Ontrak, Inc. - Annual Report: 2007 (Form 10-K)
UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
10-K
ANNUAL
REPORT PURSUANT TO SECTION 13 OR 15(d)
OF
THE SECURITIES EXCHANGE ACT OF 1934
For
The Fiscal Year Ended
December 31, 2007
Commission
File Number 001-31932
Hythiam,
Inc.
(Exact
name of registrant as specified in its charter)
Delaware
|
88-0464853
|
|
(State
or other jurisdiction of incorporation)
|
(I.R.S.
Employer Identification Number)
|
11150
Santa Monica Boulevard, Suite 1500
Los
Angeles, California 90025
(Address
of principal executive offices, including zip code)
(310) 444-4300
(Registrant’s
telephone number, including area code)
Securities
registered pursuant to Section 12(b) of the Act:
Common Stock, $0.0001 par
value
|
Nasdaq Global
Market
|
|
(Title
of each class)
|
(Name
of each exchange on which
registered)
|
Securities
registered pursuant to Section 12(g) of the Act: None
Indicate
by check mark if the registrant is a well-known seasoned issuer, as defined in
Rule 405 of the Securities Act.
Yes
o No
þ
Indicate
by check mark if the registrant is not required to file reports pursuant to
Section 13 or Section 15(d) of the Act.
Yes
o No
þ
Indicate
by check mark whether the registrant: (1) has filed all reports required to
be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934
during the preceding 12 months (or for such shorter period that the
registrant was required to file such reports), and (2) has been subject to
such filing requirements for the past 90 days.
Yes þ No o
Indicate
by check mark if disclosure of delinquent filers pursuant to Item 405 of
Regulation S-K is not contained herein, and will not be contained, to the
best of registrant’s knowledge, in definitive proxy or information statements
incorporated by reference in Part III of the Form 10-K or any amendment to
this Form 10-K. þ
Indicate
by check mark whether the registrant is a large accelerated filer, an
accelerated filer, or a non-accelerated filer. See definition of ‘‘accelerated
filer and large accelerated filer’’ in Rule 12b-2 of the Exchange Act. (Check
one):
Large
accelerated filer o
|
Accelerated
filer þ
|
Non-accelerated
filer o
|
Indicate
by check mark whether the registrant is a shell company (as defined in Rule
12b-2 of the Exchange Act).
Yes
o No
þ
As
of June 30, 2007, the aggregate market value of the common stock held by
non-affiliates of the registrant was $264,125,000 based on the $8.65 closing
price on the Nasdaq Global Market on that date. This amount excludes the value
of $120,812,000 shares of common stock directly or indirectly held by the
registrant’s affiliates.
As
of March 14, 2008, there were 54,387,604
shares of the registrant’s common stock outstanding.
DOCUMENTS
INCORPORATED BY REFERENCE
Portions
of the registrant’s proxy statement for its 2008 annual meeting of stockholders
to be held on June 20, 2008, are incorporated by reference into
Part III of this report.
HYTHIAM,
INC.
Form 10-K
Annual Report
For
The Fiscal Year Ended December 31, 2007
TABLE OF CONTENTS
|
||
Exhibit
10.13
|
||
Exhibit
10.15
|
||
Exhibit
21.1
|
||
Exhibit
23.1
|
||
Exhibit
23.2
|
||
Exhibit
31.1
|
||
Exhibit
31.2
|
||
Exhibit
32.1
|
||
Exhibit
32.2
|
PART I
Forward-Looking
Statements
This
report contains forward-looking statements that involve risks and uncertainties.
Our actual results may differ materially from those discussed due to factors
such as, among others, limited operating history, difficulty in developing,
exploiting and protecting proprietary technologies, intense competition and
substantial regulation in the healthcare industry. Additional information
concerning factors that could cause or contribute to such differences can be
found in the following discussion, as well as in Item 1.A Risk Factors and Item
7. Management’s Discussion and Analysis of Financial Condition and Results of
Operations.
ITEM
1. BUSINESS
Overview
We are a healthcare services management
company, integrating both medical and psychosocial treatment modalities,
providing behavioral health management services to health plans, employers,
criminal justice and government agencies through a network of licensed and
company-managed healthcare providers. We also research, develop, license
and commercialize innovative physiological, nutritional and behavioral treatment
programs. We manage behavioral health disorders through our subsidiary,
Comprehensive Care Corporation (CompCare), in which we acquired a majority
controlling interest in January 2007. We approach the management of behavioral
health disorders with a focus on using the latest medical and health technology
towards improved outcomes and outpatient treatment. We offer disease
management programs for substance dependence built around our patented
PROMETA®
Treatment Programs for alcoholism and dependence to cocaine and
methamphetamines. Our proprietary PROMETA Treatment Programs--which integrate
behavioral, nutritional and medical components--are available only through
physicians and other treatment providers who have entered into licensing
agreements with us for the use of our treatment programs. We also manage medical
practices and treatment centers that offer the PROMETA Treatment Programs, as
well as other treatments for substance dependencies.
Our
PROMETA-based disease management programs allow healthcare providers who license
our technology to offer an integrated approach for the treatment of substance
dependence that can be tailored for the specific needs of patients with medical
and psychiatric comorbidities.
CompCare
manages the delivery of a continuum of psychiatric and substance abuse services
to commercial, Medicare and Medicaid members on behalf of employers, health
plans, government organizations, third-party claims administrators and
commercial and other group purchasers of behavioral healthcare services. The
customer base for CompCare’s services includes both private and governmental
entities.
Our
unique PROMETA Treatment Programs for alcohol, cocaine and methamphetamine
dependence integrate physiological, nutritional and psychosocial therapies
designed to help patients meet their individual recovery goals. PROMETA
Treatment Programs seek to target key neuroreceptors to help relieve cravings
and improve cognitive function, restore nutritional balance and initiate
psychosocial counseling, so that patients can fully engage in the entire
recovery process. Our two proprietary PROMETA Treatment Programs, one for
alcohol dependence and the other for stimulant dependence or a combination of
alcohol and stimulant dependence, incorporate FDA-approved oral and IV
medications prescribed off-label and administered in a unique dosing algorithm.
The pharmacologic intervention is integrated with nutritional support and the
selection and initiation of psychosocial therapy. As a result, our PROMETA
Treatment Programs represent an innovative approach to substance dependence
designed to address physiological, nutritional and psychosocial aspects of the
disease, and are thereby intended to offer patients an opportunity to achieve
sustained recovery.
Historically,
the disease of addiction has been treated primarily through behavioral
intervention, with fairly high relapse rates. We believe the PROMETA Treatment
Programs offer an advantage to traditional alternatives because they provide a
treatment methodology that is discreet and only mildly sedating and can be
initiated in only three days, with a two-day follow-up treatment three weeks
later for addictive stimulants. Our PROMETA
Treatment
Programs also provide for one month of prescription medication and nutritional
supplements, combined with psychosocial or other recovery-oriented therapy
chosen by the patient in conjunction with their treatment provider. The medical
treatment is followed by continuing care, such as individual or group
counseling, as a key part of recovery. Limited initial clinical observations
indicate that our treatment programs may improve cognitive function, reduce
withdrawal symptoms, be associated with higher initial completion rates than
conventional treatments, and reduce physical cravings which can be a major
factor in relapse, thus allowing patients to more meaningfully engage in
counseling or other forms of psychosocial therapy.
We
believe the short initial treatment period when using our PROMETA Treatment
Programs is a major advantage over traditional inpatient detoxification
treatments and residential treatment programs, which typically consist of up to
28 days of combined inpatient detoxification and recovery in a rehabilitation or
residential treatment center. Treatment with PROMETA does not require an
extensive stay at an inpatient facility. Rather, the PROMETA Treatment Programs
offer the convenience of a three-day treatment (for addictive stimulants there
is a two-day follow-up treatment three weeks later) and can be administered on
an outpatient basis. This is particularly relevant since results from the
National Survey on Drug Use and Health – 2006 reported that approximately 75% of
adults using illicit drugs in 2006 were employed, and loss of time
from work can be a significant deterrent from seeking treatment.
We
have been unprofitable since our inception in 2003 and expect to continue
to incur operating losses for at least the next twelve
months. However, we believe our operating losses will decrease and we
will achieve positive cash flows within the next two years as the number of
patients treated with the PROMETA Treatment Program
increases. Accordingly, our historical operations and financial
information are not necessarily indicative of future operating results,
financial condition or ability to operate profitably as a commercial
enterprise.
We
believe that our business and operations as outlined above are in substantial
compliance with applicable laws and regulations. However, the healthcare
industry is highly regulated, and the criteria are often vague and subject to
change and interpretation by various federal and state legislatures, courts,
enforcement and regulatory authorities. Additional clinical studies are underway
to evaluate our treatment programs and confirm initial studies and reports from
physicians using them in their practices. The medications used in the PROMETA
Treatment Programs are FDA approved for uses other than treating dependence on
alcohol, cocaine or methamphetamine. Therefore, the risks and benefits of using
those medications to treat dependence on those substances have not been
evaluated by the FDA, which may not find them to be sufficiently safe or
effective. We do not manufacture, distribute or sell any medications and have no
relationship with any manufacturers or distributors of medications used in the
PROMETA Treatment Programs. Only a treating physician can determine if the
PROMETA Treatment Program is appropriate for any individual patient. Our future
prospects are subject to the legal, regulatory, commercial and scientific risks
outlined above and in Item 1.A Risk Factors.
Market for PROMETA®
Substance dependence is a worldwide
problem with prevalence rates continuing to rise despite the efforts by national
and local health authorities to curtail its growth. Substance dependence
disorders affect many people and have wide-ranging social consequences. In 2006,
an estimated 22.6 million Americans aged 12 and older suffered from alcohol or
other forms of drug abuse or dependence, of which 4.0 million, or 17.7%,
received some kind of treatment, according to the National Survey on Drug Use
and Health published by the Substance Abuse and Mental Health Services
Administration (SAMHSA), an agency of the U.S. Department of Health and Human
Services. Furthermore, according to the survey, approximately 10.4 million
Americans age 12 and older, or 4.3 % of the population, are reported as having
tried methamphetamine, and the percentage of methamphetamine use characterized
as abuse or dependence increased 57% from 2002 to 2005. Findings from the
Treatment Episode Data Set (TEDS) Highlights – 2006 published by SAMHSA’s Office
of Applied Studies show that the proportion of admissions for primary abuse of
methamphetamine as a percent of substance abuse treatment admissions increased
from 2.5% in 1996 to 8.3% in 2006.
Summarizing
data from the Office of National
Drug Control Policy (ONDCP) and
the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the economic
cost of alcohol and drug abuse exceeds $365 billion annually in the U.S.,
including $42 billion in healthcare costs and approximately $245 billion in
productivity losses. Despite these staggering figures, it is a testament to the
unmet need in the market that only 17.7% of those who need
treatment
actually receive help. Traditional treatment methods are often not particularly
effective, especially when it comes to those who are dependent on
stimulants.
There
are approximately 13,000 facilities reporting to SAMHSA that provide substance
abuse treatment on an inpatient or outpatient basis. Historically, the disease
of substance dependence has been treated primarily through behavioral
intervention, with fairly high relapse rates. SAMHSA’s TEDS 2004 report states
that in 2004 only 70% of those treated for alcoholism and 54% of those treated
for cocaine completed detoxification, and that alcohol and cocaine outpatient
treatment completion rates were only 46% and 27%, respectively.
Pharmacological
options for alcohol dependence exist and a number of pharmaceutical companies
have introduced or announced drugs to treat alcohol dependence. These drugs may
require chronic or long-term administration. In addition, several of these drugs
are generally not to be used until the patient has already achieved abstinence,
are generally administered on a chronic or long-term continuing basis, and do
not represent an integrated treatment approach to addiction. We believe PROMETA
can be used at various stages of recovery, including initiation of abstinence
and during early recovery, and can also complement other existing treatments. As
such, our treatment programs offer a potentially valuable alternative or
addition to traditional treatment methods.
It
is commonly reported that addiction to methamphetamine is an epidemic rapidly
spreading throughout the United States. Methamphetamine addicts are highly
resistant to treatment and, even after intervention, relapse at very high
rates. Methamphetamine use is also spreading to the
workplace. A study funded by the Wal-Mart Foundation in 2004
determined that each methamphetamine-using employee costs his or her employer
$47,500 per year in terms of lost productivity, absenteeism, higher healthcare
costs and higher workers’ compensation costs. For city, state and
county governments and their taxpayers, methamphetamine abuse causes legal,
medical, environmental and social problems. A study entitled “The Criminal
Effect of Meth on Communities” conducted in 2005 by the National Association of
Counties, which surveyed 500 counties in 45 states, reported that 58% of
counties surveyed reported methamphetamine as their largest drug problem, with
87% reporting increases in arrests involving methamphetamine starting three
years earlier. Cocaine was reported as the number one drug problem in 19% of the
counties. There are currently no generally accepted medical treatments for
cocaine or methamphetamine dependence.
Substance
Dependence as a Disease
Scientific
research indicates that not only can drugs interfere with normal brain
functioning but can also have long-lasting effects that persist even after the
drug is no longer being used. Data indicates that at some point changes may
occur in the brain that can turn drug and alcohol abuse into substance
dependence—a chronic, relapsing and sometimes fatal disease. Those dependent on
drugs may suffer from compulsive drug craving and usage and be unable to stop
drug use or remain drug abstinent without effective treatment. Professional
medical treatment is often necessary to end this physiologically-based
compulsive behavior. We believe that addressing the physiological basis of
substance dependence as part of an integrated treatment program will improve
clinical outcomes, reduce the cost of treating dependence, and reduce the cost
to society by decreasing related criminality and violence and mitigating the
costs associated with high risk behavior.
Methamphetamine
According to a
National Institute on Drug Abuse (NIDA) research report “Methamphetamine: Abuse
and Addiction” (January 2002), the effects of methamphetamine use can include
memory loss, aggression, psychotic behavior and heart and brain damage.
The damage to the brain caused by methamphetamine use appears similar to
damage caused by Alzheimer’s disease, stroke and epilepsy. Methamphetamine
is highly addictive and users trying to abstain from use may suffer withdrawal
symptoms that include depression, anxiety, fatigue, paranoia, aggression, and
intense cravings for the drug. Chronic methamphetamine use can cause violent
behavior, anxiety, confusion, and insomnia. Users can also exhibit psychotic
behavior including auditory hallucinations, mood disturbances, delusions, and
paranoia, possibly resulting in homicidal or suicidal thoughts. According to
NIDA’s report, “Methamphetamine Linked to Long-Term Damage to Brain Cells”
(March 2000), use of methamphetamine can cause damage to the brain that is
detectable months after the use of the drug.
Alcohol
The
Centers for Disease Control and Prevention rank alcohol the number three
preventable cause of death in the United States, with more than 75,000 deaths
annually. According to NIAAA, 44% of all deaths due to liver cirrhosis are
alcohol related, with most of these deaths occurring in people 40 to 65 years
old. One
study found that 20 to 37% of all emergency room trauma cases involve alcohol
use (Roizen, J., Alcohol and Trauma, 1988). Another found that 46% of
asymptomatic alcoholic men exhibited evidence of cardiomyopathy (Rubin, E., The
Effects of Alcoholism on Skeletal and Cardiac Muscle, 1989).
The
consequences of alcoholism and alcohol abuse affect most American families. One
study estimated that 20-25% of all injury-related hospital admissions are the
result of alcoholism or alcohol problems (Waller J., Diagnosis of Alcoholism in
the Injured Patient, 1988). According to the National Commission Against Drunk
Driving, nearly 600,000 Americans are injured in alcohol-related traffic crashes
each year, resulting in 17,000 fatalities.
Cocaine
and Crack Cocaine
Cocaine
and crack use are societal problems that place a heavy load upon our criminal
justice system. According to a Bureau of Justice Statistics Bulletin, “Prisoners
in 2004,” published in October 2005, 55% of the 170,000 federal prisoners and
21% of the 1.2 million state prisoners were convicted of drug offenses. The
National Institute of Justice reports that over 30% of all arrestees test
positive for cocaine or crack.
The
consequences of cocaine and crack use extend beyond the criminal justice system.
NIDA reports the medical complications of cocaine use can include heart
arrhythmias and heart attacks, chest pain, respiratory failure, strokes,
seizures and headaches, as well as abdominal pain and nausea. NIDA also notes
that there have been no medications available to treat cocaine
dependence.
Our
Solution: PROMETA®
Treatment Programs
People
suffering from alcohol, cocaine or methamphetamine dependence have a clinical
disease, but are often characterized as having a social disorder or a lack of
self-discipline. In this context traditional treatment approaches have generally
focused on the psychosocial aspect of the disease. While we recognize the
psychological approach to substance dependence treatment is important, we
believe that a more comprehensive approach to this multi-factorial disease
should be addressed as part of an integrated treatment approach intended to
provide patients with an improved chance for recovery. We believe our integrated
approach will offer patients an opportunity to achieve their individual recovery
goals.
Current
research indicates that substance dependence is associated with altered cortical
activity and changes in neurotransmitter function in the specific areas of the
brain which are critical to normal brain function. Moreover, changes in the
neurochemistry of the brain may underlie the hallmarks of substance dependence,
including tolerance, withdrawal symptoms, craving, decrease in cognitive
function and propensity for relapse. Our PROMETA Treatment Programs include
medically directed and supervised treatments, prescription medications and
nutritional supplements, combined with psychosocial or other recovery-oriented
therapy. We provide a proprietary integrated treatment program to medical
professionals. The specific implementation of the treatment programs is at the
discretion and judgment of the medical professionals providing care and tailored
to individual patient needs.
The
PROMETA Treatment Programs provide for:
·
|
A
comprehensive physical examination, including specific laboratory tests,
prior to initiation of treatment by the treating physician, to determine
if the patient is appropriate for
PROMETA
|
·
|
Prescription
medications delivered in a unique dosing
algorithm
|
·
|
A
nutritional plan and recommendations, designed to help facilitate and
maintain the other aspects of
recovery
|
·
|
One
month of prescription medications and nutritional supplements following
the initial treatment
|
·
|
Individualized
psychosocial counseling or other recovery oriented
counseling
|
The
initiation of treatment under PROMETA involves the oral and intravenous
administration of pharmaceuticals in a medically directed and supervised setting
over a period of three days. The medications used in the PROMETA Treatment
Programs have been approved by the Food and Drug Administration (FDA) for uses
other than treatment of substance dependence. Treatment generally takes place on
an outpatient basis at a properly equipped outpatient setting or clinic, or at a
hospital or other in-patient facility, by physicians and healthcare providers
who have licensed the rights to use our PROMETA Treatment Programs. The
outpatient nature of the treatment provides the opportunity for the care to be
provided in a discreet manner and without long periods away from home or work.
The PROMETA Treatment Program for stimulant dependence provides for a second,
two-day administration at the facility, which takes place about three weeks
after initiation of treatment. Following the
initial three
days,
our treatment
programs provide that
patients receive one month of prescription medication, nutritional
supplements, nutritional
guidelines designed to assist in recovery, and individualized psychosocial or
other recovery-oriented therapy.
Initial
results indicate that the PROMETA Treatment Programs may be associated with
higher initial completion rates than conventional treatments, reduce cravings
which can be a major factor in relapse and allow patients to more quickly engage
in counseling or other forms of psychosocial therapy in a meaningful way. These
initial conclusions have been reported in the treatment of over 2,500 patients
at licensed sites, commercial pilots and in research studies being
conducted to study our treatment programs. They may not be
confirmed by additional
double-blind, placebo-controlled research studies,
and may not be indicative of the long-term future performance of our
treatment
programs.
We
believe the PROMETA Treatment Programs may offer an advantage to traditional
alternatives for several reasons:
·
|
The
PROMETA Treatment Programs are designed to address a spectrum of patient
needs, including physiological, nutritional and psychological elements in
an integrated way
|
·
|
The
PROMETA Treatment Programs include medically directed and supervised
procedures designed to address neurochemical imbalances in the
brain that may be caused or worsened by substance dependence.
The rationale for this approach is that by addressing the underlying
physiological balance thought to be disrupted by substance dependence,
dependent persons may be better able to address the
behavioral/psychological and environmental components of their
disease
|
·
|
Treatment
using the PROMETA Treatment Programs generally can be performed on an
outpatient basis and does not require long periods away from home or
work
|
·
|
The
PROMETA Treatment Programs may be initiated at various stages of recovery,
including initiation of abstinence and during early recovery, and can
complement other treatment
modalities
|
Additionally,
we provide training, education and other administrative services to assist
physicians, healthcare providers and treatment centers with staff education,
marketing and administrative support.
Our
Strategy
Our
business strategy is to provide quality treatment programs that will become the
standard-of-care for those suffering from alcoholism and other substance
dependencies in a cost effective manner. We intend to grow our business through
increased utilization from within existing and new licensees, additional managed
treatment centers, and increased adoption of our PROMETA Treatment Programs and
substance abuse disease management treatment approach by government agencies,
criminal justice systems, managed care and other third-party
payers.
Key
elements of our business strategy include:
·
|
Providing
our substance abuse disease management program to managed care health
plans for reimbursement on a case rate or capitated basis, utilizing the
CompCare infrastructure to provide some components of our
services
|
·
|
Demonstrating
the potential for improved clinical outcomes and cost effectiveness
associated with using the PROMETA Treatment Programs, through commercial
pilot studies with key managed care and other third-party
payers
|
·
|
Expanding
the base of our self-pay licensed treatment sites and managed treatment
centers, focusing primarily on existing service
areas
|
·
|
Seeking
additional scientific and clinical research data to further validate the
benefits of using the PROMETA Treatment Programs, through unrestricted
grants for research studies by leading research institutions and
preeminent researchers in the field of alcohol and substance
abuse
|
·
|
Exploring
opportunities in foreign markets
|
Disease
Management
There
are currently approximately 180 million lives in the United States covered by
various managed care programs, including Preferred Provider Organizations
(PPOs), Health Maintenance Organizations (HMOs), self-insured employers and
managed Medicare/Medicaid programs. We believe our greatest opportunities for
growth are in this market segment.
Our
proprietary disease management programs are designed to improve treatment
outcomes and lower the utilization of medical and behavioral health plan
services by high utilizers and high risk enrollees. Our disease
management program includes the use of our PROMETA Treatment Programs, a
proprietary information technology platform and database, predictive modeling,
clinical algorithms, psychosocial programs, and integrated case management and
coaching services. CompCare utilizes its infrastructure to provide many disease
management services, including credentialing, peer review, monitoring, case
management, coaching services, quality assurance and other standard behavioral
healthcare services.
The
proposed value proposition to our customers includes the following
benefits:
·
|
Increased
worker productivity, by reducing workplace absenteeism, compensation
claims, and job related injuries
|
·
|
Decreased
emergency room and inpatient
utilization
|
·
|
Decreased
readmission rates
|
·
|
Medical
cost savings
|
We
expect to gain leverage from our disease management program, which will allow us
to market to managed care populations with one product and a relatively small,
specialized sales force. In addition, we believe that positive cost
savings and clinical outcomes demonstrated in disease management with healthcare
plans will provide a compelling motivation for speed of adoption by other health
plans and other business sectors.
Self-pay
Patients – Licensees
Our principal source of revenues to
date has been from license fees derived from the licensing of our PROMETA
Treatment Programs to physicians and other licensed treatment
providers. Although we plan to continue to provide such services to
our existing licensees for the treatment of substance dependencies using our
PROMETA Treatment Programs, we do not expect to significantly invest in or
expand this line of business without positive returns on our investment.
Accordingly, in 2008 we have significantly reduced our resources in each market
area to more closely match our resources and expenditures with revenues from our
licensees.
Managed
Medical Practices and Treatment Centers
Under the
terms of full business service management agreements with medical professional
corporations and treatment centers, we manage their business components and
license the PROMETA Treatment Programs and use of our PROMETA trademark in
exchange for management and licensing fees. These treatment centers
offer the PROMETA Treatment Programs for dependencies on alcohol, cocaine
and methamphetamines, and also offer medical interventions for other
substance dependencies. Under generally accepted accounting principles, the
revenues and expenses of such managed treatment centers are included in our
consolidated financial statements. We currently manage two such treatment
centers, the PROMETA Center in Santa Monica, California and Murray
Hill Recovery in Dallas, Texas.
Criminal
Justice Systems and Government Agencies
Drug
and alcohol offenders impact all divisions of criminal justice including law
enforcement, drug courts, probation, and correctional facilities. A
significant number of state and federal prisoners receive alcohol treatment in
prison or during the re-entry period while under community supervision. ONDCP
estimates that more than 40% of the sentenced federal inmate population will
have a diagnosable substance disorder that requires some type of drug abuse
treatment program. City, county, state and federal criminal justice systems are
in need of a more beneficial and convenient treatment alternative.
We began to establish
PROMETA as a covered treatment for city, state and
county agencies in the criminal
justice sectors in several states in 2006 and
2007. We will continue to
leverage existing pilots and programs with governmental agencies to
provide adoption and funding by criminal justice, state and local government
systems. However, while we have seen some early adoption, we will limit our
investment in this sector due to the inherent inefficiencies we see at the
present time in the public sector to adopt and implement our programs in a
timely manner.
International
Operations
We
have received allowances, issuances or notices that patent grants are intended
for inventions related to one or more of our treatment programs for the
treatment of alcohol and stimulant dependence in the U.S., Mexico, Australia,
New Zealand, Singapore, South Africa, Russia, Ukraine, South Korea,
China and the European Union. We will consider future
opportunities in these and other countries where our intellectual property is
protected.
We
currently offer the PROMETA Treatment Program as well as other treatments for
dependencies in Europe and Central America, and we plan to continue to
expand in these markets.
Clinical
Data from Research Studies
A
key to our success will be the publication of results from research studies
evaluating treatment with the PROMETA Treatment Programs conducted by leading
research institutions and preeminent researchers in the field of alcohol and
substance abuse. Studies funded by our unrestricted grants that are completed,
pending or underway include:
Completed
Studies
·
|
An
88-patient randomized, double-blind, placebo-controlled study of the
PROMETA Treatment Program’s acute and immediate effects on cravings and
cognition in methamphetamine dependent subjects designed and supervised by
Harold Urschel, M.D., completed in October 2007. Top line
results showed a statistically significant reduction in cravings versus
placebo.
|
·
|
A
50-patient open-label study of the physiological component of the PROMETA
Treatment Program for methamphetamine dependence conducted by Dr. Urschel
that was completed in 2006, in which it was reported that more than 80% of
study participants experienced a significant clinical benefit—measured
through decrease in cravings, reduction of methamphetamine use and
treatment retention—after treatment, with no adverse events. The results
of this study were reported in October 2007 in a peer-reviewed journal,
Mayo Clinic Proceedings.
|
·
|
A
30-patient open label randomized controlled study of the PROMETA Treatment
Programs in the treatment of alcohol dependence being conducted by Jeffery
Wilkins, M.D., at Cedars-Sinai Medical Center in Los Angeles completed in
August 2007. Top line results reported at 30 days showed a 94% decrease in
median cravings and an 82% reduction in mean percentage of total drinking
days.
|
·
|
In
February 2007, Sheryl Smith, Ph.D., a leading researcher in the field of
neurosteroids, provided evidence supporting a mechanism of action
underlying our PROMETA Treatment Programs at the Neurobiology of
Addiction Conference. Dr. Smith presented data from her
research on methamphetamine dependent rats, describing the methamphetamine
induced increase in the
α4 subunit of the GABAA
receptor and the post-treatment decrease of this pathological marker,
which has been associated with states of hyper-excitability and
anxiety. This receptor dysregulation and associated symptomatology
has previously been associated with alcohol and neurosteroid withdrawal in
animal studies, and suggests a common cause of cravings in substance
dependent individuals.
|
Pending
Studies
·
|
An
ongoing 60-patient randomized, double-blind, placebo-controlled study of
the PROMETA Treatment Program’s acute and immediate effects on cravings
and cognition in alcohol dependent subjects designed and being supervised
by renowned alcoholism researcher, Joseph R. Volpicelli, M.D., of
University of Pennsylvania, and conducted by Institute of Addiction
Medicine’s Dr. Jenny Starosta.
|
·
|
An
ongoing 90-patient multi-site, randomized, double-blind,
placebo-controlled study of the PROMETA Treatment Programs for the
treatment of methamphetamine dependence being conducted by Walter Ling,
M.D., of UCLA.
|
·
|
An
ongoing 60–patient, randomized, double-blind, placebo-controlled study of
the PROMETA Treatment Program for the initiation and extension of
abstinence of alcoholism being conducted by Raymond Anton, M.D., at
Medical University of South
Carolina.
|
·
|
An
80–patient, randomized, double-blind, placebo-controlled study of the
PROMETA Treatment Programs’ acute and immediate effects on cravings and
cognition in alcohol dependent subjects being conducted by Dr. Wilkins at
Cedars-Sinai Medical Center.
|
Our
Operations
Healthcare
Services
We commenced operations in July 2003
and signed our first licensing and administrative services agreement in November
2003. Under our licensing agreements, we provide physicians and other licensed
treatment providers access to our PROMETA Treatment Programs, education and
training in the implementation and use of the licensed technology and marketing
support. We receive a fee for the licensed technology and related services
generally on a per patient basis. As of December 31, 2007, we had licensing
agreements with physicians, hospitals and treatment providers for approximately
100 sites throughout the United States, with approximately 70 sites contributing
to revenues in 2007. We continue to enter into agreements with
additional healthcare providers to increase the availability of the PROMETA
Treatment Programs. As revenues are generally related to the number
of patients treated, key indicators of our financial performance will be the
number of facilities and healthcare providers that license our technology, and
the number of patients that are treated by those providers using our PROMETA
Treatment Programs. Since July 2003, over 2,500 patients have completed
treatment using our PROMETA Treatment Programs at our licensed sites, and in
commercial pilots and research studies being conducted to study our treatment
programs.
We
currently manage two treatment centers, located in Santa Monica, California (The
PROMETA Center, Inc.) and Dallas, Texas (Murray Hill Recovery, LLC), whose
revenues and expenses are included in our consolidated financial
statements.
To date, a
substantial portion of our healthcare services revenues has been derived from
license fees for the use of the PROMETA Treatment Program in treating self-pay
patients, and consolidation of self-pay patient revenues from managed treatment
centers. We expect revenues from governmental agencies and other third party
payers will increase as our PROMETA Treatment Program and disease management
products are adopted and implemented by managed care providers, and state and
county criminal justice systems. Furthermore, we believe additional positive
results from published studies of our PROMETA Treatment Programs
will enhance our efforts to increase third-party reimbursement for
providers using our treatment programs.
We
do not operate our own healthcare facilities, employ our own treating physicians
or provide medical advice or treatment to patients. We provide services and
access to tools that physicians may use to treat their patients as they
determine appropriate. The hospitals, licensed healthcare facilities, and
physicians that contract for the use of our technology own their facilities or
professional licenses, and control and are responsible for the clinical
activities provided on their premises. Patients receive medical care in
accordance with orders from their attending physicians. Physicians
with license rights to use the PROMETA Treatment Programs exercise their
independent medical judgment in determining the use and specific application of
our treatment programs, and the appropriate course of care for each patient.
Following the medical portion of the treatment procedure, physicians, local
clinics and healthcare providers specializing in drug abuse treatment administer
and provide the psychosocial component of the PROMETA Treatment
Program.
Behavioral
Health Managed Care Services
To
date, all of our behavioral health managed care revenues have been derived from
the operations of our consolidated subsidiary, CompCare, in which we acquired a
majority controlling interest on January 12, 2007.
CompCare
typically enters into contracts on an annual basis to provide managed behavioral
healthcare and substance abuse treatment to clients’ members. Arrangements with
clients fall into two broad categories: capitation arrangements, where clients
pay CompCare a fixed fee per member per month, and fee-for-service and
administrative service arrangements where CompCare may manage behavioral
healthcare programs or perform various managed care services. Approximately 97%
of CompCare’s revenues for the period January 13 through December 31, 2007 were
derived from capitation arrangements. Under capitation arrangements, CompCare
receives premiums from clients based on the number of covered members as
reported by the clients. CompCare reviews membership eligibility records and
other reported information to verify its accuracy in determining the amount of
revenue to be recognized. The amount of premiums received for each member is
fixed at the beginning of the contract term. These premiums may be subsequently
adjusted, up or down, generally at the commencement of each renewal
period.
For
the period January 13 through December 31, 2007, 87% of behavioral health
managed care services revenue was concentrated in contracts with six health
plans to provide behavioral healthcare services under commercial, Medicare,
Medicaid, and children’s health insurance plans (CHIP). This includes
a contract with a health plan to provide behavioral healthcare services to
approximately 250,000 Medicaid recipients in Indiana, which represented
approximately 40% of behavioral health managed care services revenue for the
period January 13 through December 31, 2007. The term of each contract is
generally for one year and is automatically renewable for additional one-year
periods unless terminated by either party by giving the requisite written
notice.
Competition
Healthcare
Services
Our
healthcare services business focuses on providing licensing, administrative and
management services to licensees that administer PROMETA and other treatment
programs, including managed treatment centers that are licensed and/or managed
by us. We compete with many types of substance dependence treatment methods,
treatment facilities and other service providers. Conventional forms of
treatment for alcohol dependence are usually divided into phases:
·
|
Detoxification,
which is typically conducted in medically directed and supervised
environments
|
·
|
Rehabilitation,
which is often conducted through short- or long-term therapeutic
facilities or programs, most of which do not offer medical management
options
|
·
|
Relapse
prevention/aftercare that is provided via structured outpatient treatment
programs.
|
Most
medically managed treatments require long-term usage of pharmaceuticals,
resulting in low patient compliance. Conventional forms of treatment for
stimulant dependence generally consist only of relapse prevention (psychosocial
and recovery oriented therapy), conducted through therapeutic
programs. Regardless of the approach, there is great variability in
the duration of treatment procedures, level of medical supervision, price to the
patients and success rates.
One
currently accepted practice for detoxifying patients from dependence on alcohol
consists of heavily sedating the patient at an inpatient hospital facility for a
period of 3 to 5 days. Due to the heavy sedation, the patient may need to
be further observed for an additional 5 to 7 days. This procedure, while
medically necessary to prevent severe complications, e.g. seizures or delirium
tremens when withdrawing these patients from alcohol, does not consistently
relieve the patient’s cravings or otherwise attempt to address the long term
recovery of the patient. Further, the drugs typically used during this procedure
(the most commonly utilized medications are Valium®
(diazepam), Ativan®
(lorazepam), and Xanax®
(alprazolam)) can be addictive, require a time-intensive dose tapering and
washout period, and may cause side effects.
While
withdrawal from cocaine or methamphetamine dependence is not considered to be
life threatening, withdrawal symptoms can be extremely unpleasant and may
lead to repeated relapses and treatment failures. Detoxification procedures
typically involve the use of sedatives to assist patients through this difficult
period. Following treatment, environmentally “cue induced” cravings, however,
are especially pronounced and may re-occur for months to years.
Treatment
Programs
There
are approximately 13,000 facilities reporting to the Substance Abuse and Mental
Health Services Administration (SAMHSA) that provide substance dependence
medical treatment services on an inpatient or outpatient basis. Well-known
examples of residential treatment programs include the Betty Ford Center®, Caron
Foundation®,
Hazelden® and
Sierra Tucson®. In
addition, individual physicians may provide substance dependence treatment
in the course of their practices. There appears to be no readily available
reliable information about the success rates of these programs, nor agreed upon
standards of how outcomes should be measured (e.g., self-reported abstinence or
reduction in days of heavy drinking). Many of these traditional treatment
programs have established name recognition, and their treatments may be covered
in large part by insurance or other third party payers. To date, treatments
using our PROMETA Treatment Programs have generally not been covered by
insurance, and patients treated with the PROMETA Treatment Programs have been
substantially self-pay patients.
Traditional
treatment approaches for substance dependence focus mainly on group therapy,
abstinence, and behavioral modification, while the disease’s underlying
physiology and pathology is rarely addressed, resulting in fairly high relapse
rates. Currently therapies are beginning to target brain receptors thought to
play a central role in the disease process. We believe that our PROMETA
Treatment Programs offer an improvement to traditional treatments because the
integrated PROMETA Treatment Programs are designed to target
the pathophysiology induced by chronic use of alcohol or other
drugs in addition to nutritional and psychosocial aspects of substance
dependence. The abnormalities in brain function induced by chronic
substance dependence may take weeks to years of drug abstinence to return to
normal function, if at all. We believe the PROMETA Treatment Programs offer an
advantage to traditional alternatives because they provide an integrated
treatment methodology that is discreet, mildly sedating and that can be
initiated in only three days, with a second two-day treatment three weeks later
for addictive stimulants. Our PROMETA Treatment Programs also provide for one
month of prescription medication and nutritional supplements, integrated with
psychosocial or other recovery-oriented therapy.
We
further believe the short initial outpatient treatment period when using our
PROMETA Treatment Programs is a major advantage over traditional inpatient
treatments and residential treatment programs, which typically consist of
approximately 15 to 28 days of combined inpatient detoxification and
recovery in a rehabilitation or residential treatment center. The PROMETA
Treatment Programs do not require an extensive stay at an inpatient facility.
Rather, the treatment programs offer the convenience of a three day treatment
(addictive stimulants require a second two-day treatment three weeks later) and
can generally be administered on an outpatient basis. This is particularly
relevant since approximately 75% of adults classified with dependence or abuse
are employed, and loss of time from work can be a major deterrent for seeking
treatment. Moreover, we believe the PROMETA Treatment Programs can be
used at various stages of recovery, including initiation of abstinence and
during early recovery, and can complement other forms of alcohol and drug abuse
treatments. As such, our treatment programs offer a potentially valuable
alternative or addition to traditional behavioral or pharmacotherapy
treatments.
