depreciation and Amortization Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Property, Plant and Equipment [Abstract]
Fixed assets depreciation and amortization expense, including finance leases	$ 26,847	$ 32,324	$ 46,705

Goodwill and Intangible Assets - Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	$ 1,209,097	$ 1,209,428
Accumulated Amortization	(1,025,167)	(974,826)
Intangible Assets, Net	183,930	234,602
Registered trademarks	52,000	52,000
Goodwill	974,478	974,729	$ 974,110
Total	1,026,478	1,026,729
Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	535,019	535,092
Accumulated Amortization	(492,681)	(465,292)
Intangible Assets, Net	42,338	69,800
Customer Contracts and Relationships [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	674,078	674,336
Accumulated Amortization	(532,486)	(509,534)
Intangible Assets, Net	$ 141,592	$ 164,802

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)		12 Months Ended
	Oct. 01, 2019	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill impairment charge		$ 0	$ 0	$ 25,700,000
Goodwill		974,478,000	974,729,000	974,110,000
Accumulated impairment losses associated with goodwill		$ 0	0	39,200,000
NantHealth, Inc. [Member] \| Customer Relationship Intangible [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Intangible asset impairment charges			$ 23,100,000	8,100,000
Hospital and Health Systems [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill impairment charge	$ 25,700,000			25,700,000
Goodwill				$ 485,500,000

Goodwill and Intangible Assets - Changes in Carrying Amount of Goodwill (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Goodwill [Line Items]
Goodwill	$ 974,729	$ 974,110
Foreign exchange translation	(251)	619
Goodwill	974,478	974,729
Hospitals and Large Physician Practices [Member] \| Operating Segments [Member]
Goodwill [Line Items]
Goodwill	531,393	530,774
Foreign exchange translation	(251)	619
Goodwill	531,142	531,393
Veradigm [Member] \| Operating Segments [Member]
Goodwill [Line Items]
Goodwill	433,188	433,188
Foreign exchange translation	0	0
Goodwill	433,188	433,188
Unallocated [Member] \| Operating Segments [Member]
Goodwill [Line Items]
Goodwill	10,148	10,148
Foreign exchange translation	0	0
Goodwill	$ 10,148	$ 10,148

Goodwill and Intangible Assets - Amortization Expense Related to Intangible Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Finite Lived Intangible Assets [Line Items]
Total intangible amortization expense	$ 50,552	$ 57,734	$ 62,222
Proprietary Technology Amortization Included in Cost of Revenue [Member]
Finite Lived Intangible Assets [Line Items]
Total intangible amortization expense	27,443	32,130	35,034
Intangible Amortization Included in Operating Expenses [Member]
Finite Lived Intangible Assets [Line Items]
Total intangible amortization expense	$ 23,109	$ 25,604	$ 27,188

Goodwill and Intangible Assets - Future Amortization Expense for Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
2022	$ 44,117
2023	27,905
2024	23,765
2025	20,177
2026	16,521
Thereafter	51,445
Intangible Assets, Net	$ 183,930	$ 234,602

Asset Impairment Charges - Additional Information (Detail) - USD ($)		3 Months Ended	12 Months Ended
	Oct. 01, 2019	Sep. 30, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Asset Impairment Charges [Line Items]
Asset impairment charges			$ 11,772,000	$ 74,969,000	$ 10,837,000
Impairment (recovery) of long-term investments			0	1,575,000	651,000
Non-cash asset impairment charges related to disposal of fixed assets					2,700,000
Goodwill impairment charge			0	0	25,700,000
Hospital and Health Systems [Member]
Asset Impairment Charges [Line Items]
Goodwill impairment charge	$ 25,700,000				25,700,000
Health Grid [Member] \| Customer Relationship Intangible [Member]
Asset Impairment Charges [Line Items]
Asset impairment charges				23,100,000
NantHealth, Inc. [Member] \| Customer Relationship Intangible [Member]
Asset Impairment Charges [Line Items]
Intangible asset impairment charges				23,100,000	8,100,000
Cost Method Investment [Member]
Asset Impairment Charges [Line Items]
Impairment (recovery) of long-term investments		$ 1,000,000.0		1,000,000.0	(1,000,000.0)
Long-term Equity Investments [Member]
Asset Impairment Charges [Line Items]
Impairment (recovery) of long-term investments				600,000	1,700,000
Impairment recoveries					$ 1,000,000.0
Health Grid Contingent Consideration Accrual [Member]
Asset Impairment Charges [Line Items]
Asset impairment charges				13,900,000
Capitalized Software [Member]
Asset Impairment Charges [Line Items]
Asset impairment charges				31,200,000
Deferred Costs Related Private Cloud Hosting Operations [Member]
Asset Impairment Charges [Line Items]
Asset impairment charges			$ 11,300,000	$ 34,300,000

Asset Impairment Charges - Summary of Non-Cash Asset Impairment Charges (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Asset Impairment Charges [Abstract]
Asset impairment charges	$ 11,772,000	$ 74,969,000	$ 10,837,000
Goodwill impairment charge	0	0	25,700,000
Impairment of long-term investments	$ 0	$ 1,575,000	$ 651,000

Debt - Debt Outstanding Excluding Lease Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Principal Balance	$ 342,853	$ 167,853
Unamortized Discount and Debt Issuance Costs	(7,209)	266
Net Carrying Amount	350,062	167,587
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Principal Balance	167,853	167,853
Unamortized Discount and Debt Issuance Costs	(9,057)	(3,166)
Net Carrying Amount	176,910	171,019
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Principal Balance	175,000	0
Unamortized Discount and Debt Issuance Costs	1,848	3,432
Net Carrying Amount	$ 173,152	$ (3,432)

Debt - Debt Outstanding Excluding Lease Obligations (Parenthetical) (Detail) - USD ($)	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 20, 2019	Dec. 09, 2019
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 342,853,000	$ 167,853,000
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument principal amount	207,911,000	207,900,000	$ 218,000,000.0	$ 18,000,000.0	$ 200,000,000.0
Long-term Debt, Gross	167,853,000	167,853,000
Additional paid-in capital recognized	10,900,000				$ 1,000
Additional Paid-In Capital [Member] \| 0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Additional paid-in capital recognized	$ 40,058,000	$ 40,058,000	$ 40,100,000

