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NextGen Healthcare
Annual Report 2015

NXGN · NASDAQ Healthcare
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FY2015 Annual Report · NextGen Healthcare
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C O R P O R AT E   H E A D Q U A R T E R S   &

Q S I D E N TA L   L O C AT I O N

18111 Von Karman Avenue, Suite 700

Irvine, California 92612

949.255.2600

Q S I / N E X T G E N   L O C AT I O N S

3340 Peachtree Road NE, Suite 2700

1155 F Street NW, Suite 1050

Atlanta, Georgia 30326

Washington, DC 20004

11350 McCormick Road

2795 E. Cottonwood Parkway

Hunt Valley, Maryland 21031

Salt Lake City, Utah 84121

1836 Lackland Hill Parkway

St. Louis, Missouri 63146

611 Anton Boulevard, Suite 500

Costa Mesa, California 92626

5200 Stoneham Road, Suite 210

3200 Park Center Drive, Suite 310

North Canton, Ohio 44720

Costa Mesa, California 92626

Q S I   H E A LT H C A R E   P R I VAT E   L I M I T E D   L O C AT I O N

795 Horsham Road

Horsham, Pennsylvania 19044

12301-B Riata Trace Parkway, Suite 200

Austin, Texas 78727

Outer Ring Road, Bellandur Post

Pritech Park SEZ

Block 11, First Floor

Bangalore – 560103

Karnataka India

www.qsii.com         www.nextgen.com

2 0 1 5   A N N U A L   R E P O R T

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T O O L S   T O   P O W E R 
T H E   N E X T   G E N E R AT I O N 
O F   H E A LT H C A R E

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
C O M P A N Y   P R O F I L E

C O R P O R A T E   I N F O R M A T I O N

Quality Systems, Inc. (NASDAQ:QSII) and its NextGen Healthcare subsidiary 

B O A R D   O F   D I R E C T O R S

A N N U A L   M E E T I N G

(QSI/NextGen Healthcare) develop and market a wide range of cutting-edge healthcare 

information technology software and services, including practice management solutions, 

electronic health records, revenue cycle management services and patient engagement 

tools along with connectivity and interoperability applications. The Company serves 

medical and dental group practices as well as rural and community hospitals. The 

Managing Director, Janas Associates

F O R M   1 0 - K

QSI/NextGen Healthcare solution suite is designed to address the changing healthcare 

landscape and evolving models.

Fiscal Year 2015

Revenue: $490.2 million
Diluted Non-GAAP EPS: $0.62*

Revenue: 

$373.8 million
(76% of Total)

Revenue: 

~ 85,000
Providers

$18.5 million
(4% of Total)

~ 10,000
Dentists

Revenue: 

$80.0 million
(16% of Total)

Revenue: 

~ 6,500
Providers

$18.0 million
(4% of Total)

~ 300
Hospitals

Market 
Served: 

Ambulatory  
Practices

Market 
Served: 

Dental
Practices

Market 
Served: 

Ambulatory
Practices

Market 
Served: 

Small
Hospitals

Executive Vice President, General Counsel 

• Practice
  Management

• EHR

• Population 
  Health
   Management

• Patient Portal

• Practice
  Management

• Electronic
  Health Records

• Revenue Cycle
  Management

• Other Services

• Financials

• Clinical

• Surgery
  Scheduling

*  This is a non-GAAP (Generally Accepted Accounting Principles) fi nancial measure, which is being provided only as supplemental information. Investors 

should consider this non-GAAP fi nancial measure only in conjunction with the comparable GAAP fi nancial measure. This non-GAAP fi nancial measure 

is not in accordance with or a substitute for U.S. GAAP. Pursuant to the requirements of Regulation G, we have provided a reconciliation of this non-

GAAP fi nancial measure to the most directly comparable GAAP fi nancial measure in the fi nancial tables accompanying our press release announcing 

our fi nancial performance for the period ended March 31, 2015, a copy of which is furnished as Exhibit 99.1 of the Form 8-K fi led on May 21, 2015 with 

the Securities and Exchange Commission. Other companies may calculate this non-GAAP measure differently than we do, which limits comparability 

between companies. We believe that the presentation of non-GAAP diluted earnings per share provides useful supplemental information to investors 

and management regarding our fi nancial condition and results. We calculate non-GAAP diluted earnings per share by excluding acquisition costs, 

amortization of acquired intangible assets, impairment of goodwill and other assets, securities litigation defense costs, share-based compensation, 
and other non-run-rate expenses from GAAP income before provision for income taxes. The non-GAAP provision for income taxes is calculated by 

excluding the income tax effect of the non-GAAP adjustments.