Treatment
Medications
There are currently no generally
accepted medical treatments for methamphetamine dependence. Anti-depressants and
dopamine agonists have been investigated as possible maintenance therapies, but
none have been FDA approved or are generally accepted for medical
practice.
Several
classes of pharmaceutical agents have been investigated as potential maintenance
agents (e.g., anti-depressants and dopamine agonists) for cocaine
dependence; however, none are FDA approved for treatment of cocaine dependence
or widely generally accepted in medical practice. Their effects are variable in
terms of providing symptomatic relief, and many of the agents may cause side
effects or may not be well tolerated by patients.
There
are a number of companies developing or marketing medications for reducing
craving in the treatment of alcoholism. These include:
·
|
The
addiction medication naltrexone, an opiate receptor antagonist, is
marketed by a number of generic pharmaceutical companies as well as under
the trade name ReVia®,
for treatment of alcohol
dependence;
|
·
|
VIVITROL®,
an extended release formulation of naltrexone manufactured by Alkermes, is
intended to be administered by a physician via monthly injections for
the treatment of alcohol dependence in patients who are able to abstain
from drinking in an outpatient setting and are not actively drinking prior
to treatment initiation. Alkermes reported that in clinical trials, when
used in combination with psychosocial support, VIVITROL was shown to
reduce the number of drinking days and heavy drinking days and to prolong
abstinence in patients who abstained from alcohol the week prior to
starting treatment;
|
·
|
Campral®
Delayed-Release Tablets (acamprosate calcium), an NMDA receptor antagonist
taken two to three times per day on a chronic or long-term basis and
marketed by Forest
Laboratories. Clinical
|
studies
supported the effectiveness in the maintenance of abstinence for
alcohol-dependent patients who had undergone inpatient detoxification and were
already abstinent from alcohol;
·
|
Topiramate
(Topamax), a drug manufactured by Ortho-McNeill Jannssen, which is
approved for the treatment of seizures. A multi-site clinical trial
reported in October 2007 found that topiramate significantly reduced heavy
drinking days in alcohol-dependent
individuals.
|
Many medications marketed to treat
alcohol or drug dependence are not administered until the patient is already
abstinent, require long-term chronic administration and/or must be taken several
times a day to achieve the desired effect. As noted above, we believe
the PROMETA Treatment Programs represent an integrated approach to
treatment that includes medical, nutritional and psychosocial components that
can be used at various stages of recovery, including initiation of abstinence
and during early recovery, and can complement other existing treatments. As
such, our treatment programs offer a potentially valuable addition to
traditional medical treatment. Moreover, because treatment with the PROMETA
Treatment Programs is an integrated treatment, we do not view the current
medical therapies as directly competitive and in some cases may be used in
conjunction with our treatment programs. We also believe, based on the
limited initial results discussed above, that treatment using our treatment
programs may have higher completion rates, greater compliance, reduction or
elimination of cravings, improved cognitive functioning and potentially lower
relapse rates.
Behavioral
Health Managed Care Services
The
behavioral healthcare industry is very competitive and provides products and
services that are price sensitive. We believe that there are
approximately 150 managed behavioral healthcare organizations (MBHOs) providing
services for an estimated 227 million covered lives in the United States.
CompCare’s competitors include both freestanding MBHOs as well as HMOs with
internal behavioral health units or subsidiaries. Many of these competitors have
revenues, financial resources, and membership substantially larger than
CompCare. The extent of competition results in significant pricing pressures
which limits CompCare’s revenue growth. Accordingly, we expect
CompCare’s future growth to come mainly from additional contracts.
In
addition to MBHOs, there are disease management companies that may offer
services or programs that will compete with our disease management products. We
believe, however, that because our disease management programs are built around
our proprietary, patented PROMETA Treatment Programs, no other company, MBHO or
healthcare provider will be able to directly compete with our disease management
product offering.
Development
of Our Technology
Much
of our proprietary, patented and patent–pending, substance dependence technology
known as the PROMETA Treatment Program, was developed by
Dr. Juan José Legarda, a European scientist educated at University of
London who has spent most of his professional career conducting research related
to substance abuse. Through his studies and research, Dr. Legarda
identified some of the adverse physical effects of substance abuse on the brain
and began to develop technologies that specifically focused on the
neurochemistry of the brain as a core part of addictive behavior modification.
In 2002, Dr. Legarda filed Patent Cooperation Treaty
(PCT) applications in Spain to protect treatment programs that he
developed for dependencies to alcohol and cocaine. We acquired the rights to
these patent filings in March 2003 through a technology purchase and license
agreement with Dr. Legarda’s company, Tratamientos Avanzados de la Adiccion
S.L., to which we pay a royalty of three percent of the amount the patient pays
for treatment using our treatment programs. After acquiring these rights, we
filed U.S. patent applications and other national phase patent applications
based on the PCT filings, as well as provisional U.S. patent applications
to protect aspects of additional treatment programs for alcohol,
cocaine and other addictive stimulants.
We
have two issued U.S. patents, one relating to the treatment of cocaine
dependency with our PROMETA Treatment Program and one relating to our PROMETA
Treatment Program for the treatment of certain symptoms associated with
alcohol. We have also received allowances, issuances or notices that
patent grants are intended for our core intellectually property for the
treatment of alcohol and/or stimulant dependence in Mexico, Australia, New
Zealand, Singapore, South Africa, Russia, Ukraine, South Korea, China and
the European Union.
Once
patents are issued, they generally will expire 20 years from the dates of
original filing. Our two issued U.S. patents will expire in
2021.
Proprietary
Rights and Licensing
Our success depends in large part on
our ability to protect our proprietary technology and operate without infringing
on the proprietary rights of others. We rely on a combination of patent,
trademark, trade secret and copyright laws and contractual restrictions to
protect the proprietary aspects of our technology. To help ensure compliance
with our license/joint venture agreements, we employ site managers in each of
our major markets. Our branded trade names include the
following:
·
|
Hythiam®
|
·
|
PROMETA®
|
·
|
PROMETA
Center®
|
·
|
Catasys™
|
·
|
The
Science of Recovery®
|
We
impose restrictions in our license agreements on our customers’ rights to
utilize and disclose our technology. We also seek to protect our intellectual
property by generally requiring employees and consultants with access to our
proprietary information to execute confidentiality agreements and by restricting
access to our proprietary information. We require that, as a condition of their
employment, employees assign to us their interests in inventions, original works
of authorship, copyrights and similar intellectual property rights conceived or
developed by them during their employment with us.
Our
Management Team
The following table sets forth
information regarding our executive officers:
Name
|
Position
|
Age
|
Terren
S. Peizer
|
Chief
Executive Officer
|
48
|
Richard
A. Anderson
|
Senior
Executive Vice President
|
38
|
Christopher
S. Hassan
|
Senior
Executive Vice President
|
47
|
Anthony
M. LaMacchia
|
Senior
Executive Vice President
|
54
|
Chuck
Timpe
|
Chief
Financial Officer
|
61
|
Terren S. Peizer is the
founder of our company and has served as our chief executive officer and
chairman of our board of directors since our inception in February
2003. Mr. Peizer served as chief executive officer of Clearant, Inc.,
a company which he founded in April 1999 to develop and commercialize a
universal pathogen inactivation technology, until October 2003. He served
as chairman of its board of directors from April 1999 to October 2004
and as a director until February 2005. From February 1997 to
February 1999, Mr. Peizer served as president and vice chairman of
Hollis-Eden Pharmaceuticals, Inc., a Nasdaq Global Market listed company. In
addition, from June 1999 through May 2003 he was a director, and from
June 1999 through December 2000 he was chairman of the board, of
supercomputer designer and builder Cray Inc., a Nasdaq Global Market company,
and remains its largest beneficial stockholder. Since August 2006, he has served
as chairman of the board of Xcorporeal, Inc., an American Stock Exchange listed
company. Mr. Peizer has been the largest beneficial stockholder and has
held various senior executive positions with several technology and biotech
companies. He has assisted companies by assembling management teams, boards of
directors and scientific advisory boards, formulating business and financial
strategies, and investor relations. Mr. Peizer has a background in venture
capital, investing, mergers and acquisitions, corporate finance, and previously
held senior executive positions with the investment banking firms Goldman Sachs,
First Boston and Drexel Burnham Lambert. He received his B.S.E. in Finance from
The Wharton School of Finance and Commerce.
Richard A. Anderson has more
than fifteen years of experience in business development, strategic planning and
financial management. He has served as a director since July 2003 and an officer
since April 2005. He was the chief financial officer of Clearant, Inc. from
November 1999 until March 2005, and served as a director from
November 1999 to March 2006. Mr. Anderson was previously
with PriceWaterhouseCoopers, LLP, for seven
years,
most recently a director and founding member of PriceWaterhouseCoopers Los
Angeles Office Transaction Support Group, where he was involved in operational
and financial due diligence, valuations and structuring for high technology
companies. He received a B.A. in Business Economics from University of
California, Santa Barbara.
Christopher S. Hassan is a
senior healthcare executive who, prior to joining us in July 2006, served
as vice president, sales for Reckitt Benckiser Pharmaceuticals since
October 2003. From 2000 to October 2002, he served as director of
sales, North America for Drugabuse Sciences, Inc. a bio-pharmaceutical company.
From 1996 to 2000, Mr. Hassan served as area business manager for
Parke-Davis/Pfizer. From 1989 to 1996 he served as district sales manager for
Bayer Pharmaceuticals. Mr. Hassan received a B.B.A. in Accounting from
University of Texas, Austin.
Anthony M. LaMacchia is a
senior healthcare executive who, prior to joining us in July 2003, was the
business development principal of GME Solutions, a healthcare financial
consulting company providing Medicare graduate medical education and kidney
acquisition cost recovery services, since October 2002. From
November 1999 to April 2002, he was president & chief executive
officer of Response Oncology, Inc., a diversified physician practice management
company. He was recruited to this financially distressed company to direct a
high-risk turnaround, and when continued market declines and debt covenant
breaches compelled a bankruptcy filing, directed the company through all phases
of the Chapter 11 process, the sale of all assets and the closure of its
facilities. In June 1999, Mr. LaMacchia left Salick Health Care, Inc.,
which developed and operated outpatient cancer and kidney treatment centers and
a clinical research organization engaging in pharmaceutical and clinical
treatment trials, as executive vice president & chief operating officer,
having started with the company as director of strategic planning &
reimbursement in 1984. Previously, Mr. LaMacchia held positions of
increasing responsibility with Blue Cross of California, Ernst & Young and
Cedars-Sinai Medical Center. He is a certified public accountant who received
his B.S. in Business Administration, Accounting from California State
University, Northridge.
Chuck Timpe is a senior
healthcare financial executive with over 35 years experience in the
healthcare industry. Since March 1998, he has served as a director and
since June 2002 as chairman of the audit committee for IPC-The Hospitalist
Company, a $190 million Nasdaq Global Market listed company. Prior to
joining us in June 2003, Mr. Timpe was chief financial officer, from
its inception in February 1998, of Protocare, Inc., a clinical research and
pharmaceutical outsourcing company which merged with Radiant Research, Inc. in
March 2004, creating one of the country’s largest clinical research site
management organizations. Previously, he was a principal in private healthcare
management consulting firms he co-founded, chief financial officer of National
Pain Institute, treasurer and corporate controller for American Medical
International (now Tenet Healthcare Corp.), and a member of Arthur Andersen,
LLP’s healthcare practice, specializing in public company and hospital system
audits. Mr. Timpe received his B.S. from University of Missouri, School of
Business and Public Administration, and is a certified public
accountant.
Financial
Information about Segments
We
conduct our operations through two business segments: healthcare services and
behavioral health managed care services. Our healthcare services segment focuses
on providing licensing, administrative and management services to licensees that
administer PROMETA and other treatment programs, including managed treatment
centers that are licensed and/or managed by us. Our behavioral health managed
care services segment focuses on providing managed care services in the
behavioral health, psychiatric and substance abuse fields, and principally
includes the operations of our majority-owned, controlled subsidiary, CompCare.
A majority of
our consolidated
revenues and assets
are earned or located within the United
States.
Employees
As of
December 31, 2007, we and our consolidated managed treatment centers
employed approximately 160 persons. In January 2008 we significantly reduced the
number of employees in connection with streamlining our operations to focus on
disease management and managed care, and we currently employ approximately 115
persons. We are not a party to any labor agreements and none of our employees
are represented by a labor union.
Our
Offices
We are incorporated under the laws of
the State of Delaware. Our principal executive offices are located at 11150
Santa Monica Boulevard, Suite 1500, Los Angeles, California 90025 and
our telephone number is (310) 444-4300.
Company
Information
We
make our annual reports on Form 10-K, our proxy statement, our quarterly reports
on Form 10-Q, our current reports on Form 8-K, and any amendments to these
reports available free of charge through links on our corporate website as soon
as reasonably practicable after such reports are filed with, or furnished to,
the Securities and Exchange Commission (SEC). Our corporate website is located
on the Internet at http://www.hythiam.com. These reports are not part of this
report or incorporated by reference herein. The public may read and copy any
materials we file with the SEC at the SEC’s Public Reference Room at 100 F
Street, NE, Washington, DC 20549. The public may obtain information on the
operation of the Public Reference Room by calling the SEC at 1-800-SEC-0330.
Additionally, the SEC maintains an Internet site that contains reports, proxy
and information statements, and other information regarding issuers that file
electronically with the SEC, which can be found at
http://www.sec.gov.
ITEM 1A. RISK FACTORS
You should carefully consider and
evaluate all of the information in this report, including the risk factors
listed below. Risks and uncertainties in addition to those we describe below,
that may not be presently known to us, or that we currently believe are
immaterial, may also harm our business and operations. If any of these risks
occurs, our business, results of operations and financial condition could be
harmed, the price of our common stock could decline, and future events and
circumstances could differ significantly from those anticipated in the
forward-looking statements contained in this report.
Risks
related to our business
We
have a limited operating history, and expect to continue to incur operating
losses, making it difficult to evaluate our future prospects
We
have been unprofitable since our inception in 2003 and expect to continue to
incur substantial additional operating losses and negative cash flow from
operations for at least the next twelve months. While we currently
estimate that our existing cash, cash equivalents and marketable securities will
be sufficient to fund our operating expenses and capital requirements for at
least the next two years or until we achieve positive cash flows, there can be
no assurance this will be the case. If cash reserves are insufficient
to sustain us to profitability, our ability to meet our obligations as they
become due may depend on our ability to delay or reduce operating expenses, sell
additional securities, borrow funds or some combination thereof. We may seek
additional funding through public or private financing or through collaborative
arrangements with strategic partners. We may also seek to raise additional
capital through public or private financing in order to increase the amount of
our cash reserves on hand. We may not be successful in raising necessary funds
on acceptable terms, or at all. If this occurs, we may be unable to
meet our cash obligations as they become due and we may be required to delay or
reduce operating expenses and curtail our operations, which would have a
material adverse effect on us.
In
addition, because of the significant publicly held minority interest in
CompCare, we do not anticipate receiving dividends from CompCare or otherwise
having access to cash flows generated by CompCare's business. Although we
do not anticipate advancing any funds to CompCare to fund its operations, you
also should assume that we will not have access to cash generated by CompCare to
fund the growth of our PROMETA-based business.
We
may fail to successfully manage and maintain the growth of our business, which
could adversely affect our results of operations, financial condition and
business
Continued
expansion could put significant strain on our management, operational and
financial resources. The need to comply with the rules and regulations of the
SEC and The NASDAQ Global Market will continue to
place
significant demands on our financial and accounting staff, financial, accounting
and information systems, and our internal controls and procedures, any of which
may not be adequate to support our anticipated growth. We may not be able to
effectively hire, train, retain, motivate and manage required personnel. Our
failure to manage growth effectively could limit our ability to satisfy our
reporting obligations, or achieve our marketing, commercialization and financial
goals.
In
January 2007 we acquired a controlling equity interest in CompCare, a publicly
traded company, and our ability to oversee this business, which is a new
business for us and one with which we have had little previous experience, may
significantly exacerbate the strain on our resources.
We
may need additional funding, and we cannot guarantee that we will find adequate
sources of capital in the future.
We
have incurred negative cash flows from operations since inception and have
expended, and expect to continue to expend, substantial funds to grow our
business. Although we currently estimate that our existing cash, cash
equivalents and marketable securities will be sufficient to fund our operating
expenses and capital requirements for at least the next twelve months, we cannot
assure you that we will not require additional funds before we achieve positive
cash flows. We have based this estimate on assumptions that may prove to be
wrong. Our existing cash, cash equivalents and marketable securities may not be
sufficient to fund our business until we can become cash flow positive and we
may never become cash flow positive.
If
we raise additional funds by issuing equity securities, such financing will
result in further dilution to our stockholders. Any equity securities issued
also may provide for rights, preferences or privileges senior to those of
holders of our common stock. If we raise additional funds by issuing additional
debt securities, these debt securities would have rights, preferences and
privileges senior to those of holders of our common stock, and the terms of the
debt securities issued could impose significant restrictions on our operations.
If we raise additional funds through collaborations and licensing arrangements,
we might be required to relinquish significant rights to our technology or
products, or to grant licenses on terms that are not favorable to
us.
We
do not know whether additional financing will be available on commercially
acceptable terms when needed. If adequate funds are not available or are not
available on commercially acceptable terms, we may need to downsize or halt our
operations and may be unable to continue developing our products.
Our
investments in adjustable rate securities are subject to risks which may cause
losses and affect the liquidity of these investments.
As
of December 31, 2007, approximately $19 million of our marketable securities
consisted of auction rate securities, which are variable-rate instruments with
longer stated maturities whose interest rates are reset at predetermined
short-term intervals through a Dutch auction system. Through February 13, 2008,
all of our auction rate securities held at December 31, 2007 had completed at
least one auction successfully through the normal auction process, and we had reduced our total
investments in auction rate securities to $11.5 million. However, from February
14 through March 12, 2008, auctions for these securities had failed, meaning the
parties desiring to sell securities could not be matched with an adequate number
of buyers, resulting in our having to continue to hold these
securities. Although the securities are Aaa/AAA rated and collateralized by
portfolios of student loans guaranteed by the U.S. government, based on current
market conditions it is likely that auctions will continue to be unsuccessful,
limiting the short-term liquidity of these investments until the auction
succeeds, the issuer calls the securities, or they mature. As a
result, our ability to liquidate our investment and fully recover the carrying
value of our investment in the near term may be limited or not exist. If the
issuers are unable to successfully close future auctions or their credit ratings
deteriorate, we may in the future record an impairment charge on these
investments. In addition, these types of developments could cause us to
reclassify our investments in auction rate securities from a current asset to a
long-term asset. While we currently believe we will be able to liquidate our
investment without significant loss within the next year and that these
securities are not significantly impaired due to the government guarantee of the
underlying securities, it could take until the final maturity of the underlying
notes (up to 30 years) to realize our investments’ recorded value. Although we
do not anticipate the potential lack of liquidity on these investments will
affect our ability to execute our current business plan, based on our expected
operating cash flows and our other sources of cash, there can be no assurance
this will be the case.
Our
treatment programs may not be as effective as we believe them to be, which could
limit our revenues and adversely affect our business
Our
belief in the efficacy of our PROMETA Treatment Programs is based on a limited
number of studies and commercial pilots that have been conducted to date, and
our initial experience with a relatively small number of patients. Such results
may not be statistically significant, have not been subjected to close
scientific scrutiny, and may not be indicative of the long-term future
performance and safety of treatment with our programs. Controlled scientific
studies, including those that have been announced and planned for the future,
may yield results that are unfavorable or demonstrate that treatment with our
programs is not clinically effective or safe. If the initially indicated results
cannot be successfully replicated or maintained over time, utilization of our
programs could decline substantially.
Our
PROMETA Treatment Programs may not become widely accepted, which could limit our
growth
Further
marketplace acceptance of our treatment programs may largely depend upon
healthcare providers’ and third-party payers’ interpretation of our limited
data, the results of pending studies, or upon reviews and reports that may be
given by independent researchers. In the event such research does not establish
our treatment programs to be safe and effective, it is unlikely we will be able
to achieve widespread market acceptance.
Disappointing
results for our PROMETA Treatment Programs, or failure to attain our publicly
disclosed milestones, could adversely affect market acceptance and have a
material adverse effect on our stock price
There
are a number of studies, evaluations and pilot programs currently in progress
that are evaluating our PROMETA Treatment Programs, and we expect results of
many to become available throughout the remainder of 2008 and during
2009. Disappointing results or termination of evaluations or pilot
programs could have a material adverse effect on the commercial acceptance of
the PROMETA Treatment Programs and on our results of operations. In
addition, announcements regarding results, or anticipation of results, may
increase volatility in our stock price. On October 24, 2007, the Pierce County
Council in the State of Washington voted to end funding for PROMETA. This
announcement had an immediate negative effect on our stock price, and we are
unable to assess the longer term impact on our business. In addition to numerous
upcoming milestones, from time to time we provide financial guidance and other
forecasts to the market. While we believe that the assumptions
underlying projections and forecasts we make publicly available are reasonable,
projections and forecasts are inherently subject to numerous risks and
uncertainties. Any failure to achieve milestones, or to do so in a
timely manner, or to achieve publicly announced guidance and forecasts, could
have a material adverse effect on our results of operations and the price of our
common stock.
Our
industry is highly competitive, and we may not be able to compete
successfully
The
healthcare business in general, and the substance dependence treatment business
in particular, are highly competitive. We compete with many types of substance
dependence treatment methods, treatment facilities and other service providers,
many of whom are more established and better funded than we are. Many of these
other treatment methods and facilities are well established in the same markets
we target, have substantial sales volume, and are provided and marketed by
companies with much greater financial resources, facilities, organization,
reputation and experience than we have. The historical focus on the use of
psychological or behavioral therapies, as opposed to medical or physiological
treatments for substance dependence, may create further resistance to
penetrating the substance dependence treatment market.
There
are a number of companies developing or marketing medications for reducing
craving in the treatment of alcoholism, including:
·
|
the
addiction medication naltrexone, an opiate receptor antagonist, is
marketed by a number of generic pharmaceutical companies as well as under
the trade name ReVia®,
for treatment of alcohol
dependence;
|
·
|
VIVITROL®,
an extended release formulation of naltrexone manufactured by Alkermes, is
intended to be administered by a physician via monthly injections for
the treatment of alcohol dependence
in
|
patients
who are able to abstain from drinking in an outpatient setting and are not
actively drinking prior to treatment initiation. Alkermes reported that in
clinical trials, when used in combination with psychosocial support, VIVITROL
was shown to reduce the number of drinking days and heavy drinking days and to
prolong abstinence in patients who abstained from alcohol the week prior to
starting treatment;
·
|
Campral®
Delayed-Release Tablets (acamprosate calcium), an NMDA receptor antagonist
taken two to three times per day on a chronic or long-term basis and
marketed by Forest Laboratories. Clinical studies supported the
effectiveness in the maintenance of abstinence for alcohol-dependent
patients who had undergone inpatient detoxification and were already
abstinent from alcohol;
|
·
|
Topiramate
(Topamax), a drug manufactured by Ortho-McNeill Jannssen, which is
approved for the treatment of seizures. A multi-site clinical trial
reported in October 2007 found that tropiramate significantly reduced
heavy drinking days in alcohol-dependent
individuals.
|
Our
competitors may develop and introduce new processes and products that are equal
or superior to our programs in treating alcohol and substance dependencies.
Accordingly, we may be adversely affected by any new processes and technology
developed by our competitors.
There
are approximately 13,000 facilities reporting to the Substance Abuse and Mental
Health Services Administration that provide substance abuse treatment on an
inpatient or outpatient basis. Well known examples of residential treatment
programs include the Betty Ford Center®, Caron Foundation®, Hazelden® and Sierra
Tucson®. In addition, individual physicians may provide substance dependence
treatment in the course of their practices.
We
depend on key personnel, the loss of which could impact the ability to manage
our business
Our
future success depends on the performance of our senior management, in
particular our Chairman and Chief Executive Officer, Terren S. Peizer, Senior
Executive Vice Presidents, Richard A. Anderson, Anthony LaMacchia and
Christopher S. Hassan and Chief Financial Officer, Chuck Timpe. Messrs. Peizer,
Hassan and Anderson each is party to an employment agreement which, subject to
termination for cause or good reason, has a remaining term of approximately six,
two and one years, respectively. Messrs. Timpe and LaMacchia do not have
employment contracts.
CompCare's
operations are highly dependent on the efforts of its senior management, in
particular its President and Chief Executive Officer, John M. Hill, and Chief
Financial Officer, Robert J. Landis. Each is party to an employment agreement
which, subject to termination for cause or good reason, has a remaining term of
approximately three years and eighteen months, respectively.
The
loss of the services of Mr. Peizer or any other key member of management
could have a material adverse effect on our ability to manage our
business.
We
are subject to litigation, which could result in substantial liabilities that
may exceed our insurance coverage
All
significant medical treatments and procedures, including treatment utilizing our
programs, involve the risk of serious injury or death. Even under proper medical
supervision, withdrawal from alcohol may cause severe physical reactions. While
we have not been the subject of any such claims, our business entails an
inherent risk of claims for personal injuries and substantial damage awards. We
cannot control whether individual physicians will apply the appropriate standard
of care, or conform to our treatment programs in determining how to treat their
patients. While our agreements typically require physicians to indemnify us for
their negligence, there can be no assurance they will be willing and financially
able to do so if claims are made. In addition, our license agreements require us
to indemnify physicians, hospitals or their affiliates for losses resulting from
our negligence.
CompCare
is subject to lawsuits and claims of professional liability alleging negligence
in performing utilization review and other managed care activities, and in the
denial of payment for services. Such incidents may
result
in professional negligence or other claims against CompCare causing it to incur
fees and expend substantial resources in defense of such actions.
We
currently have insurance coverage for up to $5 million per year, in the
aggregate, for personal injury claims. Hythiam and CompCare maintain directors’
and officers’ liability insurance coverage, subject to a $100,000 per claim self
insured retention. CompCare maintains a program of insurance coverage
against a broad range of risks related to its business, subject to deductibles
and self-insured retentions. We may not be able to maintain adequate liability
insurance at acceptable costs or on favorable terms. We expect that liability
insurance will be more difficult to obtain and that premiums will increase over
time and as the volume of patients treated with our programs increases. In the
event of litigation, we may sustain significant damages or settlement expense
(regardless of a claim's merit), litigation expense and significant harm to our
reputation.
If
government and third-party payers fail to provide coverage and adequate payment
rates for treatment using our treatment programs, our revenue and prospects for
profitability will be harmed
Our
future revenue growth will depend in part upon the availability of reimbursement
for treatment using our programs from third-party payers such as government
health programs including Medicare and Medicaid, managed care providers, private
health insurers and other organizations. To date, we have received an
insignificant amount of revenue from our PROMETA Treatment Programs from
governmental payers, managed care organizations and other third-party payers,
and acceptance of our PROMETA Treatment Programs is important to the future
prospects of our business. In addition, third-party payers are increasingly
attempting to contain healthcare costs, and may not cover or provide adequate
payment for treatment using our programs. Adequate third-party reimbursement
might not be available to enable us to realize an appropriate return on
investment in research and product development, and the lack of such
reimbursement could have a material adverse effect on our operations and could
adversely affect our revenues and earnings.
Our
international operations may be subject to foreign regulation, and the success
of our foreign operations will depend on many factors
The
criteria of foreign laws, regulations and requirements are often vague and
subject to change and interpretation. Our international operations may become
the subject of foreign regulatory, civil, criminal or other investigations or
proceedings, and our interpretations of applicable laws and regulations may be
challenged. The defense of any such challenge could result in substantial cost
and a diversion of management’s time and attention, regardless of whether it
ultimately is successful. If we fail to comply with any applicable international
laws, or a determination is made that we have failed to comply with these laws,
our financial condition and results of operations, including our domestic
operations, could be adversely affected.
In
addition, the private pay healthcare system in Europe is not as developed as in
the U.S and as a result it may be more difficult to convince patients in these
countries to pay substantial amounts for treatment. We will be reliant on
relationships that we establish with local companies, thought leaders and
governments. There can be no assurance we will be able to establish these
relationships, maintain them or that the partners will retain their influence in
the market. It may take longer than we expect to commence operations or to
operate our business at profitable levels as we do not have the established
relationships and or knowledge of the regulations and business practices in the
markets we are in or entering.
Our
ability to utilize net operating loss carryforwards may be limited
As of December 31, 2007,
we had net operating loss carryforwards (NOLs) of approximately $ 100 million
for federal income tax purposes that will begin to expire in 2024. These NOLs
may be used to offset future taxable income, to the extent we generate any
taxable income, and thereby reduce or eliminate our future federal income taxes
otherwise payable. Section 382 of the Internal Revenue Code imposes limitations
on a corporation's ability to utilize NOLs if it experiences an ownership change
as defined in Section 382. In general
terms, an ownership change may result from transactions increasing the ownership
of certain stockholders in the stock of a corporation by more than 50 percent
over a three-year period. In the event that an ownership change has occurred, or
were to occur, utilization of our NOLs would be subject to an annual limitation
under Section 382 determined by multiplying the value of our
stock
at
the time of the ownership change by the applicable long-term tax-exempt rate as
defined in the Internal Revenue Code. Any
unused annual limitation may be carried over to later years. We may
be found to have experienced an ownership change under Section 382 as a result
of events in the past or the issuance of shares of common stock upon a
conversion of notes, or a combination thereof. If so, the use of our
NOLs, or a portion thereof, against our future taxable income may be subject to
an annual limitation under Section 382, which may result in expiration of a
portion of our NOLs before utilization.
Risks
related to our acquisition of CompCare
We
may not realize the expected benefits of the CompCare acquisition, and may not
be able to successfully utilize CompCare’s infrastructure
We
may not be successful in realizing the expected benefits of our license
agreement with Comprehensive Care Corporation or the recent acquisition of a
majority controlling interest in CompCare. Achieving the benefits of our
relationship with CompCare will depend in part on our ability to successfully
utilize CompCare’s infrastructure and integrating with the benefits of its
operations and personnel in a timely and efficient manner. The process will
divert management time and attention from our other business, and require the
effective coordination of personnel, systems, applications, policies,
procedures, business processes and operations. This, too, will be difficult,
unpredictable, and subject to delay because of possible cultural conflicts and
different opinions on technical decisions and business strategy. CompCare is
engaged in a business with which we have little experience, and this may present
additional challenges to us. Further, we may be unable to realize synergies
between our PROMETA business and CompCare's managed behavioral healthcare
business. CompCare may be unable to retain its key management, technical, sales
and customer support personnel. If we cannot successfully coordinate our
operations and personnel, we will not realize the expected benefits of our
relationship. In addition, because of the significant publicly held
minority interest in CompCare, we may be unable to gain access to the cash flows
for CompCare and may be unable to realize the same level of benefits that we
might be able to realize if CompCare were a wholly-owned subsidiary of
ours.
There
may be ongoing legal challenges to our relationship with CompCare, which could
adversely affect our results of operations
On
May 25, 2007, we entered into a Termination Agreement with CompCare terminating
a proposed merger with CompCare and the acquisition of the remaining common
stock of CompCare. There are potential legal and economic risks associated with
terminating the merger agreement and continuing with our ongoing relationship as
CompCare’s majority controlling shareholder, including challenges from public
minority shareholders concerning the procedural and financial fairness of our
existing agreements, and any future agreements or arrangement between
us. Current or future litigation may be expensive and time consuming,
and may impede or restrict our ability to operate effectively, which could
negatively impact our results of operations.
Risks
related to CompCare’s business
CompCare
may not be able to accurately predict utilization of its full-risk contracts
resulting in contracts priced at levels insufficient to ensure
profitability
CompCare's managed care operations are
at risk for costs incurred to provide agreed upon levels of service. Failure to
anticipate or control costs could have material, adverse effects on CompCare’s
business. A very large percentage of CompCare's services are provided on a
full-risk capitation basis which exposes CompCare to significant risk that
contracts negotiated and entered into may ultimately be unprofitable if
utilization levels require it to provide services at a cost in excess of the
capitation rates CompCare receives for the services. The population CompCare
began managing in 2007 for its large Indiana client had not been subject to
managed care previously and consequently there was little historical utilization
data upon which to base initial pricing. Actual utilization experience has been
greater than initial estimates, resulting in higher claim costs and lower profit
margins. Failure to manage its costs or achieve anticipated cost reductions in
populations brought under management would have an adverse effect on CompCare’s
financial results.
CompCare
may be unsuccessful in profitably managing its new Indiana Medicaid contract,
and may not be able to meet specified performance measures that would allow it
to receive an increase in the rate
CompCare may
be unsuccessful in managing its new Indiana Medicaid contract that started
January 1, 2007, which provided over 40% of its operating revenues in 2007.
Providing services under a new contract for populations at risk that have not
been managed before exposes CompCare to the risk it may be unprofitable. There
is a limited historical basis for the actuarial assumptions about the
utilization of benefits by members covered under this new managed care
behavioral program, and premiums based on these assumptions may be insufficient
to cover the benefits provided and CompCare may be unable to obtain offsetting
rate increases. Contract premiums have been set based on anticipated significant
savings and on types of utilization management that may not be possible, may
cause disagreements with providers and divert management resources, which would
have an adverse impact on CompCare’s financial results. Claims
expense equaled revenues for this contract for the year ended December 31, 2007.
CompCare is negotiating and believes it will receive a rate increase
effective January 1, 2008, provided it complies with monthly performance
measures it believes it will meet. Although CompCare
believes it will meet these standards, any failure to comply with one or more of
the measurement criteria will reduce CompCare's anticipated cash flow and
profitability from this contract.
CompCare’s
existing and potential managed care clients operate in a highly competitive
environment and may be subject to a higher rate of merger, acquisition and
regulation than in other industries
CompCare
typically contracts with small to medium sized HMOs which may be adversely
affected by the continuing efforts of governmental and third party payers to
contain or reduce the costs of healthcare through various means. Its clients may
also determine to manage the behavioral healthcare benefits “in house” and, as a
result, discontinue contracting with CompCare. Additionally, its clients may be
acquired by larger HMOs, in which case there can be no assurance that the
acquiring company would renew its contract.
Many
of CompCare’s managed care company clients provide services to groups covered by
Medicare, Medicaid or Children’s Health Insurance Program (CHIP) plans
susceptible to annual changes in reimbursement rates and eligibility
requirements that could ultimately affect CompCare
As
of December 31, 2007, CompCare managed over 900,000 lives in connection with
behavioral and substance abuse services covered through Medicaid and CHIP
programs in Texas, Medicare and Medicaid in Florida, Medicaid in California,
Indiana and Michigan, and Medicare in Maryland and Pennsylvania. Any changes in
Medicare, Medicaid and/or CHIP reimbursement could adversely affect CompCare
through contract bidding and cost structures with the health plans impacted by
such changes. Temporary reductions have previously had a negative impact on
CompCare, and if implemented in the future could have a material, adverse impact
on its operations. In addition, states in which CompCare operates may pass
legislation that would reduce its revenue through changes in the reimbursement
rates or in the number of eligible participants. CompCare may be unable to
reduce its costs to a level that would allow it to maintain current gross
margins specific to its Medicare, Medicaid and CHIP programs.
CompCare
is dependent on its provider network to provide services to its
members
CompCare
contracts with providers as a means to assure access to behavioral health
services for its members. Some providers could refuse to contract with CompCare,
demand higher payments, or take other actions which could result in higher
healthcare operating expenses. In addition, certain providers may have
significant market position, which could cause disruption to provider access in
a particular geographic area for CompCare’s members and affect its contractual
requirements with its customers of maintaining an adequate network.
Because
providers are responsible for claims submission, the timing of which is
uncertain, CompCare must estimate the amount of claims incurred but not
reported, and actual results may differ materially
CompCare’s
costs of care include estimated amounts for claims incurred but not reported
(IBNR). The IBNR is estimated using an actuarial paid completion factor
methodology and other statistical analyses that it
continually
reviews and adjusts, if necessary, to reflect any change in the estimated
liability. These estimates are subject to the effects of trends in utilization
and other factors. CompCare’s estimates of IBNR may be inadequate, which would
negatively affect results of operations. Considerable variability is inherent in
such estimates, its unpaid claims liability may be inadequate, and actual
results may differ materially from the estimates reported.
CompCare
is dependent on a limited number of customers, and loss or reduction in business
of any one could have a material adverse effect on working capital and results
of operations
For
the year ended December 31, 2007 CompCare provide behavioral healthcare services
to the members of six health plans under contracts that on a combined basis
represented approximately 87% of CompCare’s operating revenue. The terms of each
contract are generally for one year periods and are automatically renewable for
additional one-year periods unless terminated by either party by giving the
requisite written notice. The loss of one or more of these clients, unless
replaced by new business, would negatively affect the financial condition of
CompCare. In the past, CompCare has experienced the loss of major
customers.
CompCare
may be unsuccessful in obtaining performance bonds or other security that is
required by its existing or future clients, and consequently may lose
clients
CompCare’s
new Indiana client requires CompCare to maintain a performance bond in the
amount of $1,000,000. In addition, certain of CompCare’s other
customers may require restricted cash accounts or other security with respect to
its obligations to pay IBNR claims and claims not yet processed and
paid. Due to CompCare’s small size and financial condition, it may be
unable to provide the security required by its client, which could result in the
loss of a client or clients which would negatively affect CompCare’s financial
condition.