Debt - Interest Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
Debt - Interest Expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Total interest expense	$ 13,166	$ 34,104	$ 43,172
Convertible Senior Notes and Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Interest expense	5,691	18,113	26,648
Amortization of discounts and debt issuance costs	7,475	15,991	16,524
Total interest expense	$ 13,166	$ 34,104	$ 43,172

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	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Coupon interest	$ 1,819	$ 4,016	$ 4,429
Amortization of discounts and debt issuance costs	5,891	13,484	14,926
Total interest expense related to the convertible notes	$ 7,710	$ 17,500	$ 19,355

Debt - Additional Information (Detail)										1 Months Ended		12 Months Ended
Debt - Additional Information (Detail)	Dec. 31, 2020 USD ($)	Oct. 29, 2020 USD ($)	Jul. 20, 2020 USD ($)	Jul. 01, 2020	Dec. 20, 2019 USD ($)	Dec. 09, 2019 USD ($) $ / shares	Aug. 07, 2019 USD ($)	Feb. 15, 2018 USD ($)	Jun. 18, 2013 USD ($)	Jun. 30, 2020 USD ($)	Dec. 31, 2019 USD ($) $ / shares	Dec. 31, 2021 USD ($) TradingDay $ / shares	Dec. 31, 2020 USD ($)	Dec. 31, 2019 USD ($) $ / shares	Dec. 31, 2013 USD ($)
Debt Instrument [Line Items]
Maturity date												Jul. 01, 2020
Debt issuance costs												$ 0	$ 758,000	$ 5,445,000
Maximum percentage of foreign subsidiary capital stock guaranteeing credit facility												65.00%
Debt instrument principal amount	$ 167,853,000											$ 342,853,000	167,853,000
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
Maximum [Member] \| Second Amended Credit Agreement [Member]
Debt Instrument [Line Items]
Leverage ratio												425.00%
Maximum [Member] \| Second Amended Credit Agreement [Member] \| Covenant On Potential Acquisition [Member]
Debt Instrument [Line Items]
Leverage ratio												450.00%
Minimum [Member] \| Second Amended Credit Agreement [Member]
Debt Instrument [Line Items]
Interest coverage ratio												350.00%
Minimum [Member] \| Second Amended Credit Agreement [Member] \| Covenant On Potential Acquisition [Member]
Debt Instrument [Line Items]
Consideration to be paid for acquisitions												$ 100,000,000
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument principal amount	$ 207,900,000				$ 18,000,000.0	$ 200,000,000.0					$ 218,000,000.0	$ 207,911,000	$ 207,900,000	$ 218,000,000.0
Interest rate	0.875%					0.875%				0.875%	0.875%	0.875%	0.875%	0.875%
Interest payment, terms													The 0.875% Notes are Allscripts’ senior, unsecured obligations that bear interest at a rate of 0.875% per year, payable semiannually in arrears on January 1 and July 1 of each year
Debt instrument payment commencement date						Jul. 01, 2020
Maturity date						Jan. 01, 2027					Jan. 01, 2027
Debt instrument convertible, principal amount						$ 1,000						$ 10,900,000
Convertible number of equity instrument						75.0962
Conversion price per common stock \| $ / shares						$ 13.32					$ 13.32			$ 13.32
Percentage of common stock sale price for initial conversion price						32.50%
Common stock sale price per share \| $ / shares						$ 10.05					10.05			$ 10.05
Debt instrument convertible, principal amount						$ 1,000
Repurchase percentage on principal						100.00%
Initial cap price of capped call transactions \| $ / shares											$ 17.5875
Cap interest rate											75.00%			75.00%
Proceeds from debt					17,500,000						$ 195,000,000.0
Debt instrument, initial purchaser's discounts deduction amount											5,000,000.0
Net proceeds used to payments for capped call transactions cost					1,400,000	$ 15,800,000
Repayment of outstanding borrowing						$ 179,200,000
Debt issuance costs					$ 500,000
Debt issuance costs incurred											$ 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			$ 177,900,000
Payments for repurchase debt instrument										$ 7,700,000
Debt instrument aggregate principal amount repurchased										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
Debt instrument, net carrying value of equity component												10,900,000
Debt instrument principal amount	$ 167,853,000											167,853,000	$ 167,853,000
0.875% Convertible Senior Notes [Member] \| Additional Paid-In Capital [Member]
Debt Instrument [Line Items]
Debt instrument convertible, principal amount	40,058,000										40,100,000	$ 40,058,000	40,058,000	$ 40,100,000
Payments of capped call fees											17,200,000
Debt discounts and issuance costs											$ 1,100,000
0.875% Convertible Senior Notes [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Percentage of aggregate principal amount required to be held by trustee or holders to declare notes immediately due and payable						25.00%
0.875% Convertible Senior Notes [Member] \| Condition One [Member]
Debt Instrument [Line Items]
Threshold trading days \| TradingDay												20
Threshold consecutive trading days \| TradingDay												30
Debt instrument conversion price percentage												130.00%
0.875% Convertible Senior Notes [Member] \| Condition Two [Member]
Debt Instrument [Line Items]
Threshold trading days \| TradingDay												5
Threshold consecutive trading days \| TradingDay												5
Debt instrument conversion price percentage												98.00%
Debt instrument convertible, principal amount												$ 1,000
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			$ 1,400,000				$ 800,000
Credit facility borrowing capacity, amount available												724,000,000.0
Senior Secured Revolving Facility [Member] \| Base Rate [Member]
Debt Instrument [Line Items]
Initial margin for borrowings								1.00%
Senior Secured Revolving Facility [Member] \| Eurocurrency Rate [Member]
Debt Instrument [Line Items]
Initial margin for borrowings								2.00%
Senior Secured Revolving Facility [Member] \| Second Amended Credit Agreement [Member]
Debt Instrument [Line Items]
Debt instrument principal amount												$ 175,000,000.0
Senior Secured Revolving Facility [Member] \| Maximum [Member] \| Second Amended Credit Agreement [Member] \| Base Rate [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread								1.25%
Senior Secured Revolving Facility [Member] \| Maximum [Member] \| Second Amended Credit Agreement [Member] \| Eurocurrency Rate [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread								2.25%
Senior Secured Revolving Facility [Member] \| Minimum [Member] \| Second Amended Credit Agreement [Member] \| Base Rate [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread								0.50%
Senior Secured Revolving Facility [Member] \| Minimum [Member] \| Second Amended Credit Agreement [Member] \| Eurocurrency Rate [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread								1.50%
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 commenced on June 30, 2018.
Senior Secured Term Loan [Member] \| Second Amended Credit Agreement [Member] \| EPSi Purchase Agreement [Member]
Debt Instrument [Line Items]
Prepayment of debt		$ 19,000,000.0
Senior Secured Term Loan [Member] \| Second Amended Credit Agreement [Member] \| CarePort [Member]
Debt Instrument [Line Items]
Prepayment of debt	161,000,000.0
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Aggregate amount of additional credit facilities authorized								$ 600,000,000
Debt instrument principal amount	$ 0											$ 175,000,000	$ 0
Senior Secured Credit Facility [Member] \| Second Amended Credit Agreement [Member]
Debt Instrument [Line Items]
Letters of credit outstanding												$ 1,000,000.0
Senior Secured Credit Facility [Member] \| Second Amended Credit Agreement [Member] \| United States dollars [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate, effective percentage												0.60%
Senior Secured Credit Facility [Member] \| Second Amended Credit Agreement [Member] \| LIBOR Rate [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread												0.50%
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument principal amount									$ 345,000,000.0
Interest rate				1.25%					1.25%		1.25%	1.25%		1.25%
Maturity date				Jul. 01, 2020								Jul. 01, 2020
Conversion price per common stock \| $ / shares												$ 17.19
Proceeds from debt									$ 305,100,000
Payments for 1.25% Call Option															$ 82,800,000