Sheldon Razin

Chairman of the Board and Founder 

Quality Systems, Inc.

Steven T. Plochocki

President and Chief Executive Officer 

Quality Systems, Inc. (Retiring June 30, 2015)

Craig A. Barbarosh

Partner, Katten Muchin Rosenman LLP

George H. Bristol

James C. Malone

Executive Vice President and 

Chief Financial Officer, XIFIN, Inc.

Jeffrey H. Margolis

Chairman and Chief Executive Officer, Welltok, Inc.

Morris Panner

Chief Executive Officer, DICOM Grid

D. Russell Pflueger

Chairman and Chief Executive Officer 

Quiescence Medical, Inc.

Lance E. Rosenzweig

Operating Partner, Marlin Equity Partners

O F F I C E R S   O F   T H E   C O M PA N Y

Steven T. Plochocki

President and Chief Executive Officer

(Retiring June 30, 2015)

Incoming President and Chief Executive Officer

Rusty Frantz

(Effective July 1, 2015)

Jocelyn A. Leavitt

and Secretary

Daniel J. Morefield

Executive Vice President, Chief Operating Officer

Stephen K. Puckett

Executive Vice President, Chief Technology Officer

John K. Stumpf

Interim Chief Financial Officer

I N D E P E N D E N T   A U D I T O R S

PricewaterhouseCoopers LLP

Irvine, California

S T O C K   T R A N S F E R   A G E N T 

&   R E G I S T R A R

Computershare

Glendale, California

2015 Annual Shareholders’ Meeting is scheduled to 

be held on Tuesday, August 11, 2015 at 1:00 PM 

Pacific Time.

The meeting will be held at:

The Center Club

650 Town Center Drive

Costa Mesa, California 92626

The meeting may be subject to change or 

postponement by Quality Systems’ Board of Directors. 

A copy of the Company’s Annual Report on Form 10-K, 

filed with the Securities and Exchange Commission, is 

available on the Company’s website at www.qsii.com 

or by contacting the Company at:

Quality Systems, Inc.

Attention: Investor Relations

18111 Von Karman Avenue, Suite 700

Irvine, California 92612

949.255.2600

F O R W A R D - L O O K I N G   S TAT E M E N T S

Statements made in this Annual Report to Shareholders and 

in our Annual Report on Form 10-K (“Form 10-K”) contained 

herein (collectively, this “Report”), other reports and proxy 

statements fi led with the Securities and Exchange Commission 

(“Commission”),  communications  to  shareholders,  press 

releases  and  oral  statements  made  by  our  representatives 

that are not historical in nature, or that state our or manage-

ment’s intentions, hopes, beliefs, expectations or predictions 

of the future, may constitute “forward-looking statements” 

within  the  meaning  of  Section  21E  of  the  Securities  and 

Exchange Act of 1934, as amended. Forward-looking state-

ments can often be identifi ed by the use of forward-looking 

terminology, such as “could,” “should,” “will,” “will be,” “will 

lead,” “will assist,” “intended,” “continue,” “believe,” “may,” 

“expect,”  “hope,”  “anticipate,”  “goal,”  “forecast,”  “plan,” 