CompCare’s
industry is subject to diverse licensure requirements varying by state, and
regulation changes could adversely affect contract profitability and ability to
gain and retain clients
CompCare
is required to hold licenses or certificates to perform utilization review and
third party administrator (TPA) services in certain states in which it does
business. Additional utilization review or TPA licenses may be required in the
future and CompCare may not qualify to obtain them. In many states, entities
that assume risk under contract with licensed insurance companies or health
plans have not been considered by state regulators to be conducting an insurance
or HMO business. As a result, CompCare has not sought licensure as either an
insurer or HMO in any state. If the regulatory positions of these states were to
change, its business could be materially affected until such time as it is able
to meet the regulatory requirements, if at all. Additionally, some states may
determine to contract directly with companies such as CompCare for managed
behavioral healthcare services in which case they may also require it to
maintain financial reserves or net worth requirements that it may not be able to
meet. Currently, CompCare cannot quantify the potential effects of additional
regulation of the managed care industry, but such costs will have an adverse
effect on CompCare’s future operations to the extent that they are not able to
be recouped in future managed care contracts.
CompCare
is subject to existing clients issuing RFPs for the management of behavioral
services currently being managed
CompCare’s
clients are aware of the highly competitive nature of the industry, and its
contracts with them frequently contain provisions allowing termination of the
contract by either party without cause with 90 days written
notice. Consequently CompCare’s clients may request from
CompCare and any of its competitors a request for proposal (RFP) for behavioral
services currently managed by CompCare, putting CompCare at risk of losing a
client or clients. For example, during 2007 a major Texas client
issued an RFP prior to the end of CompCare’s contract. CompCare
submitted a proposal but were not chosen to continue services, resulting in a
significant reduction in revenue. In addition, certain administrative
and overhead costs continued to be incurred past the termination
date.
CompCare
is subject to intense competition that may prevent it from gaining new customers
or pricing its contracts at levels to achieve sufficient gross margins to ensure
profitability
CompCare
is continually pursuing new business. However, many of CompCare's competitors
are significantly larger and better capitalized than CompCare and the smaller
size and financial condition of CompCare
has
proved a deterrent to some prospective customers. Additionally, CompCare will
likely have difficulty in matching the financial resources expended on marketing
by its competitors. As a result, CompCare may not be able to successfully
compete in its industry. CompCare's major competitors include Magellan Health
Services, United Behavioral Health, ValueOptions, and APS
Healthcare.
CompCare's
sales cycle is long, which complicates its ability to predict its
growth.
The
sales and implementation process of CompCare's services is lengthy and requires
CompCare's potential clients to commit time and other
resources. CompCare's sales cycle is unpredictable and has generally
ranged from 12 to 18 months from initial contact to an executed
contract. Accordingly, it may be difficult to replace any lost
business quickly.
A
failure of CompCare's information systems would significantly impair its ability
to serve its customers and manage its business.
An
effective and secure information system, available at all times, is vital to
CompCare's health plan customers and their members. CompCare depends
on its computer systems for significant service and management functions, such
as providing membership verification, monitoring utilization, processing
provider claims, and providing regulatory data and other client and managerial
reports. Although CompCare's computer and communications hardware is protected
by physical and software safeguards, it is still vulnerable to computer viruses,
fire, storm, flood, power loss, telecommunications failures, physical or
software break-ins and similar events. CompCare does not have 100% redundancy
for all of its computer and telecommunications facilities. A catastrophic event
could have a significant negative effect on CompCare's business, results of
operations, and financial condition.
CompCare also
depends on a third party provider of application services for its core business
application. Any sustained disruption in their services to us would
have a material effect on our business.
CompCare
is subject to fines and penalties being assessed by its clients
Many
of CompCare’s contracts contain provisions stating that if its clients are
assessed penalties or fines by a regulatory agency due to CompCare’s
noncompliance with a contractual requirement, CompCare will be responsible for
paying the assessed fine or penalty. Though to date, no material
fines have been assessed under such provisions, any future fines would have a
negative impact on results of operations.
CompCare
may be unsuccessful in renewing its NCQA accreditation and may lose customers
who require such accreditation
NCQA
accreditation is required by several of CompCare’s client contracts and is an
important consideration to its prospective clients. CompCare is
periodically evaluated by NCQA to validate the Company’s adherence to NCQA
industry-accepted standards covering operational areas such as preventative
care, utilization management, credentialing, member rights and responsibilities,
and quality improvement. Maintaining these quality standards
and the NCQA accreditation are important considerations of our customers and
prospective clients who are evaluated against similar standards. If CompCare is
not successful in renewing its NCQA accreditation, this could result in the loss
of a client or clients which would negatively affect CompCare’s financial
condition.
Risks
related to our intellectual property
We
may not be able to adequately protect the proprietary PROMETA Treatment Programs
which are the core of our business
We
consider the protection of our proprietary PROMETA Treatment Programs to be
critical to our business prospects. We obtained the rights to some of our most
significant PROMETA technologies through an agreement that is subject to a
number of conditions and restrictions, and a breach or termination of that
agreement or the bankruptcy of any party to that agreement could significantly
impact our ability to use and develop our technologies. While we have
two issued U.S. patents, one relating to the treatment of cocaine dependency
with our PROMETA Treatment Program and one relating to our PROMETA Treatment
Program for the treatment of certain symptoms associated with alcohol
dependency, we currently have no issued U.S. patents covering our PROMETA
Treatment Program for the treatment of methamphetamine dependency. The patent
applications we have licensed or filed may not issue as patents, and any issued
patents may be too narrow in scope to provide us with a competitive advantage.
Our patent position is uncertain and includes complex factual and legal issues,
including the existence of prior art that may preclude or limit the scope of
patent protection. Issued patents will generally expire twenty years after their
priority date. Our two issued U.S. patents will expire in 2021.
Further, our patents and pending applications for patents and other intellectual
property have been pledged as collateral to secure our obligations to pay
certain debts, and our default with respect to those obligations could result in
the transfer of our patents to our creditor. In the event of such a
transfer, we may be unable to continue to operate our business.
Patent
examiners may reject our patent applications and thereby prevent us from
receiving more patents. Competitors, licensees and others may
challenge our patents and, if successful, our patents may be denied, subjected
to reexamination, rendered unenforceable, or invalidated. The cost of litigation
to uphold the validity of patents, and to protect and prevent infringement can
be substantial. We may not be able to adequately protect the aspects of our
treatment programs that are not patented or have only limited patent protection.
Furthermore, competitors and others may independently develop similar or more
advanced treatment programs and technologies, may design around aspects of our
technology, or may discover or duplicate our trade secrets and proprietary
methods.
To
the extent we utilize processes and technology that constitute trade secrets
under applicable laws, we must implement appropriate levels of security to
ensure protection of such laws, which we may not do effectively. Policing
compliance with our confidentiality agreements and unauthorized use of our
technology is difficult. In addition, the laws of many foreign countries do not
protect proprietary rights as fully as the laws of the United
States.
The loss of any of our trade secrets or proprietary rights which may be
protected under the foregoing intellectual property safeguards may result in the
loss of our competitive advantage over present and potential competitors. Our
intellectual property may not prove to be an effective barrier to competition,
in which case our business could be materially adversely affected.
Our
pending patent applications disclose and claim various approaches to the use of
the PROMETA Treatment Program. There is no assurance that we will
receive one or more patents from these pending applications, or that, even if we
receive one or more patents, the patent claims will be sufficiently broad to
create patent infringement liability for competitors using treatment programs
similar to the PROMETA Treatment Programs.
Confidentiality
agreements with employees, licensees and others may not adequately prevent
disclosure of trade secrets and other proprietary information
In
order to protect our proprietary technology and processes, we rely in part on
confidentiality provisions in our agreements with employees, licensees, treating
physicians and others. These agreements may not effectively prevent disclosure
of confidential information and may not provide an adequate remedy in the event
of unauthorized disclosure of confidential information. In addition, others may
independently discover trade secrets and proprietary information. Costly and
time-consuming litigation could be necessary to enforce and determine the scope
of our proprietary rights, and failure to obtain or maintain trade secret
protection could adversely affect our competitive business position. We have had
three instances in which it was necessary to send a formal demand to cease and
desist using our programs to treat patients due to breach of confidentiality
provisions in our agreements, and in one instance have had to file suit to
enforce these provisions.
We
may be subject to claims that we infringe the intellectual property rights of
others, and unfavorable outcomes could harm our business
Our
future operations may be subject to claims, and potential litigation, arising
from our alleged infringement of patents, trade secrets or copyrights owned by
other third parties. Within the healthcare, drug and bio-technology industry,
many companies actively pursue infringement claims and litigation, which makes
the entry of competitive products more difficult. We may experience claims or
litigation initiated by existing, better-funded competitors and by other third
parties. Court-ordered injunctions may prevent us from continuing to market
existing products or from bringing new products to market and the outcome of
litigation and any resulting loss of revenues and expenses of litigation may
substantially affect our ability to meet our expenses and continue
operations.
Risks
related to our industry
Our
policies and procedures may not fully comply with complex and increasing
regulation by state and federal authorities, which could negatively impact our
business operations
Our
PROMETA Treatment Programs have not been approved by the Food and Drug
Administration (FDA), and while the drugs incorporated in the PROMETA Treatment
Program have been approved for other indications, they are not FDA approved for
the treatment of alcohol or substance dependency. We have not sought, and do not
currently intend to seek, FDA approval for the PROMETA Treatment
Program. It is possible that in the future the FDA could require us
to seek FDA approval for the PROMETA Treatment Program.
The
healthcare industry is highly regulated and continues to undergo significant
changes as third-party payers, such as Medicare and Medicaid, traditional
indemnity insurers, managed care organizations and other private payers increase
efforts to control cost, utilization and delivery of healthcare services.
Healthcare companies are subject to extensive and complex federal, state and
local laws, regulations and judicial decisions. The U.S. Congress and state
legislatures are considering legislation that could limit funding to our
licensees and CompCare's clients. In addition, the FDA regulates
development, testing, labeling, manufacturing, marketing, promotion,
distribution, record-keeping and reporting requirements for prescription drugs,
medical devices and biologics. Other regulatory requirements apply to dietary
supplements, including vitamins. Compliance with laws and regulations enforced
by regulatory agencies who have broad discretion in applying them may be
required for our programs or other medical programs or services developed or
used by us. Many healthcare laws and regulations applicable to our business are
complex, applied broadly and subject to interpretation by courts and government
agencies. Regulatory, political and
legal
action and pricing pressures could prevent us from marketing some or all of our
products and services for a period of time or permanently. Our failure, or the
failure of our licensees, to comply with applicable regulations may result in
the imposition of civil or criminal sanctions that we cannot afford, or require
redesign or withdrawal of our programs from the market.
We
may be subject to regulatory, enforcement and investigative proceedings,
which could adversely affect our financial condition or operations
We
could become the subject of regulatory, enforcement, or other
investigations or proceedings, and our relationships, business structure, and
interpretations of applicable laws and regulations may be challenged. The
defense of any such challenge could result in substantial cost and a diversion
of management’s time and attention. In addition, any such challenges could
require significant changes to how we conduct our business. Any such challenge
could have a material adverse effect on our business, regardless of whether it
ultimately is successful. If determination is made that we have failed to comply
with any applicable laws, our business, financial condition and results of
operations could be adversely affected.
The
promotion of our treatment programs may be found to violate federal law
concerning off-label uses of prescription drugs, which could prevent us from
marketing our programs
Generally,
the Food, Drug, and Cosmetic (FDC) Act, requires that a prescription drug be
approved by FDA for a specific indication before the product can be distributed
in interstate commerce. Although the FDC Act does not prohibit a
doctor’s use of a drug for another indication (this is referred to as off-label
use), it does prohibit the promotion of a drug product for an unapproved use.
FDA also permits the non-promotional discussion of information related to
off-label use in the context of scientific or medical communications. Our
treatment programs include the use of prescription drugs that have been approved
by FDA, but not for the treatment of chemical dependence and drug addiction,
which is how the drugs are used in our programs. Although we carefully structure
our communications in a way that is intended to comply with the FDC Act and FDA
regulations, it is possible that our actions could be found to violate the
prohibition on off-label promotion of drugs. In addition, the FDC Act imposes
limits on the types of claims that may be made for a dietary supplement, and the
promotion of a dietary supplement beyond such claims may also be seen as the
unlawful promotion of a drug product for an unapproved use. Because our
treatment programs also include the use of nutritional supplements, it is
possible that claims made for those products could also put us at risk of FDA
enforcement for making unlawful claims.
Violations
of the FDC Act or FDA regulations can result in a range of sanctions, including
administrative actions by FDA (such as issuance of a Warning Letter), seizure of
product, issuance of an injunction prohibiting future violations, and imposition
of criminal or civil penalties. A successful enforcement action could prevent
promotion of our treatment programs and we may be unable to continue operating
under our current business model. Even if we defeat an enforcement action, the
expenses associated with doing so, as well as the negative publicity concerning
the “off-label” use of drugs in our treatment programs, could adversely affect
our business and results of operation.
The
FDA has recently increased enforcement efforts in the area of promotion of
“off-label” use of drugs, and we cannot assure you that our business practices
or third party clinical trials will not come under scrutiny.
Treatment
using our programs may be found to require FDA or other review or approval,
which could delay or prevent the study or use of our treatment
programs
Under
authority of the FDC Act, FDA extensively regulates entities and individuals
engaged in the conduct of clinical trials, which broadly includes experiments in
which a drug is administered to humans. FDA regulations require,
among other things, submission of a clinical trial treatment program for FDA
review, obtaining from the agency an investigational new drug (IND) exemption
before initiating a clinical trial, obtaining appropriate informed consent from
study subjects, having the study approved and subject to continuing review by an
Institutional Review Board (IRB), and reporting to FDA safety information
regarding the conduct of the trial. Certain third parties have
engaged or are engaging in the use of our treatment program and the collection
of outcomes data in ways that may be considered to constitute a clinical trial,
and that may be subject to FDA regulations and require IRB approval and
oversight. In addition, it is possible that use of our treatment
program by individual physicians in treating their patients may be found to
constitute a clinical trial or investigation that requires IRB review or
submission of an IND
or
is otherwise subject to regulation by FDA. FDA has authority to
inspect clinical investigation sites and IRBs, and to take action with regard to
any violations. Violations of FDA regulations regarding clinical
trials can result in a range of actions, including suspension of the trial,
prohibiting the clinical investigator from ever participating in clinical
trials, and criminal prosecution. Individual hospitals and physicians
may also submit their use of our treatment programs to their IRBs, which may
prohibit or place restrictions on it. FDA enforcement actions or IRB
restrictions could adversely affect our business and the ability of our
customers to use our treatment programs.
The
FDA has recently increased enforcement efforts regarding clinical trials, and we
cannot assure you that the activities of our customers or others using our
treatment programs will not come under scrutiny.
Failure
to comply with FTC or similar state laws could result in sanctions or limit the
claims we can make
Our
promotional activities and materials, including advertising to consumers and
professionals, and materials provided to licensees for their use in promoting
our treatment programs, are regulated by the Federal Trade Commission
(FTC) under the FTC Act, which prohibits unfair and deceptive acts and
practices, including claims which are false, misleading or inadequately
substantiated. The FTC typically requires competent and reliable scientific
tests or studies to substantiate express or implied claims that a product or
service is safe or effective. If the FTC were to interpret our promotional
materials as making express or implied claims that our treatment programs are
safe or effective for the treatment of alcohol, cocaine or methamphetamine
addiction, or any other claims, it may find that we do not have adequate
substantiation for such claims. Allegations of a failure to comply with the FTC
Act or similar laws enforced by state attorneys general and other state and
local officials could result in administrative or judicial orders limiting or
eliminating the claims we can make about our treatment programs, and other
sanctions including substantial financial penalties.
Our
business practices may be found to constitute illegal fee-splitting or corporate
practice of medicine, which may lead to penalties and adversely affect our
business
Many states,
including California in which our principal executive offices and one of our
managed treatment centers is located, have laws that prohibit business
corporations, such as us, from practicing medicine, exercising control over
medical judgments or decisions of physicians, or engaging in arrangements with
physicians such as employment, payment for referrals or fee-splitting.
Courts, regulatory authorities or other parties, including physicians, may
assert that we are engaged in the unlawful corporate practice of medicine by
providing administrative and other services in connection with our treatment
programs or by consolidating the revenues of the physician practices we manage,
or that licensing our technology for a license fee that could be characterized
as a portion of the patient fees, or subleasing space and providing turn-key
business management to affiliated medical groups in exchange for management and
licensing fees, constitute improper fee-splitting or payment for referrals, in
which case we could be subject to civil and criminal penalties, our contracts
could be found invalid and unenforceable, in whole or in part, or we could be
required to restructure our contractual arrangements. If so, we may be unable to
restructure our contractual arrangements on favorable terms, which would
adversely affect our business and operations.
Our
business practices may be found to violate anti-kickback, physician
self-referral or false claims laws, which may lead to penalties and adversely
affect our business
The
healthcare industry is subject to extensive federal and state regulation with
respect to financial relationships and kickbacks involving healthcare providers,
physician self-referral arrangements, filing of false claims and other fraud and
abuse issues. Federal anti-kickback laws and regulations prohibit offers,
payments, solicitations, or receipts of remuneration in return for (i) referring
patients for items or services covered by Medicare, Medicaid or other federal
healthcare programs, or (ii) purchasing, leasing, ordering or arranging for or
recommending any service, good, item or facility for which payment may be made
by a federal health care program. In addition, subject to numerous exceptions,
federal physician self-referral legislation, commonly known as the Stark law,
generally prohibits a physician from referring patients for certain
designated health services reimbursable by Medicare or Medicaid from
any entity with which the physician has a financial relationship, and many
states have analogous laws. Other federal and state laws govern the submission
of claims for reimbursement, or false claims laws. One of the most prominent of
these laws is the federal Civil False Claims Act, and violations of other laws,
such as the federal anti-kickback law or the FDA prohibitions against promotion
of off-label uses of drugs,
may
also be prosecuted as violations of the Civil False Claims Act. CompCare
provides services to health plans that could become involved with false claims,
which could include allegations against CompCare as well.
Federal
or state authorities may claim that our fee arrangements, agreements and
relationships with contractors, hospitals and physicians violate these laws and
regulations. Violations of these laws may be punishable by monetary fines, civil
and criminal penalties, exclusion from participation in government-sponsored
healthcare programs and forfeiture of amounts collected in violation of such
laws. If our business practices are found to violate any of these provisions, we
may be unable to continue with our relationships or implement our business
plans, which would have an adverse effect on our business and results of
operations.
We
may be subject to healthcare anti-fraud initiatives, which may lead to penalties
and adversely affect our business
State
and federal governments are devoting increased attention and resources to
anti-fraud initiatives against healthcare providers, and may take an expansive
definition of fraud that includes receiving fees in connection with a healthcare
business that is found to violate any of the complex regulations described
above. While to our knowledge we have not been the subject of any anti-fraud
investigations, if such a claim were made defending our business practices could
be time consuming and expensive, and an adverse finding could result in
substantial penalties or require us to restructure our operations, which we may
not be able to do successfully.
Our
use and disclosure of patient information is subject to privacy and security
regulations, which may result in increased costs
In
conducting research or providing administrative services to healthcare providers
in connection with the use of our treatment programs, we may collect, use,
disclose, maintain and transmit patient information in ways that will be subject
to many of the numerous state, federal and international laws and regulations
governing the collection, use, disclosure, storage, transmission and/or
confidentiality of patient-identifiable health information, including
the administrative simplification requirements of the Health Insurance
Portability and Accountability Act of 1996 and its implementing regulations
(HIPAA). The HIPAA Privacy Rule restricts the use and disclosure of patient
information, and requires safeguarding that information. The HIPAA Security Rule
establishes elaborate requirements for safeguarding patient information
transmitted or stored electronically. HIPAA applies to covered
entities, which may include healthcare facilities and does include health plans
that will contract for the use of our programs and our services. The HIPAA rules
require covered entities to bind contractors like us to compliance with certain
burdensome HIPAA rule requirements known as business associate requirements. If
we are providing management services that include electronic billing on behalf
of a physician practice or facility that is a covered entity, we may be required
to conduct those electronic transactions in accordance with the HIPAA
regulations governing the form and format of those transactions (HIPAA
Transactions Rule). Other federal and state laws restricting the use and
protecting the privacy and security of patient information also apply to our
licensees directly and in some cases to us, either directly or indirectly. We
may be required to make costly system purchases and modifications to comply with
the HIPAA rule requirements that are imposed on us and our failure to comply may
result in liability and adversely affect our business.
CompCare
is subject to HIPAA for most healthcare facilities and health plans that
contract for the use of CompCare’s services. The HIPAA Transactions
Rule requires CompCare to comply with format and data content standards for
common healthcare transactions on behalf of our licensees. Failure to comply may
result in civil and criminal liability and penalties, and have a material
adverse effect on CompCare’s ability to retain its customers or to gain new
business.
Federal
and state consumer protection laws are being applied increasingly by the FTC and
state attorneys general to regulate the collection, use, storage, and disclosure
of personal or patient information, through web sites or otherwise, and to
regulate the presentation of web site content. Courts may also adopt the
standards for fair information practices promulgated by the FTC, which concern
consumer notice, choice, security and access. Numerous other federal and state
laws protect the confidentiality and security of personal and patient
information. Other countries also have, or are developing laws governing the
collection, use, disclosure and transmission of personal or patient information
and these laws could create liability for us or increase our cost of doing
business.
Our
business arrangements with health care providers may be deemed to be franchises,
which could negatively impact our business operations
Franchise
arrangements in the United States are subject to rules and regulations of the
FTC and various state laws relating to the offer and sale of
franchises. A number of the states in which we operate regulate the
sale of franchises and require registration of the franchise offering circular
with state authorities and the delivery of a franchise offering circular to
prospective franchisees. State franchise laws often limit, among
other things, the duration and scope of non-competitive provisions, the ability
of a franchisor to terminate or refuse to renew a franchise and the ability of a
franchisor to designate sources of supply. Franchise laws and
regulations are complex, apply broadly and are subject to interpretation by
courts and government agencies. Federal or state authorities or
healthcare providers with whom we contract may claim that the agreements under
which we license rights to our technology and trademarks and provide services
violate these laws and regulations. Violations of these laws are punishable by
monetary fines, civil and criminal penalties, and forfeiture of amounts
collected in violation of such laws. If our business practices are found to
constitute franchises, we could be subject to civil and criminal penalties, our
contracts could be found invalid and unenforceable, in whole or in part, or we
could be required to restructure our contractual arrangements. We may
be unable to continue with our relationships or restructure them on favorable
terms, which would have an adverse effect on our business and results of
operations. We may also be required to furnish prospective
franchisees with a franchise offering circular containing prescribed
information, and restrict how we market to or deal with healthcare providers,
potentially limiting and substantially increasing our cost of doing
business.
Risks
related to our common stock
Over
25% of our stock is controlled by our chairman and chief executive officer,
who has the ability to substantially influence the election of directors and
other matters submitted to stockholders
Reserva
Capital, LLC and Bonmore, LLC, whose sole managing member is our chairman and
chief executive officer, beneficially own 13,700,000 shares of our common stock,
which represent approximately 25.2% of our 54,387,604 shares outstanding. As a
result, he has and is expected to continue to have the ability to significantly
influence the election of our board of directors and the outcome of all other
issues submitted to our stockholders. The interests of these principal
stockholders may not always coincide with our interests or the interests of
other stockholders, and they may act in a manner that advances his best
interests and not necessarily those of other stockholders. One consequence to
this substantial influence or control is that it may be difficult for investors
to remove management of the company. It could also deter unsolicited takeovers,
including transactions in which stockholders might otherwise receive a premium
for their shares over then current market prices.
Our
stock price may be subject to substantial volatility, and the value of your
investment may decline
Our
common stock is traded on The NASDAQ Global Market, and trading volume may be
limited or sporadic. The market price of our common stock has
experienced, and may continue to experience, substantial volatility. Over 2007,
our common stock has traded between $2.68 and $10.21 per share, on volume
ranging from approximately 50,000 to 3 million shares per day. As a
result, the current price for our common stock on NASDAQ is not necessarily a
reliable indicator of our fair market value. The price at which our common stock
will trade may fluctuate as a result of a number of factors, including the
number of shares available for sale in the market, quarterly variations in our
operating results and actual or anticipated announcements of pilots and
scientific studies of the effectiveness of our PROMETA Treatment Programs, new
products or services by us or competitors, regulatory investigations or
determinations, acquisitions or strategic alliances by us or our competitors,
recruitment or departures of key personnel, the gain or loss of significant
customers, changes in the estimates of our operating performance, actual or
threatened litigation, market conditions in our industry and the economy as a
whole.
Volatility
in the price of our common stock on the NASDAQ Global Market may depress the
trading price of the common stock our common stock. The risk of
volatility and depressed prices of our common stock also applies to warrant
holders who receive shares of common stock upon conversion.
Numerous
factors, including many over which we have no control, may have a significant
impact on the market price of our common stock, including:
·
|
announcements
of new products or services by us or our competitors; current events
affecting the political, economic and social situation in the United
States and other countries where we
operate;
|
·
|
trends
in our industry and the markets in which we
operate;
|
·
|
changes
in financial estimates and recommendations by securities
analysts;
|
·
|
acquisitions
and financings by us or our
competitors;
|
·
|
the
gain or loss of a significant
customer;
|
·
|
quarterly
variations in operating results;
|
·
|
volatility
in exchanges rate between the US dollar and the currencies of the foreign
countries in which we operate;
|
·
|
the
operating and stock price performance of other companies that investors
may consider to be comparable; and
|
·
|
purchases
or sales of blocks of our
securities.
|
Furthermore,
stockholders may initiate securities class action lawsuits if the market price
of our stock drops significantly, which may cause us to incur substantial costs
and could divert the time and attention of our management.
Future
sales of common stock by existing stockholders, or the perception that such
sales may occur, could depress our stock price
The
market price of our common stock could decline as a result of sales by, or the
perceived possibility of sales by, our existing stockholders. We have
completed a number of private placements of our common stock and other
securities over the last several years, and we have effective resale
registration statements pursuant to which the purchasers can freely resell their
shares into the market. In addition, most of our outstanding shares are
eligible for public resale pursuant to Rule 144 under the Securities Act of
1933, as amended. Approximately 15 million shares of our common stock are
currently held by our affiliates and may be sold pursuant to an effective
registration statement or in accordance with the volume and other limitations of
Rule 144 or pursuant to other exempt transactions. Future sales of
common stock by significant stockholders, including those who acquired
their shares in private placements or who are affiliates, or the perception that
such sales may occur, could depress the price of our common stock.
Future
issuances of common stock and hedging activities may depress the trading price
of our common stock
Any
future issuance of equity securities, including the issuance of shares upon
exercise of outstanding warrants, could dilute the interests of our existing
stockholders, and could substantially decrease the trading price of our common
stock. We currently have outstanding more than 10 million warrants
and options to acquire our common stock at prices between $2.50 and $9.24
per share. We may issue equity securities in the future for a
number of reasons, including to finance our operations and business strategy, in
connection with acquisitions, to adjust our ratio of debt to equity, to satisfy
our obligations upon the exercise of outstanding warrants or options or for
other reasons.
Additionally,
we have outstanding warrants to acquire up to 285,185 shares of our common stock
at an exercise price of $10.52 per share that contain anti-dilution adjustments
that will be triggered if the sale price of the common stock is less than
$10.52.
Provisions
in our certificate of incorporation, bylaws, charter documents and Delaware law
could discourage a change in control, or an acquisition of us by a third party,
even if the acquisition would be favorable to you, thereby and adversely affect
existing stockholders
Our
certificate of incorporation and the Delaware General Corporation Law contain
provisions that may have the effect of making more difficult or delaying
attempts by others to obtain control of our company, even when these attempts
may be in the best interests of stockholders. For example, our certificate of
incorporation also authorizes our board of directors, without stockholder
approval, to issue one or more series of preferred stock, which could have
voting and conversion rights that adversely affect or dilute the voting power of
the holders of common stock. Delaware law also imposes conditions on certain
business combination transactions with “interested stockholders.”
These
provisions and others that could be adopted in the future could deter
unsolicited takeovers or delay or prevent changes in our control or management,
including transactions in which stockholders might otherwise receive a premium
for their shares over then current market prices. These provisions may also
limit the ability of stockholders to approve transactions that they may deem to
be in their best interests.
We
do not expect to pay dividends in the foreseeable future, and accordingly you
must rely on stock appreciation for any return on your investment
We
have paid no cash dividends on our common stock to date, and we currently intend
to retain our future earnings, if any, to fund the continued development and
growth of our business. As a result, we do not expect to pay any cash dividends
in the foreseeable future. Further, any payment of cash dividends
will also depend on our financial condition, results of operations, capital
requirements and other factors, including contractual restrictions to which we
may be subject, and will be at the discretion of our board of
directors.
ITEM
2. PROPERTY
Information
concerning our principal facilities, all of which are leased at
December 31, 2007, is set forth below:
Location
|
Use
|
Approximate
Area in
Square Feet
|
||||
11150
and 11100 Santa Monica Blvd.
Los
Angeles, California
|
Principal
executive and administrative offices
|
20,000
|
||||
1315
Lincoln Blvd.
Santa
Monica, California
|
Medical
office space for The PROMETA Center, Inc.
|
5,400
|
||||
1700
Montgomery St.
San
Francisco, California
|
Medical
office space for The PROMETA Center, Inc.
|
4,000
|
Our principal executive and
administrative offices are located in Los Angeles, California and consist of
leased office space totaling approximately 20,000 square feet. Our base rent is
currently approximately $64,000 per month, subject to annual adjustments, with
aggregate minimum lease commitments at December 31, 2007, totaling
approximately $2.3 million. The initial term of the lease expires in December
2010, with an option to extend for five additional years.
In
April 2005 we entered into a five-year lease for approximately 5,400 square feet
of medical office space in Santa Monica, California, which is occupied by The
PROMETA Center, Inc., which operates under a full service management agreement
with us. Our base rent is currently approximately $21,000 per month. In August
2006, we entered into a five-year lease for approximately 4,000 square feet of
medical office space, located in San Francisco, California, at an initial base
rent of approximately $11,000 per month, which was occupied by The
PROMETA
Center,
Inc., until it was closed in January 2008. We are currently seeking
to sublease this vacant space. The minimum base rent for the two medical offices
are subject to annual adjustments, with aggregate minimum lease commitments at
December 31, 2007, totaling approximately $1.4 million.
In
November 2006, we entered into a 5-year lease for office space in Switzerland at
an initial base rent of 4,052 Swiss Francs per month (US$3,600 using the
December 31, 2007 conversion rate).
In
connection with a management services agreement that we executed with a
treatment center in Dallas, Texas, we assumed the obligation for two lease
agreements at a current combined amount of approximately $9,000 per month, which
expire in May 2011.
As
we expand in the future, we may lease additional regional office facilities, as
necessary, to service our customer base. We believe that the current office
space is adequate to meet our current needs and that additional facilities will
be available for lease to meet our future needs.
ITEM
3. LEGAL
PROCEEDINGS
From
time to time, we may be involved in litigation relating to claims arising out of
our operations in the normal course of business. As of the date of
this report, we are not currently involved in any legal proceeding that we
believe would have a material adverse effect on our business, financial
condition or operating results.
ITEM
5.
|
MARKET
FOR REGISTRANT’S COMMON EQUITY AND RELATED STOCKHOLDER
MATTERS
|
Our
common stock is traded on The Nasdaq Global Market under the symbol “HYTM.” As
of March 1, 2008, there were approximately 82 record holders representing
approximately 5,000 beneficial owners of our common stock. Following is a list
by fiscal quarters of the closing sales prices of our stock:
Closing
Sales Prices
|
||||||||
2007
|
High
|
Low
|
||||||
4th
Quarter
|
$ | 8.64 | $ | 2.68 | ||||
3rd
Quarter
|
$ | 8.77 | $ | 6.43 | ||||
2nd
Quarter
|
$ | 8.71 | $ | 6.53 | ||||
1st
Quarter
|
$ | 10.21 | $ | 6.48 | ||||
2006
|
High
|
Low
|
||||||
4th
Quarter
|
$ | 9.35 | $ | 6.20 | ||||
3rd
Quarter
|
$ | 7.63 | $ | 4.77 | ||||
2nd
Quarter
|
$ | 9.04 | $ | 6.52 | ||||
1st
Quarter
|
$ | 9.19 | $ | 5.42 |
Dividends
We
have never declared or paid any dividends. We may, as our board of directors
deems appropriate, continue to retain all earnings for use in our business or
may consider paying dividends in the future.
*
The above graph measures the change of $100 invested in Hythiam, Inc. common
stock based on its closing price of $7.10 on September 30, 2003 and its
quarter-end and December 31 year-end closing price thereafter. Hythiam, Inc.'s
relative performance is then compared with the Russell 2000 and S&P Health
Care total return indices.
Copyright
© 2008, Standard & Poor's, a division of The McGraw-Hill Companies, Inc. All
rights reserved.
www.researchdatagroup.com/S&P.htm
Recent
Sales of Unregistered Securities
None
Additional
information is incorporated by reference to Part III of this
report.
ITEM
6. SELECTED
FINANCIAL DATA
The selected financial data set forth
below, derived from our audited consolidated financial statements and the
related notes thereto (collectively, the Financial Statements), should be read
in conjunction with the Financial Statements, Item 7. Management’s
Discussion and Analysis of Results of Financial Condition and Results of
Operations and Item 8. Financial Statements and Supplementary Data,
included elsewhere in this report.
Period
from
|
||||||||||||||||||||||
February
13,
|
||||||||||||||||||||||
(In
thousands, except per share amounts)
|
2003
to
|
|||||||||||||||||||||
December
31,
|
December
|
|||||||||||||||||||||
2007
|
2006
|
2005
|
2004
|
31,
2003
|
||||||||||||||||||
Statement
of Operations Data:
|
||||||||||||||||||||||
Revenues:
|
||||||||||||||||||||||
Behavioral
health managed care services
|
$ | 36,306 |
(a)
|
$ | - | $ | - | $ | - | $ | - | |||||||||||
Healthcare
services
|
7,695 | 3,906 | 1,164 | 192 | 75 | |||||||||||||||||
Total
revenues
|
44,001 | 3,906 | 1,164 | 192 | 75 | |||||||||||||||||
Loss
from operations
|
(47,531 | ) | (d) | (39,926 | ) | (24,872 | ) | (e) | (11,945 | ) | (3,545 | ) | ||||||||||
Loss
on extingishment of debt
|
(741 | ) |
(b)
|
|||||||||||||||||||
Change
in fair value of warrant liability
|
3,471 |
(c)
|
- | - | - | - | ||||||||||||||||
Net
loss
|
(45,462 | ) | (38,298 | ) | (24,038 | ) | (11,775 | ) | (3,504 | ) | ||||||||||||
Loss
Per Share:
|
||||||||||||||||||||||
Net
loss per share - basic and diluted
|
$ | (0.99 | ) | $ | (0.96 | ) | $ | (0.77 | ) | $ | (0.47 | ) | $ | (0.21 | ) | |||||||
Weighted
average shares outstanding - basic and diluted
|
45,695 | 39,715 | 31,173 | 24,877 | 16,888 | |||||||||||||||||
Cash
Flows Data:
|
||||||||||||||||||||||
Net
cash used in operating activities
|
$ | (39,220 | ) | $ | (28,499 | ) | $ | (18,819 | ) | $ | (9,947 | ) | $ | (1,374 | ) | |||||||
Net
cash provided by (used in) investing activities
|
(4,091 | ) | 4,730 | (22,206 | ) | (10,913 | ) | (16,527 | ) | |||||||||||||
Net
cash provided by financing activities
|
48,759 | 26,053 | 40,442 | 21,416 | 21,345 | |||||||||||||||||
As
of December 31,
|
||||||||||||||||||||||
2007
|
2006
|
2005
|
2004
|
2003
|
||||||||||||||||||
Balance
Sheet Data:
|
||||||||||||||||||||||
Cash,
cash equivalents and marketable
|
||||||||||||||||||||||
securities
|
$ | 46,989 | $ | 43,447 | $ | 47,000 | $ | 27,479 | $ | 16,640 | ||||||||||||
Total
current assets
|
50,342 | 44,549 | 47,720 | 28,093 | 17,344 | |||||||||||||||||
Total
assets
|
70,646 | 52,205 | 54,462 | 33,962 | 22,580 | |||||||||||||||||
Short-term
debt
|
4,742 | - | - | - | - | |||||||||||||||||
Long-term
debt
|
2,057 |
(a)
|
- | - | - | - | ||||||||||||||||
Warrant
liability
|
2,798 |
(c)
|
- | - | - | - | ||||||||||||||||
Total
liabilities
|
27,382 | 10,176 | 4,723 | 2,128 | 2,092 | |||||||||||||||||
Stockholders’
equity
|
43,264 | 42,029 | 49,739 | 31,834 | 20,488 | |||||||||||||||||
Book
value per share
|
0.80 | 0.96 | 1.27 | 1.07 | 0.83 | |||||||||||||||||
(a)
|
We
began consolidating CompCare’s operations on January 13,
2007. See further discussion in Note 5 –Acquisition of
Woodcliff.
|
(b)
|
The
$741,000 loss on extinguishment of debt resulted from a $5 million
redemption of the Highbridge senior secured notes on November 7,
2007. See further discussion in Note 7 – Debt
Outstanding.
|
(c)
|
The
fair value of warrants issued in conjunction with the registered direct
placement on November 7, 2007 was accounted for as a liability and was
revalued at $2.8 million at December 31, 2007, resulting in a $3.5 million
non-operating gain.
|
(d)
|
Includes
a $2.4 million impairment loss related to the non-cash stock settlement
reached with XINO Corporation in August 2007. See further
discussion in Note 6 – Intangible
Assets.
|
(e)
|
We
recorded an impairment charge of $272,000 in December 2005 to fully write
off the cost of a patent for opiate addiction treatment. See
further discussion in Note 6 – Intangible
Assets.
|
ITEM
7.
|
MANAGEMENT’S
DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF
OPERATIONS
|
Forward-Looking Statements
The forward-looking comments contained
in the following discussion involve risks and uncertainties. Our actual results
may differ materially from those discussed here due to factors such as, among
others, limited operating history, difficulty in developing, exploiting and
protecting proprietary technologies, intense competition and substantial
regulation in the healthcare industry. Additional factors that could cause or
contribute to such differences can be found in the following discussion, as well
as under Item 1A, “Risks Factors.”