Debt - Summary of Future Debt Payments (Detail) $ in Thousands	Dec. 31, 2021 USD ($)
Debt Instrument [Line Items]
Total	$ 382,911
2022	0
2023	175,000
2024	0
2025	0
2026	0
Thereafter	207,911
0.875% Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Total	207,911
2022	0
2023	0
2024	0
2025	0
2026	0
Thereafter	207,911
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Total	175,000
2022	0
2023	175,000
2024	0
2025	0
2026	0
Thereafter	$ 0

Income Taxes - Geographic Breakdown of Income (Loss) From Continuing Operations Before Income Tax Provision (Benefit) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
United States	$ 141,367	$ (148,174)	$ (287,088)
Foreign	20,459	(1,137)	5,337
Income (loss) from continuing operations before income taxes	$ 161,826	$ (149,311)	$ (281,751)

- Definition

Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 940
-SubTopic 20
-Section 25
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=123384075&loc=d3e41242-110953

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(10))
-URI http://asc.fasb.org/extlink&oid=123367319&loc=SL114868664-224227

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 220
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(8))
-URI http://asc.fasb.org/extlink&oid=120400993&loc=SL114874131-224263

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 235
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-05(b)(2))
-URI http://asc.fasb.org/extlink&oid=120399901&loc=d3e537907-122884

Reference 9: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8924-108599

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 220
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-04(15))
-URI http://asc.fasb.org/extlink&oid=120399700&loc=SL114874048-224260

+ Details

Income Taxes - Components of Provision (Benefit) for Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Current tax provision (benefit), Federal	$ 17,179	$ (19,346)	$ (8,232)
Current tax provision (benefit), State	507	(219)	(1,809)
Current tax provision (benefit), Foreign	7,998	3,803	5,054
Current tax provision (benefit)	25,684	(15,762)	(4,987)
Deferred tax provision (benefit), Federal	3,341	2,931	(28,732)
Deferred tax provision (benefit), State	(34)	(2,981)	(8,763)
Deferred tax provision (benefit), Foreign	(1,140)	(880)	(858)
Deferred tax provision (benefit)	2,167	(930)	(38,353)
Income tax provision (benefit)	$ 27,851	$ (16,692)	$ (43,340)

Income Taxes - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2017	Dec. 31, 2018
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Statutory tax rate	21.00%	21.00%	21.00%
Net operating loss carryforwards expiry beginning period	2031
Tax holiday savings				$ 400
Diluted earnings per share, increase	$ 0.01			$ 0.01
Partial tax holiday period	5 years
Tax savings impact	$ 300
Unrecognized tax benefits	30,294	$ 28,885	$ 20,604		$ 19,821
Estimated increase in income tax benefit	33,500	30,800
Unrecognized tax benefits, accrued interest and penalties	3,220	2,048
Other Tax Expense (Benefit)	18,200
Valuation allowance	$ (1,504)	16,949	$ 922
Cumulative operating income loss period considered	3 years
U.S and Foreign Deferred Tax Asset [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Valuation allowance	$ 1,900
Unvested Stock Compensation of Covered Officers [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Valuation allowance	$ 400
India [Member] \| Partially Expire [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Tax holiday expiration date	2012
India [Member] \| Fully Expire [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Tax holiday expiration date	2017
State [Member] \| Minimum [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2016
State [Member] \| Maximum [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2021
US [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Net operating loss carryforwards	$ 12,500
Israeli [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Net operating loss carryforwards	$ 47,000
Foreign Jurisdictions [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2016
Federal [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Net operating loss carryforwards	$ 151,000	$ 164,000
Federal [Member] \| Minimum [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2018
Federal [Member] \| Maximum [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2021