OVERVIEW
General
We are a healthcare services management
company, providing behavioral health management services to health plans,
employers, criminal justice, and government agencies through a network of
licensed and company managed healthcare providers. We also research,
develop, license and commercialize innovative physiological, nutritional, and
behavioral treatment programs. We manage behavioral health disorders through our
majority-owned subsidiary, Comprehensive Care Corporation (CompCare). We utilize
CompCare’s infrastructure to offer our proprietary disease management services.
Our disease management offering combines medical and behavioral treatment
modalities to manage substance dependent populations, and is built around our
proprietary PROMETA® Treatment Programs for alcoholism and dependence to cocaine
and methamphetamines. Our PROMETA Treatment Programs--which integrate
behavioral, nutritional, and medical components--are available through
physicians and other treatment providers who have entered into licensing
agreements with us for the use of our programs. We also license or manage
treatment centers that offer the PROMETA Treatment Programs, as well as other
treatments for substance dependencies.
Our
Strategy
Our
business strategy is to provide quality treatment programs that will become the
standard-of-care for those suffering from alcoholism and other substance
dependencies in a cost effective manner. We intend to focus on disease
management and managed care and grow our business through increased adoption of
our PROMETA Treatment Programs and a substance abuse disease management
treatment approach for managed care, self-insured employers, unions, government
agencies, criminal justice systems, and other third-party payers, in addition to
increased utilization from within existing and new licensees and managed
treatment centers for substance dependencies.
Key
elements of our business strategy include:
·
|
Providing
our substance abuse disease management program to managed care health
plans for reimbursement on a case rate or capitated basis, utilizing the
CompCare infrastructure to provide some service
components
|
·
|
Demonstrating
the potential for improved clinical outcomes and cost effectiveness
associated with using the PROMETA Treatment Programs, through commercial
pilot studies with key managed care and other third-party
payers
|
·
|
Expanding
the base of our self-pay licensed treatment sites and managed medical
treatment centers, focusing primarily on existing service
areas
|
·
|
Seeking
additional scientific and clinical research data to further validate the
efficacy of using the PROMETA Treatment Programs through unrestricted
grants for research studies by leading research institutions and
preeminent researchers in the field of alcohol and substance
abuse
|
·
|
Exploring
opportunities in foreign markets
|
CompCare
Acquisition
Effective
January 12, 2007, we acquired a 50.25% controlling interest in CompCare through
the acquisition of Woodcliff Healthcare Investment Partners, LLP (Woodcliff).
Our consolidated financial statements include the business and operations of
CompCare subsequent to this date.
CompCare
provides managed care services in the behavioral health and psychiatric
fields. CompCare manages the delivery of a continuum of psychiatric
and substance abuse services to commercial, Medicare and Medicaid members on
behalf of employers, health plans, government organizations, third-party claims
administrators, and commercial and other group purchasers of behavioral
healthcare services. The customer base for CompCare’s services
includes both private and governmental entities.
Segment
Reporting
We
currently operate within two reportable segments: healthcare services and
behavioral health managed care services. Our healthcare services segment focuses
on providing licensing, administrative and management services to licensees that
administer PROMETA and other treatment programs, including managed treatment
centers that are licensed and/or managed by us. Our behavioral health managed
care services segment focuses on providing managed care services in the
behavioral health, psychiatric and substance abuse fields, and principally
includes the operations of our majority-owned, controlled subsidiary, CompCare.
A majority of our consolidated revenues and assets are earned or located within
the United States.
Operations
Healthcare
Services
Under our licensing agreements, we
provide physicians and other licensed treatment providers access to our PROMETA
Treatment Programs, education and training in the implementation and use of the
licensed technology and marketing support. The patient’s physician determines
the appropriateness of the use of the PROMETA Treatment Program. We receive a
fee for the licensed technology and related services generally on a per patient
basis. At the end of 2004, we had seven licensed sites, of which one licensee
had generated 93% of our revenues that year. Through increased
efforts to obtain additional licensing agreements with hospitals and healthcare
providers in major U.S. markets, we increased the number of sites by 25, 29 and
40 sites in 2005, 2006 and 2007, respectively, bringing the total number of
licensed sites throughout the United States to 101 as of December 31, 2007, with
70 sites contributing to revenues in 2007.
Managed
Medical Practices and Treatment Centers
In December
2005, The PROMETA Center, Inc., a medical professional corporation (now owned by
Lawrence Weinstein, M.D., our senior vice president of medical
affairs), opened a state-of-the-art outpatient facility in Santa Monica,
California, that we built out under a lease agreement. Under the terms of a full
business service management agreement we manage the business components of the
medical practice and license the PROMETA Treatment Programs and use of the name
in exchange for management and licensing fees. The
practice offers treatment with the PROMETA Treatment Programs for
dependencies on alcohol, cocaine and methamphetamines, but also offers medical
interventions for other substance dependencies. The financial results of The
PROMETA Center, Inc. are included in our consolidated financial statements under
accounting standards applicable to variable interest
entities.
In
January 2007, a second PROMETA Center was opened in San Francisco, which was
subsequently closed in January 2008.
In
2007 we entered into additional management services agreements with other
medical corporations and treatment centers, under similar terms and conditions,
including the Murray Hill Recovery Center located in Dallas,
Texas. In addition,
we
have a licensing and administrative services agreement with Canterbury
Institute, LLC, which manages two PROMETA Center teatment centers in New Jersey
and Florida.
Revenues
from licensed and managed treatment centers, including the PROMETA Centers,
accounted for approximately 31% of our healthcare services revenues in
2007.
Research
and Development, Pilot Studies
To
date, we have spent approximately $9.2 million related to research and
development, including $3.3 million in 2007, $3.1 million in 2006 and $2.6
million in 2005, respectively, in funding for commercial pilots and unrestricted
grants for a number of clinical research studies by researchers in the field of
substance dependence and leading research institutions to evaluate the efficacy
of the PROMETA Treatment Program in treating alcohol and stimulant
dependence. We plan to spend approximately $4.9 million in 2008 for
unrestricted research grants and commercial pilots.
Pilot
programs are used in conjunction with drug court systems, state programs and
managed care organizations to allow such programs to evaluate the outcomes and
cost effectiveness of the PROMETA Treatment Programs. The focus of these pilot
programs is to assist such organizations in assessing the impact on their
population, and as a result, the method, manner, timing, participants and
metrics may change and develop over time, based on initial results from the
particular program, other pilots, and research studies. We generally do not
provide updates on status after a pilot is initially announced.
International
We
have expanded our operations in Europe, with our Swiss foreign subsidiary
signing PROMETA license and services agreements with three sites in Switzerland
in 2006 to serve the international market. These sites commenced
operations in the first quarter of 2007. Our European operations were
also expanded in 2007 to include the treatment of other
dependencies. In August 2007 we signed a PROMETA licensing agreement
with a leading hospital in Panama, which commenced operations in September
2007.
Recent
Developments
In
January 2008, we streamlined our operations to increase our focus on disease
management and managed care opportunities, which is expected to result in an
overall reduction of 25% to 30% of cash operating expenses for the year ending
December 31, 2008 from 2007 levels. The actions we took included eliminating
field and regional sales personnel and related corporate support personnel,
closing the PROMETA Center in San Francisco, a reduction in outside
consultants and overall reductions in overhead costs. Estimated one-time
costs associated with these actions were approximately $1.0 million and will be
recognized as a charge to operating expenses in the statement of operations for
the quarter ending March 31, 2008. Such costs primarily represent severance
payments and related benefits and costs incurred in closing the San Francisco
PROMETA Center. We do not expect to incur any material additional costs
associated with this initiative. We also anticipate that in addition to
previously entered into and announced business relationships, new disease
management agreements from labor unions, self-insured employers, and managed
care health plans will add to the current self-pay revenue base and result in
increased revenues for 2008. The combination of increased revenues and cost
reductions is expected to reduce the company's net cash utilization for 2008
compared to 2007. Following the streamlining actions taken in January 2008, we
anticipate that our cash operating expenditures will average approximately $2.5
million per month for the remainder of 2008 compared to an average of
approximately $3.6 million per month in the fourth quarter
2007, excluding research and development costs and costs incurred by
our consolidated subsidiary, CompCare. We believe that existing capital
resources will be sufficient to fund our operating expenses and capital
requirements until we achieve positive cash flow, which we believe will be
within the next two years.
On
November 1, 2007, we announced the top line results of an
88-patient randomized, double-blind, placebo-controlled study conducted
by Harold Urschel, M.D. The 30-day study on cravings and
neurocognition funded by us was a follow-up to Dr. Urschel’s 90-day open-label
study on the effects of the PROMETA Treatment Program in treatment-seeking,
methamphetamine-dependent subjects. The resulting data showed a statistically
significant reduction in cravings versus placebo.
These
placebo-controlled outcomes confirmed the findings in a prior study by Dr.
Urschel, which showed that there was an immediate reduction of cravings within
the one-month treatment period. Dr.
Urschel’s prior study was published in Mayo Clinic Proceedings, a peer-reviewed
medical journal, in their October 2007 installment and was an
open-label study of the pharmacological component of the PROMETA Treatment
Program for methamphetamine dependence. According to the publication, over 80%
of the study's 50 participants experienced a statistically significant reduction
in cravings for methamphetamine with no adverse events from the treatment.
On
November 7, 2007, we entered into securities purchase agreements with
select institutional investors in a registered direct placement, in which we
issued an aggregate of approximately 9.6 million shares of common stock at
a price of $4.79 per share, for gross proceeds of approximately
$46.2 million before related fees and offering expenses. We also issued
5-year warrants to purchase an aggregate of approximately 2.4 million
additional shares of our common stock at an exercise price of $5.75 per
share. The fair value of the warrants at the date of issue amounted
to approximately $6.3 million and was accounted for as a liability in
accordance with the Financial Accounting Standards Board (FASB) Emerging Issues
Task Force Issue No. 00-19, "Accounting for Derivative Financial
Instruments Indexed to, and Potentially Settled in, a Company's Own Stock" (EITF
00-19). The shares and warrants were sold pursuant to our shelf registration
statement on Form S-3 filed with the SEC on September 6, 2007 and declared
effective on October 5, 2007. We intend to use the proceeds of the
registered direct common stock placement for working capital and general
corporate purposes.
Included
in the gross proceeds was $5.35 million from the conversion of $5 million of the
senior secured notes issued to Highbridge, which includes $350,000 based on a
redemption price of 107% of the principal amount being redeemed pursuant to a
redemption agreement entered into with Highbridge on November 7, 2007. The
$350,000 was included as part of the reacquisition cost of the notes and the
difference between the reacquisition price and the net carrying amount of the
principal amount being redeemed amounted to $741,000 and was recognized as a
loss on extinguishment of debt in our statement of operations during the fourth
quarter of 2007.
Behavioral
Health Managed Care Services
Our
consolidated subsidiary, CompCare, typically enters into contracts on an annual
basis to provide managed behavioral healthcare and substance abuse treatment to
clients’ members. Arrangements with clients fall into two broad categories:
capitation arrangements, where clients pay CompCare a fixed fee per member per
month, and fee-for-service and administrative service arrangements where
CompCare may manage behavioral healthcare programs or perform various managed
care services. Approximately $35.2 million, or 97% of CompCare’s revenues for
the period January 13 through December 31, 2007, were derived from capitation
arrangements. Under capitation arrangements, CompCare receives premiums from
clients based on the number of covered members as reported by the clients.
CompCare reviews membership eligibility records and other reported information
to verify its accuracy in determining the amount of revenue to be recognized.
The amount of premiums received for each member is fixed at the beginning of the
contract term. These premiums may be subsequently adjusted, up or down,
generally at the commencement of each renewal period.
Effective
January 1, 2007, CompCare commenced a contract with a health plan to provide
behavioral healthcare services to approximately 250,000 Medicaid recipients in
Indiana. This contract amounted to $14.6 million in revenues for the period
January 13 through December 31, 2007, and is anticipated to generate
approximately $16 million to $17 million in annual revenues in
2008.
Seasonality
of Business
Historically,
CompCare’s managed care plans have experienced increased member utilization
during the months of March, April and May, and consistently lower utilization by
members during the months of June, July, and August. Such variations
in member utilization impact the costs of care during these months, generally
having a negative impact on gross margins and operating profits during the
former period, and a positive impact on gross margins and operating profits
during the latter period.
Concentration
of Risk
For
the period January 13 through December 31, 2007, 87% of behavioral health
managed care services revenue (or 72% of our consolidated revenues for the year
ended December 31, 2007) was concentrated in contracts with six health plans to
provide behavioral healthcare services under commercial, Medicare, Medicaid, and
children’s health insurance plans (CHIP). This includes the new
Indiana Medicaid HMO contract, which represented approximately 40% of behavioral
health managed care services revenue for the period January 13 through December
31, 2007 (or 33% of our consolidated revenues for the year ended December 31,
2007). The term of each contract is generally for one year and is automatically
renewable for additional one-year periods unless terminated by either party by
giving the requisite written notice. The loss of one or more of these
clients, unless replaced by new business, would have an adverse impact on the
financial condition of CompCare.
Recent
Developments
On
January 4, 2008 CompCare announced the appointment of John M. Hill as its
new President and Chief Executive Officer, replacing Mary Jane Johnson, who
resigned for health reasons effective December 14, 2007.
In
January 2008, CompCare’s Pennsylvania and Maryland Medicare Advantage health
plan client, representing $5.4 million, or 15%, of CompCare’s total revenue
during 2007, issued a request for proposal (RFP) for management of behavioral
healthcare services for its Pennsylvania, Maryland and Texas regions. CompCare
submitted a bid to retain its current business from this client as well as
attempt to contract for the Texas membership. This client intends to select a
finalist in March 2008 with an effective date of July 1, 2008 for a new
agreement. CompCare does not expect to be selected as a finalist and accordingly
the majority of the revenues under this contract are expected to end during the
third quarter of 2008.
One
of CompCare’s existing commercial health plan clients in Indiana has decided to
exit the group health plan business. Beginning January 1, 2008 and throughout
the remainder of 2008, this health plan will not be renewing any of its existing
customer contracts, as all of their members are being transitioned to other
health plans. This health plan accounted for approximately 5.0% of
behavioral health managed care services revenues for the period January 13
through December 31, 2007.
On
August 1, 2007, CompCare began providing behavioral healthcare services to
approximately 23,000 Medicare members of an existing client in
Pennsylvania. Such services are estimated to generate between $4.5
and $5.0 million in annual revenues.
On
July 19, 2007, CompCare received from an existing client in Texas a notice of
termination, which resulted in termination of the contract effective November
30, 2007. This client accounted for approximately 8% of behavioral
health managed care services revenues for the period January 13 through December
31, 2007 and had been a customer since 1998.
CompCare
has entered into negotiations with its major Indiana HMO client to obtain a rate
increase to offset higher than expected costs of
utilization. CompCare believes it will receive a rate increase
effective January 1, 2008, provided it complies with monthly performance
measures it believes it will meet. The rate increase would amount
to approximately $2.0 million per annum.
How
We Measure Our Results
Our
healthcare services revenues are generated from fees that we charge to
hospitals, healthcare facilities and other healthcare providers that license our
PROMETA Treatment Programs, and from patient service revenues related to our
licensing and management services agreements with managed treatment centers. Our
technology license and management services agreements provide for an initial fee
for training and other start-up related costs, plus a combined fee for the
licensed technology and other related services, generally set on a per-treatment
basis, and thus a substantial portion of our revenues is closely related to the
number of patients treated. Patients treated by managed treatment centers
generate higher average revenues per PROMETA patient than our other licensed
sites due to consolidation of their gross patient revenues in our financial
statements. Key indicators of our financial performance are the
number of facilities and healthcare providers that contract with us to license
our technology and the number of patients that are treated by those providers
using the PROMETA Treatment Programs. Additionally, our financial results will
depend on our ability to expand the adoption of PROMETA among government and
other third party payer groups, and our ability to effectively price these
products, and manage general, administrative and other operating
costs.
For
behavioral health managed care services, our largest expense is CompCare’s cost
of behavioral health managed care services that it provides, which is based
primarily on its arrangements with healthcare providers. Since CompCare’s costs
are subject to increases in healthcare operating expenses based on an increase
in the number and frequency of the members seeking behavioral health care
services, CompCare’s profitability depends on its ability to predict and
effectively manage healthcare operating expenses in relation to the fixed
premiums it receives under capitation arrangements. Providing
services on a capitation basis exposes CompCare to the risk that its contracts
may ultimately be unprofitable if CompCare is unable to anticipate or control
healthcare costs. Estimation of healthcare operating expense is
one of our most significant critical accounting estimates. See “Management’s
Discussion and Analysis of Financial Condition and Results of Operations —
Critical Accounting Estimates.”
CompCare
currently depends upon a relatively small number of customers for a significant
percentage of its behavioral health managed care operating revenues. A
significant reduction in sales to any of CompCare’s large customers or a
customer exerting significant pricing and margin pressures on CompCare would
have a material adverse effect on our consolidated results of operations and
financial condition. In the past, some of CompCare’s customers have terminated
their arrangements or have significantly reduced the amount of services
requested. There can be no assurance that present or future customers will not
terminate their arrangements or significantly reduce the amount of services
requested. Any such termination of a relationship or reduction in use of
CompCare's services would have a material adverse effect on our consolidated
results of operations or financial condition (see Note 13 — Major
Customers/Contracts).
Results
of Operations
Table
of Summary Financial Information
The
table below and the discussion that follows summarize our results of operations
and certain selected operating statistics for the last three fiscal years
(amounts in thousands except patient treatment data):
(In
thousands)
|
Year
Ended December 31, 2007
|
|||||||||||
2007
|
2006
|
2005
|
||||||||||
Revenues
|
||||||||||||
Behavioral
health managed care services
|
$ | 36,306 | $ | - | $ | - | ||||||
Healthcare
services
|
7,695 | 3,906 | 1,164 | |||||||||
Total
revenues
|
44,001 | 3,906 | 1,164 | |||||||||
Operating
Expenses
|
||||||||||||
Behavioral
health managed care expenses
|
35,679 | - | - | |||||||||
Cost
of healthcare services
|
2,052 | 818 | 134 | |||||||||
General
and administrative expenses
|
45,554 | 38,680 | 22,105 | |||||||||
Impairment
loss
|
2,387 | - | 272 | |||||||||
Research
and development
|
3,358 | 3,053 | 2,646 | |||||||||
Depreciation
and amortization
|
2,502 | 1,281 | 879 | |||||||||
Total
operating expenses
|
91,532 | 43,832 | 26,036 | |||||||||
Loss
from operations
|
(47,531 | ) | (39,926 | ) | (24,872 | ) | ||||||
Interest
income
|
1,584 | 1,630 | 834 | |||||||||
Interest
expense
|
(2,190 | ) | - | - | ||||||||
Loss
on extinguishment of debt
|
(741 | ) | - | - | ||||||||
Change
in fair value of warrant liability
|
3,471 | - | - | |||||||||
Other
non-operating expense, net
|
32 | - | - | |||||||||
Loss
before provision for income taxes
|
$ | (45,375 | ) | $ | (38,296 | ) | $ | (24,038 | ) |
Summary
of Consolidated Operating Results
We
acquired a majority controlling interest in CompCare, resulting from our
acquisition of Woodcliff on January 12, 2007, and began including its results in
our consolidated financial statements subsequent to that date. These results are
reported in our behavioral health managed care services segment.
The
increased loss in 2007 compared to 2006 is due to the inclusion of a loss of
$4.1 million from CompCare, including purchase accounting adjustments, higher
operating expenses, $2.4 million impairment loss, and $741 thousand loss on
extinguishment of debt, partially offset by an increase in revenues from our
healthcare services segment and the $3.5 million fair value adjustment of the
warrant liability.
The
increase in the loss before provision for income taxes in 2006 compared to 2005
was due to significantly higher operating costs as we expanded our business
operations.
Our
healthcare services revenues nearly doubled in 2007 when compared to 2006. The
increase was due to the increase in the number of patients treated at our U.S.
licensed sites and at our managed treatment centers, administrative fees from
new licensees and other revenues from the commencement of international
operations and licenses with government agencies and other third-party
payers.
The
increase in revenues between 2006 and 2005 was primarily attributable to the
increase in the number of patients treated at our U.S. license sites and at the
managed treatment centers.
Excluding
the impact of CompCare, total operating expenses for the year ended December 31,
2007 increased by approximately $7.4 million when compared to the same period in
2006. The increase is due mainly to the $2.4 million impairment loss related to
the non-cash stock settlement reached with XINO Corporation (as discussed more
fully in “Healthcare Services” below), the increase in the number of our sales
field personnel, the expansion in number of licensees, the strengthening and
expansion in our management and support teams, the funding of clinical research
studies and investment in development of additional markets for our services,
including managed care, statewide agencies, criminal justice systems and other
third-party payers as well as international opportunities.
Total
share based compensation expense decreased to $2.6 million for the year ended
December 31, 2007 compared to $3.7 for the same period in 2006 due principally
to the decline in market value of our common stock. The 2006 expense
increased from the $1.7 million incurred in 2005 due to the adoption of SFAS
No.123R, “Share-based Payment” (SFAS 123R).
We
incurred approximately $1.9 million of interest expense during the year ended
December 31, 2007 associated with the CompCare acquisition-related financing
with Highbridge that originally consisted of the issuance of a $10 million
senior secured note and warrants to purchase up to approximately 250,000 shares
of our common stock.
Reconciliation
of Segment Results
The
following table summarizes and reconciles the loss from operations of our
reportable segments to the loss before provision for income taxes from our
consolidated statements of operations for the years ended December 31, 2007,
2006 and 2005:
Year
Ended December 31,
|
||||||||||||
(In
thousands)
|
2007
|
2006
|
2005
|
|||||||||
Healthcare
services
|
$ | (41,270 | ) | $ | (38,296 | ) | $ | (24,038 | ) | |||
Behavioral
health managed care services
|
(4,105 | ) | - | - | ||||||||
Loss
before provision for income taxes
|
$ | (45,375 | ) | $ | (38,296 | ) | $ | (24,038 | ) | |||
Healthcare
Services
The
following table summarizes the operating results for healthcare services for the
years ended December 31, 2007, 2006 and 2005:
(In
thousands, except patient treatment data)
|
December
31,
|
|||||||||||
2007
|
2006
|
2005
|
||||||||||
Revenues
|
||||||||||||
U.S.
licensees
|
$ | 3,807 | $ | 2,650 | $ | 1,105 | ||||||
Managed
treatment centers (a)
|
2,416 | 1,137 | 59 | |||||||||
Other
revenues
|
1,472 | 119 | - | |||||||||
Total
revenues
|
7,695 | 3,906 | 1,164 | |||||||||
Operating
Expenses
|
||||||||||||
Cost
of healthcare services
|
2,052 | 818 | 134 | |||||||||
General
and administrative expenses
|
||||||||||||
Salaries
and benefits
|
21,272 | 16,212 | 9,204 | |||||||||
Other
expenses
|
20,561 | 22,468 | 12,901 | |||||||||
Impairment
loss
|
2,387 | - | 272 | |||||||||
Research
and development
|
3,358 | 3,053 | 2,646 | |||||||||
Depreciation
and amortization
|
1,578 | 1,281 | 879 | |||||||||
Total
operating expenses
|
51,208 | 43,832 | 26,036 | |||||||||
Loss
from operations
|
(43,513 | ) | (39,926 | ) | (24,872 | ) | ||||||
Interest
income
|
1,439 | 1,630 | 834 | |||||||||
Interest
expense
|
(1,926 | ) | - | - | ||||||||
Loss
on extinguishment of debt
|
(741 | ) | - | - | ||||||||
Change
in fair value of warrant liability
|
3,471 | - | - | |||||||||
Loss
before provision for income taxes
|
$ | (41,270 | ) | $ | (38,296 | ) | $ | (24,038 | ) | |||
PROMETA
Patients Treated
|
||||||||||||
U.S.
licensees
|
559 | 427 | 207 | |||||||||
Managed
treatment centers (a)
|
239 | 140 | 9 | |||||||||
Other
|
124 | 15 | - | |||||||||
922 | 582 | 216 | ||||||||||
Average
revenue per PROMETA patient treated (b)
|
||||||||||||
U.S.
licensees
|
$ | 5,444 | $ | 5,915 | $ | 5,337 | ||||||
Managed
treatment centers (a)
|
8,840 | 8,121 | 6,564 | |||||||||
Other
|
5,810 | 2,463 | - | |||||||||
Overall
average
|
6,374 | 6,357 | 5,388 |
(a)
Includes managed and/or licensed PROMETA Centers.
(b)
The average revenue per patient treated excludes administrative fees and other
non-PROMETA patient revenues.
Year
Ended December 31, 2007 Compared to Year Ended December 31,
2006
Revenues
Revenues
for the year ended December 31, 2007 nearly doubled compared to 2006, due to an
increase in the number of patients treated across all of our markets, expansion
of the number of contributing licensees, administrative fees from new licensees
and other revenues from the commencement of international operations and
licenses with third-party payers. The number of PROMETA patients treated
increased by 58% in 2007 compared to 2006. The number of licensed sites that
contributed to revenues increased to 70 for the year ended December 31, 2007
compared to 41 sites contributing to revenues in 2006, including two new PROMETA
Centers that were
opened
in San Francisco and New Jersey in January 2007, and the addition of a managed
treatment center in Dallas, Texas, in August 2007. The average revenue per
patient treated at U.S. licensed sites in 2007 decreased compared to 2006 due to
higher average discounts granted by our licensees resulting principally from the
launch of a patient assistance program with our licensees, new site training and
business development initiatives. The average revenue for PROMETA patients
treated at the managed treatment centers increased in 2007 from 2006 due to a
lower percentage of discounted and training patients, and is higher than our
other licensed sites due to the consolidation of their gross patient revenues in
our financial statements. Other revenues in 2007 consisted of revenues from our
international operations and third-party payers. International revenues in
2007 include the commencement of operations in Europe in the first quarter
of 2007 and revenues from Panama commencing in September 2007.
Operating
Expenses
Total
operating expenses increased by $7.4 million during the year ended December 31,
2007 compared to the same period in 2006, as we incurred a $2.4 million
impairment loss related to the non-cash stock settlement reached with XINO
Corporation, increased the number of our sales field personnel, expanded the
number of licensees, strengthened and expanded our management and support teams,
funded clinical research studies and invested in development of additional
markets for our services, including managed care, statewide agencies, criminal
justice systems and other third-party payers as well as international
opportunities.
Cost
of healthcare services consists of royalties we pay for the use of the PROMETA
Treatment Program, and costs incurred by our consolidated managed treatment
centers (including PROMETA Centers) for direct labor costs for physicians and
nursing staff, continuing care expense, medical supplies and treatment program
medicine costs. The increase in these costs primarily reflects the increase in
revenues from these treatment centers, including the new sites added in 2007
discussed above.
General
and administrative expenses consist primarily of salaries and benefits expense
and other operating expense, including support and occupancy costs, outside
services and marketing. General and administrative expenses increased by $3.2
million during the year ended December 31, 2007 compared to the same period in
2006, due mainly to an increase in salaries and benefits expenses and support
and occupancy costs, partially offset by reductions in certain outside services
costs and advertising expenses. Salaries and benefits expenses increased by $5.1
million in 2007 compared to 2006, due to the increase in personnel from 120
employees at December 31, 2006 to approximately 160 employees at December 31,
2007, as we added managers and staff in the field to support our licensed sites,
increased our corporate staff to support our rapid growth in operations,
research, sales and marketing efforts, new business initiatives and general and
administrative functions. Support and occupancy costs, such as insurance, rent
and travel costs, increased by $2.5 million in 2007 compared to 2006 due to the
growth of our business and the resulting overall increase in staffing and
corporate infrastructure to support this growth. Costs related to
outside services, such as audit, legal, investor relations, marketing, business
development and other consulting expenses and non-cash stock-based compensation
charges for services received from non-employees, decreased by $1.9 million in
2007 compared to 2006. Advertising expense declined to $872,000 from $3.4
million in 2006, primarily due to increased costs for a drug addiction awareness
campaign for PROMETA in the first half of 2006.
The
impairment loss of $2.4 million resulted from the non-cash settlement
agreement reached with XINO Corporation in August 2007 to release 310,000 of the
360,000 shares of our common stock previously issued to XINO in 2003 in
connection with our acquisition of a patent for a treatment method for opiate
addition, which has never been utilized in our business plan.
Research
and development expense increased by $306,000 in 2007 compared to 2006 due to an
increase in funding for unrestricted grants for research studies to evaluate the
clinical effectiveness of our PROMETA Treatment Programs and the commencement of
additional commercial pilot studies. We plan to spend $4.9 million in 2008 for
such studies.
In
January 2008, we streamlined our operations to increase our focus on disease
management and managed care opportunities, which is expected to result in an
overall reduction of 25% to 30% of cash operating expenses for the year ending
December 31, 2008. See Healthcare Services - Recent Developments
above.
Interest
Income
Interest
income for the year ended December 31, 2007 decreased compared to the same
period in 2006 due to a decrease in the average invested balance of cash
equivalents and marketable securities, and a decrease in average interest
rates.
Interest
Expense
Interest
expense primarily relates to the $10 million senior secured note issued on
January 17, 2007 to finance the CompCare acquisition, accrued at a rate equal to
prime plus 2.5% (9.75% at December 31, 2007). For the year ended December 31,
2007, interest expense includes $949,000 in amortization of the
$1.4 million discount resulting from the value allocated to the warrants issued
with the debt and related borrowing costs. As discussed more fully in
Note 7 – Debt Outstanding, we entered into a redemption agreement to redeem $5
million in principal related to the senior secured notes as part of the
securities offering completed on November 7, 2007.
Loss
on extinguishment of debt
The
loss on extinguishment of debt of $741,000 was due to a redemption agreement
with Highbridge to redeem $5 million in principal related to the
senior secured notes as part of our securities offering completed on
November 7, 2007. The loss represents the difference between the reacquisition
price, which included $350,000 for an early redemption penalty, and the net
carrying amount of the principal amount being redeemed and related deferred
costs of issuance.
Change
in fair value of warrant liability
We
issued 5-year warrants to purchase an aggregate of approximately
2.4 million additional shares of our common stock at an exercise price of
$5.75 per share in connection with a registered direct stock placement
completed on November 7, 2007. The proceeds attributable to the warrants,
based on the fair value of the warrants at the date of issue, amounted to
approximately $6.3 million, and is accounted for as a liability in
accordance with EITF 00-19. The warrant liability was revalued at $2.8 million
at December 31, 2007, resulting in a $3.5 million non-operating gain to the
statement of operations. We will continue to mark the warrants to market value
each quarter-end until they are completely settled.
Year
Ended December 31, 2006 Compared to Year Ended December 31,
2005
Revenues
Revenues for the years ended
December 31, 2006 and 2005 were $3.9 million and $1.2 million, respectively, an
increase of 236%. The increase in revenues was primarily
attributable to the increase in the number of patients treated at our
U.S. licensed sites and at the PROMETA Center. In addition, our
average license fees per patient treatment at U.S licensed sites increased by
17% from $5,337 in 2005 to $5,915 in 2006, primarily due to lower average
discounts granted by our licensees in 2006 than in 2005. There were no
significant changes in our licensing fees charged to our licensees between the
periods. The average revenue for patients treated at the PROMETA Center in 2006
was $8,121, which is higher than our other licensed sites due to the
consolidation of its gross patient revenues in our financial
statements.
Operating
Expenses
Our operating expenses increased from
$26.0 million in 2005 to $43.8 million in 2006, as we expanded the number of
licensees, strengthened and expanded our management and support teams, increased
brand awareness, marketing and advertising for our PROMETA Treatment Programs,
funded clinical research studies and invested in development of additional
markets for our services, including managed care, statewide agencies, criminal
justice systems and other third-party payers as well as international
opportunities.
Cost
of services consists of royalties we pay for the use of the PROMETA Treatment
Program, and the PROMETA Center’s direct labor costs for its physician and
nursing staff, continuing care expense, medical supplies
and
program medicine costs for patients treated at the PROMETA Center. The increase
in these costs primarily reflects a full year of operation at the PROMETA
Center, which opened in December 2005, and the related increase in
revenues.
Salaries
and benefits expenses were $16.2 million and $9.2 million for the years ended
December 31, 2006 and 2005, respectively. The significant increases
in 2006 over 2005 reflect the increase in personnel from 90 to approximately 120
employees at the end of 2006, as we have added managers in the field to support
our licensed sites and have increased our corporate staff to support our rapid
growth in operations, research, sales and marketing efforts, new business
initiatives and general and administrative functions. Additionally,
the increase in 2006 includes $2.3 million of non-cash expense for stock options
granted to employees and directors, resulting from our adoption of SFAS 123R on
January 1, 2006. In 2005 and prior years such costs were not included in our
statements of operations, but were reflected as pro forma disclosures in the
footnotes to the financial statements.
Other
expenses amounted to $22.5 million and $12.9 million for the years ended
December 31, 2006 and 2005, respectively, which included non-cash charges of
$1.4 million and $1.7 million, respectively, related to the issuance of common
stock, stock options and warrants for services received from non
employees. Other expenses include advertising, legal, audit,
insurance, rent, travel and entertainment, investor relations, marketing,
business development and other professional consulting costs. Most
expenditures increased significantly in 2006 from 2005, due to the rapid growth
of our business and the resulting overall increase in staffing and corporate
infrastructure to support this growth. Additionally, in 2006, we
increased spending in marketing and direct-to-consumer advertising in some of
the major metropolitan services areas, where we have established a market
presence. Our advertising costs increased from $1.1 million in 2005
to $3.3 million in 2006, a significant portion of which was spent on a branding
awareness campaign for PROMETA. We also incurred higher costs for auditing and
consulting costs for Sarbanes-Oxley Section 404 compliance and new initiatives
for expanding our business to managed care, statewide agencies, government
affairs, the gay community and international developmental
activities.
In
2006 we incurred approximately $3.1 million for research and development,
compared to $2.6 million in 2005, as we funded unrestricted grants for research
studies to evaluate the clinical effectiveness of our PROMETA Treatment
Programs and commenced additional commercial pilot
studies.
Interest
Income
Interest income increased from $834,000
in 2005 to $1.6 million in 2006 primarily due to higher average marketable
securities balances from the proceeds of our $40 million equity offering in
November 2005 and an increase in the weighted average interest rates during
2006.
Behavioral
Health Managed Care Services
The
following table summarizes the operating results for behavioral health managed
care services for the period January 13 through December 31, 2007, which
consisted entirely of the operations of CompCare subsequent to our acquisition
of a majority controlling interest in CompCare on January 12, 2007 and related
purchase accounting adjustments. CompCare’s operating results for prior periods
are not included in our consolidated financial statements.
(Dollar
amounts in thousands)
|
For the period January 13
through December
31,
|
||
|
2007
|
||
Revenues
|
|||
Capitated
contracts
|
$ | 35,226 | |
Non-capitated
contracts
|
1,080 | ||
Total
revenues
|
36,306 | ||
Operating
Expenses
|
|||
Claims
expense
|
29,041 | ||
Other
behavioral health managed care services expense
|
6,638 | ||
Total
healthcare operating expense
|
35,679 | ||
General
and administrative expenses
|
3,721 | ||
Depreciation
and amortization
|
923 | ||
Loss
from operations
|
(4,017 | ) | |
Other
non-operating income, net
|
32 | ||
Interest
income
|
143 | ||
Interest
expense
|
(263 | ) | |
Loss
before provision for income taxes
|
$ | (4,105 | ) |
Total
membership
|
1,025,000 | ||
Medical
Loss Ratio (1)
|
82 | % |
(1) Medical
loss ratio reflects claims expenses as a percentage of revenue of capitated
contracts.
Revenues
Revenues
for the period January 13 through December 31, 2007 include $14.6 million
attributable to the new HMO client in Indiana now with 279,000 Medicaid
recipients. This contract started on January 1, 2007, accounted for 40% of
behavioral health managed care services revenues in 2007. The premiums for this
agreement were based on actuarial assumptions on the level of utilization of
benefits by members covered under this new managed care behavioral health
program and have limited historical basis. The premiums based on these
assumptions may be insufficient to cover the benefits provided and CompCare may
be unable to obtain offsetting rate increases. Contract premiums have been set
based on anticipated significant savings and on types of utilization management
that may not be possible, which may cause disagreements with providers that
divert management resources and that may have an adverse impact on our
consolidated financial statements in future periods. To offset high utilization
costs during 2007, CompCare is negotiating and believes it will
receive a rate increase effective January 1, 2008, provided it complies with
monthly performance measures it believes it will meet. The rate
increase would amount to approximately $2.0 million per
annum.
Operating
Expenses
The medical loss ratio amounted to 82%
for the period January 13 through December 31, 2007, and reflects increased
member utilization during the months of March, April and May due to historical
seasonality and from higher utilization of services by members during the
initial months under the new contract with the Indiana HMO client. Providing
services under a new contract for populations at risk that have not yet been
managed previously
necessitates
the adjustment to an increased level of management and approval
called for in the managed care agreements. It typically takes time
and resources to facilitate the adjustment to the new environment by the
providers and other participants in the system. As a result, higher
utilization and related claims costs were incurred at the beginning of this
contract compared to what we expect to incur in the future as the population
becomes more accustomed to managed care. There has been higher utilization
during the first year of the contract for services to members that were
currently receiving treatment or had previously received treatment prior to the
start of the contract. In response, CompCare hired additional personnel and
contracted for more psychiatrist services. In addition, to help better manage
the care for new members seeking treatment, the higher amount of initial
authorizations experienced in the first month of the contract were reduced so
that the needs of the members could be better evaluated. All of these
measures have reduced authorizations granted in subsequent
months. CompCare is taking additional steps to further increase
management of this population, including working with providers to facilitate
appropriate levels of care and more strictly applying benefit definitions. Due
to the factors discussed above, the medical loss ratio for this contract
amounted to 100% for the period January 13 through December 31, 2007.
As
discussed above, CompCare is
negotiating and believes it will receive a rate increase effective January
1, 2008, provided it complies with monthly performance measures it
believes it will meet. The rate increase would amount to
approximately $2.0 million per annum.
Other healthcare expenses, which are
attributable to servicing both capitated and non-capitated contracts, were 18%
of operating revenue for the period January 13 through December 31,
2007.
General and administrative expenses for
the period January 13 through December 31, 2007 reflect $416,000 in costs
incurred as a result of the retirement of CompCare’s previous CEO, which
represented two years of base salary pursuant to a change in control provision
in her employment agreement. General and administrative expenses for this period
also reflect approximately $239,000 in costs and expenses resulting from the
acquisition and proposed merger between Hythiam and CompCare, and for legal
services in defense against two class action lawsuits related to the proposed
merger that have subsequently been dismissed.
Depreciation and amortization for the
period January 13 through December 31, 2007 includes $775,000 of amortization
related to the fair value attributable to managed care contracts and other
identifiable intangible assets acquired as part of the CompCare
acquisition.
Interest
Expense
Interest
expense relates to the $2.0 million in 7.5% convertible subordinated debentures
at CompCare and includes approximately $78,000 of amortization related to the
purchase price allocation adjustment related to the CompCare acquisition for the
period January 13 through December 31, 2007.
Liquidity
and Capital Resources
We have financed our operations, since
inception, primarily through the sale of shares of our common stock in public
and private placement stock offerings. The following table sets forth a
summary of our equity offering proceeds, net of expenses, since our inception
(in millions):
Date
|
Transaction
Type
|
Amount
|
||
September
2003
|
Private
Placement
|
$ 21.3
|
||
December
2004
|
Private
Placement
|
21.3
|
||
November
2005
|
Public
Offering
|
40.2
|
||
December
2006
|
Private
Placement
|
24.4
|
||
November
2007
|
Registered
Direct Placment
|
42.8
|
||
$ 150.0
|
On
November 7, 2007, we completed a registered direct placement, in which we
issued an aggregate of 9,635,000 shares of common stock at a price of $4.79 per
share, for gross proceeds of approximately $46.2 million, with select
institutional investors. We also issued 5-year warrants to purchase an aggregate
of approximately 2.4 million additional shares of our common stock at an
exercise price of $5.75 per share. Included in the gross proceeds
was
$5.35 million from the conversion of $5 million of the senior secured notes
issued to Highbridge (see discussion below), which includes $350,000 based on a
redemption price of 107% of the principal amount being redeemed pursuant to a
redemption agreement entered into with Highbridge in November 2007. The fair
value of the warrants at the date of issue was estimated at $6.3 million,
accounted for as a liability in accordance with EITF 00-19. We intend
to use the proceeds of the registered direct common stock placement for working
capital and general corporate purposes. We incurred approximately $3.4 million
in fees to placement agents and other transaction costs in connection with the
transaction, of which $1.2 million was accrued and payable at December 31,
2007.
In
December 2006, we issued 3,573,000 shares of common stock at a price of
$7.30 per share in a closed private placement offering for a total of $26.1
million in proceeds from funds affiliated with existing investors and accredited
institutional investors. We paid $1.8 million in placement fees to the
underwriters in connection with the transaction.
In
November 2005, we completed an underwritten equity offering of 9,200,000 shares
at a price of $4.75 per share for a total of $43.7 million in
proceeds. We paid $3.1 million in placement fees to the underwriters
in connection with the transaction.
We
received $10 million in proceeds from the issuance of a secured note to finance
the cash portion of our acquisition cost to acquire a controlling interest in
CompCare, and we received an additional $2.0 million of proceeds from exercises
of stock options and warrants during the year ended December 31,
2007.
As
of December 31, 2007, we had a balance of approximately $47.0 million in cash,
cash equivalents and marketable securities, of which approximately $6.3 million
is held by CompCare. As of December 31, 2007, approximately $19 million of our
marketable securities consisted of auction rate securities, which are
variable-rate instruments with longer stated maturities whose interest rates are
reset at predetermined short-term intervals through a Dutch auction system.
Through February 13, 2008, all of our auction rate securities held at December
31, 2007 had completed at least one auction successfully through the normal
auction process, and we had reduced our total investments in auction rate
securities to $11.5 million. However, from February 14 through March 12, 2008,
auctions for these securities had failed, meaning the parties desiring to sell
securities could not be matched with an adequate number of buyers, resulting in
our having to continue to hold these securities. Although the securities
are Aaa/AAA rated and collateralized by portfolios of student loans guaranteed
by the U.S. government, based on current market conditions it is likely that
auctions will continue to be unsuccessful, limiting the short-term liquidity of
these investments until the auction succeeds, the issuer calls the securities,
or they mature. As a result, our ability to liquidate our investment
and fully recover the carrying value of our investment in the near term may be
limited or not exist. If the issuers are unable to successfully close future
auctions or their credit ratings deteriorate, we may in the future record an
impairment charge on these investments. In addition, these types of developments
could cause us to reclassify our investments in auction rate securities from a
current asset to a long-term asset. We believe that the higher reset
rates on failed auctions provide sufficient incentive for the security issuers
to address this lack of liquidity. While these failures in the auction process
have affected our ability to access these funds in the near term, we do not
believe that the underlying securities or collateral have been affected.
At this time, we have not obtained sufficient evidence to conclude that these
investments are impaired or that they will not be settled in the short term,
although the market for these investments is uncertain. We believe that we will
not require access to these funds in the near-term prior to restoration of
liquidity in this market. These securities will be analyzed each reporting
period for other-than-temporary impairment factors. If the credit rating of
the security issuers deteriorates, we may be required to adjust the carrying
value of these investments through an impairment charge.
In
January 2008, we streamlined our operations to increase our focus on disease
management and managed care opportunities, which is expected to result in an
overall reduction of 25% to 30% of cash operating expenses for the fiscal year
ending December 31, 2008. The actions we took included eliminating field and
regional sales personnel and related corporate support personnel, closing the
PROMETA Center in San Francisco, a reduction in outside consultants
and overall reductions in overhead costs. Estimated one-time costs
associated with these actions were approximately $1.0 million and will be
recognized as a charge to operating expenses in the statement of operations for
the quarter ended March 31, 2008. Such costs primarily represent severance and
related benefits and costs incurred to close the San Francisco PROMETA Center.
We do not expect to incur any material additional costs associated with this
initiative. We also anticipate that in addition to previously entered into and
announced business relationships, new disease management agreements from labor
unions, self-insured employers, and managed care
health
plans will add to the current private pay revenue base and result in higher
revenues for 2008. The combination of increased revenues and cost reductions is
expected to reduce the company's net cash utilization for 2008 compared to 2007.
Following the streamlining actions taken in January 2008, we anticipate that our
cash operating expenditures will average approximately $2.5 million per month
for the remainder of 2008 compared to an average of approximately $3.6 million
per month in the fourth quarter of 2007, excluding research and
development costs and costs incurred by our consolidated subsidiary, CompCare,
as discussed below. We plan to spend approximately $4.9 million in 2008 for
research and development. CompCare had positive net cash flow in 2007,
principally due to new contracts that started January 1, 2007, but is expected
to incur negative cash flows during 2008 resulting from increased claims
expense. However, CompCare believes that it has sufficient cash reserves to
sustain its current operations and to meet its obligations. Because of the
significant publicly held minority interest in CompCare, we do not anticipate
receiving dividends from CompCare or otherwise having access to cash flows
generated by CompCare’s business.
In
2006 and 2007, we expended approximately $957,000 and $1.5 million,
respectively, in capital expenditures for the build-out and equipping of the new
PROMETA Center in San Francisco, the purchase of computers and office equipment
for the increase in staff, expansion of our corporate office facilities and
additional investments in the development of our information systems and other
equipment needs. We expect our capital expenditures to be approximately $900,000
in 2008, primarily for the purchase of computer software related to our planned
disease management products, computers and office equipment for our staff and
additional investments in the development of our information systems. Capital
spending by CompCare in 2008 is not expected to be material. Our future capital
requirements will depend upon many factors, including progress with our
marketing efforts, the time and costs involved in preparing, filing,
prosecuting, maintaining and enforcing patent claims and other proprietary
rights, the necessity of, and time and costs involved in obtaining, regulatory
approvals, competing technological and market developments, and our ability to
establish collaborative arrangements, effective commercialization, marketing
activities and other arrangements.
We
expect to continue to incur negative cash flows and net losses for at least the
next twelve months. Based upon our current plans, including anticipated
revenues, we believe that our existing cash, cash equivalents and marketable
securities, together with the estimated proceeds from the November 7, 2007
offering discussed above, will be sufficient to fund our operating expenses and
capital requirements until we generate positive cash flows, which we believe
will be within the next two years. Our ability to meet our obligations as
they become due and payable will depend on our ability to delay or reduce
operating expenses, sell securities, borrow funds or some combination thereof.
We may also seek to raise additional capital through public or private financing
or through collaborative arrangements with strategic partners. We may also seek
to raise additional capital through public or private financing in order to
increase the amount of our cash reserves on hand. We may not be successful in
raising necessary funds on acceptable terms, or at all. If this
occurs, and we do not or are unable to borrow funds or sell additional
securities, we may be unable to meet our cash obligations as they become due and
we may be required to delay or reduce operating expenses and curtail our
operations, which would have a material adverse effect on us.
CompCare
Acquisition and Financing
In
January 2007, we acquired all of the outstanding membership interests of
Woodcliff for $9 million in cash and approximately 215,000 shares of our common
stock. Woodcliff owns 1,739,000 shares of common stock and 14,400 shares of
Series A Convertible Preferred Stock of CompCare, the conversion of which would
result in us owning over 50% the outstanding shares of common stock of CompCare.
The preferred stock has voting rights and, combined with the common shares held
by us, gives us voting control over CompCare. The preferred stock
gives us rights, including:
·
|
the
right to designate the majority of CompCare’s board of
directors
|
·
|
dividend
and liquidation preferences, and
|
·
|
anti-dilution
protection.
|
In
addition, without our consent, CompCare is prevented from engaging in any of the
following transactions:
·
|
any
sale or merger involving a material portion of assets or
business
|
·
|
any
single or series of related transactions in excess of $500,000,
and
|
·
|
incurring
any debt in excess of $200,000.
|
In
January 2007, to finance the CompCare acquisition, we entered into a securities
purchase agreement pursuant to which we sold to Highbridge (a) $10 million
original principal amount of senior secured notes and (b) warrants to purchase
up to approximately 250,000 shares of our common stock (adjusted to 285,000
shares as of December 31, 2007). The note bears interest at a rate of prime plus
2.5%, interest payable quarterly commencing on April 15, 2007, and matures on
January 15, 2010, with an option for Highbridge to demand redemption of the
Notes after 18 months from the date of issuance.
In
connection with the debt financing, we entered into a security agreement
granting Highbridge a first-priority perfected security interest in all of our
assets now owned or thereafter acquired. We also entered into a pledge agreement
with Highbridge, as collateral agent, pursuant to which we will deliver equity
interests evidencing 65% of our ownership of our foreign subsidiaries. In the
event of a default, the collateral agent is given broad powers to sell or
otherwise deal with the pledged collateral.
As
discussed above, we redeemed $5 million in principal related to the senior
secured notes on November 7, 2007.
The
acquisition of Woodcliff and a majority controlling interest in CompCare did not
require any material amount of additional cash investment or expenditures by us
in 2007, and is not expected to do so in 2008, other than expenditures expected
to be made by CompCare from its existing cash reserves and cash flow from its
operations.
The
unpaid claims liability for managed care services is estimated using an
actuarial paid completion factor methodology and other statistical
analyses. These estimates are subject to the effects of trends in
utilization and other factors. Any significant increase in member
utilization that falls outside of our estimations would increase healthcare
operating expenses and may impact the ability for these plans to achieve and
sustain profitability and positive cash flow. Although considerable variability
is inherent in such estimates, we believe that the unpaid claims liability is
adequate. However, actual results could differ from the $5.5 million claims
payable amount reported as of December 31, 2007.
Legal
Proceedings
From
time to time, we may be involved in litigation relating to claims arising out of
our operations in the normal course of business. As of the date of
this report, we are not currently involved in any legal proceeding that we
believe would have a material adverse effect on our business, financial
condition or operating results.
Contractual
Obligations and Commercial Commitments
The following table sets forth a
summary of our material contractual obligations and commercial commitments as of
December 31, 2007 (in thousands):
Contractual
Obligations
|
Total
|
Less
than 1 year
|
1
- 3 years
|
3
- 5 years
|
More
than 5 years
|
||||||||||
Long-term
debt obligations, including interest
|
$ | 8,434 | $ | 5,290 | $ | 3,144 | $ | - | $ | - | |||||
Claims
payable (1)
|
5,464 | 5,464 | - | - | - | ||||||||||
Reinsurance
claims payable (2)
|
2,526 | - | 2,526 | - | - | ||||||||||
Capital
lease obligations
|
607 | 231 | 297 | 79 | - | ||||||||||
Operating
lease obligations (3)
|
4,643 | 1,624 | 2,611 | 408 | - | ||||||||||
Contractual
commitments for clinical studies
|
4,150 | 4,150 | - | - | - | ||||||||||
$ | 25,824 | $ | 16,759 | $ | 8,578 | $ | 487 | $ | - |
(1)
|
These
claim liabilities represent the best estimate of benefits to be paid under
capitated contracts and consist of reserves for claims and IBNR. Because
of the nature of such contracts, there is typically no minimum contractual
commitment associated with covered claims. Both the amounts and timing of
such payments are estimates, and the actual claims paid could differ from
the estimated amounts presented.
|
(2)
|
This
item represents a liability relating to denied claims for a terminated
reinsurance contract. Any adjustment to the reinsurance claims liability
subsequent to December 31, 2007 would be accounted for in our statement of
operations in the period in which the adjustment is
determined.
|
(3)
|
Operating
lease commitments for our and CompCare’s corporate office facilities, two
PROMETA Centers, including deferred rent liability, a managed treatment
center in Dallas, Texas and facilities related to our international
operations.
|
Off-Balance
Sheet Arrangements
As of December 31, 2007, we had no
off-balance sheet arrangements.
Effects
of Inflation
Our most liquid assets are cash,
cash equivalents and marketable securities. Because of their liquidity, these
assets are not directly affected by inflation. Because we intend to retain and
continue to use our equipment, furniture and fixtures and leasehold
improvements, we believe that the incremental inflation related to replacement
costs of such items will not materially affect our operations. However, the rate
of inflation affects our expenses, such as those for employee compensation and
contract services, which could increase our level of expenses and the rate at
which we use our resources.
Critical
Accounting Estimates
The
discussion and analysis of our financial condition and results of operations is
based upon our financial statements, which have been prepared in accordance with
accounting principles generally accepted in the United States. Generally
accepted accounting principles require management to make estimates, judgments
and assumptions that affect the reported amounts of assets, liabilities,
revenues and expenses, and the disclosure of contingent assets and liabilities.
We base our estimates on experience and on various other assumptions that we
believe to be reasonable under the circumstances, the results of which form the
basis for making judgments about the carrying values of assets and liabilities
that may not be readily apparent from other sources. On an on-going basis,
we evaluate the appropriateness of our estimates and we maintain a thorough
process to review the application of our accounting policies. Our
actual results may differ from these estimates.
We
consider our critical accounting estimates to be those that (1) involve
significant judgments and uncertainties, (2) require estimates that are
more difficult for management to determine, and (3) may produce materially
different results when using different assumptions. We have discussed these
critical accounting estimates,
the
basis for their underlying assumptions and estimates and the nature of our
related disclosures herein with the audit committee of our board of directors.
We believe our accounting policies specific to behavioral health managed care
services revenue recognition, managed care premium deficiencies, accrued claims
payable and claims expense for managed care services, share-based compensation
expense and the impairment assessments for goodwill and other intangible assets
involve our most significant judgments and estimates that are material to our
consolidated financial statements. They are discussed further
below:
Managed
Care Services Revenue Recognition
We
provide managed behavioral healthcare and substance abuse services to
recipients, primarily through subcontracts with HMOs. Revenue under
the vast majority of these agreements is earned and recognized monthly based on
the number of covered members as reported to us by our clients regardless of
whether services actually provided are lesser or greater than anticipated when
we entered into such contracts (generally referred to as capitation
arrangements). The information regarding qualified participants is supplied by
CompCare’s clients and CompCare reviews membership eligibility records and other
reported information to verify its accuracy in determining the amount of revenue
to be recognized. Consequently, the vast majority of our revenue is determined
by the monthly receipt of covered member information and the associated payment
from the client, thereby removing uncertainty and precluding us from needing to
make assumptions to estimate monthly revenue amounts.
We
may experience adjustments to our revenues to reflect changes in the number and
eligibility status of members subsequent to when revenue is
recognized. Subsequent adjustments to our revenue have not been
material.
Premium
Deficiencies
CompCare
accrues losses under capitated contracts when it is probable that a loss has
been incurred and the amount of the loss can be reasonably estimated. CompCare
performs this loss accrual analysis on a specific contract basis taking into
consideration such factors as future contractual revenue, projected future
healthcare and maintenance costs, and each contract's specific terms related to
future revenue increases as compared to expected increases in healthcare costs.
The projected future healthcare and maintenance costs are estimated based on
historical trends and our estimate of future cost increases.
At
any time prior to the end of a contract or contract renewal, if a capitated
contract is not meeting its financial goals, CompCare generally has the ability
to cancel the contract with 60 to 90 days written notice. Prior to
cancellation, CompCare will usually submit a request for a rate increase
accompanied by supporting utilization data. Although CompCare’s
clients have historically been generally receptive to such requests, no
assurance can be given that such requests will be fulfilled in the future in
CompCare’s favor. If a rate increase is not granted, CompCare has the
ability to terminate the contract and limit its risk to a short-term
period.
On
a quarterly basis, CompCare performs a review of its portfolio of contracts for
the purpose of identifying loss contracts (as defined in the American Institute
of Certified Public Accountants Audit and Accounting Guide – Health Care
Organizations) and developing a contract loss reserve, if applicable, for
succeeding periods. During the period January 13 through December 31, 2007,
CompCare identified two contracts that were not meeting their financial goals.
CompCare successfully obtained a rate increase from one client effective January
1, 2008. CompCare is negotiating and believes it will receive a rate
increase from the other client effective January 1, 2008, provided it complies
with monthly performance measures it believes it will meet. The
rate increase would amount to approximately $2.0 million per annum. At December
31, 2007, CompCare believes no contract loss reserve for future periods is
necessary for these contracts.
Accrued
Claims Payable and Claims Expense
Behavioral
health managed care operating expenses are composed of claims expense and other
healthcare expenses. Claims expense includes amounts paid to
hospitals, physician groups and other managed care organizations under capitated
contracts. Other healthcare expenses include items such as information systems,
provider contracting, case management and quality assurance, attributable to
both capitated and non-capitated contracts.
The
cost of behavioral health services is recognized in the period in which an
eligible member actually receives services and includes an estimate of IBNR.
CompCare contracts with various healthcare providers including hospitals,
physician groups and other managed care organizations either on a discounted
fee-for-service or a per-case basis. CompCare determines that a
member has received services when it receives a claim within the contracted
timeframe with all required billing elements correctly completed by the service
provider. CompCare then determines whether (1) the member is eligible
to receive such services, (2) the service provided is medically necessary and is
covered by the benefit plan’s certificate of coverage, and (3) the service has
been authorized by one of CompCare’s employees. If all of these
requirements are met, the claim is entered into CompCare’s claims system for
payment and the associated cost of behavioral health services is recognized. If
the claim is denied, the service provider is notified and has appeal rights
under their contract with us.
Accrued
claims payable consists primarily of CompCare’s reserves established for
reported claims and claims that have been incurred but not reported (IBNR),
which are unpaid through the respective balance sheet dates. CompCare’s policy
is to record management’s best estimate of IBNR. The IBNR liability is estimated
monthly using an actuarial paid completion factor methodology and is continually
reviewed and adjusted, if necessary, to reflect any change in the estimated
liability as more information becomes available. In deriving an initial range of
estimates, CompCare’s management uses an actuarial model that incorporates past
claims payment experience, enrollment data and key assumptions such as trends in
healthcare costs and seasonality. Authorization data, utilization statistics,
calculated completion percentages and qualitative factors are then combined with
the initial range to form the basis of management’s best estimate of the accrued
claims payable balance.
At
December 31, 2007, CompCare’s management determined its best estimate of the
accrued claims liability to be $5.5 million. Approximately $2.3 million of the
$5.5 million accrued claims payable balance at December 31, 2007 is attributable
to the new major HMO contract in Indiana that started January 1,
2007. As of December 31, 2007 CompCare has accrued as claims expense
approximately 100% of the revenue from this contract. Due to limited historical
claims payment data, CompCare’s management estimated the IBNR for this contract
primarily by using estimated completion factors based on authorization
data.
Accrued
claims payable at December 31, 2007 comprises approximately $1.1 million of
submitted and approved claims, which had not yet been paid, and $4.4 million for
IBNR claims.
Many
aspects of the managed care business are not predictable with consistency, and
therefore, estimating IBNR claims involves a significant amount of management
judgment. Actual claims incurred could differ from the estimated
claims payable amount presented. The following are factors that would
have an impact on CompCare’s future operations and financial
condition:
·
|
Changes
in utilization patterns
|
·
|
Changes
in healthcare costs
|
·
|
Changes
in claims submission timeframes by
providers
|
·
|
Success
in renegotiating contracts with healthcare
providers
|
·
|
Adverse
selection
|
·
|
Changes
in benefit plan design
|
·
|
The
impact of present or future state and federal
regulations
|
A
5% increase or decrease in assumed healthcare cost trends from those used in the
calculations of IBNR at December 31, 2007, could increase or decrease CompCare’s
claims expense by approximately $193,000.
Share-based
expense
Commencing
January 1, 2006, we implemented the accounting provisions of SFAS 123R on a
modified-prospective basis to recognize share-based compensation for employee
stock option awards in our statements of operations for future periods. We
accounted for the issuance of stock, stock options and warrants for services
from non-employees in accordance with SFAS 123, “Accounting for Stock-Based
Compensation.” and the FASB Emerging Issues Task Force
Issue No. 96-18, “Accounting For Equity Instruments That Are Issued To
Other Than Employees For Acquiring Or In Conjunction With Selling Goods Or
Services.” We estimate the fair value of options and warrants issued using the
Black-Scholes pricing model. This model’s calculations include the exercise
price, the market price of shares on grant date, weighted average assumptions
for risk-free interest rates, expected life of the option or warrant, expected
volatility of our stock and expected dividend yield.
The
amounts recorded in the financial statements for share-based expense could vary
significantly if we were to use different assumptions. For example, the
assumptions we have made for the expected volatility of our stock price have
been based on the historical volatility of our stock and the stock of other
public healthcare companies, measured over a period generally commensurate with
the expected term, since we have a limited history as a public company and
complete reliance on our actual stock price volatility would not be meaningful.
If we were to use the actual volatility of our stock price, there may be a
significant variance in the amounts of share-based expense from the amounts
reported. Based on the 2007 assumptions used for the Black-Scholes pricing
model, a 50% increase in stock price volatility would have increased the fair
values of options by approximately 25%. The weighted average expected option
term for 2007 and 2006 reflects the application of the simplified method set out
in SEC Staff Accounting Bulletin No. 107, which defines the life as the average
of the contractual term of the options and the weighted average vesting period
for all option tranches.
Goodwill
We
evaluate goodwill for impairment annually based on the estimated fair value of
our healthcare services reportable segment. We test for impairment on a more
frequent basis in cases where events and changes in circumstances would indicate
that we might not recover the carrying value of goodwill. In estimating the fair
value, management considers both the income and market approaches to fair value
determination. The income approach is based on a discounted cash flow
methodology, in which management makes its best assumptions regarding future
cash flows and a discount rate to be applied to the cash flows to yield a
present, fair value of the reporting unit. The market approach is based
primarily on reference to transactions involving the company’s common stock and
the quoted market prices of the company’s common stock. As a result of such
tests, management believes there is no material risk of loss from impairment of
goodwill. However, actual results may differ significantly from
management’s assumptions, resulting in potentially adverse impact to our
consolidated financial statements.
Impairment
of intangible assets
We
have capitalized significant costs, and plan to capitalize additional costs, for
acquiring patents and other intellectual property directly related to our
products and services. We will continue to evaluate our intangible assets for
impairment on an ongoing basis by assessing the future recoverability of such
capitalized costs based on estimates of our future revenues less estimated
costs. Since we have not recognized significant revenues to date, our estimates
of future revenues may not be realized and the net realizable value of our
capitalized costs of intellectual property may become impaired. In December
2005, we recorded an impairment charge of $272,000 to write off the capitalized
costs of intellectual property relating to an acquired patent for a treatment
method for opiate addiction that we have determined would not likely be utilized
in our current business plan. As a result of a non-cash stock settlement
agreement reached in August 2007 with seller of the opiate patent, we released
310,000 shares of our common stock, which shares had been subject to a stock
pledge agreement pending the resolution of certain contingencies, as additional
consideration related to the purchase of the patent. The fair market value of
these shares amounted to $2.4 million, based on the closing stock price on the
date of the settlement, and was recorded as an additional impairment loss for
the year ended December 31, 2007. We recorded no impairment charges in
2006.
Recent
Accounting Pronouncements
In
September 2006, The FASB issued SFAS No. 157, “Fair Value Measurements,” SFAS
157 which defines fair value, establishes a framework for measuring fair value
in generally accepted accounting principles, and expands disclosures about fair
value measurements. The statement is effective for financial statements issued
for fiscal years beginning after November 15, 2007, and interim periods within
those fiscal years. The adoption of SFAS No. 157 is not expected to have a
material impact on our financial position, results of operations or cash
flows.
In
February 2007, the FASB issued SFAS No. 159, "The Fair Value Option for
Financial Assets and Financial Liabilities" ("SFAS 159"). SFAS 159 allows
companies to measure many financial assets and liabilities at fair value. It
also establishes presentation and disclosure requirements designed to facilitate
comparisons between companies that choose different measurement attributes for
similar types of assets and liabilities. SFAS 159 is effective for financial
statements issued for fiscal years beginning after November 15, 2007 and
interim periods within those fiscal years. The adoption of SFAS No. 159 is
not expected to have a material impact on our financial position, results of
operations or cash flows.
In
December 2007, the FASB issued SFAS No. 141(R), "Business Combinations"
("SFAS 141(R)"). SFAS 141(R) replaces SFAS No. 141, "Business Combinations", but
retains the requirement that the purchase method of accounting for acquisitions
be used for all business combinations. SFAS 141(R) expands on the disclosures
previously required by SFAS 141, better defines the acquirer and the acquisition
date in a business combination, and establishes principles for recognizing and
measuring the assets acquired (including goodwill), the liabilities assumed and
any non-controlling interests in the acquired business. SFAS 141(R) also
requires an acquirer to record an adjustment to income tax expense for changes
in valuation allowances or uncertain tax positions related to acquired
businesses. SFAS 141(R) is effective for all business combinations with an
acquisition date in the first annual period following December 15, 2008;
early adoption is not permitted. We will adopt this statement as of January 1,
2009. We are currently evaluating the impact SFAS 141(R) will have on our
consolidated financial statements.
In
December 2007, the FASB issued SFAS No. 160, "Noncontrolling Interests in
Consolidated Financial Statements—an amendment of ARB No. 51" ("SFAS 160").
SFAS 160 requires that non-controlling (or minority) interests in subsidiaries
be reported in the equity section of the company's balance sheet, rather than in
a mezzanine section of the balance sheet between liabilities and equity. SFAS
160 also changes the manner in which the net income of the subsidiary is
reported and disclosed in the controlling company's income statement. SFAS 160
also establishes guidelines for accounting for changes in ownership percentages
and for deconsolidation. SFAS 160 is effective for financial statements for
fiscal years beginning on or after December 1, 2008 and interim periods
within those years. The adoption of SFAS 160 is not expected to have a material
impact on our financial position, results of operations or cash
flows.
ITEM
7A. QUANTITATIVE
AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
We invest our cash in short term high
grade commercial paper, certificates of deposit, money market accounts and
marketable securities. We consider any liquid investment with an original
maturity of three months or less when purchased to be cash equivalents. We
classify investments with maturity dates greater than three months when
purchased as marketable securities, which have readily determined fair values
and are classified as available-for-sale securities. Our investment policy
requires that all investments be investment grade quality and no more than ten
percent of our portfolio may be invested in any one security or with one
institution.
As
of December 31, 2007, approximately $19 million of our marketable securities
consisted of auction rate securities, which are variable-rate instruments with
longer stated maturities whose interest rates are reset at predetermined
short-term intervals through a Dutch auction system. Through February 13, 2008,
all of our auction rate securities held at December 31, 2007 had completed at
least one auction successfully through the normal auction process, and we had
reduced our total investments in auction rate securities to $11.5 million.
However, from February 14 through March 12, 2008, auctions for these securities
had failed, meaning the parties desiring to sell securities could not be matched
with an adequate number of buyers, resulting in our having to continue to hold
these securities. Although the securities are Aaa/AAA rated and
collateralized by portfolios of student loans guaranteed by the U.S. government,
based on current market conditions it is likely that auctions will continue to
be unsuccessful,
limiting
the short-term liquidity of these investments until the auction succeeds, the
issuer calls the securities, or they mature. As a result, our ability
to liquidate our investment and fully recover the carrying value of our
investment in the near term may be limited or not exist. If the issuers are
unable to successfully close future auctions or their credit ratings
deteriorate, we may in the future record an impairment charge on these
investments. In addition, these types of developments could cause us to
reclassify our investments in auction rate securities from a current asset to a
long-term asset. We believe that the higher reset rates on failed
auctions provide sufficient incentive for the security issuers to address this
lack of liquidity. While these failures in the auction process have affected our
ability to access these funds in the near term, we do not believe that the
underlying securities or collateral have been affected. At this time, we
have not obtained sufficient evidence to conclude that these investments are
impaired or that they will not be settled in the short term, although the market
for these investments is uncertain. We believe that we will not require access
to these funds in the near-term prior to restoration of liquidity in this
market. These securities will be analyzed each reporting period for
other-than-temporary impairment factors. If the credit rating of the
security issuers deteriorates, we may be required to adjust the carrying value
of these investments through an impairment charge.
The
weighted average interest rate of marketable securities held at
December 31, 2007 was 5.49%. Investments in both fixed rate and
floating rate interest earning instruments carry a degree of interest rate
risk arising from changes in the level or volatility of interest rates;
however interest rate movements do not materially affect the market value of our
auction rate securities because of the frequency of the rate resets and the
short-term nature of these investments. A reduction in the overall level of
interest rates may produce less interest income from our investment portfolio.
If overall interest rates had declined by an average of 100 basis points during
2007, the amount of interest income earned from our investment portfolio in 2007
would have decreased by an estimated amount of $368,000. The market
risk associated with our investments in debt securities is substantially
mitigated by the frequent turnover of our portfolio.
ITEM
8. FINANCIAL
STATEMENTS AND SUPPLEMENTARY DATA
Our
consolidated financial statements and related financial information required to
be filed hereunder are indexed under Item 15 of this report and are incorporated
herein by reference.
ITEM
9. CHANGES IN
AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL
DISCLOSURE
None.
ITEM
9A. CONTROLS
AND PROCEDURES
Disclosure
Controls
We
have evaluated, with the participation of our chief executive officer and our
chief financial officer, the effectiveness of our system of disclosure controls
and procedures as of the end of the period covered by this report. Based on this
evaluation our chief executive officer and our chief financial officer have
determined that they are effective in connection with the preparation of this
report.
Management's
Report on Internal Control over Financial Reporting
Our management is responsible for
establishing and maintaining adequate internal control over financial reporting
(as defined in Rule 13a-15(f) under the Exchange Act) and for assessing the
effectiveness of our internal control over financial reporting. Our internal
control system is designed to provide reasonable assurance to our management and
board of directors regarding the preparation and fair presentation of published
financial statements in accordance with United States generally accepted
accounting principles (GAAP).
There
were no changes in our internal controls over financial reporting during the
year ended December 31, 2007 that have materially affected, or are
reasonably likely to materially affect, our internal control over financial
reporting.
Our
internal control over financial reporting is supported by written policies and
procedures that:
·
|
pertain
to the maintenance of records that, in reasonable detail, accurately and
fairly reflect the transactions and dispositions of our
assets;
|
·
|
provide
reasonable assurance that transactions are recorded as necessary to permit
preparation of financial statements in accordance with GAAP and that our
receipts and expenditures are being made only in accordance with
authorizations of our management and our board of directors;
and
|
·
|
provide
reasonable assurance regarding prevention or timely detection of
unauthorized acquisition, use or disposition of our assets that could have
a material effect on our financial
statements.
|
Our
management assessed the effectiveness of our internal control over financial
reporting as of December 31, 2007 using the criteria set forth by the
Committee of Sponsoring Organizations of the Treadway Commission in Internal Control-Integrated
Framework. Management's assessment included an evaluation of the design
of our internal control over financial reporting and testing of the operational
effectiveness of our internal control over financial reporting. Based on this
assessment, our management concluded that, as of December 31, 2007, our
internal control over financial reporting was effective.
Because
of its inherent limitations, a system of internal control over financial
reporting can provide only reasonable assurance and may not prevent or detect
misstatements. In addition, projections of any evaluation of effectiveness to
future periods are subject to the risks that controls may become inadequate
because of changes in conditions and that the degree of compliance with the
policies or procedures may deteriorate.
BDO
Seidman, LLP, the independent registered public accounting firm that audited the
financial statements included in this Annual Report on Form 10-K, was
engaged to attest to and report on the effectiveness of our internal control
over financial reporting as of December 31, 2007. A copy of this report is
included at page F-3 of this Annual Report on Form 10-K.
ITEM
9B. OTHER
INFORMATION
Not
applicable.
PART III
The
information required by Items 10 through 14 of Part III is incorporated by
reference from Item 1 of this report and from registrants’ proxy statement
that will be mailed to stockholders in connection with the registrant’s 2008
annual meeting of stockholders.
PART IV
ITEM
15. EXHIBITS,
FINANCIAL STATEMENT SCHEDULES
(a)(1),(2) Financial
Statements
The Financial Statements and Financial
Statement Schedules listed on page F-1 of this document are filed as part of
this filing.
(a)(3) Exhibits
The following exhibits are filed as
part of this report:
Exhibit
No.
|
Description
|
||
3.1
|
Certificate
of Incorporation of Hythiam, Inc., a Delaware corporation, filed with the
Secretary of State of Delaware on September 29, 2003(1)
|
||
3.2
|
By-Laws
of Hythiam, Inc., a Delaware corporation(1)
|
||
4.1
|
Specimen
Common Stock Certificate(3)
|
||
10.1*
|
2003
Stock Incentive Plan(1)
|
||
10.2*
|
Employment
Agreement of Terren S. Peizer(3)
|
||
10.3*
|
Employment
Agreement of Richard A. Anderson(3)
|
||
10.6*
|
Management
and Support Services Agreement between Hythiam, Inc. and David E. Smith,
M.D. Medical Group, Inc.
(3)
|
||
10.7*
|
Consulting
Services Agreement between Hythiam, Inc. and David E. Smith &
Associates(3)
|
||
10.8*
|
First
Amendment to Consulting Services Agreement between Hythiam, Inc. and David
E. Smith, M.D. Medical Group, Inc.
(4)
|
||
10.9*
|
First
Amendment to Management and Support Services Agreement Services Agreement
between Hythiam, Inc. and David E. Smith, M.D. Medical Group, Inc.
(4)
|
||
10.10*
|
Second
Amendment to Management and Support Services Agreement Services Agreement
between Hythiam, Inc. and David E. Smith, M.D. Medical Group, Inc.