Income Taxes - Taxes Computed at Statutory Federal Income Tax Rate Reconciled to Provision for Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
United States federal tax at statutory rate	$ 33,983	$ (31,355)	$ (59,170)
Non-deductible acquisition and reorganization expenses	0	0	31
Non-deductible portion of Department of Justice Settlement	(1,050)	0	18,546
Research credits	(5,000)	(6,500)	(6,126)
Change in unrecognized tax benefits	2,007	3,204	1,046
State income taxes, net of federal benefit	7,161	(2,940)	(7,411)
Compensation	(1,103)	5,314	4,664
Meals and entertainment	7	118	549
Impact of foreign operations	2,579	1,443	3,079
Provision-to-Return adjustments	(9,544)	(2,362)	(383)
Deemed Dividends	208	352	473
Federal, state and local rate changes	0	0	(630)
US Tax reform impact	0	0	(2,972)
Goodwill impairment	0	0	5,397
Non-deductible items	66	28	43
Valuation allowance	(1,504)	16,949	922
Other	41	(943)	(1,398)
Income tax provision (benefit)	$ 27,851	$ (16,692)	$ (43,340)

Income Taxes - Components of Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Deferred tax assets
Accruals and reserves, net	$ 11,689	$ 18,260
Allowance for doubtful accounts	8,750	9,571
Stock-based compensation, net	9,869	8,428
Deferred revenue	42,672	35,016
Operating and finance lease liabilities	15,612	22,902
Net operating loss carryforwards	33,231	35,695
Research and development tax credit	432	251
Other	0	4,519
Less: Valuation Allowance	(34,339)	(35,491)
Total deferred tax assets	87,916	99,151
Deferred tax liabilities
Prepaid expense	(4,272)	(4,329)
Property and equipment, net	(88)	(2,062)
Acquired intangibles, net	(80,273)	(86,841)
Operating and finance right-of-use assets	(11,840)	(18,315)
Other	(1,461)	0
Total deferred tax liabilities	(97,934)	(111,547)
Net deferred tax liabilities	$ (10,018)	$ (12,396)

Income Taxes - Deferred Tax Assets (Liabilities) Classified in Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Non-current deferred tax assets, net	$ 6,607	$ 5,790
Non-current deferred tax liabilities, net	(16,625)	(18,186)
Net deferred tax liabilities	$ (10,018)	$ (12,396)

Income Taxes - Change in the Amount of Unrecognized Tax Benefits (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Unrecognized tax benefit, beginning balance	$ 28,885	$ 20,604	$ 19,821
Increases for tax positions related to the current year	1,000	8,053	1,240
Decreases for tax positions related to prior years	(276)	0	0
Increases for tax positions related to prior years	685	427	95
Foreign currency translation	0	2	3
Reductions due to lapsed statute of limitations	0	(201)	(555)
Unrecognized tax benefit, ending balance	$ 30,294	$ 28,885	$ 20,604

Income Taxes - Recognized Interest and Penalties Related to Uncertain Tax Positions (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Interest and penalties included in the provision for income taxes	$ 1,172	$ 1,620	$ 229

Income Taxes - Amount of Interest and Penalties Included in Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Interest and penalties included in the liability for uncertain tax positions	$ 3,220	$ 2,048

Stock Award Plan - Stock-Based Compensation Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 43,563	$ 38,890	$ 42,690
Cost of revenue [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	5,615	6,061	6,142
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	1,529	1,640	2,075
Cost of revenue [Member] \| Client services [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	4,086	4,421	4,067
Selling, General and Administrative Expense [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	31,661	25,002	27,348
Research and development [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 6,287	$ 7,827	$ 9,200

Stock Award Plan - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	May 23, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense included in provision for income taxes	$ 4,900,000
Capitalized stock-based compensation costs	0	$ 0	$ 0
Unrecognized compensation cost	$ 58,800,000
Unrecognized compensation expense expected to recognized over weighted-average period, in years	2 years 3 months 18 days
Shares settled for tax withholding	904,000	808,000	705,000
Stock options, contractual terms	7 years
Aggregate intrinsic value of stock options outstanding	$ 0
Aggregate intrinsic value of stock options exercisable	0
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Annual fair value limit on shares purchased	25,000
Service-based share awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 45,400,000
Unrecognized compensation expense expected to recognized over weighted-average period, in years	2 years 6 months
Share based compensation award vesting period	4 years
Deferred share units awarded to directors [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based compensation award vesting period	1 year
Awards Granted Under Financial Performance [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based compensation award vesting period	3 years
Performance-Based Share Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 8,200,000
Unrecognized compensation expense expected to recognized over weighted-average period, in years	1 year 9 months 18 days
Market-Based Share Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 5,200,000
Unrecognized compensation expense expected to recognized over weighted-average period, in years	1 year 8 months 12 days
Share based compensation award vesting period	3 years
2019 Stock Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum number of shares available for awards				5,500,000
Common stock shares reserved for issuance under future share-based awards	6,500,000
Employee Stock Purchase Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Payroll deductions	20.00%
Offering price percentage	15.00%
Shares purchased under the ESPP	900,000	2,000,000.0

Stock Award Plan - Activity for Restricted Stock Units (Detail) - Restricted Stock Unit [Member] - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Shares
Shares, Unvested restricted stock units, beginning balance	9,668	8,914	7,950
Shares, Awarded	3,010	5,607	4,777
Shares, Vested	(3,051)	(2,756)	(2,360)
Shares, Forfeited	(1,407)	(2,097)	(1,453)
Shares, Unvested restricted stock units, ending balance	8,220	9,668	8,914
Weighted-Average Grant Date Fair Value
Weighted-Average Grant Date Fair Value, Unvested restricted stock units, beginning balance	$ 8.95	$ 11.53	$ 12.81
Weighted-Average Grant Date Fair Value, Awarded	15.50	6.88	10.15
Weighted-Average Grant Date Fair Value, Vested	9.52	11.69	12.62
Weighted-Average Grant Date Fair Value, Forfeited	11.63	10.79	12.20
Weighted-Average Grant Date Fair Value, Unvested restricted stock units, ending balance	$ 10.68	$ 8.95	$ 11.53