(4)
|
||
10.11*
|
Employment
Agreement of Christopher Hassan(4)
|
||
10.12*
|
2007
Stock Incentive Plan(5)
|
||
10.13
|
Form
of Standard Technology License and Administrative Services
Agreement
|
||
10.14*
|
Second
Amendment to Consulting Services Agreement between Hythiam, Inc. and David
E. Smith, M.D. Medical Group, Inc.
|
||
10.15
|
Redemption
Agreement between Hythiam, Inc. and Highbridge International,
LLC.
|
||
14.1
|
Code
of Conduct and Ethics(2)
|
||
14.2
|
Code
of Ethics for CEO and Senior Financial Officers(2)
|
||
21.1
|
Subsidiaries
of the Company
|
||
23.1
|
Consent
of Independent Registered Public Accounting Firm – BDO Seidman,
LLP
|
||
23.2
|
Consent
of Independent Valuation Specialist – Actuarial Risk
Management
|
||
31.1
|
Certification
by the Chief Executive Officer, pursuant to Rule 13a-14(a) and Rule
15d14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley
Act of 2002
|
||
31.2
|
Certification
by the Chief Financial Officer, pursuant to Rule 13a-14(a) and Rule
15d14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley
Act of 2002
|
||
32.1
|
Certification
by the Chief Executive Officer, pursuant to 18 U.S.C. Section 1350,
as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of
2002
|
||
32.2
|
Certification
by the Chief Financial Officer, pursuant to 18 U.S.C. Section 1350,
as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of
2002
|
(1) | Incorporated by reference to exhibit of the same number to the registrant’s Form 8-K filed September 30, 2003. | |
(2)
|
Incorporated by
reference to exhibit of the same number to the registrant’s annual report
on Form 10-K for the year ended December 31, 2003.
|
|
(3)
|
Incorporated by reference to exhibit of the same number to the registrant's annual report on Form 10-K for the year ended December 31, 2005. |
|
(4) Incorporated
by reference to exhibit of the same number to the registrant's annual
report on Form 10-K for the year ended December 31,
2006.
|
|
(5) Incorporated
by reference to the registrant's Revised Definitive Proxy on Form DEFR14A
filed May 11, 2007.
|
* Management contract or compensatory plan or
arrangement.
SIGNATURES
Pursuant
to the requirements of Section 13 or 15(d) of the Securities Exchange Act
of 1934, the registrant has duly caused this report to be signed on its behalf
by the undersigned, thereunto duly authorized.
HYTHIAM,
INC.
|
|||
Date:
March 17, 2008
|
By:
|
/s/
TERREN S. PEIZER
|
|
Terren
S. Peizer
|
|||
President
and Chief Executive Officer
|
POWER
OF ATTORNEY
Pursuant
to the requirements of the Securities Exchange Act of 1934, this report has been
signed by the following persons on behalf of the registrant and in the
capacities and on the dates indicated.
Signature
|
Title(s)
|
Date
|
||
/s/
TERREN S. PEIZER
|
Chairman
of the Board of Directors and Chief Executive Officer (Principal Executive
Officer)
|
March 17,
2008
|
||
Terren
S. Peizer
|
||||
/s/
CHUCK TIMPE
|
Chief
Financial Officer (Principal Financial Officer)
|
March 17,
2008
|
||
Chuck Timpe
|
||||
/s/
MAURICE HEBERT
|
Corporate
Controller (Principal Accounting Officer)
|
March 17,
2008
|
||
Maurice Hebert
|
||||
/s/
RICHARD A. ANDERSON
|
Director
and Senior Executive Vice President
|
March 17,
2008
|
||
Richard A. Anderson
|
||||
/s/
CHRISTOPHER S. HASSAN
|
Director
and Senior Executive Vice President
|
March 17,
2008
|
||
Christopher S. Hassan
|
||||
/s/
LESLIE F. BELL, ESQ.
|
Director
|
March 17,
2008
|
||
Leslie F. Bell, Esq.
|
||||
/s/
KAREN FREEMAN-WILSON
|
Director
|
March 17,
2008
|
||
Karen
Freeman-Wilson
|
||||
/s/
IVAN M. LIEBERBURG, PH.D., M.D.
|
Director
|
March 17,
2008
|
||
Ivan
M. Lieberburg, Ph.D., M.D.
|
||||
/s/
MARC G. CUMMINS
|
Director
|
March 17,
2008
|
||
Marc G. Cummins
|
||||
/s/
ANDREA GRUBB BARTHWELL, M.D.
|
Director
|
March 17,
2008
|
||
Andrea
Grubb Barthwell, M.D.
|
HYTHIAM,
INC. AND SUBSIDIARIES
Index
to Financial Statements and Financial Statement Schedules
Financial
Statements
Report
of Independent Registered Public Accounting Firm
|
F-2
|
Report
of Independent Registered Public Accounting Firm
|
F-3
|
Consolidated
Balance Sheets as of December 31, 2007 and 2006
|
F-4
|
Consolidated
Statements of Operations for the Years Ended December 31, 2007, 2006,
and 2005
|
F-5
|
Consolidated
Statements of Stockholders’ Equity for Years Ended December 31, 2007, 2006
and 2005
|
F-6
|
Consolidated
Statements of Cash Flows for the Years Ended December 31, 2007, 2006
and 2005
|
F-7
|
Notes
to Consolidated Financial Statements
|
F-8
|
Financial
Statement Schedules
All
financial statement schedules are omitted because they are not applicable, not
required, or the information is shown in the Financial Statements or Notes
thereto.
Report
of Independent Registered Public Accounting Firm
To
the Board of Directors and Shareholders
Hythiam,
Inc.
Los
Angeles, California
We
have audited the accompanying consolidated balance sheets of Hythiam, Inc. as of
December 31, 2007 and 2006 and the related consolidated statements of
operations, stockholders’ equity, and cash flows for each of the three years in
the period ended December 31, 2007. These financial statements are
the responsibility of the Company’s management. Our responsibility is
to express an opinion on these financial statements based on our
audits.
We
conducted our audits in accordance with the standards of the Public Company
Accounting Oversight Board (United States). Those standards require
that we plan and perform the audit to obtain reasonable assurance about whether
the financial statements are free of material misstatement. An audit
also includes examining, on a test basis, evidence supporting the amounts and
disclosures in the financial statements, assessing the accounting principles
used and significant estimates made by management, as well as evaluating the
overall financial statement presentation. We believe that our audits
provide a reasonable basis for our opinion.
In
our opinion, the consolidated financial statements referred to above present
fairly, in all material respects, the financial position of the Company at
December 31, 2007 and 2006, and the results of its operations and its cash flows
for each of the three years in the period ended December 31, 2007, in conformity with
accounting principles generally accepted in the United States of
America.
As
more fully described in Note 1 to the consolidated financial statements,
effective January 1, 2006, the Company adopted the provisions of Statement of
Financial Accounting Standard No.123 (R), “Share-Based Payment.”
We
also have audited, in accordance with the standards of the Public Company
Accounting Oversight Board (United States), the Company’s internal control over
financial reporting as of December 31, 2007, based on criteria established in
Internal Control – Integrated
Framework issued by the Committee of Sponsoring Organizations of the
Treadway Commission (COSO) and our report dated March 14, 2008 expressed an
unqualified opinion thereon.
Los
Angeles, California
March
14, 2008
Report
of Independent Registered Public Accounting Firm
To
the Board of Directors and Shareholders
Hythiam,
Inc.
Los
Angeles, California
We
have audited Hythiam, Inc. and subsidiaries’ (the Company) internal control over
financial reporting as of December 31, 2007, based on criteria established in
Internal Control – Integrated
Framework issued by the Committee of Sponsoring Organizations of the
Treadway Commission (the COSO criteria). The Company’s management is responsible
for maintaining effective internal control over financial reporting and for its
assessment of the effectiveness of internal control over financial reporting,
included in Item 9A, Management’s Report on Internal Control Over Financial
Reporting. Our responsibility is to express an opinion on the Company’s internal
control over financial reporting based on our audit.
We
conducted our audit in accordance with the standards of the Public Company
Accounting Oversight Board (United States). Those standards require that we plan
and perform the audit to obtain reasonable assurance about whether effective
internal control over financial reporting was maintained in all material
respects. Our audit included obtaining an understanding of internal control over
financial reporting, assessing the risk that a material weakness exists, and
testing and evaluating the design and operating effectiveness of internal
control based on the assessed risk. Our audit also included performing such
other procedures as we considered necessary in the circumstances. We believe
that our audit provides a reasonable basis for our opinion.
A
company’s internal control over financial reporting is a process designed to
provide reasonable assurance regarding the reliability of financial reporting
and the preparation of financial statements for external purposes in accordance
with generally accepted accounting principles. A company’s internal control over
financial reporting includes those policies and procedures that (1) pertain to
the maintenance of records that, in reasonable detail, accurately and fairly
reflect the transactions and dispositions of the assets of the company; (2)
provide reasonable assurance that transactions are recorded as necessary to
permit preparation of financial statements in accordance with generally accepted
accounting principles, and that receipts and expenditures of the company are
being made only in accordance with authorizations of management and directors of
the company; and (3) provide reasonable assurance regarding prevention or timely
detection of unauthorized acquisition, use, or disposition of the company’s
assets that could have a material effect on the financial
statements.
Because
of its inherent limitations, internal control over financial reporting may not
prevent or detect misstatements. Also, projections of any evaluation of
effectiveness to future periods are subject to the risk that controls may become
inadequate because of changes in conditions, or that the degree of compliance
with the policies or procedures may deteriorate.
In
our opinion, Hythiam, Inc and subsidiaries maintained, in all material respects,
effective internal control over financial reporting as of December 31, 2007,
based on the COSO criteria.
We
also have audited, in accordance with the standards of the Public Company
Accounting Oversight Board (United States), the consolidated balance sheets of
Hythiam, Inc. as of December 31, 2007 and 2006, and the related consolidated
statements of operations, stockholders’ equity, and cash flows for each of the
three years in the period ended December 31, 2007 and our report dated March 14,
2008 expressed an unqualified opinion thereon.
Los
Angeles, California
March
14, 2008
HYTHIAM, INC. AND
SUBSIDIARIES
|
||||||||
CONSOLIDATED
BALANCE SHEETS
|
||||||||
(In
thousands, except share data)
|
December
31,
|
|||||||
2007
|
2006
|
|||||||
ASSETS
|
||||||||
Current
assets
|
||||||||
Cash
and cash equivalents
|
$ | 11,149 | $ | 5,701 | ||||
Marketable
securities, at fair value
|
35,840 | 37,746 | ||||||
Restricted
cash
|
39 | 82 | ||||||
Receivables,
net
|
1,787 | 637 | ||||||
Notes
receivable
|
133 | - | ||||||
Prepaids
and other current assets
|
1,394 | 383 | ||||||
Total
current assets
|
50,342 | 44,549 | ||||||
Long-term
assets
|
||||||||
Property
and equipment, net of accumulated depreciation
|
||||||||
of
$5,630,000 and $2,224,000, respectively
|
4,291 | 3,711 | ||||||
Goodwill
|
10,557 | - | ||||||
Intangible
assets, less accumulated amortization of
|
||||||||
$1,609,000
and $591,000, respectively
|
4,836 | 3,397 | ||||||
Deposits
and other assets
|
620 | 548 | ||||||
Total
Assets
|
$ | 70,646 | $ | 52,205 | ||||
LIABILITIES
AND STOCKHOLDERS' EQUITY
|
||||||||
Current
liabilities
|
||||||||
Accounts
payable
|
$ | 4,038 | $ | 6,114 | ||||
Accrued compensation and benefits | 2,860 | 2,786 | ||||||
Accrued
liabilities
|
2,030 | 551 | ||||||
Accrued
claims payable
|
5,464 | - | ||||||
Short-term
debt
|
4,742 | - | ||||||
Income
taxes payable
|
94 | - | ||||||
Total
current liabilities
|
19,228 | 9,451 | ||||||
Long-term
liabilities
|
||||||||
Long-term
debt
|
2,057 | - | ||||||
Accrued
reinsurance claims payable
|
2,526 | - | ||||||
Warrant
liability
|
2,798 | - | ||||||
Capital
lease obligations
|
331 | 183 | ||||||
Deferred
rent and other long-term liabilities
|
442 | 542 | ||||||
Total
Liabilities
|
27,382 | 10,176 | ||||||
Commitments and contingencies
(See Note 14)
|
||||||||
Stockholders'
equity
|
||||||||
Preferred
stock, $.0001 par value; 50,000,000 shares authorized;
|
||||||||
no
shares issued and outstanding
|
- | - | ||||||
Common
stock, $.0001 par value; 200,000,000 shares authorized;
|
||||||||
54,335,000
and 43,917,000 shares issued and 54,335,000
|
||||||||
and
43,557,000 shares outstanding at December 31, 2007
|
||||||||
and
December 31, 2006, respectively
|
5 | 4 | ||||||
Additional
paid-in-capital
|
166,460 | 119,764 | ||||||
Accumulated
deficit
|
(123,201 | ) | (77,739 | ) | ||||
Total
Stockholders' Equity
|
43,264 | 42,029 | ||||||
Total
Liabilities and Stockholders' Equity
|
$ | 70,646 | $ | 52,205 | ||||
See
accompanying notes to financial
statements.
|
HYTHIAM, INC. AND
SUBSIDIARIES
|
||||||||||||
CONSOLIDATED
STATEMENTS OF OPERATIONS
|
||||||||||||
(In
thousands, except per share amounts)
|
Year
Ended December 31,
|
|||||||||||
2007
|
2006
|
2005
|
||||||||||
Revenues
|
||||||||||||
Behavioral
health managed care services
|
$ | 36,306 | $ | - | $ | - | ||||||
Healthcare
services
|
7,695 | 3,906 | 1,164 | |||||||||
Total
revenues
|
44,001 | 3,906 | 1,164 | |||||||||
Operating
Expenses
|
||||||||||||
Behavioral
health managed care expenses
|
35,679 | - | - | |||||||||
Cost
of healthcare services
|
2,052 | 818 | 134 | |||||||||
General
and administrative expenses
|
45,554 | 38,680 | 22,105 | |||||||||
Impairment
loss
|
2,387 | - | 272 | |||||||||
Research
and development
|
3,358 | 3,053 | 2,646 | |||||||||
Depreciation
and amortization
|
2,502 | 1,281 | 879 | |||||||||
Total
operating expenses
|
91,532 | 43,832 | 26,036 | |||||||||
Loss
from operations
|
(47,531 | ) | (39,926 | ) | (24,872 | ) | ||||||
Interest
income
|
1,584 | 1,630 | 834 | |||||||||
Interest
expense
|
(2,190 | ) | - | - | ||||||||
Loss
on extinguishment of debt
|
(741 | ) | - | - | ||||||||
Change
in fair value of warrant liability
|
3,471 | - | - | |||||||||
Other
non-operating income, net
|
32 | - | - | |||||||||
Loss
before provision for income taxes
|
(45,375 | ) | (38,296 | ) | (24,038 | ) | ||||||
Provision
for income taxes
|
87 | 2 | - | |||||||||
Net
loss
|
$ | (45,462 | ) | $ | (38,298 | ) | $ | (24,038 | ) | |||
Net
loss per share - basic and diluted
|
$ | (0.99 | ) | $ | (0.96 | ) | $ | (0.77 | ) | |||
Weighted
average number of shares outstanding - basic and diluted
|
45,695 | 39,715 | 31,173 | |||||||||
See
accompanying notes to financial statements.
|
HYTHIAM, INC. AND
SUBSIDIARIES
|
||||||||||||||||||||
CONSOLIDATED
STATEMENTS OF STOCKHOLDERS' EQUITY
|
||||||||||||||||||||
Additional
|
||||||||||||||||||||
(In
thousands)
|
Common
Stock
|
Paid-In
|
Accumulated
|
|||||||||||||||||
Shares
|
Amount
|
Capital
|
Deficit
|
Total
|
||||||||||||||||
Balance
at December 31, 2004
|
29,751 | $ | 3 | $ | 47,234 | $ | (15,403 | ) | $ | 31,834 | ||||||||||
Common
stock, options and warrants
|
||||||||||||||||||||
issued
for outside services
|
23 | - | 1,501 | - | 1,501 | |||||||||||||||
Exercise
of options and warrants
|
170 | - | 265 | - | 265 | |||||||||||||||
Common
stock issued in public
|
||||||||||||||||||||
offering,
net of expenses
|
9,200 | 1 | 40,176 | - | 40,177 | |||||||||||||||
Net
loss
|
- | - | - | (24,038 | ) | (24,038 | ) | |||||||||||||
Balance
at December 31, 2005
|
39,144 | 4 | 89,176 | (39,441 | ) | 49,739 | ||||||||||||||
Common
stock issued for intellectual property
|
||||||||||||||||||||
and
outside services
|
157 | - | 1,064 | - | 1,064 | |||||||||||||||
Options
and warrants issued for
|
||||||||||||||||||||
employee
and outside services
|
- | - | 3,462 | - | 3,462 | |||||||||||||||
Exercise
of options and warrants
|
683 | - | 1,690 | - | 1,690 | |||||||||||||||
Common
stock issued in private
|
||||||||||||||||||||
placement
offering, net of expenses
|
3,573 | - | 24,372 | - | 24,372 | |||||||||||||||
Net
loss
|
- | - | - | (38,298 | ) | (38,298 | ) | |||||||||||||
Balance
at December 31, 2006
|
43,557 | 4 | 119,764 | (77,739 | ) | 42,029 | ||||||||||||||
Common
stock issued for intellectual property
|
||||||||||||||||||||
and
outside services
|
315 | - | 2,447 | - | 2,447 | |||||||||||||||
Options
and warrants issued for
|
||||||||||||||||||||
employee
and outside services
|
- | - | 2,397 | - | 2,397 | |||||||||||||||
Exercise
of options and warrants
|
586 | - | 1,940 | - | 1,940 | |||||||||||||||
Common
stock issued for employee stock
|
||||||||||||||||||||
purchase
plan
|
27 | - | 124 | - | 124 | |||||||||||||||
Common
stock issued for CompCare
|
||||||||||||||||||||
acquisition
|
215 | - | 2,084 | - | 2,084 | |||||||||||||||
Warrants
issued with debt
|
- | - | 1,342 | - | 1,342 | |||||||||||||||
Common
stock issued in registered
|
||||||||||||||||||||
direct
placement, net of expenses
|
9,635 | 1 | 36,362 | - | 36,363 | |||||||||||||||
Net
loss
|
- | - | - | (45,462 | ) | (45,462 | ) | |||||||||||||
Balance
at December 31, 2007
|
54,335 | $ | 5 | $ | 166,460 | $ | (123,201 | ) | $ | 43,264 | ||||||||||
See
accompanying notes to consolidated financial statements.
|
HYTHIAM,
INC. AND SUBSIDIARIES
|
||||||||||||
CONSOLIDATED
STATEMENTS OF CASH FLOWS
|
||||||||||||
Year
ended December 31,
|
||||||||||||
(In
thousands)
|
2007
|
2006
|
2005
|
|||||||||
Operating
activities
|
||||||||||||
Net
loss
|
$ | (45,462 | ) | $ | (38,298 | ) | $ | (24,038 | ) | |||
Adjustments
to reconcile net loss to net cash used in operating
activities:
|
||||||||||||
Depreciation
and amortization
|
2,500 | 1,281 | 879 | |||||||||
Amortization
of debt discount, issuance cost included in interest
expense
|
1,026 | - | - | |||||||||
Provision
for doubtful accounts
|
528 | 281 | 25 | |||||||||
Deferred
rent
|
(6 | ) | 134 | 124 | ||||||||
Share-based
compensation expense
|
2,605 | 3,691 | 1,701 | |||||||||
Impairment
loss
|
2,387 | - | 272 | |||||||||
Loss
on extinguishment of debt
|
741 | - | - | |||||||||
Fair
value adjustment on warrant liability
|
(3,471 | ) | - | - | ||||||||
Loss
on disposition of fixed assets
|
- | - | 64 | |||||||||
Changes
in current assets and liabilities, net of business
acquired:
|
||||||||||||
Receivables
|
(810 | ) | (737 | ) | (136 | ) | ||||||
Prepaids
and other current assets
|
(529 | ) | 141 | (181 | ) | |||||||
Accrued
claims payable
|
2,865 | - | - | |||||||||
Accounts
payable
|
(1,594 | ) | 5,008 | 2,471 | ||||||||
Net
cash used in operating activities
|
(39,220 | ) | (28,499 | ) | (18,819 | ) | ||||||
Investing
activities
|
||||||||||||
Purchases
of marketable securities
|
(80,168 | ) | (47,813 | ) | (80,704 | ) | ||||||
Proceeds
from sales and maturities of marketable securities
|
82,104 | 53,650 | 60,600 | |||||||||
Cash
paid related to acquisition of a business, net of cash
acquired
|
(4,760 | ) | - | - | ||||||||
Restricted
cash
|
43 | (38 | ) | (44 | ) | |||||||
Purchases
of property and equipment
|
(1,142 | ) | (889 | ) | (1,773 | ) | ||||||
Deposits
and other assets
|
152 | (37 | ) | (146 | ) | |||||||
Cost
of intangibles
|
(320 | ) | (143 | ) | (139 | ) | ||||||
Net
cash (used in) provided by investing activities
|
(4,091 | ) | 4,730 | (22,206 | ) | |||||||
Financing
activities
|
||||||||||||
Proceeds
from sale of common stock and warrants
|
37,512 | 24,372 | 40,177 | |||||||||
Cost
related to issuance of common stock
|
(230 | ) | - | - | ||||||||
Cost
related to issuance of debt and warrants
|
(303 | ) | - | - | ||||||||
Proceeds
from issuance of debt and warrants
|
10,000 | - | - | |||||||||
Capital
lease obligations
|
(178 | ) | (9 | ) | - | |||||||
Exercises
of stock options and warrants
|
1,958 | 1,690 | 265 | |||||||||
Net
cash provided by financing activities
|
48,759 | 26,053 | 40,442 | |||||||||
Net
increase in cash and cash equivalents
|
5,448 | 2,284 | (583 | ) | ||||||||
Cash and cash
equivalents at beginning of
period
|
5,701 | 3,417 | 4,000 | |||||||||
Cash and cash
equivalents at end of
period
|
$ | 11,149 | $ | 5,701 | $ | 3,417 | ||||||
Supplemental
disclosure of cash paid
|
||||||||||||
Interest
|
$ | 1,059 | $ | - | $ | - | ||||||
Income
taxes
|
36 | 2 | - | |||||||||
Supplemental
disclosure of non-cash activity
|
||||||||||||
Common
stock, options and warrants issued for outside services
|
$ | 232 | $ | 97 | $ | - | ||||||
Common
stock issued for intellectual property
|
- | 738 | - | |||||||||
Property
and equipment acquired through capital leases and other
financing
|
284 | 320 | - | |||||||||
Common
stock issued for acquisition of a business
|
2,084 | - | - | |||||||||
Stock
issued for redemption of debt
|
5,350 | - | - |
HYTHIAM,
INC. AND SUBSIDIARY
Notes
to Consolidated Financial Statements
Note
1. Summary of Significant Accounting Policies
Description
of Business
Hythiam,
Inc. (referred to herein as the company, we, us and our) is a healthcare
services management company, providing behavioral health management services to
health plans, employers, criminal justice, and government agencies through a
network of licensed and company managed healthcare providers. We also
research, develop, license and commercialize innovative physiological,
nutritional, and behavioral treatment programs. Through our subsidiary,
Comprehensive Care Corporation (CompCare), we manage all behavioral health
disorders. We utilize CompCare’s infrastructure to offer our proprietary disease
management services. Our disease management offering combines medical
and behavioral treatment modalities to manage substance dependent populations,
and is built around our proprietary PROMETA® Treatment Programs for alcoholism
and dependence to cocaine and methamphetamines. Our PROMETA Treatment Programs,
which integrate behavioral, nutritional, and medical components, are available
through licensed treatment providers. We also license or manage treatment
centers that offer the PROMETA Treatment Programs, as well as other
treatments for substance dependencies.
On
January 12, 2007, we acquired all of the outstanding membership interest of
Woodcliff Healthcare Investment Partners, LLC (Woodcliff), which owns 1,739,130
shares of common stock and 14,400 shares of Series A Convertible Preferred
Stock of CompCare. The conversion of the preferred stock would result in us
owning approximately 50.05% of the outstanding shares of CompCare based on
shares outstanding as of December 31, 2007. The preferred stock has voting
rights and, combined with the common shares held by us, gives us voting control
over CompCare. We began consolidating CompCare’s accounts on January 13,
2007. See further discussion in Note 5 — Acquisition of Woodcliff and
Controlling Interest in CompCare.
CompCare
manages the delivery of a continuum of psychiatric and substance abuse services
to commercial, Medicare and Medicaid members on behalf of employers, health
plans, government organizations, third-party claims administrators and
commercial and other group purchasers of behavioral healthcare services. The
customer base for CompCare’s services includes both private and governmental
entities.
We
currently operate within two reportable segments: healthcare services and
behavioral health managed care services. Our healthcare services segment focuses
on providing licensing, administrative and management services to licensees that
administer PROMETA and other treatment programs, including managed treatment
centers. Our behavioral health managed care services segment currently focuses
on providing managed care services in the behavioral health, psychiatric and
substance abuse fields, and principally
includes the operations of our majority-owned, controlled subsidiary,
CompCare. A majority of our consolidated revenues and assets are earned
or located within the United States.
Basis
of Consolidation and Presentation
Our consolidated financial statements
include the accounts of the company, our wholly-owned subsidiaries, CompCare,
and company-managed professional medical corporations. Based on the
provisions of management services agreements between us and the medical
corporations, we have determined that the medical corporations are variable
interest entities, and that we are the primary beneficiary as defined in
Financial Accounting Standards Board (FASB) Interpretation No. 46R,
“Consolidation of Variable Interest Entities,” an Interpretation of Accounting
Research Bulletin No. 51 (FIN 46R). Accordingly, we are required to consolidate
the revenues and expenses of the managed medical corporations. See further
discussion below in “Variable Interest Entities” and Note 2 – Management
Services Agreement.
All
intercompany transactions have been eliminated in consolidation. Certain amounts
in the consolidated financial statements and notes thereto for the years ended
December 31, 2006 and 2005 have been reclassified to conform to the presentation
for the year ended December 31, 2007.
Use
of Estimates
The preparation of financial statements
in conformity with generally accepted accounting principles (GAAP) in the United
States of America requires management to make estimates and assumptions
that affect the reported amounts in the financial statements and disclosed in
the accompanying notes. Significant areas requiring the use of management
estimates related to expense accruals, accounts receivable allowances, patient
continuing care reserves, accrued claims payable, premium deficiencies, the
useful life of depreciable assets, the evaluation of asset impairment and
shared-based compensation. Actual results could differ from those
estimates.
Revenue
Recognition
Healthcare
Services
Our
healthcare services revenues to date have been derived from licensing our
treatment programs and providing administrative services to hospitals, treatment
facilities and other healthcare providers, and from revenues generated by our
managed treatment centers. We determine revenues earned based on the terms
of our licensing and management contracts, which determination requires the use
of judgment, including the assessment of the collectability of receivables.
Licensing agreements typically provide for a fixed fee on a per-patient basis,
payable to us following the provider’s commencement of the use of our program to
treat a patient. For revenue recognition purposes, we treat the
program licensing and related administrative services as one unit of
accounting. We record the fees owed to us under the terms of the
agreements at the time we have performed substantially all required services for
each use of our program, which for the significant majority of our license
agreements to date is in the period in which the provider begins using the
program for medically directed and supervised treatment of a patient
and, in other cases, is at the time that medical treatment has been
completed.
The revenues of the managed treatment
centers, which we include in our consolidated financial statements, are derived
from charging fees directly to patients for medical treatments, including the
PROMETA Treatment Programs. Revenues from patients treated at the
managed treatment centers are recorded based on the number of days of treatment
completed during the period as a percentage of the total number treatment days
for the PROMETA Treatment Programs. Revenues relating to the
continuing care portion of the PROMETA Treatment Programs are deferred and
recorded over the period that the continuing care services are
provided.
One
of our managed treatment centers, the PROMETA Center, located in Santa
Monica California, accounted for approximately 18% and 29% of healthcare
services revenues, and 3% and 29% of consolidated revenues in 2007 and 2006,
respectively. No other licensee or managed medical practice accounted for over
10% of healthcare services or consolidated revenues in 2007 or 2006. In 2005
three of our licensees each accounted for over 10% of healthcare services
revenues, representing 25%, 20% and 18% of such revenues.
Behavioral
Health Managed Care Services
Managed
care activities are performed by CompCare under the terms of agreements with
health maintenance organizations (HMOs), preferred provider organizations, and
other health plans or payers to provide contracted behavioral healthcare
services to subscribing participants. Revenue under a substantial portion of
these agreements is earned monthly based on the number of qualified participants
regardless of services actually provided (generally referred to as capitation
arrangements). The information regarding qualified participants is supplied by
CompCare’s clients and CompCare reviews membership eligibility records and other
reported information to verify its accuracy in determining the amount of revenue
to be recognized. Capitation agreements accounted for $35.6 million, or 97% of
behavioral health managed care revenues for the period January 13 through
December 31, 2007. The remaining balance of CompCare’s revenues is earned
on a fee-for-service basis and is recognized as services are
rendered.
Cost
of Healthcare Services
Cost
of healthcare services represent direct costs that are incurred in connection
with licensing our treatment programs and providing administrative services in
accordance with the various technology license and services agreements, and are
associated directly with or vary directly with, the revenue that we recognize.
Consistent
with
our revenue recognition policy, the costs associated with providing these
services are recognized, for a significant majority of our agreements, in the
period in which patient treatment commences, and in other cases, at the time
treatment has been completed. Such costs include royalties paid for the use of
the PROMETA Treatment Program for patients treated by all licensees, and direct
labor costs, continuing care expense, medical supplies and program medications
for patients treated at the managed treatment centers.
Behavioral
Health Managed Care Services Expense Recognition
Behavioral
health managed care operating expense is recognized in the period in which an
eligible member actually receives services and includes an estimate of the cost
of behavioral health services that have been incurred but not yet reported
(IBNR). See “Accrued Claims Payable” for a discussion of IBNR claims.
CompCare contracts with various healthcare providers including hospitals,
physician groups and other licensed behavioral healthcare professionals either
on a discounted fee-for-service or a per-case basis. CompCare
determines that a member has received services when CompCare receives a claim
within the contracted timeframe with all required billing elements correctly
completed by the service provider. CompCare then determines that the member is
eligible to receive such services, the service provided is medically necessary
and is covered by the benefit plan’s certificate of coverage, and the service is
authorized by one of its employees. If all of these requirements are
met, the claim is entered into CompCare’s claims system for
payment.
Premium
Deficiencies
CompCare
accrues losses under its capitated contracts when it is probable that a loss has
been incurred and the amount of the loss can be reasonably estimated. CompCare
performs this loss accrual analysis on a specific contract basis taking into
consideration such factors as future contractual revenue, projected future
healthcare and maintenance costs, and each contract's specific terms related to
future revenue increases as compared to expected increases in healthcare costs.
The projected future healthcare and maintenance costs are estimated based on
historical trends and CompCare’s estimate of future cost increases.
At
any time prior to the end of a contract or contract renewal, if a capitated
contract is not meeting its financial goals, CompCare generally has the ability
to cancel the contract with 60 to 90 days’ written notice. Prior to
cancellation, CompCare will usually submit a request for a rate increase
accompanied by supporting utilization data. Although CompCare’s
clients have historically been generally receptive to such requests, no
assurance can be given that such requests will be fulfilled in the future in
CompCare’s favor. If a rate increase is not granted, CompCare has the
ability, in most cases, to terminate the contract and limit its risk to a
short-term period.
On
a quarterly basis, CompCare performs a review of its portfolio of contracts for
the purpose of identifying loss contracts (as defined in the American Institute
of Certified Public Accountants Audit and Accounting Guide – Health Care
Organizations) and developing a contract loss reserve, if applicable, for
succeeding periods. During the period January 13 through December 31, 2007,
CompCare identified two contracts that were not meeting their financial goals.
CompCare successfully obtained a rate increase from the clients, effective
January 1, 2008. At December 31, 2007, CompCare believes no contract
loss reserve for future periods is necessary for these contracts.
Share-Based
Compensation
Under
our 2003 and 2007 Stock Incentive Plans (the Plans), we have granted incentive
stock options (ISOs) under Section 422A of the Internal Revenue Code and
non-qualified options (NSOs) to executive officers, employees, members of our
board of directors, and certain outside consultants. We grant all such
share-based compensation awards at no less than the fair market value of our
stock on the date of grant. Employee and board of director awards generally vest
on a straight-line basis over five and four years, respectively. Total
share-based compensation expense on a consolidated basis amounted to $2.6
million, $3.7 million and $1.7 million for the years ended December 31, 2007,
2006 and 2005, respectively.
Stock
Options – Employees and Directors
On
January 1, 2006, we adopted Statement of Financial Accounting Standards (SFAS)
No. 123 (Revised 2004), “Share-Based Payment,” (SFAS 123R), which requires the
measurement and recognition of compensation expense for all share-based payment
awards made to employees and directors based on estimated fair values at the
date of grant using an option-pricing model. SFAS 123R replaces SFAS 123,
“Accounting for Stock-Based Compensation” for awards granted to employees and
directors and supersedes Accounting Principles Board Opinion No. 25, “Accounting
for Stock Issued to Employees” (APB 25). Prior to the adoption of SFAS 123R, we
accounted for share-based payment awards to employees and directors using the
intrinsic value method in accordance with APB 25 as allowed under SFAS 123.
Under APB 25, we recognized no share-based compensation expense in our
consolidated statements of operations for awards to employees and directors
because the exercise price of our stock options equaled the fair market value of
the underlying stock at the date of grant. Under the provisions of SFAS 123R,
share based compensation expense is recognized over the employee’s requisite
service period (generally the vesting period of the equity grant) using the
straight-line method, and is reduced for estimated forfeitures. SFAS 123R
requires forfeitures to be estimated at the time of grant and revised, if
necessary, in subsequent periods if actual forfeitures differ from those
estimates. In our pro forma information required under SFAS 123 for the periods
prior to 2006, we accounted for forfeitures as they occurred.
We
adopted SFAS 123R using the modified prospective method, and in accordance with
that method, our consolidated financial statements for 2006 include compensation
expense related to the unvested portion of share-based payment awards granted
prior to January 1, 2006 based on the grant date fair value estimated in
accordance with the pro forma provisions of SFAS 123. Prior periods have not
been restated to reflect, and do not include, the impact of SFAS 123R. As a
result of adopting SFAS 123R on January 1, 2006, share-based compensation
expense recognized under SFAS 123R for employees and directors for 2006 and 2007
was $2.3 million and $2.4 million, respectively, which impacted our basic and
diluted loss per share by $0.06 and $0.05, respectively.
Had
we determined compensation cost based on the fair value at the grant date for
such stock options under SFAS 123 for the year ended December 31, 2005, the pro
forma effect on net loss and net loss per share would have been as
follows:
2005
|
||||
Net
loss as reported
|
$ | (24,038,000 | ) | |
Add:
Stock-based compensation expense
|
20,000 | |||
Less:
Stock-based expense determined under
|
||||
fair
value based method
|
(901,000 | ) | ||
Pro
forma net loss
|
$ | (24,919,000 | ) | |
Net
loss per share:
|
||||
As
reported – basic and diluted
|
$ | (0.77 | ) | |
Pro
forma – basic and diluted
|
$ | (0.80 | ) |
The
estimated weighted average fair values of options granted during 2007, 2006
and 2005 were $4.50, $3.95 and $4.08 per share, respectively, and were
calculated using the Black-Scholes pricing model based on the following
assumptions:
2007
|
2006
|
2005
|
|||
Expected
volatility
|
64%
|
66%
|
58%
|
||
Risk-free
interest rate
|
4.46%
|
4.72%
|
4.18%
|
||
Weighted
average expected lives in years
|
6.5
|
6.1
|
10.0
|
||
Expected
dividend yield
|
0%
|
0%
|
0%
|
The
expected volatility assumption for 2007, 2006 and 2005 was based on the
historical volatility of our stock and the stock of other public healthcare
companies, measured over a period generally commensurate with the expected term.
The weighted average expected option term for 2007 and 2006 reflects the
application of the
simplified
method set out in SEC Staff Accounting Bulletin No. 107, which defines the life
as the average of the contractual term of the options and the weighted average
vesting period for all option tranches. We use historical data to
estimate the rate of forfeitures assumption for awards granted to employees,
which amounted to 29% in 2007 and 27% in 2006.
We
have elected to adopt the detailed method prescribed in SFAS 123R for
calculating the beginning balance of the additional paid-in capital pool (APIC
pool) related to the tax effects of employee share-based compensation, and to
determine the subsequent impact on the APIC pool and consolidated statements of
cash flows of the tax effects of employee share-based compensation awards that
were outstanding upon adoption of SFAS 123R.
Stock
Options and Warrants – Non-employees
We
account for the issuance of stock options and warrants for services from
non-employees in accordance with SFAS 123 by estimating the fair value of stock
options and warrants issued using the Black-Scholes pricing model. This model’s
calculations include the exercise price, the market price of shares on grant
date, the weighted average information for risk-free interest, expected life of
the option or warrant, expected volatility of our stock and expected
dividends.
For
options and warrants issued as compensation to non-employees for services that
are fully vested and non-forfeitable at the time of issuance, the estimated
value is recorded in equity and expensed when the services are performed and
benefit is received as provided by FASB Emerging Issues Task Force Issue (EITF)
No. 96-18, “Accounting For Equity Instruments That Are Issued To Other Than
Employees For Acquiring Or In Conjunction With Selling Goods Or Services.” For
unvested shares, the change in fair value during the period is recognized in
expense using the graded vesting method.
Share-based
expense relating to stock options and warrants granted and common stock issued
to non-employees was $104,000, $1.4 million and $1.6 million for 2007, 2006 and
2005, respectively.