Stock Award Plan - Stock Options Outstanding (Detail) - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Options Outstanding
Options Outstanding, Beginning balance	0	1,234	1,332
Options Outstanding, Options granted	0	0	0
Options Outstanding, Options exercised	0	0	0
Options Outstanding, Options forfeited	0	(1,234)	(98)
Options Outstanding, Ending balance	0	0	1,234
Weighted-Average Exercise Price
Weighted-Average Exercise Price, Beginning balance	$ 0.00	$ 13.67	$ 13.69
Weighted-Average Exercise Price, Options granted	0.00	0.00	0.00
Weighted-Average Exercise Price, Options exercised	0.00	0.00	0.00
Weighted-Average Exercise Price, Options forfeited	0.00	13.67	14.01
Weighted-Average Exercise Price, Ending balance	$ 0.00	$ 0.00	$ 13.67
Options Exercisable
Options Exercisable	0	0	1,234	1,332
Weighted-Average Exercise Price, Exercisable	$ 0.00	$ 0.00	$ 13.67	$ 13.69

Stock Award Plan - Stock Option Activity (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Share-based Payment Arrangement [Abstract]
Total fair value of share awards vested	$ 29,045	$ 32,218	$ 29,793

Stockholders' Equity - Additional Information (Detail)											1 Months Ended			3 Months Ended	12 Months Ended
Stockholders' Equity - Additional Information (Detail)	Jan. 24, 2022 USD ($)	Jun. 16, 2021 USD ($)	Jun. 14, 2021 USD ($)	May 26, 2021 USD ($)	Dec. 30, 2020 $ / shares shares	Dec. 02, 2020 USD ($)	Nov. 30, 2020 USD ($)	Nov. 18, 2020 USD ($)	Dec. 09, 2019 USD ($)	Jun. 30, 2016 USD ($) Installment $ / shares shares	Aug. 31, 2021 $ / shares shares	May 31, 2021 $ / shares shares	Dec. 31, 2019 USD ($)	Dec. 31, 2020 USD ($) $ / shares shares	Dec. 31, 2021 USD ($) $ / shares shares	Dec. 31, 2020 USD ($) Installment $ / shares shares	Dec. 31, 2019 USD ($)	Jun. 30, 2020	Aug. 02, 2018 USD ($)	Jun. 30, 2013 $ / shares shares
Class Of Stock [Line Items]
Common stock repurchased, amount															$ 417,443,000	$ 334,863,000	$ 111,460,000
Common stock, par value \| $ / shares														$ 0.01	$ 0.01	$ 0.01
Maturity date															Jul. 01, 2020
0.875% Convertible Senior Notes [Member]
Class Of Stock [Line Items]
Interest rate									0.875%				0.875%	0.875%	0.875%	0.875%	0.875%	0.875%
Debt instrument convertible, principal amount									$ 1,000						$ 10,900,000
Maturity date									Jan. 01, 2027				Jan. 01, 2027
0.875% Convertible Senior Notes [Member] \| Additional Paid-In Capital [Member]
Class Of Stock [Line Items]
Debt instrument convertible, principal amount													$ 40,100,000	$ 40,058,000	$ 40,058,000	$ 40,058,000	$ 40,100,000
Warrant Issued to Commercial Partner [Member]
Class Of Stock [Line Items]
Number of warrants issued \| shares														1,500,000		1,500,000
Initial exercise price of warrant per share \| $ / shares														$ 9.82		$ 9.82
Number of installments \| Installment																4
Number of warrants vesting annually \| shares																375,000
Warrant expiration period																2026-12
Warrants value														$ 12,400,000		$ 12,400,000
Warrants vesting period																3 years
Warrant Issued to Commercial Partner [Member] \| Customary Anti-Dilution Adjustments [Member]
Class Of Stock [Line Items]
Number of warrants issued \| shares					900,000,000
Initial exercise price of warrant per share \| $ / shares					$ 14.18
Number of installments \| Installment										4
Number of warrants vesting annually \| shares					108,000					750,000
Warrant expiration period										2026-06
Warrants value										$ 11,000,000
Warrants vesting period										4 years
Additional warrants issued \| shares															0
Warrant Issued to Commercial Partner [Member] \| Case 1 [Member] \| Customary Anti-Dilution Adjustments [Member]
Class Of Stock [Line Items]
Number of warrants issued \| shares										900,000
Common stock, par value \| $ / shares										$ 0.01
Sale of common stock, price per share \| $ / shares										$ 12.47
Warrant Issued to Commercial Partner [Member] \| Case 2 [Member] \| Customary Anti-Dilution Adjustments [Member]
Class Of Stock [Line Items]
Number of warrants issued \| shares										1,000,000
Sale of common stock, price per share \| $ / shares										$ 14.34
Warrant Issued to Commercial Partner [Member] \| Case 3 [Member] \| Customary Anti-Dilution Adjustments [Member]
Class Of Stock [Line Items]
Number of warrants issued \| shares										1,100,000
Sale of common stock, price per share \| $ / shares										$ 15.59
1.25% Warrants [Member]
Class Of Stock [Line Items]
Number of warrants issued \| shares																				20,100,000
Initial exercise price of warrant per share \| $ / shares																				$ 23.135
Warrants value														$ 51,200,000	$ 51,200,000	$ 51,200,000
Warrant expiration term															The 1.25% Warrants began to expire on October 1, 2020, with expiration continuing to expire over the next 70 trading days. The 1.25% Warrants are exercisable only upon expiration. All of the 1.25% Warrants expired by the end of the first quarter in 2021, and none were exercised.
Warrant expiration beginning period															Oct. 01, 2020
Warrant expiration period															70 days
August 2018 Stock Repurchase Program [Member]
Class Of Stock [Line Items]
Common stock repurchased, shares \| shares																10,600,000
Common stock repurchased, amount																$ 102,000,000.0
Stock repurchase program, authorized amount																			$ 250,000,000
November 2020 Stock Repurchase Program [Member]
Class Of Stock [Line Items]
Common stock repurchased, shares \| shares														14,100,000	5,600,000
Common stock repurchased, amount								$ 300,000,000
May 2021 Stock Purchase Program [Member]
Class Of Stock [Line Items]
Common stock repurchased, shares \| shares															20,400,000
Common stock repurchased, amount				$ 350,000,000
2022 Program [Member] \| Subsequent Event [Member] \| Maximum [Member]
Class Of Stock [Line Items]
Common stock repurchase	$ 250,000,000
Accelerated Share Repurchase Agreement [Member]
Class Of Stock [Line Items]
Common stock repurchased, amount			$ 200,000,000.0				$ 200,000,000.0
Initial delivery received		$ 9,100,000				$ 11,700,000
Percentage of expected shares repurchased			80.00%				80.00%
Reduction to shareholders equity			$ 161,200,000				$ 165,700,000
Reduction to shareholders equity as an unsettled forward contract			$ 38,800,000				$ 34,300,000
Receipt of shares as part of final settlement \| shares											2,400,000	1,600,000
Weighted-average share repurchase price \| $ / shares											$ 17.28	$ 15.07