Stock
Options – CompCare Employees, Directors and Consultants
CompCare’s
1995 and 2002 Incentive Plans (the CompCare Plans) provide for the issuance of
ISOs, NSOs, stock appreciation rights, limited stock appreciation rights, and
restricted stock grants to eligible employees and consultants, and stock options
to its employees and non-employee directors. Options for ISOs may be granted for
terms of up to ten years and are generally exercisable in cumulative increments
of 50% each six months. CompCare also has a non-qualified stock option plan for
its outside directors, in which the option grants vest in accordance with
vesting schedules established by CompCare’s Compensation and Stock Option
Committee.
CompCare
has adopted SFAS 123R, using the modified prospective method and used a
Black-Scholes valuation model to determine the fair value of options on the
grant date. As a result of adopting SFAS 123R, share-based compensation expense
recognized for employees and directors for the period January 13 through
December 31, 2007 was $83,000.
The
following table lists the assumptions utilized in applying the Black-Scholes
valuation model. CompCare uses historical data to estimate the
expected term of the option. Expected volatility is based on the
historical volatility of the CompCare’s traded stock. CompCare did
not declare dividends in the past nor does it expect to do so in the near
future, and as such it assumes no expected dividend. The risk-free
rate is based on the U.S. Treasury yield curve with the same expected term as
that of the option at the time of grant.
For
the period
January
13 through
December
31, 2007
|
||
Expected
volatility
|
110 | % |
Risk-free
interest rate
|
4.87 | % |
Weighted
average expected lives in years
|
3.3 | |
Expected
dividend yield
|
0 | % |
Advertising
Costs
Costs incurred for advertising,
including production costs, are generally expensed when incurred or expensed on
a straight-line basis over the periods that advertisements are
run. Our advertising costs were approximately $680,000, $3.3 million
and $1.1 million in 2007, 2006 and 2005, respectively.
Foreign
Currency
Assets
and liabilities of foreign subsidiaries are translated into U.S. dollars at
year-end exchange rates. Income and expense items are translated at
average exchange rates prevailing during the year. The local currency
is the functional currency. Foreign currency transaction gains
(losses) of approximately ($22,000), $20,000 and $21,000 for the years
ended December 31, 2007, 2006 and 2005, respectively, are primarily related to
intercompany receivables and payables for which settlement is planned in the
foreseeable future, and are included in the consolidated statements of
operations. There were no foreign currency translation adjustments
recorded to other comprehensive income.
Income
Taxes
We
account for income taxes using the liability method in accordance with SFAS 109,
"Accounting for Income Taxes." To date, no current income tax liability has
been recorded due to our accumulated net losses. Deferred tax assets and
liabilities are recognized for temporary differences between the financial
statement carrying amount of assets and liabilities and the amounts that are
reported in the tax return. Deferred tax assets and liabilities are recorded on
a net basis; however, our net deferred tax assets have been fully reserved by a
valuation allowance due to the uncertainty of our ability to realize future
taxable income and to recover our net deferred tax assets.
In
June 2006, the FASB issued Interpretation No. 48 (FIN 48), “Accounting
for Uncertainty in Income Taxes,” which clarifies the accounting for uncertainty
in income taxes. FIN 48 requires that companies recognize in the consolidated
financial statements the impact of a tax position, if that position is more
likely than not of being sustained on audit, based on the technical merits of
the position. FIN 48 also provides guidance on derecognition, classification,
interest and penalties, accounting in interim periods and disclosure. The
provisions of FIN 48 are effective for fiscal years beginning after
December 15, 2006. We adopted FIN 48 on January 1, 2007, with no impact to
our consolidated financial statements.
Comprehensive
Income
Comprehensive
income generally represents all changes in stockholders’ equity (deficit) during
the period except those resulting from investments by, or distributions to,
stockholders. We have no other comprehensive income or loss items and
accordingly, our net loss equals comprehensive loss.
Basic
and Diluted Loss per Share
Basic
loss per share is computed by dividing the net loss to common stockholders
for the period by the weighted average number of common shares outstanding
during the period. Diluted loss per share is computed by dividing the net
loss for the period by the weighted average number of common and dilutive
common equivalent shares outstanding during the period.
Common
equivalent shares, consisting of approximately 9,846,000, 7,222,000, and
6,901,000 of incremental common shares as of December 31, 2007, 2006
and 2005, respectively, issuable upon the exercise of stock options and
warrants have been excluded from the diluted earnings per share calculation
because their effect is anti-dilutive.
Cash
and Cash Equivalents
We
invest available cash in short-term commercial paper, certificates of deposit
and high grade variable rate securities. Liquid investments with an
original maturity of three months or less when purchased are considered to be
cash equivalents.
Restricted
cash represents deposits secured as collateral for a bank credit card
program.
Marketable
Securities
Investments
include auction rate securities, commercial paper and certificates of
deposit with maturity dates greater than three months when purchased, and have
readily determined fair values, which are classified as available-for-sale
investments and reflected in current assets as marketable securities at fair
market value. Our marketable securities at December 31 consisted of the
following investments with the following maturities:
Fair
Market Value
|
Less
than
1
Year
|
1-5
Years
|
5-10
Years
|
More
than
10
Years
|
|||||||||||
December 31,
2007
|
|||||||||||||||
Variable
auction rate securities
|
$ | 19,000,000 | $ | - | $ | - | $ | - | $ | 19,000,000 | |||||
Commercial
paper
|
16,518,000 | - | - | - | 16,518,000 | ||||||||||
Certificates
of deposits
|
322,000 | 322,000 | - | - | - | ||||||||||
$ | 35,840,000 | $ | 322,000 | $ | - | $ | - | $ | 35,518,000 | ||||||
December 31,
2006
|
|||||||||||||||
Variable
auction rate securities
|
$ | 27,464,000 | $ | - | $ | - | $ | - | $ | 27,464,000 | |||||
Commercial
paper
|
9,948,000 | - | - | - | 9,948,000 | ||||||||||
Certificates
of deposits
|
334,000 | 334,000 | - | - | - | ||||||||||
$ | 37,746,000 | $ | 334,000 | $ | - | $ | - | $ | 37,412,000 | ||||||
Auction
rate securities are variable rate debt instruments with longer stated maturities
whose interest rates are reset at predetermined short-term intervals through a
Dutch auction system. Through February 13, 2008, all of our auction rate
securities held at December 31, 2007 had completed at least one auction
successfully through the normal auction process, and we had reduced our total
investments in auction rate securities to $11.5 million. However, from February
14 through March 12, 2008, auctions for these securities had failed, meaning the
parties desiring to sell securities could not be matched with an adequate number
of buyers, resulting in our having to continue to hold these
securities. Although the securities are Aaa/AAA rated and collateralized by
portfolios of student loans guaranteed by the U.S. government, based on current
market conditions it is likely that auctions will continue to be unsuccessful,
limiting the short-term liquidity of these investments until the auction
succeeds, the issuer calls the securities, or they mature. As a
result, our ability to liquidate our investment and fully recover the carrying
value of our investment in the near term may be limited or not exist. If the
issuers are unable to successfully close future auctions or their credit ratings
deteriorate, we may in the future record an impairment charge on
these
investments.
In addition, these types of developments could cause us to reclassify our
investments in auction rate securities from a current asset to a long-term
asset. We believe that the higher reset rates on failed auctions
provide sufficient incentive for the security issuers to address this lack of
liquidity. While these failures in the auction process have affected our ability
to access these funds in the near term, we do not believe that the underlying
securities or collateral have been affected. At this time, we have not
obtained sufficient evidence to conclude that these investments are impaired or
that they will not be settled in the short term, although the market for these
investments is uncertain. We believe that we will not require access to these
funds in the near-term prior to restoration of liquidity in this market. These
securities will be analyzed each reporting period for other-than-temporary
impairment factors. If the credit rating of the security issuers
deteriorates, we may be required to adjust the carrying value of these
investments through an impairment charge.
The
cost of all securities presented above approximated fair market value at
December 31.
Fair
Value of Financial Instruments and Concentration of Credit Risk
FASB
Statement No. 107, “Disclosures about Fair Value of Financial Instruments”
requires disclosure of fair value information about financial instruments for
which it is practical to estimate that value. The carrying amounts reported in
the balance sheet for cash, cash equivalents, marketable securities, accounts
receivable, accounts payable and accrued liabilities approximate fair value
because of the immediate or short-term maturity of these financial instruments.
At December 31, 2007, all of our cash equivalents and marketable securities
were invested in high grade auction rate securities, commercial paper and
certificates of deposit. At December 31, 2007, no single investment
represented more than 7% of our investment portfolio. For debt outstanding, the
fair value at December 31, 2007 is estimated at $4.4 million, based on
discounted cash flow calculations using the Company’s estimated incremental
borrowing rate.
Property
and Equipment
Property and equipment are stated at
cost, less accumulated depreciation. Additions and improvements to property and
equipment are capitalized at cost. Expenditures for maintenance and repairs are
charged to expense as incurred. Depreciation is computed using the straight-line
method over the estimated useful lives of the related assets, which range from
two to seven years for furniture and equipment. Leasehold improvements are
amortized over the lesser of the estimated useful lives of the assets or the
related lease term, principally five to seven years.
Variable
Interest Entities
An
entity is subject to FIN 46R and is called a Variable Interest Entity (VIE) if
it has (a) equity that is insufficient to permit the entity to finance its
activities without additional subordinated financial support from other parties,
or (b) equity investors that cannot make significant decisions about the
entity’s operations, or that do not absorb the expected losses or receive the
expected returns of the entity. A VIE is consolidated by its primary
beneficiary, which is the party that has a majority of the expected losses, or a
majority of the expected residual returns of the VIE, or both. As discussed in
Note 2 – Management Services Agreements, we have management services agreements
with managed medical corporations, in which we agree to provide and perform all
non-medical management and administrative services for the respective medical
group. We also agreed to provide working capital loans to allow for the medical
group to pay for its obligations. Payment of our management fee is subordinate
to payments of the obligations of the medical group, and repayment of the
working capital loan is not guaranteed by the shareholder or other third party.
Based on the provisions of these agreements, we have determined that the managed
medical corporations are VIEs, and that we are the primary beneficiary as
defined in FIN 46R. Accordingly, we are required to consolidate the revenues and
expenses of the managed medical corporations.
Goodwill
In
accordance with SFAS 141, “Business Combinations,” the purchase price for
the CompCare acquisition was allocated to the fair values of the assets
acquired, including identifiable intangible assets, in accordance with our
proportionate share of ownership interest, and the excess amount of purchase
price over the fair values of net assets acquired resulted in goodwill that will
not be deductible for tax purposes. In December 2007, we recorded a $192,000
adjustment to reduce the balance of goodwill for the favorable resolution of
assumed, pre-acquisition
liabilities.
The
balance of goodwill at December 31, 2007 also reflects a $98,000 reduction
related to a change in minority shareholders’ interests. As
discussed in Note 5 — Acquisition of Woodcliff and Controlling Interest in
CompCare, we believe our association with CompCare creates synergies to
facilitate the use of PROMETA Treatment Programs by managed care treatment
providers and to provide access to an infrastructure for our planned disease
management product offerings. Accordingly, the resulting goodwill has been
assigned to our healthcare services reporting unit. In accordance with
SFAS 142 “Goodwill and Other Intangible Assets,” goodwill is not amortized,
but instead is subject to impairment tests. The change in the carrying amount of
goodwill by reporting unit is as follows:
Healthcare
Services
|
Behavioral
Health Managed Care
|
Total
|
||||||||||
Balance
as of January 1, 2007
|
$ | - | $ | - | $ | - | ||||||
Goodwill
- CompCare acquisition
|
10,064,000 | 493,000 | 10,557,000 | |||||||||
Balance
as of December 31, 2007
|
$ | 10,064,000 | $ | 493,000 | $ | 10,557,000 | ||||||
Intangible
Assets
Intellectual
Property
Intellectual property consists
primarily of the costs associated with acquiring certain technology, patents,
patents pending, know-how and related intangible assets with respect to programs
for treatment of dependence to alcohol, cocaine, methamphetamine, and other
addictive stimulants. These assets are stated at cost and are being amortized on
a straight-line basis, since the pattern in which the economic benefits of the
intangible assets are realized cannot be precisely determined, over the
remaining life of the respective patents, or patent applications, which range
from twelve to twenty years.
Other
Intangible Assets
Other
intangible assets consist primarily of identified intangible assets acquired as
part of the CompCare acquisition, representing the value of managed care
contracts and marketing-related assets associated with its managed care business
including the value of the healthcare provider network and the professional
designation from the National Council on Quality Association (NCQA). Such assets
are being amortized on a straight-line basis over their estimated remaining
lives, which approximate the rate at which we believe the economic benefits of
these assets will be realized.
Impairment
of Long-Lived Assets
In accordance with SFAS 144,
“Accounting for the Impairment or Disposal of Long-Lived Assets,” long-lived
assets such as property, equipment and intangible assets subject to amortization
are reviewed for impairment whenever events or circumstances indicate that the
carrying amount of these assets may not be recoverable. In reviewing for
impairment, we compare the carrying value of such assets to the estimated
undiscounted future cash flows expected from the use of the assets and their
eventual disposition. When the estimated undiscounted future cash
flows are less than their carrying amount, an impairment loss is recognized
equal to the difference between the assets’ fair value and their carrying
value. In December 2005, we recorded an impairment charge of $272,000
in other expense to write off the capitalized costs of intellectual property
relating to an acquired patent for a treatment method for opiate addiction that
we have determined would not likely be utilized in our current business plan. In
August 2007, we recorded an additional impairment charge of $2.4 million when we
recognized the fair value of 310,000 shares of our common stock that had been
previously issued as additional consideration related to the purchase of the
patent. The shares had been subject to a stock pledge agreement pending the
resolution of certain contingencies until we agreed to release the shares as a
result of a settlement agreement reached in August 2007 with the seller of the
opiate patent. The fair value of these shares was based on the closing stock
price on the date of the settlement. No other impairments were identified in our
reviews at December 31, 2007 and 2006.
Accrued
Claims Payable
The accrued claims payable liability
represents the estimated ultimate net amounts owed for all behavioral healthcare
services provided through the respective balance sheet dates, including
estimated amounts for claims incurred but not yet reported (IBNR) to
CompCare. The unpaid claims liability is estimated using an actuarial
paid completion factor methodology and other statistical analyses and is
continually reviewed and adjusted, if necessary, to reflect any change in the
estimated liability. These estimates are subject to the effects of trends in
utilization and other factors. However, actual claims incurred could
differ from the estimated accrued claims payable amount reported. Although
considerable variability is inherent in such estimates, CompCare management
believes that the unpaid claims liability is adequate.
Accrued
Reinsurance Claims Payable
The accrued reinsurance claims payable
liability represents amounts payable to providers under a state reinsurance
program associated with CompCare’s contract to provide behavioral healthcare
services to members of a Connecticut HMO. CompCare’s contract with the HMO ended
December 31, 2005. At December 31, 2007, $2.5 million of reinsurance claims
payable remains and is attributable to providers having submitted claims for
authorized services having incorrect service codes or otherwise incorrect
information that has caused payment to be denied by CompCare. In such
cases, there are statutory provisions that allow the provider to appeal a denied
claim. If no appeal is received by CompCare within the prescribed
amount of time, it is probable that CompCare will be required to remit the
reinsurance funds back to the appropriate party.
Capital
Leases
Assets held under capital leases
include furniture and computer equipment, and are recorded at the lower of the
net present value of the minimum lease payments or the fair value of the leased
asset at the inception of the lease. Depreciation expense is computed using the
straight-line method over the estimated useful lives of the
assets. All lease agreements contain bargain purchase options at
termination of the lease.
Minority
Interest
Minority
interest represents the minority stockholders’ proportionate share of the equity
of CompCare. As discussed in Note 5, we acquired a majority controlling interest
in CompCare as part of our Woodcliff acquisition, and we have the ability to
control 50.05% of CompCare’s common stock as of December 31, 2007 from our
ownership of 1,739,130 shares of common stock and 14,400 shares of CompCare’s
Series A Convertible Preferred Stock (assuming conversion). Our ownership
percentage as of December 31, 2007 has decreased from the 50.25% as of the
date of our acquisition due to additional common stock issued by CompCare during
the period. Our controlling interest requires that CompCare’s operations be
included in our consolidated financial statements, with the remaining 49.95%
being attributed to minority stockholder interest. Due to CompCare’s accumulated
deficit on the date of our acquisition, a deficit minority stockholders’ balance
in the amount of $544,000 existed at the time of the acquisition which was
valued at zero, resulting in an increase in the amount of goodwill recognized in
the acquisition. The minority stockholders’ interest in any further net losses
will not be recorded due to the accumulated deficit. The unrecorded minority
stockholders’ interest in net loss amounted to $1.6 million during the
period January 13 through December 31, 2007. The minority
stockholders’ interest in any future net income will first be credited to
goodwill to the extent of the original deficit interest, and will not be
recognized in the financial statements until the aggregate amount of such
profits equals the aggregate amount of unrecognized losses.
Recent
Accounting Pronouncements
In
September 2006, the FASB issued SFAS 157, “Fair Value Measurements,” which
defines fair value, establishes a framework for measuring fair value in
generally accepted accounting principles, and expands disclosures about fair
value measurements. The statement is effective for financial statements issued
for fiscal years beginning after November 15, 2007, and interim periods within
those fiscal years. We are currently evaluating the statement to determine what,
if any, impact it will have on our consolidated financial statements. The
adoption of SFAS 157 is not expected to have a material impact on our financial
position, results of operations or cash flows.
In
February 2007, the FASB issued SFAS No. 159, "The Fair Value Option for
Financial Assets and Financial Liabilities" ("SFAS 159"). SFAS 159 allows
companies to measure many financial assets and liabilities at fair value. It
also establishes presentation and disclosure requirements designed to facilitate
comparisons between companies that choose different measurement attributes for
similar types of assets and liabilities. SFAS 159 is effective for financial
statements issued for fiscal years beginning after November 15, 2007 and
interim periods within those fiscal years. The adoption of SFAS No. 159 is
not expected to have a material impact on our financial position, results of
operations or cash flows.
In
December 2007, the FASB issued SFAS No. 141(R), "Business Combinations"
("SFAS 141(R)"). SFAS 141(R) replaces SFAS No. 141, "Business Combinations", but
retains the requirement that the purchase method of accounting for acquisitions
be used for all business combinations. SFAS 141(R) expands on the disclosures
previously required by SFAS 141, better defines the acquirer and the acquisition
date in a business combination, and establishes principles for recognizing and
measuring the assets acquired (including goodwill), the liabilities assumed and
any non-controlling interests in the acquired business. SFAS 141(R) also
requires an acquirer to record an adjustment to income tax expense for changes
in valuation allowances or uncertain tax positions related to acquired
businesses. SFAS 141(R) is effective for all business combinations with an
acquisition date in the first annual period following December 15, 2008;
early adoption is not permitted. We will adopt this statement as of January 1,
2009. The impact SFAS 141(R) will have on our consolidated financial statements
will depend on the nature and size of acquisitions we complete after we adopt
SFAS 141(R).
In
December 2007, the FASB issued SFAS No. 160, "Noncontrolling Interests in
Consolidated Financial Statements—an amendment of ARB No. 51" (SFAS 160).
SFAS 160 requires that non-controlling (or minority) interests in subsidiaries
be reported in the equity section of the company's balance sheet, rather than in
a mezzanine section of the balance sheet between liabilities and equity. SFAS
160 also changes the manner in which the net income of the subsidiary is
reported and disclosed in the controlling company's income statement. SFAS 160
also establishes guidelines for accounting for changes in ownership percentages
and for deconsolidation. SFAS 160 is effective for financial statements for
fiscal years beginning on or after December 1, 2008 and interim periods
within those years. The adoption of SFAS 160 is not expected to have a material
impact on our financial position, results of operations or cash
flows.
Note
2. Management Services Agreements
We
have executed management services agreements with medical professional
corporations and related treatment centers, with terms generally ranging from
one to ten years, with provisions to continue on a month-to-month basis
following the initial term, unless terminated for cause.
Under
each of these management services agreements we generally license to the medical
group or treatment center the right to use our proprietary treatment programs
and related trademarks and agreed to provide all required day-to-day business
management services, including general administrative support services,
information systems, recordkeeping, scheduling, billing, collection, marketing
and local business development, and assistance in obtaining and maintaining all
federal, state and local licenses, certifications and regulatory permits
required for, or in connection with, the medical group’s operation and equipment
located at any of its offices. The medical group or treatment facility retains
the sole right and obligation to provide medical services to its patients and to
make other medically related decisions such as the choice of medical
professionals to hire or medical equipment to acquire and the ordering of
drugs.
In
addition, we provide medical office space to each medical group on a
non-exclusive basis, and we are responsible for all costs associated with rent
and utilities. The medical group pays us a monthly fee equal to the aggregate
amount of (a) our costs of providing management services (including reasonable
overhead allocable to the delivery of our services and including start-up costs
such as pre-operating salaries, rent, equipment, and tenant improvements
incurred for the benefit of the medical group, provided that any capitalized
costs, including all start-up expense, will be amortized over a five year
period), (b) 10%-15% of the foregoing costs, and (c) any performance bonus
amount, as determined by the medical group in its sole discretion. The medical
group’s payment of our fee is subordinate to payment of the medical group's
obligations, including physician fees and medical group employee
compensation.
We
have also agreed to provide a credit facility to each medical practice to be
available as a working capital loan, with interest at the Prime Rate plus 2%, to
allow for the medical group to pay for its obligations, pursuant to a revolving
credit note. Funds are advanced pursuant to the terms of the management services
agreement described above. The notes are due on demand, or upon termination of
the respective management services agreement.
Based
on the provisions of these agreements, we have determined that the managed
medical corporations are VIEs, and that we are the primary beneficiary as
defined in FIN 46R. Accordingly, we are required to consolidate the revenues and
expenses of the managed treatment centers as discussed in Note 1 – Summary of
Significant Accounting Policies under “Variable Interest Entities.”
Note
3. Receivables
Receivables
consisted of the following as of December 31.
2007
|
2006
|
|||||||
License
fees receivable
|
$ | 2,100,000 | $ | 659,000 | ||||
Patient
fees receivable
|
282,000 | 49,000 | ||||||
Tenant
improvement allowance (1)
|
- | 224,000 | ||||||
Managed
care contracts
|
35,000 | - | ||||||
Other
|
21,000 | 5,000 | ||||||
Total
Receivables
|
2,438,000 | 937,000 | ||||||
Less-allowance
for doubtful accounts
|
(651,000 | ) | (300,000 | ) | ||||
Total
Receivables, net
|
$ | 1,787,000 | $ | 637,000 |
(1)
Amounts receivable from landlord upon completion of lease build-out of new
office space.
We
use the specific identification method for recording the provision for doubtful
accounts, which was $528,000, $281,000 and $25,000 for the years ended
December 31, 2007, 2006 and 2005, respectively. Accounts written
off against the allowance for doubtful accounts totaled $177,000 and
$16,000 for the years ended December 31, 2007 and 2005, respectively. There
were no accounts written off against the allowance for doubtful accounts during
the year ended December 31, 2006.
Note
4. Property and Equipment
Depreciation and amortization of
property and equipment are provided using the straight-line method over two to
seven years. Leasehold improvements are amortized over the term of
the lease. Construction in progress is not depreciated until the
related asset is completed and placed into service.
Property
and equipment consisted of the following as of December 31:
2007
|
2006
|
|||||||
Furniture
and equipment
|
$ | 6,363,000 | $ | 2,968,000 | ||||
Leasehold
improvements
|
3,558,000 | 2,967,000 | ||||||
Total
Cost
|
9,921,000 | 5,935,000 | ||||||
Less-accumulated
depreciation
|
(5,630,000 | ) | (2,224,000 | ) | ||||
Property
and Equipment, net
|
$ | 4,291,000 | $ | 3,711,000 |
Depreciation
expense was $1.5 million, $1.1 million and $665,000 for the years ended
December 31, 2007, 2006 and 2005, respectively.
Note
5. Acquisition of Woodcliff and Controlling Interest in
CompCare
On
January 12, 2007, we acquired all of the outstanding membership interests
of Woodcliff in exchange for $9 million in cash and 215,053 shares of our
common stock. The purchase price was equal to $667.27 per share of preferred
stock and $0.80 per share of common stock of CompCare owned by Woodcliff.
Woodcliff had no other assets or liabilities at the date of the
acquisition. Woodcliff owns 1,739,130 shares of common stock and 14,400
shares of Series A Convertible Preferred Stock of CompCare, the conversion
of which would result in us owning approximately 50.25% and 50.05% of the
outstanding shares of common stock of CompCare based on shares outstanding at
January 12, 2007 and December 31, 2007, respectively. The preferred stock has
voting rights and, combined with the common shares held by us, gives us voting
control over CompCare. We have anti-dilution protection and the right to
designate a majority of the board of directors of CompCare. In addition,
CompCare is required to obtain our consent for a sale or merger involving a
material portion of CompCare's assets or business, and prior to entering into
any single or series of related transactions exceeding $500,000 or incurring any
debt in excess of $200,000. The acquisition was accounted for as a purchase, and
we began consolidating CompCare’s results of operations on January 13,
2007. The remaining ownership interest in CompCare is being accounted for as
minority interest.
CompCare
provides managed care services in the behavioral health and psychiatric fields.
CompCare manages the delivery of a continuum of psychiatric and substance abuse
services to commercial, Medicare and Medicaid members on behalf of employers,
health plans, government organizations, third-party claims administrators, and
commercial and other group purchasers of behavioral healthcare services. The
customer base for CompCare’s services includes both private and governmental
entities. CompCare’s services are provided primarily by unrelated vendors on a
subcontract basis. Since February 2006, we have had a marketing agreement
with CompCare under which CompCare has the right to offer our PROMETA Treatment
Programs as part of a disease management offering to its customers and other
mutually agreed parties on an exclusive basis. We believe our association with
CompCare creates synergies to facilitate the use of PROMETA Treatment Programs
by managed care treatment providers and to provide access to an
infrastructure for our disease management product offerings.
In
accordance with SFAS 141, the Woodcliff purchase price was allocated to the fair
value of CompCare’s assets and liabilities, including identifiable intangible
assets, in accordance with our proportionate share of ownership interest, and
the excess of purchase price over the fair value of net assets acquired resulted
in goodwill. Goodwill related to this acquisition is not deductible for tax
purposes. In accordance with SFAS 142, goodwill is not amortized, but instead is
subject to impairment tests. Identified intangibles with definite useful lives
are amortized on a straight-line basis over their estimated remaining lives (see
Note 1 – Summary of Significant Accounting Policies, under
“Goodwill”).
The
primary source of funds for the Woodcliff acquisition was a $10 million senior
secured note and warrant sold and issued to Highbridge International LLC (see
Note 7 – Debt Outstanding).
The
following table presents the allocation of the total acquisition cost, which
includes the purchase price and related acquisition expenses, to the assets
acquired and liabilities assumed:
At
January 12, 2007
|
|||
Cash
and cash equivalents
|
$ | 4,304,000 | |
Other
current assets
|
1,840,000 | ||
Property
and equipment
|
389,000 | ||
Goodwill
|
10,847,000 | ||
Intangible
assets
|
2,136,000 | ||
Other
non-current assets
|
237,000 | ||
Total
assets
|
$ | 19,753,000 | |
Accounts
payable and accrued liabilities
|
$ | (1,285,000 | |
Accrued
claims payable
|
(2,599,000 | ||
Accrued
reinsurance claims payable
|
(2,526,000 | ||
Long-term
debt
|
(1,978,000 | ||
Other
liabilities
|
(217,000 | ||
Total
liabilities
|
$ | (8,605,000 | |
Total
acquisition cost
|
$ | 11,148,000 | |
The
allocation of the total acquisition cost is based primarily on a valuation
analysis of identifiable intangible assets completed by an independent valuation
specialist, Actuarial Risk Management, on July 19, 2007. In December 2007, we
recorded a $192,000 adjustment to reduce the balance of goodwill for the
favorable resolution of assumed, pre-acquisition liabilities. The balance of
goodwill at December 31, 2007 amounted to $10.6 million, which also reflects a
$98,000 reduction related to a change in minority shareholders’ interests. As
discussed in Note 1, goodwill was assigned to our healthcare services reportable
segment and the remaining net assets and intangible assets acquired were
assigned to our behavioral health managed care reportable
segment.
Assuming
the acquisition had occurred January 1, 2006 pro forma revenues, net loss
and net loss per share would have been $45.1 million, $45.7 million, and $1.00
for the year ended December 31, 2007, and $22.9 million, $42.3 million and $1.06
for the year ended December 31, 2006, respectively. This unaudited pro forma
information does not purport to represent what our actual results of operations
would have been if the acquisition had occurred as of the dates indicated or
what results would be for any future periods.
Note
6. Intangible Assets
Intangible
assets consist of intellectual property and intangible assets associated with
the CompCare acquisition. Intellectual property consists primarily of the costs
associated with acquiring certain technology, patents, patents pending, know-how
and related intangible assets with respect to programs for treatment of
dependence to alcohol, cocaine, methamphetamine, and other addictive stimulants.
Intangible assets are stated at cost, net of accumulated amortization.
Intellectual property is being amortized on a straight-line basis from the date
costs are incurred over the remaining life of the respective patents or patent
applications, which range from twelve to twenty years, and other intangible
assets are being amortized on a straight-line basis from the date of the
acquisition over the remaining life of the managed care contracts to which they
relate, which range from two to seven years. As of December 31, 2007 and 2006,
the gross and net carrying amounts of intangible assets that are subject to
amortization are as follows:
2007
|
2006
|
Amortization
Period
(in
years)
|
|||||||
Intellectual
property (IP)
|
$ | 4,308,000 | $ | 3,988,000 |
12
to 20
|
||||
Managed
care contracts (Note 5)
|
832,000 | - |
3 to
7
|
||||||
Provider
networks, NCQA (Note 5)
|
1,305,000 | - |
2 to
3
|
||||||
Total
Cost
|
6,445,000 | 3,988,000 | |||||||
Less-Accumulated
amort-IP
|
(832,000 | ) | (591,000 | ) | |||||
Less-Accumulated
amort-Other
|
(777,000 | ) | - | ||||||
$ | 4,836,000 | $ | 3,397,000 |
PROMETA
Treatment Programs
In
March 2003, we entered into a Technology Purchase and License Agreement
(Technology Agreement) with Tratamientos Avanzados de la Adicción
S.L. (Tavad), a Spanish corporation, to acquire, on an exclusive basis, all
of the rights, title and interest to use and or sell the products and services
and license the intellectual property owned by Tavad with respect to a method
for the treatment of alcohol and cocaine dependence, known as the PROMETA
Treatment Programs, on a worldwide basis except in Spain (as amended in
September 2003). We have granted Tavad a security interest in the
intellectual property to secure the payments and performance obligations under
the Technology Agreement. As consideration for the intellectual property
acquired, we issued to Tavad approximately 836,000 shares of our common stock in
September 2003 at a fair market value of $2.50 per share, plus warrants to
purchase approximately 532,000 shares of our common stock at an exercise price
of $2.50 per share, valued at approximately $192,000. Warrants for 160,000
shares are exercisable at any time through September 29, 2008, and the
remaining warrants for 372,000 shares become exercisable equally over five years
and expire ten years from date of grant.
In
addition to the purchase price for the above intellectual property, we agreed to
pay a royalty fee to Tavad equal to three percent (3%) (six percent (6%) in
Europe) of gross revenues from the PROMETA Treatment Programs using the acquired
intellectual property for so long as we (or any licensee) use the acquired
intellectual property. For purposes of the royalty calculations, gross
revenue is defined as all payments made by patients for the treatment, including
payments made to our licensees. Royalty fees, which totaled $192,000, $71,000
and $18,000 for the years ended December 31, 2007, 2006, and 2005, respectively,
are reflected in cost of services expense in the consolidated statements of
operations as revenues are recognized.
In
October 2004, the Technology Agreement was amended (Amendment) to expand
the definition of “Processes,” limited to alcohol and cocaine in the original
agreement dated March 2003, to also include crack cocaine and methamphetamine
treatment processes, and the term “Intellectual Property” was expanded to
include all improvements through September 14, 2004. As consideration for
the Amendment, we paid $75,000 and issued 83,221 shares of our common stock,
valued at $354,000.
Under
the Technology Agreement, we are obligated to allocate each year a minimum of
50% of the funds we expend on sales, marketing, research and development to such
activities relating to the use of the intellectual property acquired. If we do
not expend at least the requisite percentage on such activities, the Tavad has
the right to have the intellectual property revert to Tavad. We may terminate
Tavad’s reversion rights by making an additional payment of an amount which,
taken together with previously paid royalties and additional payments, would
aggregate $1.0 million. In 2005, 2006 and 2007 we met our obligations
with respect to this requirement.
The
total cost of the assets acquired, plus additional costs incurred by us related
to filing patent applications on such assets have been reflected in long-term
assets as intellectual property. Amortization is being recorded on a
straight-line basis over the remaining 16.5 year life of the pending
patents, commencing July 1, 2003.
In
May 2006, we issued 105,000 shares of our common stock valued at $738,000 to
Tavad as initial consideration for a further amendment to the Technology
Agreement. The amendment expands the definition of “Processes” to
include additional indications for the use of the PROMETA Treatment Program. The
amendment
requires
us to issue 35,000 shares for each indication for which we file a patent
application claim, plus an additional 50,000 shares for each indication from
which we derive revenues in the future.
Patent
for Opiate Addiction Treatment
In
August 2003, we acquired a patent for a treatment method for opiate
addiction at a foreclosure sale held by Reserva Capital, LLC, a company owned
and controlled by our chief executive officer and major shareholder, through a
foreclosure sale in satisfaction of debt owed to Reserva by a XINO, medical
technology development company. We paid approximately $314,000 in cash and
agreed to issue 360,000 shares of our common stock to XINO at a future date
conditional upon the occurrence of certain events, including a full release of
claims by all of the technology development company’s creditors.
In
December 2005, we evaluated our potential use of this patent and determined that
it would not likely be utilized in our current business plan. Accordingly, we
recorded an impairment charge of $272,000 in 2005 to write off the remaining
capitalized costs of intellectual property relating to this patent.
On
August 8, 2007, we reached an agreement with XINO to release 310,000 of the
360,000 shares of our common stock previously issued to XINO. In consideration
for a full release from the stock pledge agreement, XINO relinquished 50,000 of
the previously issued shares and has agreed not to sell or transfer any of its
310,000 shares for a period of time following the settlement agreement, which
expired in January 2008. We recorded the fair market value of the 310,000 shares
issued as an additional impairment loss amounting to $2.4 million, based on the
closing stock price of $7.70 per share on August 8, 2007.
Treatment
for Nicotine Dependence
In
June 2005, we and a wholly-owned foreign subsidiary entered into an asset
purchase agreement with Dr. Jacob Hiller to obtain the worldwide rights to his
trade secret protocols for the treatment of nicotine and other dependencies, in
exchange for a percentage of future net profits from exploitation of the
protocols. We have engaged Dr. Hiller as a consultant to explore
opportunities in Europe to open treatment clinics for the treatment of
dependencies using these protocols.
Other
Intangible Assets
In
accordance with SFAS 141, “Business Combinations”, the purchase price for the
CompCare acquisition was allocated to the fair values of the assets acquired,
including identifiable intangible assets, in accordance with our proportionate
share of ownership interest. These identified intangible assets include the
value of managed care contracts and marketing-related assets associated with its
managed care business, including the value of the healthcare provider network
and the professional designation from the NCQA. Such assets will be amortized on
a straight-line basis over their estimated remaining lives, which approximate
the rate at which we believe the economic benefits of these assets will be
realized.
Amortization
In
accordance with SFAS 144, “Accounting for the Impairment or Disposal of
Long-Lived Assets”,, we performed an impairment test and re-evaluated the useful
lives and amortization methods on intellectual property and other intangible
assets as of December 31, 2007. We determined that the estimated useful lives of
intellectual property and other intangible assets properly reflected the current
remaining economic useful lives of these assets.
Amortization
expense for all intangible assets amounted to $1.0 million, $217,000 and
$214,000 for the years ended December 31, 2007, 2006 and 2005,
respectively. Estimated amortization expense for intangible assets for the next
five years ending December 31, is as follows:
2008
|
$
|
974,000 | |
2009
|
$
|
854,000 | |
2010
|
$
|
263,000 | |
2011
|
$
|
244,000 | |
2012
|
$
|
244,000 |
Note
7. Debt Outstanding
On
January 17, 2007, in connection with the Woodcliff acquisition, we entered
into a securities purchase agreement pursuant to which we agreed to issue and
sell to Highbridge International LLC (Highbridge) a $10 million senior secured
note and a warrant to purchase up to approximately 250,000 shares of our common
stock (together, the Financing). The note bears interest at a rate of prime plus
2.5%, interest payable quarterly commencing on April 15, 2007 and matures
on January 15, 2010. The current interest rate in effect at December 31,
2007 was 9.75%. The note is redeemable at our option anytime prior to maturity
at a redemption price ranging from 103% to 110% of the principal amount during
the first 18 months and is redeemable at the option of Highbridge beginning on
July 17, 2008.
The
Highbridge note restricts debt offerings so that we are only able to issue
unsecured, subordinated debt so long as the principal payments are beyond the
maturity of the Highbridge debt (January 15, 2010), and the interest rate is not
greater than the Highbridge rate (Prime+2.5%). The debt cannot have
call rights during the Highbridge term and Highbridge must consent to the
issuance of new debt.
The
warrant has a term of five years, and was initially exercisable at $12.01 per
share, or 120% of the $10.01 closing price of our common stock on
January 16, 2007. Pursuant to an anti-dilution adjustment clause in the
note, the exercise price of the warrant has been adjusted to $10.52 per share
and the number of shares have been adjusted to 285,000, and is subject to
further adjustments if we sell or are deemed to have sold shares at a price
below the adjusted exercise price per share, and will be proportionately
adjusted for stock splits or dividends. Similarly, if we were to issue
convertible debt, the anti-dilution adjustment would also be triggered should
the conversion price be less than $10.52 per share.