Earnings (Loss) Per Share - Calculations of Earnings (Loss) Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Basic earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax	$ 133,975	$ (132,619)	$ (238,411)
Net loss attributable to non-controlling interests	0	0	424
Net Income (Loss) from Continuing Operations Available to Common Shareholders, Basic, Total	133,975	(132,619)	(237,987)
Income from discontinued operations, net of tax	463	833,026	55,809
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ 134,438	$ 700,407	$ (182,178)
Weighted Average Number of Shares Outstanding, Basic	130,140	159,281	166,306
Basic earnings (loss) from continuing operations per Common Share	$ 1.03	$ (0.83)	$ (1.43)
Basic earnings from discontinued operations per Common Share	0.00	5.23	0.33
Net earnings (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$ 1.03	$ 4.40	$ (1.10)
Diluted earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax	$ 133,975	$ (132,619)	$ (238,411)
Net loss attributable to non-controlling interests	0	0	424
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	133,975	(132,619)	(237,987)
Income from discontinued operations, net of tax	463	833,026	55,809
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ 134,438	$ 700,407	$ (182,178)
Weighted-average common shares outstanding	130,140	159,281	166,306
Plus: Dilutive effect of stock options, restricted stock unit awards and warrants	8,518	0	0
Weighted-average common shares outstanding assuming dilution	138,658	159,281	166,306
Diluted earnings (loss) from continuing operations per Common Share	$ 0.97	$ (0.83)	$ (1.43)
Diluted earnings from discontinued operations per Common Share	0.00	5.23	0.33
Net earnings (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$ 0.97	$ 4.40	$ (1.10)

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	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Earnings Per Share [Abstract]
Shares subject to anti-dilutive stock options, restricted stock unit awards and warrants excluded from calculation	0	42,845	27,945

Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	$ 1,666,243
Other comprehensive income (loss) before reclassifications	282	$ 3,022	$ 1,253
Net (gains) losses reclassified from accumulated other comprehensive loss	(1,209)	(468)	(256)
Total other comprehensive (loss) income	(927)	2,554	997
Balance at the end of the period	1,408,138	1,666,243
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	(2,957)	(4,392)	(5,584)
Other comprehensive income (loss) before reclassifications	(69)	1,435	1,192
Net (gains) losses reclassified from accumulated other comprehensive loss	0	0	0
Total other comprehensive (loss) income	(69)	1,435	1,192
Balance at the end of the period	(3,026)	(2,957)	(4,392)
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	1,119	0	195
Other comprehensive income (loss) before reclassifications	351	1,587	61
Net (gains) losses reclassified from accumulated other comprehensive loss	(1,209)	(468)	(256)
Total other comprehensive (loss) income	(858)	1,119	(195)
Balance at the end of the period	261	1,119	0
Accumulated Other Comprehensive Loss [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	(1,838)	(4,392)	(5,389)
Balance at the end of the period	$ (2,765)	$ (1,838)	$ (4,392)

- Definition

Amount after tax and reclassification adjustments of other comprehensive income (loss).

+ References

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+ Details

- Definition

Total of all stockholders' equity (deficit) items, net of receivables from officers, directors, owners, and affiliates of the entity which are attributable to the parent. The amount of the economic entity's stockholders' equity attributable to the parent excludes the amount of stockholders' equity which is allocable to that ownership interest in subsidiary equity which is not attributable to the parent (noncontrolling interest, minority interest). This excludes temporary equity and is sometimes called permanent equity.

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+ Details

Accumulated Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2021	Dec. 31, 2020
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized net gains (losses), taxes (benefits)				$ 390
Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized net gains (losses), taxes (benefits)			$ 91
Revaluation of tax effects	$ 149	$ 149

Accumulated Other Comprehensive Loss - Income Tax Effects Related to Components of Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Accumulated Other Comprehensive Income Loss [Line Items]
Foreign currency translation adjustments, Before-Tax Amount	$ (69)	$ 1,435	$ 1,192
Other comprehensive (loss) income before income tax benefit (expense)	(1,226)	2,944	930
Foreign currency translation adjustments, Tax Effect	0	0	0
Other Comprehensive Income (Loss), Tax, Portion Attributable to Parent, Total	299	(390)	67
Foreign currency translation adjustments, Net	(69)	1,435	1,192
Total other comprehensive (loss) income	(927)	2,554	997
Derivatives Qualifying as Cash Flow Hedges [Member] \| Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Other Comprehensive Income (Loss), Foreign Currency Transaction and Translation Gain (Loss) Arising During Period, Net of Tax	473	2,139	82
Derivatives qualifying as cash flow hedges, net (gains) losses reclassified into income, Before-Tax Amount	(1,630)	(630)	(344)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), after Reclassification, before Tax, Noncontrolling Interest, Total	(1,157)	1,509	(262)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	(122)	(552)	(21)
Derivatives qualifying as cash flow hedges, net (gains) losses reclassified into income, Tax Effect	421	162	88
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), after Reclassification, Tax	299	(390)	67
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Net	351	1,587	61
Derivatives qualifying as cash flow hedges, net (gains) losses reclassified into income, Net	(1,209)	(468)	(256)
Derivatives qualifying as cash flow hedges, net change in unrealized gains (losses) on foreign exchange contracts, Net	(858)	1,119	(195)
Total other comprehensive (loss) income	$ (858)	$ 1,119	$ (195)