In
connection with the financing, we entered into a security agreement granting
Highbridge a first-priority perfected security interest in all of our assets now
owned or thereafter acquired. We also entered into a pledge agreement with
Highbridge, as collateral agent, pursuant to which we will deliver equity
interests evidencing 65% of our ownership of our foreign subsidiaries. In the
event of a default, the collateral agent is given broad powers to sell or
otherwise deal with the pledged collateral. There are no material financial
covenant provisions associated with this debt.
Total
funds received of $10,000,000 were allocated to the warrant and the senior
secured note in the amounts of $1,380,000 and $8,620,000, respectively, in
accordance with their relative fair values as determined at the date of
issuance. The value allocated to the warrant is being treated as a discount to
the note and is being amortized to interest expense over the 18 month period
between the date of issuance and the date that Highbridge has the right to
redeem the note, using the effective interest method. As of December
31, 2007, the unamortized discount on the senior secured notes is approximately
$258,000. In addition, we paid a $150,000 origination fee and incurred
approximately $150,000 in other costs associated with the financing, which have
been allocated to the warrant and senior secured note in accordance with the
relative fair values assigned to these instruments, and are being deferred and
amortized over the 18 month period between the date of issuance and the date
that Highbridge has the right to redeem the note.
As
discussed more fully in Note 10 – Equity Financings, we entered into a
redemption agreement with Highbridge to redeem $5 million in principal related
to the senior secured notes as part of our securities offering completed on
November 7, 2007. Included in the gross proceeds received on that date was $5.35
million for the conversion of $5 million of the senior note, which also included
payment of $350,000 for an early redemption
penalty,
based on a redemption price of 107% of the principal amount being redeemed
pursuant to the redemption agreement. The $350,000 is included as part of the
reacquisition cost of the notes and the difference between the reacquisition
price and the net carrying amount of the principal amount being redeemed was
recognized as a loss of $741,000 on extinguishment of debt in our statement of
operations during the fourth quarter of 2007.
Debt
outstanding also includes 7.5% convertible subordinated debentures of CompCare
with a remaining principal balance of $2,244,000. As part of the purchase price
allocation, an adjustment of $266,000 was made at the date of acquisition to
reduce the carrying value of this debt to its estimated fair value. This
adjustment is being treated as a discount and is being amortized over the
remaining contractual maturity term of the note using the effective interest
method.
The
following table shows the total principal amount, related interest rates and
maturities of debt outstanding, as of December 31, 2007:
Short-term
Debt
|
||||
Senior
secured note due January, 2010, interest payable quarterly at prime plus 2.5%, net
of $258,000 unamortized discount
|
$ | 4,742,000 | ||
Long-term
Debt
|
||||
7.5%
Convertible subordinated debentures due April, 2010,
interest payable
semi-annually, net of $187,000 unamortized discount
(1)
|
$ | 2,057,000 |
(1) At
December 31, 2007, the debentures are convertible into 15,051 shares of CompCare
common stock at a conversion price of $149.09 per share.
Note
8. Capital Lease Obligations
We lease certain furniture and computer
equipment under agreements entered into during 2006 and 2007 that are classified
as capital leases. The cost of furniture and computer equipment under capital
leases is included in the consolidated balance sheets in property and equipment
and was $741,000 at December 31, 2007. Accumulated amortization of the leased
equipment at December 31, 2007 was approximately $236,000. Amortization of
assets under capital leases is included in depreciation expense.
The
future minimum lease payments required under the capital leases and the present
values of the net minimum lease payments, as of December 31, 2007, are as
follows (in thousands):
Year
Ending December 31,
|
Amount
|
|||
2008
|
$ | 233 | ||
2009
|
187 | |||
2010
|
111 | |||
2011
|
76 | |||
2012
|
- | |||
Total
minimum lease payments
|
$ | 607 | ||
Less:
Amount representing interest
|
(93 | ) | ||
Total
capital lease obligations
|
514 | |||
Less:
Current maturities of capital lease obligations
|
(183 | ) | ||
Long-term
capital lease obligations
|
$ | 331 |
Note
9. Income Taxes
As
of December 31, 2007, we had net federal operating loss carry-forwards and
state operating loss carry forwards of approximately $100.0
million and $94.5 million, respectively. The net federal operating loss carry
forwards expire between 2024 and 2027, and net state operating loss carry
forwards expire between 2014 and 2017. Foreign net operating loss
carry-forwards were approximately $5.0 million, of which
$4.6 million will expire in seven years, $19,000 will expire in ten years, and
$400,000 will carry forward indefinitely.
The
primary components of temporary differences which give rise to our net deferred
tax are as follows:
2007
|
2006
|
|||||||
Deferred
tax assets:
|
||||||||
Federal,
state & foreign net operating losses
|
$ | 39,542,000 | $ | 25,454,000 | ||||
Stock-based
compensation
|
3,259,000 | 2,810,000 | ||||||
Accrued
liabilities
|
746,000 | 481,000 | ||||||
Other
temporary differences
|
(666,000 |
)
|
1,212,000 | |||||
Valuation
allowance
|
(42,881,000 | ) | (29,957,000 | ) | ||||
$ | - | $ | - |
We have
provided a valuation allowance to fully offset our net deferred tax assets, in
accordance with SFAS 109, because of our continued net losses, and management
assessment of the realizability of our net deferred tax assets as being less
than the more-likely-than-not criteria set forth in SFAS 109. Section 382
of the Internal Revenue Code limits the use of net operating loss and tax credit
carryforwards in certain situations where changes occur in the stock ownership
of a company. In the event we have a change in ownership, utilization of
the carryforward could be restricted. We have not provided deferred taxes on
CompCare, a less than 80% owned subsidiary, or our consolidated managed
treatment centers accounted for under FIN 46R as these entities have accumulated
book losses and we do not believe these losses can be realized for tax purposes
in the foreseeable future.
A
reconciliation between the statutory federal income tax rate and the effective
income tax rate for the years ended December 31 follows:
2007
|
2006
|
||
Federal
statutory rate
|
-34.0%
|
-34.0%
|
|
State
taxes
|
-4.4%
|
-4.9%
|
|
Other
|
1.6%
|
0.5%
|
|
Change
in valuation allowance
|
36.8%
|
38.4%
|
|
0.0%
|
0.0%
|
In
June 2006, the FASB issued FIN 48 which clarifies the accounting for
uncertainty in income taxes. FIN 48 requires that companies recognize in the
consolidated financial statements the impact of a tax position, if that position
is more likely than not of being sustained on audit, based on the technical
merits of the position. FIN 48 also provides guidance on de-recognition,
classification, interest and penalties, accounting in interim periods and
disclosure. The provisions of FIN 48 are effective for years beginning after
December 15, 2006. We adopted FIN 48 on January 1, 2007 with no impact to our
consolidated financial statements. The Company and its subsidiaries file income
tax returns in the U.S. federal jurisdiction and various state and
foreign jurisdictions. Tax years that remain subject to examinations by tax
authorities are 2003 through 2006. The federal and material foreign
jurisdictions statutes of limitations begin to expire in 2008. There
are no current income tax audits in any jurisdictions for open tax years and, as
of December 31, 2007, there has been no material change to our FIN 48
position.
Note
10. Equity Financings
In
November 2005, we completed an underwritten public equity offering of 9,200,000
shares at a price of $4.75 per share for a total of $43.7 million in
proceeds. We paid $3.1 million in fees to the underwriters in
connection with the transaction.
In
December 2006, we issued 3,573,258 shares of common stock at a price of
$7.30 per share in a private placement for a total of $26.1 million in proceeds.
We paid approximately $1.8 million in fees to placement agents and other
transaction costs were owed in connection with the
transaction.
In
November 2007, we entered into securities purchase agreements with select
institutional investors in a registered direct placement, in which we issued an
aggregate of 9,635,000 shares of common stock at a price of $4.79 per share, for
gross proceeds of approximately $46.2 million. We also issued 5-year
warrants to purchase an aggregate of approximately 2.4 million additional
shares of our common stock at an exercise price of $5.75 per share. The fair
value of the warrants at the date of issuance was estimated at $6.3 million
and was accounted for as a
liability
pursuant to EITF 00-19. We incurred $3.7 million in fees to placement agents and
other offering expenses in connection with the transaction. Included in the
gross proceeds was $5.35 million from the conversion of $5 million of the senior
secured notes issued to Highbridge, pursuant to a redemption agreement entered
into with Highbridge on November 7, 2007 See Note 7 Debt
Outstanding.
Note
11. Share-based Compensation
The
Hythiam, Inc. 2003 and 2007 Stock Incentive Plans (the Plans) provide for the
issuance of up to 9 million shares of our common stock. Incentive stock
options (ISOs) under Section 422A of the Internal Revenue Code,
non-qualified options (NSOs), stock appreciation rights, limited stock
appreciation rights, and restricted stock grants are authorized under the Plans.
We grant all such share-based compensation awards at no less than the fair
market value of our stock on the date of grant, and have granted stock and stock
options to executive officers, employees, members of our board of directors, and
certain outside consultants. The terms and conditions upon which options become
exercisable vary among grants, however, option rights expire no later than ten
years from the date of grant and employee and board of director awards generally
vest on a straight-line basis over five and four years, respectively. At
December 31, 2007, we had 6,257,000 vested and unvested stock options
outstanding and 1,904,000 shares reserved for future awards. Total share-based
compensation expense on a consolidated basis amounted to $2.6 million, $3.7
million and $1.3 million for the years ended December 31, 2007, 2006 and
2005.
Stock
Options – Employees and Directors
During
2007, 2006 and 2005, we granted options to employees and directors for 732,000,
1,657,000 and 1,317,000 shares, respectively, to employees and directors at the
weighted average per share exercise prices of $7.08, $6.27 and $6.49,
respectively, the fair market value of our common stock on the dates of
grants. The estimated fair value of options granted to employees and
directors during 2007, 2006 and 2005 was $3.3 million, $6.6 million and $5.4
million, respectively, calculated using the Black-Scholes pricing model with the
assumptions described in Note 1 - Share-based Compensation. Stock
option activity under the Plan for the three years ended December 31, 2007 was
as follows:
Weighted
Avg.
|
||||||||
Shares
|
Exercise
Price
|
|||||||
Balance,
December 31, 2004
|
4,057,000 | $ | 3.01 | |||||
2005
|
||||||||
Granted
|
1,317,000 | 6.49 | ||||||
Exercised
|
(54,000 | ) | 3.29 | |||||
Cancelled
|
(422,000 | ) | 4.88 | |||||
Balance,
December 31, 2005
|
4,898,000 | $ | 3.78 | |||||
2006
|
||||||||
Granted
|
1,657,000 | $ | 6.27 | |||||
Exercised
|
(80,000 | ) | 3.75 | |||||
Cancelled
|
(647,000 | ) | 5.34 | |||||
Balance,
December 31, 2006
|
5,828,000 | $ | 4.32 | |||||
2007
|
||||||||
Granted
|
732,000 | $ | 7.08 | |||||
Transfer
*
|
(695,000 | ) | 5.10 | |||||
Exercised
|
(483,000 | ) | 3.14 | |||||
Cancelled
|
(230,000 | ) | 6.47 | |||||
Balance,
December 31, 2007
|
5,152,000 | $ | 4.61 | |||||
*
Option transfer due to status change from employee to
non-employee.
|
The
weighted average remaining contractual life and weighted average exercise price
of options outstanding as of December 31, 2007 were as
follows:
Options
Outstanding
|
Options
Exercisable
|
||||||||||
Range
of Exercise Prices
|
Shares
|
Weighted
Average Remaining Life (yrs)
|
Weighted
Average
Price
|
Shares
|
Weighted
Average Price
|
||||||
$2.50
to $3.50
|
2,435,000
|
5.8
|
$ 2.62
|
1,954,000
|
$ 2.61
|
||||||
$3.51
to $4.50
|
189,000
|
8.7
|
4.13
|
44,000
|
4.25
|
||||||
$4.51
to $5.50
|
565,000
|
8.6
|
4.77
|
113,000
|
4.77
|
||||||
$5.51
to $6.50
|
717,000
|
7.5
|
6.08
|
285,000
|
5.92
|
||||||
$6.51
to $7.50
|
583,000
|
8.3
|
7.24
|
133,000
|
7.30
|
||||||
$7.51
to $8.50
|
582,000
|
9.0
|
7.92
|
172,000
|
7.89
|
||||||
$8.51
to $9.50
|
81,000
|
9.2
|
9.00
|
-
|
-
|
||||||
5,152,000
|
7.1
|
4.61
|
2,701,000
|
3.64
|
At
December 31, 2007 and 2006, the number of options exercisable was 2,419,000
and 1,430,000, respectively, at weighted-average exercise prices of $3.76 and
$2.87, respectively.
As
a result of adopting SFAS 123R on January 1, 2006, share-based expense relating
to stock options granted to employees and directors was $2.4 million and $2.3
million for the year ended December 31 2007 and 2006, respectively.
As
of December 31, 2007, there was $7.0 million of total unrecognized compensation
costs related to non-vested share-based compensation arrangements granted under
the Plans. That cost is expected to be recognized over a weighted-average period
of 3.09 years.
Stock
Options and Warrants – Non-employees
In
addition to stock options granted under the Plans, we have also granted options
and warrants to purchase our common stock to certain non-employees that have
been approved by our board of directors. During 2007, 2006 and 2005,
we granted options and warrants for 65,000, 368,000 and 110,000 shares,
respectively.
Stock
option and warrant activity for non-employee grants for services is summarized
as follows:
Weighted
Avg.
|
||||||||
Shares
|
Exercise
Price
|
|||||||
Balance,
December 31, 2004
|
2,322,000 | $ | 2.92 | |||||
2005
|
||||||||
Granted
|
110,000 | 5.32 | ||||||
Exercised
|
(116,000 | ) | 2.50 | |||||
Cancelled
|
(314,000 | ) | 2.50 | |||||
Balance,
December 31, 2005
|
2,002,000 | $ | 3.14 | |||||
2006
|
||||||||
Granted
|
368,000 | $ | 4.96 | |||||
Exercised
|
(603,000 | ) | 2.53 | |||||
Cancelled
|
(372,000 | ) | 3.78 | |||||
Balance,
December 31, 2006
|
1,395,000 | $ | 3.72 | |||||
2007
|
||||||||
Granted
|
65,000 | $ | 7.47 | |||||
Transfer
*
|
695,000 | 5.10 | ||||||
Exercised
|
(104,000 | ) | 4.57 | |||||
Cancelled
|
(42,000 | ) | 6.24 | |||||
Balance,
December 31, 2007
|
2,009,000 | $ | 4.22 | |||||
*
Option transfer due to status change from employee to
non-employee.
|
Stock
options and warrants granted to non-employees for services, debt agreement
and offerings outstanding at December 31, 2007 are summarized as
follows:
Description
|
Shares
|
Weighted
Average Remaining Contractual Life (yrs)
|
Weighted
Average Exercise Price
|
|||||||
Warrants
issued for intellectual property
|
532,000 |
4.2
|
$ | 2.50 | ||||||
Warrants
issued in connection with equity offering
|
2,515,000 |
4.7
|
5.64 | |||||||
Warrants
issued in connection with debt agreement
|
285,000 |
4.1
|
10.52 | |||||||
Options
and warrants issued to consultants
|
1,362,000 |
4.5
|
5.02 | |||||||
4,694,000 |
4.5
|
$ | 5.40 | |||||||
Share-based
expense relating to stock options and warrants granted to non-employees amounted
to ($14,000), $1.2 million and $1.6 million for 2007, 2006 and 2005,
respectively. At December 31, 2007, unvested options and warrants had
an estimated value of approximately $277,000, using the Black-Scholes pricing
model.
Common
Stock
During 2007, 2006 and 2005, we issued
30,000, 51,000 and 23,000 shares of common stock, respectively, for consulting
services, valued at $239,000, $326,000 and $134,000, respectively. These costs
are amortized to share-based expense on a straight-line basis over the related
service periods generally ranging from six months to one year. Share-based
expense relating to all common stock issued for consulting services was
$118,000, $229,000 and $134,000 for 2007, 2006 and 2005,
respectively.
Employee
Stock Purchase Plan
In
June 2006, we adopted a qualified employee stock purchase plan (ESPP), approved
by our board of directors and shareholders, which provides that eligible
employees (employed at least 90 days) have the option to purchase shares of our
common stock at a price equal to 85% of the of the lesser of the fair market
value as of the first day or the last day of each offering period. Purchase
options are granted bi-annually and are limited to the number of whole shares
that can be purchased by an amount equal to up to 10% of a participant’s annual
base salary. As of December 31, 2007, there were 27,000 shares of our
common stock issued pursuant to the ESPP. Share-based expense relating to the
ESPP was $15,000 for the year ended December 31, 2007. There was no expense in
2006 associated with the ESPP.
Stock
Options – CompCare Employees, Directors and Consultants
CompCare’s
1995 and 2002 Incentive Plans (the CompCare Plans) provide for the issuance of
up to 1 million shares of CompCare common stock for each plan. ISOs, NSOs,
stock appreciation rights, limited stock appreciation rights, and restricted
stock grants to eligible employees and consultants are authorized under the
CompCare Plans. CompCare issues stock options to its employees and non-employee
directors allowing them to purchase common stock pursuant to the CompCare
Plans. Options for ISOs may be granted for terms of up to ten years
and are generally exercisable in cumulative increments of 50% each six months.
The exercise price for ISOs must equal or exceed the fair market value of the
shares on the date of grant. The Plans also provide for the full
vesting of all outstanding options under certain change of control events. As of
December 31, 2007, under the 2002 Plan, there were 500,000 options available for
grant and there were 460,000 options outstanding, of which 440,000 are
exercisable. Additionally, as of December 31, 2007, under the 1995
Plan, there were 485,000 options outstanding and exercisable. The 1995 Plan was
terminated effective August 31, 2005 such that there are no further options
available for grant under this plan.
CompCare
also has a non-qualified stock option plan for its outside directors (the
CompCare Directors’ Plan). Each non-qualified stock option is exercisable at a
price equal to the average of the closing bid and asked prices of the common
stock in the over-the-counter market for the last preceding day there was a sale
of the stock prior to the grant date. Grants of options vest in accordance with
vesting schedules established by CompCare’s Compensation and Stock Option
Committee. Upon joining the CompCare Board, directors receive an
initial grant of 25,000 options. Annually, directors are granted
15,000 options on the date of CompCare’s annual meeting. As of December 31,
2007, under the Directors’ Plan, there were 777,000 shares available for option
grants and 125,000 options outstanding, of which none are
exercisable.
CompCare
stock option activity for the period January 13 through December 31, 2007 was as
follows:
Shares
|
Weighted
Avg. Exercise Price
|
||||||
Balance,
January 13, 2007
|
1,166,000 | $ | 1.32 | ||||
Granted
|
145,000 | 1.05 | |||||
Exercised
|
(37,000 | ) | 0.51 | ||||
Cancelled
|
(204,000 | ) | 1.77 | ||||
Balance,
December 31, 2007
|
1,070,000 | $ | 1.23 |
Stock
options totaling 145,000 were granted to board of director members and certain
employees during the period January 13 through December 31, 2007 at a weighted
average grant-date fair value of $1.05. A total of 37,000 options were exercised
during the period January 13 through December 31, 2007, which had a total
intrinsic value of $13,000. During the period January 13 through December 31,
2007, 123,000 stock options granted to directors and one officer expired
unexercised. For the period January 13 through December 31, 2007, 81,000 stock
options granted to certain CompCare board of director members and employees,
respectively, were cancelled due to the recipients’ resignation from the
CompCare board of directors or CompCare.
At
December 31, 2007, there was approximately $59,000 of total unrecognized
compensation cost related to unvested options, which is expected to be
recognized over a weighted-average period of approximately 6 months. Total
recognized compensation costs during the period January 13 through December 31,
2007 were $83,000. No compensation cost related to employees was recognized
prior to June 1, 2006.
The
following table summarizes information about options granted, exercised, and
vested for the period January 13 through December 31, 2007 is as
follows:
For
the period
January
13
through
December
31, 2007
|
|||
Options
granted
|
145,000 | ||
Weighted-average
grant-date fair value
|
$ | 0.76 | |
Options
exercised
|
37,000 | ||
Total
intrinsic value of exercised options
|
$ | 13,000 | |
Fair
value of vested options
|
$ | 11,000 |
A summary of options outstanding and
exercisable as of December 31, 2007 is as follows:
Options
Outstanding
|
Options
Exercisable
|
||||||||||
Range
of Exercise Prices
|
Shares
|
Weighted
Average Remaining Life (yrs)
|
Weighted
Average Price
|
Shares
|
Weighted
Average Price
|
||||||
$0.25
to $0.27
|
182,000
|
2.59
|
$ 0.26
|
182,000
|
$ 0.26
|
||||||
$0.39
to $0.56
|
261,000
|
2.47
|
0.54
|
261,000
|
0.54
|
||||||
$0.78
to $1.12
|
189,000
|
8.90
|
1.07
|
44,000
|
1.10
|
||||||
$1.40
to $1.78
|
247,000
|
6.76
|
1.62
|
247,000
|
1.62
|
||||||
$1.80
to $2.16
|
94,000
|
7.40
|
1.95
|
94,000
|
1.95
|
||||||
$3.56
to $4.00
|
97,000
|
0.95
|
3.95
|
97,000
|
3.95
|
||||||
1,070,000
|
4.91
|
$ 1.27
|
925,000
|
$ 1.30
|
Warrants
CompCare
periodically issues warrants to purchase common stock as compensation for the
services of consultants and marketing employees. Of the 406,000
warrants outstanding at December 31, 2007, 306,000 were issued to two
consultants and two employees as compensation for introducing strategic business
partners to CompCare. Such partners were responsible for the infusion of
approximately $776,000 in cash to CompCare in February and March 2005 in a
private placement of CompCare’s common stock. All such warrants have five-year
terms. Valuation using the Black-Scholes pricing model for the warrants issued
in February and March of 2005 was based on the following
information:
Number
of warrants
|
306,000 | |||
Exercise
price
|
$ | 1.25 | ||
Volatility
factor of CompCare's common stock
|
95 | % | ||
Expected
life of the warrants
|
3
years
|
|||
Risk-free
interest rate
|
3.9 | % | ||
Dividend
yield
|
0.0 | % | ||
Warrant
valuation (in thousands)
|
$ | 234 |
No
warrants were issued during the period January 13 through December 31,
2007.
Note
12. Segment Information
We
manage and report our operations through two business segments: healthcare
services and behavioral health managed care services.
Our
healthcare services segment is focused on delivering solutions for those
suffering from alcohol, cocaine, methamphetamine and other substance
dependencies by researching, developing, licensing and commercializing
innovative physiological, nutritional, and behavioral treatment programs.
Treatment with our PROMETA Treatment Programs, which integrate behavioral,
nutritional, and medical components, are available through physicians and other
licensed treatment providers who have entered into licensing agreements with us
for the use of our treatment programs. Also included in this segment are
licensed and managed treatment centers, which offer a range of addiction
treatment services, including the PROMETA Treatment Programs for dependencies on
alcohol, cocaine and methamphetamines.
Our
healthcare services segment also comprises international and government sector
operations; however, these operating segments are not separately reported as
they do not meet any of the quantitative thresholds under SFAS 131, “Disclosures
about Segments of an Enterprise and Related Information.”
The
behavioral health managed care services segment is focused on providing managed
care services in the behavioral health and psychiatric fields, and principally
includes the operations of our majority-owned, controlled subsidiary, CompCare,
which was acquired on January 12, 2007. CompCare manages the delivery of a
continuum of psychiatric and substance abuse services to commercial, Medicare
and Medicaid members on behalf of employers, health plans, government
organizations, third-party claims administrators, and commercial and other group
purchasers of behavioral healthcare services. The customer base for
CompCare’s services includes both private and governmental entities. We also
plan to offer disease management programs for substance dependence built around
our proprietary PROMETA Treatment Program for alcoholism and dependence to
stimulants as part of our behavioral health managed care services
operations.
We
evaluate segment performance based on total assets, revenues and net income or
loss before taxes. Our assets are included within each discrete reporting
segment. In the event that any services are provided to one reporting segment by
the other, the transaction is valued at the market price. No such services were
provided during the year ended December 31, 2007.
Summary
financial information for our two reportable segments is as
follows:
Year
Ended December 31,
|
||||||||||||
2007
|
2006
|
2005
|
||||||||||
Behavioral
health managed care services (1)
|
||||||||||||
Revenues
|
$ | 36,306,000 | $ | - | $ | - | ||||||
Loss
before provision for income taxes
|
(4,105,000 | ) | - | - | ||||||||
Assets
*
|
8,896,000 | - | - | |||||||||
Healthcare
services
|
||||||||||||
Revenues
|
$ | 7,695,000 | $ | 3,906,000 | $ | 1,164,000 | ||||||
Loss
before provision for income taxes
|
(41,270,000 | ) | (38,296,000 | ) | (24,038,000 | ) | ||||||
Assets
*
|
61,750,000 | 52,205,000 | 54,462,000 | |||||||||
Consolidated
operations
|
||||||||||||
Revenues
|
$ | 44,001,000 | $ | 3,906,000 | $ | 1,164,000 | ||||||
Loss
before provision for income taxes
|
(45,375,000 | ) | (38,296,000 | ) | (24,038,000 | ) | ||||||
Total
Assets *
|
70,646,000 | 52,205,000 | 54,462,000 | |||||||||
*
Assets are reported as of December 31.
|
||||||||||||
(1)
Results for the year in this segment represent the period January 13
through December 31, 2007.
|
Note
13. Major Customers/Contracts
For
the period January 13 through December 31, 2007, 87% of revenue in our
behavioral health managed care services segment (72% of consolidated revenues
for the year ended December 31, 2007) was concentrated in CompCare’s contracts
with six health plans to provide behavioral healthcare services under
commercial, Medicare, Medicaid, and children’s health insurance plans (CHIP).
This includes the contracts discussed below.
In
January 2008, an existing Medicare Advantage HMO client issued a request for
proposal (RFP) for renewal of a contract for management of behavioral healthcare
services for its Pennsylvania, Maryland, and Texas regions. Revenues under the
contracts accounted for $5.4 million, or 15% of our behavioral heath managed
care services revenues for the period January 13 through December 31, 2007 (12%
of consolidated revenues for the year ended December 31, 2007). CompCare ceased
providing services to the client’s Texas membership as of December 31, 2006.
CompCare submitted a bid to retain its current business with this
client as well as attempt to regain the Texas membership. This client intends to
select a finalist in March 2008 with an effective date of July 1, 2008 for a new
agreement to serve members in these states. CompCare does not expect to be
selected as a finalist and accordingly the majority of the revenues under this
contract are expected to end during the third quarter of 2008.
In January
2007, CompCare began providing behavioral health services to approximately
250,000 Indiana Medicaid recipients pursuant to a contract with an Indiana HMO.
The contract accounted for approximately $14.6 million or 40% of our behavioral
health managed care services revenues for the period January 13 through December
31, 2007 (or 33% of consolidated revenues for the year ended December 31,
2007), and is for an initial term of two years with subsequent extensions
by mutual written agreement. To offset high utilization costs during 2007,
CompCare is negotiating and believes it will receive a rate increase
effective January 1, 2008, provided it complies with monthly performance
measures it believes it will meet. The rate increase would amount
to approximately $2.0 million per annum.
CompCare
currently furnishes behavioral healthcare services to approximately 244,000
members of a health plan providing Medicaid, Medicare, and CHIP benefits in
Michigan, Texas and California. Services are provided on a
fee-for-service and Administrative Services Organization (ASO)
basis. The contracts accounted for $4.2 million, or 12% of behavioral
health managed care service revenues for the period January 13 through December
31, 2007 (10% of consolidated revenues for the year ended December 31,
2007). The initial contract, which commenced in June of 2002, was for
a one-year period and has been automatically renewed on an annual
basis. Termination by either party may occur with 90 days written
notice to the other party.
In
general, CompCare’s contracts with its customers are typically for initial
one-year terms, with automatic annual extensions. Such contracts
generally provide for cancellation by either party with 60 to 90 days written
notice.
Note
14. Commitments and Contingencies
Operating
Lease Commitments
We
incurred rent expense of approximately $1.4 million, $911,000 and $646,000 for
the years ended December 31, 2007, 2006 and 2005, respectively. In
September 2003, we signed a lease agreement for our corporate offices at an
initial lease cost of approximately $33,000 per month, with increases scheduled
annually over the lease term. The term of the lease is seven years beginning on
the lease commencement date, December 15, 2003, and includes a right to
extend the lease for an additional five years. In April, 2005 we amended
the lease to expand our corporate office facilities at an additional base rent
of approximately $11,000 per month, subject to annual adjustment over the
remaining initial six-year term. As a condition to the lease
agreement, we secured a letter of credit at the current amount of $262,500 for
the landlord as a form of security deposit. The letter of credit is
collateralized by a certificate of deposit in the amount of $262,500, which is
included in deposits and other assets in the consolidated balance sheets as of
December 31, 2007.
In
April 2005 we entered into a five year lease for approximately 5,400 square feet
of medical office space at an initial base rent of approximately $19,000 per
month commencing in August 2005. The space is occupied by The PROMETA
Center, a managed medical practice, under a full business service management
agreement. As a condition to signing the lease, we secured a $90,000
letter of credit for the landlord as a form of security deposit.
The
letter of credit is collateralized by a certificate of deposit in the amount of
$90,000, which is included in deposits and other assets in the consolidated
balance sheet as of December 31, 2007.
In
August 2006, we entered into a 62 month lease for approximately 4,000 square
feet of medical office space, located in San Francisco, California, at an
initial base rent of approximately $11,000 per month, commencing in January
2007. The space was occupied by the PROMETA Center through January
31, 2008 under an amendment to our management service agreement. We are
currently seeking to sublease the vacant space.
In
connection with a management services agreement that we executed with a medical
professional corporation in Dallas, Texas, we assumed the obligation for two
lease agreements at a current combined amount of approximately $9,000 per month,
which expire in May 2011.
In
November 2006, we entered into a 5 year lease for office space in Switzerland at
an initial base rent of 4,052 Swiss Francs per month (US$3,325 using the
December 31, 2006 conversion rate).
CompCare
leases certain office space and equipment. The Texas office lease
contains escalation clauses based on the Consumer Price Index and provisions for
payment of real estate taxes, insurance, and maintenance and repair
expenses. Total rental expense for all CompCare operating leases was
$259,000 for the period January 13 through December 31, 2007. This expense does
not include rent payments related to the Company’s use of space within the
offices of its major Indiana client, which is not subject to a written lease
agreement.
Rent
expense is calculated using the straight-line method based on the total minimum
lease payments over the initial term of the lease. Unamortized landlord tenant
improvement allowances and rent expense exceeding actual rent payments are
accounted for as deferred rent liability in the balance sheet.
Future
minimum payments, by year and in the aggregate, under non-cancelable operating
leases with initial or remaining terms of one year or more, consist of the
following at December 31, 2007:
Operating
|
||||
Leases
|
||||
Year
Ending December 31,
|
(000's)
|
|||
2008
|
$ | 1,624 | ||
2009
|
1,364 | |||
2010
|
1,246 | |||
2011
|
250 | |||
2012
|
158 | |||
Total
minimum lease payments
|
$ | 4,642 |
Clinical
Research Commitments
In
2006 and 2007, we committed to a number of unrestricted grants for clinical
research studies by preeminent researchers in the field of substance dependence
and leading research institutions to evaluate the efficacy of our PROMETA
Treatment Programs in treating alcohol and stimulant dependence. As of December
31, 2007, we have approximately $4.1 million committed to such clinical research
studies, all of which is expected to be paid in 2008.
Other
Commitments and Contingencies
CompCare
provided behavioral healthcare services to the members of a Connecticut HMO from
2001 to 2005 under a contract that provided that CompCare would also receive
funds directly from a state reinsurance program for the purpose of paying
providers. At December 31, 2007, $2.5 million of reinsurance claims
payable remains and is attributable to providers having submitted claims for
authorized services having incorrect service codes or otherwise incorrect
information that has caused payment to be denied by us. In such
cases, there are
statutory
provisions that allow the provider to appeal a denied claim. If no
appeal is received by the Company within the prescribed amount of time, it is
probable that CompCare will be required to remit the reinsurance funds back to
the appropriate party.
In
connection with CompCare’s Indiana contract that started January 1, 2007,
CompCare is required to maintain a performance bond in the amount of $1,000,000.
In addition, a $25,000 performance bond is maintained in relation to a Third
Party Administrator license in Maryland. Relating to this contract,
CompCare has become aware that the state of Indiana is considering requiring
payment of a claims billing code that CompCare had previously been instructed to
deny. If the state of Indiana implements the payment requirement, the claims
represented by these billing codes would be paid retroactively to January 1,
2007. Although CompCare does not believe they have a contractual
obligation to pay for this code, it is possible that CompCare might be
responsible for these payments, which in CompCare’s estimation could approximate
$350,000. CompCare believes that the state of Indiana will make a final
determination by mid-April 2008.
Related
to CompCare’s discontinued hospital operations, Medicare guidelines allow the
Medicare fiscal intermediary to re-open previously filed cost reports.
CompCare’s fiscal 1999 cost report, the final year CompCare was required to file
a cost report, is being reviewed, in which case the intermediary may determine
that additional amounts are due to or from Medicare. CompCare management
believes cost reports for fiscal years prior to fiscal 1999 are closed and
considered final.
Legal
Proceedings
From
time to time, we may be involved in litigation relating to claims arising out of
our operations in the normal course of business. As of the December 31, 2007, we
were not involved in any legal proceeding that we believe would have a material
adverse effect on our business, financial condition or operating
results.
CompCare
may incur further legal defense fees and may be subject to awards of plaintiff’s
attorney fees or other fees, the amounts of which are not reasonably
estimable. See Part I, Item 3, “Legal Proceedings” for a description
of these matters.
Note
15. Related Party Transactions
Andrea
Grubb Barthwell, M.D., a member of our Board of Directors, is the founder and
chief executive officer of a healthcare and policy consulting firm providing
consulting services to us. In 2007 and 2006, we paid or accrued
approximately $156,000 and $189,000, respectively, in fees to the consulting
firm.
There
were no other material related party transactions in 2007, 2006 or
2005.
Note
16. Subsequent Events (Unaudited)
In
January 2008 we streamlined our operations to increase our focus on disease
management and managed care opportunities, which is expected to result in an
overall reduction of 25% to 30% of cash operating expenses for the fiscal year
ending December 31, 2008. The actions we took included eliminating field and
regional sales personnel and related corporate support personnel, closing the
PROMETA Center in San Francisco, a reduction in outside consultants and overall
reductions in overhead costs. Estimated one-time costs associated with
these actions were approximately $1.0 million and will be recognized as a charge
to operating expenses in the statement of operations for the quarter ended March
31, 2008. Such costs primarily represent severance and related benefits and
costs incurred to close the San Francisco PROMETA Center. We do not expect to
incur any material additional costs associated with this initiative.
Note
17. Interim Financial Information (Unaudited)
Summarized quarterly supplemental
financial information is as follows:
Quarter
Ended
|
Total
|
||||||||||||||||||||||
March
|
June
|
September
|
December
|
Year
|
|||||||||||||||||||
(In
thousands, except per share amounts)
|
|||||||||||||||||||||||
Year
Ended December, 31, 2007
|
|||||||||||||||||||||||
Revenues
|
$ | 8,857 | $ | 11,340 | $ | 12,020 | $ | 11,784 | $ | 44,001 | |||||||||||||
Loss
from operations
|
(10,772 | ) | (12,020 | ) | (13,473 | ) |
(a)
|
(11,266 | ) | (47,531 | ) | ||||||||||||
Net
loss
|
(10,743 | ) | (12,252 | ) | (13,843 | ) |
(a)
|
(8,624 | ) |
(b)
|
(c)
|
(45,462 | ) | ||||||||||
Basic
and diluted loss per share
|
(0.25 | ) | (0.28 | ) | (0.31 | ) |
(a)
|
(0.17 | ) |
(b)
|
(c)
|
(0.99 | ) | ||||||||||
Year
Ended December, 31, 2006
|
|||||||||||||||||||||||
Revenues
|
$ | 653 | $ | 1,172 | $ | 1,071 | $ | 1,010 | $ | 3,906 | |||||||||||||
Loss
from operations
|
(9,204 | ) | (9,394 | ) | (10,212 | ) | (10,486 | ) | (39,296 | ) | |||||||||||||
Net
loss
|
(8,728 | ) | (8,962 | ) | (9,829 | ) | (10,779 | ) | (38,298 | ) | |||||||||||||
Basic
and diluted loss per share
|
(0.22 | ) | (0.23 | ) | (0.25 | ) | (0.27 | ) | (0.96 | ) |
(a)
|
Includes
a $2.4 million impairment loss related to the non-cash stock settlement
reached with XINO Corporation in August 2007. See further
discussion in Note 6 – Intangible
Assets.
|
(b)
|
The
fair value of warrants issued in conjunction with the registered direct
placement in November 2007 was accounted for as a liability and was
revalued at $2.8 million at December 31, 2007, resulting in $3.5 million
non-operating gain.
|
(c)
|
Includes
a loss of $741,000 on extinguishment of debt resulting from the
redemption of $5 million in Highbridge senior secured notes in
November 2007. See further discussion in Note 7 – Debt
Outstanding.
|
F-36