Derivative Financial Instruments - Fair Value and Balance Sheet Locations - (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Derivatives Fair Value [Line Items]
Derivative asset, fair value	$ 352	$ 1,509
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	$ 352	$ 1,509

Derivative Financial Instruments - Additional Information (Detail)		12 Months Ended
	Jul. 01, 2020	Dec. 31, 2021 INR (₨) Derivative	Dec. 31, 2013 USD ($)	Dec. 31, 2021 USD ($) Derivative $ / shares	Dec. 31, 2019	Jun. 18, 2013 USD ($)
Derivative [Line Items]
Maturity date		Jul. 01, 2020
1.25% Call Option [Member]
Derivative [Line Items]
Debt instrument interest rate		1.25%		1.25%
1.25% Cash Convertible Senior Notes [Member]
Derivative [Line Items]
Maturity date	Jul. 01, 2020	Jul. 01, 2020
Debt instrument interest rate	1.25%	1.25%		1.25%	1.25%	1.25%
Purchase of call option related to 1.25% senior cash convertible notes			$ 82,800,000
Conversion price per common stock \| $ / shares				$ 17.19
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				$ 400,000
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		Jan. 31, 2021
Derivative notional amount outstanding		₨ 50,000,000		700,000
Foreign Exchange Forward Contracts [Member] \| Maximum [Member]
Derivative [Line Items]
Date of contracts mature		Dec. 31, 2022
Derivative notional amount outstanding		₨ 250,000,000		$ 3,400,000
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	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Recognized in OCI	$ 473	$ 2,139	$ 82
Cost of revenue [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income	611	249	124
Selling, General and Administrative Expense [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income	351	122	83
Research and development [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income	$ 668	$ 259	$ 137

Derivative Financial Instruments - Net Impact of Changes in Fair Value of Call Option and Embedded Cash Conversion Option - (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Derivative Instruments Gain Loss [Line Items]
Net income included in Other income (loss), net	$ 0	$ 101	$ 769
1.25% Call Option [Member]
Derivative Instruments Gain Loss [Line Items]
Net income included in Other income (loss), net	0	(84)	(9,020)
1.25% Notes Embedded Cash Conversion Option [Member]
Derivative Instruments Gain Loss [Line Items]
Net income included in Other income (loss), net	$ 0	$ 185	$ 9,789

Commitments - Summary of Expense Incurred under Atos Agreement (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Long Term Purchase Commitment [Line Items]
Expenses incurred under Atos agreements with base fees	$ 57,885	$ 102,730	$ 100,089

- Definition

The aggregate cost of goods produced and sold and services rendered during the reporting period.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 28
-Subparagraph (f)
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Discontinued Operations - Additional Information (Detail) $ in Thousands		12 Months Ended
	Oct. 15, 2020 USD ($) Segment	Dec. 31, 2021 USD ($) Business Segment	Dec. 31, 2020 USD ($)	Dec. 31, 2019 USD ($)
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Number of reportable segments \| Segment	2	2
Gain (Loss) on disposal of discontinued solutions before tax		$ 647	$ 1,156,504	$ 0
EPSi and CarePort [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Number of businesses sold \| Business		2
Gain (Loss) on disposal of discontinued solutions before tax		$ 647	1,156,504	$ 0
Disposal group including discontinued operation accrued liabilities current		$ 0	6,669
EPSi [Member] \| EPSi Purchase Agreement [Member] \| Strata Decision Technology LLC [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Sale price	$ 365,000
CarePort [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Sale price			$ 1,350,000

Discontinued Operations - Summary of Major Classes of Assets and Liabilities as Reported on Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Carrying amounts of major classes of liabilities associated with EPSi and CarePort included as part of discontinued operations:
Total current liabilities attributable to discontinued operations	$ 0	$ 322,811
EPSi and CarePort [Member]
Carrying amounts of major classes of liabilities associated with EPSi and CarePort included as part of discontinued operations:
Accrued expenses	0	6,669
Income tax payable	0	316,142
Total current liabilities attributable to discontinued operations	$ 0	$ 322,811

- Definition

Amount classified as liabilities attributable to disposal group held for sale or disposed of, expected to be disposed of within one year or the normal operating cycle, if longer.

+ References + Details

Discontinued Operations - Summary of Major Income and Expense Line Items Reported in Consolidated Statements of Operations (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2021

Dec. 31, 2020

Dec. 31, 2019

Cost of revenue:

Gain on sale of discontinued operations

$ 647

$ 1,156,504

$ 0

Income from discontinued operations for EPSi and CarePort before income taxes

(15)

71,448

75,235

Income tax provision

(169)

(394,926)

(19,426)

Income from discontinued operations, net of tax

463

833,026

55,809

EPSi and CarePort [Member]

Revenue:

Total revenue

136,821

139,031

Cost of revenue:

Total cost of revenue

(24)

36,062

35,772

Amortization of software development and acquisition-related assets

9,053

8,166

Gross profit

100,759

103,259

Selling, general and administrative expenses

15,539

18,964

Research and development

(32)

8,269

9,065

Amortization of intangible assets

(Loss) income from discontinued operations for EPSi and CarePort

(17)

76,922

75,201

Interest expense

(5,241)

Other income (loss), net

(192)

Gain on sale of discontinued operations

647

1,156,504

Income from discontinued operations for EPSi and CarePort before income taxes

632

1,227,993

75,203

Income tax provision

^[1]

(169)

(394,926)

(19,417)

Income from discontinued operations, net of tax

^[2]

463

833,067

55,786

Software delivery, Support and Maintenance [Member] | EPSi and CarePort [Member]

Revenue:

Total revenue

122,791

122,268

Cost of revenue:

Total cost of revenue

(178)

11,424

12,482

Client services [Member] | EPSi and CarePort [Member]

Revenue:

Total revenue

14,030

16,763

Cost of revenue:

Total cost of revenue

$ 154

$ 15,585

$ 15,124

[1]	Income tax provision does not agree to the consolidated statement of operations for the year ended December 31, 2019 due to residual amounts related to Netsmart (as defined below). Refer to Note 20, "Supplemental Disclosures" for additional information.
[2]	Income from discontinued operations, net of tax for EPSi and CarePort does not agree to the consolidated statement of operations for the years ended December 31, 2020 and 2019 due to residual amounts related to Netsmart (as defined below). Refer to Note 20, "Supplemental Disclosures" for additional information.

Business Segments - Additional Information (Detail) - Segment		12 Months Ended
	Oct. 15, 2020	Dec. 31, 2021
Segment Reporting [Abstract]
Number of operating segments		3
Number of reportable segments	2	2

Business Segments - Revenues and Income (Loss) from Operations Related to Segment Within Reconciliation to Consolidated Amounts (Detail) - USD ($) $ in Thousands	3 Months Ended												12 Months Ended
	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Segment Reporting Information [Line Items]
Total revenue	$ 391,699	$ 369,272	$ 373,714	$ 368,352	$ 386,414	$ 365,618	$ 369,304	$ 381,364	$ 414,330	$ 408,280	$ 410,883	$ 399,118	$ 1,503,037	$ 1,502,700	$ 1,632,611
Gross profit													619,565	565,695	610,287
Income (loss) from operations													77,199	(130,880)	(99,689)
Unallocated Amounts [Member]
Segment Reporting Information [Line Items]
Total revenue													23,239	24,577	25,434
Gross profit													16,305	17,392	18,408
Income (loss) from operations													2,974	(14,903)	(18,291)
Hospitals and Large Physician Practices [Member]
Segment Reporting Information [Line Items]
Total revenue													927,590	950,155	1,052,267
Gross profit													330,720	293,672	317,776
Income (loss) from operations													(7,231)	(154,315)	(132,593)
Veradigm [Member]
Segment Reporting Information [Line Items]
Total revenue													552,208	527,968	554,910
Gross profit													272,540	254,631	274,103
Income (loss) from operations													$ 81,456	$ 38,338	$ 51,195

- Definition

Aggregate revenue less cost of goods and services sold or operating expenses directly attributable to the revenue generation activity.

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Supplemental Disclosures - Supplemental Disclosures (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$ 188,351	$ 531,104
Restricted cash	2,169	6,361
Total cash, cash equivalents and restricted cash	190,520	537,465
Interest, including convertible senior notes	4,993	24,616	$ 23,917
Income taxes paid, net of tax refunds	330,473	76,595	42,972
Non-cash transactions:
Issuance of treasury stock to commercial partner	534	752	701
2bPrecise [Member]
Non-cash transactions:
Sale of 2bPrecise business in exchange for a non-controlling interest in the combined entity	$ 11,768	$ 0	$ 0

Supplemental Disclosures - Accrued Expenses (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Schedule Of Supplemental Disclosures [Line Items]
Royalties, certain third-party product costs and licenses	$ 39,146	$ 37,841
Other	53,379	62,421
Total Accrued expenses	$ 92,525	$ 100,262

Supplemental Disclosures - Additional Information (Detail)	Dec. 31, 2021
Supplemental Disclosures [Abstract]
Maximum percentage accounted by individual expenses of total current liabilities	5.00%

Supplemental Disclosures - Prepaid and Other Current Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Supplemental Disclosures [Abstract]
Prepaid assets	$ 116,640	$ 132,944
Other current assets	2,302	3,320
Total Prepaid and other current assets	$ 118,942	$ 136,264

Supplemental Disclosures - Other Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Other Assets Noncurrent [Line Items]
Derivative asset, fair value	$ 352	$ 1,509
Long-term deferred hosting fees	0	11,025
Long-term prepaid commissions	27,031	27,882
Investments in non-marketable securities	61,553	35,805
Long-term deposits and other assets	12,576	16,916
Other Assets, Noncurrent, Total	$ 101,160	$ 91,628

Supplemental Disclosures - Other Assets (Parenthetical) (Detail)	Dec. 31, 2021
1.25% Call Option [Member]
Other Assets Noncurrent [Line Items]
Debt instrument interest rate	1.25%

Geographic Information - Revenues by Geographic Area (Detail) - USD ($) $ in Thousands	3 Months Ended												12 Months Ended
	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Schedule Of Revenues From External Customers [Line Items]
Total Revenue	$ 391,699	$ 369,272	$ 373,714	$ 368,352	$ 386,414	$ 365,618	$ 369,304	$ 381,364	$ 414,330	$ 408,280	$ 410,883	$ 399,118	$ 1,503,037	$ 1,502,700	$ 1,632,611
United States [Member]
Schedule Of Revenues From External Customers [Line Items]
Total Revenue													1,433,301	1,439,737	1,562,107
Canada [Member]
Schedule Of Revenues From External Customers [Line Items]
Total Revenue													16,013	15,624	16,495
Other International [Member]
Schedule Of Revenues From External Customers [Line Items]
Total Revenue													$ 53,723	$ 47,339	$ 54,009

- Definition

+ References

+ Details

Geographic Information - Long-Lived Assets by Geographic Area (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	$ 47,902	$ 72,162
United States [Member]
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	40,183	62,016
India [Member]
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	4,628	5,876
Israel [Member]
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	1,958	2,611
Canada [Member]
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	127	187
Other International [Member]
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	$ 1,006	$ 1,472

Contingencies - Additional Information (Detail) - Practice Fusion, Inc. [Member] - US Department of Justice and US Attorney [Member]	12 Months Ended
	Dec. 31, 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

Schedule II - Valuation and Qualifying Accounts (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2019 USD ($)
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
Beginning Balance	$ 25,826
Charged to Expenses/Against Revenue	3,467
Write-Offs, Net of Recoveries	(7,288)
Ending Balance	$ 22,005