“potentially”  or  “estimate”  or  variations  thereof  or  similar 

expressions. Forward-looking statements are not guarantees 

of future performance. Forward-looking statements involve 

risks, uncertainties and assumptions. It is important to note 

that any such performance and actual results, fi nancial condi-

tion or business, could differ materially from those expressed 

in such forward-looking statements. Factors that could cause 

or contribute to such differences include, but are not limited 

to, the risk factors discussed in Item 1A of our Form 10-K as 

well as factors discussed elsewhere in this and other reports 

and documents we fi le with the Commission. Other unforeseen 

factors not identifi ed herein could also have such an effect. We 

undertake no obligation to update or revise forward-looking 

statements to refl ect changed assumptions, the occurrence of 

unanticipated events or changes in future operating results, 

fi nancial condition or business over time unless required by 

law. Interested persons are urged to review the risks described 

under Item 1A, “Risk Factors” and in Item 7, “Management’s 

Discussion and Analysis of Financial Condition and Results of 

Operations” in our Form 10-K, as well as in our other public 

disclosures and fi lings with the Commission.

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LETTER TO SHAREHOLDERS

Q u a l i t y   S y s t e m s ,   I n c .   |       1

At the core of Quality System, Inc.’s (QSI) healthcare information technology (HCIT) offerings lie innovative solutions that have powered the automation of medical and dental practices for more than four decades. When the Company was founded, it began with a practice management software suite for dentists, which then expanded into a leading Electronic Health Record (EHR) platform for physicians, and later, a full spectrum of computer-based healthcare products and services. Over time, the healthcare landscape has become signifi -cantly more complex. While the provision of quality patient care remains at the industry’s nucleus, costs and effi ciencies are paramount to the successful delivery of care. Our agility and fl exibility in creating a plethora of solutions that cater to the evolving marketplace has resulted in a portfolio that now spans nearly 30 products and services designed to meet the needs of our nation’s emerging value-based healthcare system. Today, Quality Systems and its NextGen Healthcare subsidiary (QSI/NextGen Healthcare), boasts among the largest installed user bases in the country, with approxi-mately 85,000 providers across 4,400 clients and 300+ hospital relationships, all of which rely on our technology to run their practices. Billions of patient encounters are handled using QSI/NextGen Healthcare solutions. As we leverage both our substantial practice penetra-tion and broad offerings, QSI/NextGen Healthcare has an unmatched opportunity to continue to bring tools to market that cater to the next generation of healthcare. Restructuring and RetoolingThe emergence of the American Recovery and Reinvestment Act of 2009 was the fi rst indication of the nation’s transformation to an electronic-based system. As the medical industry began to reshape and undergo reform, QSI/NextGen Healthcare also reinvented its business model to successfully participate in the changing HCIT marketplace. The criteria outlining what an electronic healthcare delivery system would represent extends way beyond simply accessing and sharing information. Today, the digitization of healthcare is the vehicle by which patient populations are managed and escalating medical costs are controlled. This stands to become even more intricate as our nation’s population ages and the government mandates the management of patients by condition and cost, moving from traditional fee-for-service reimbursement models to value-based care. Accountable Care Organizations (ACOs) have become the primary care model. ACOs comprise a set of health care providers – including primary care physicians, specialists and hospitals – that work together collabora-tively and accept collective accountability for the cost and quality of care delivered to a population of patients. Many of our clients participate in ACOs today.These system shifts propelled change within our Company. Over the past three years, we evaluated our internal structure and reorganized operations accord-ingly. To this end, we restructured our management team and appointed new leadership; realigned sales and marketing efforts under one function; strengthened our sales force; and, refocused our business. By building upon our strengths, we leveraged our internal sales expertise and further trained our sales experts, better positioning them to cross-sell the expansive product offerings we now bring to the table. Additionally, QSI/NextGen Healthcare completed 11 acquisitions between 2007 and 2013, further complementing our strong foundation and expanding the breadth and depth of our offerings.A sampling of our product portfolio demonstrates the capabilities and scope of our solutions: Ambulatory• NextGen® Ambulatory EHR – Enables providers to focus on care that reaps better outcomes. • NextGen® Practice Management – Increases productivity, automates labor-intensive tasks, streamlines workfl ows and optimizes resources, resulting in bottom-line growth. • NextGen® Patient Portal – Promotes patient satisfaction through easy access to medical records, payments and scheduling – anytime, anywhere.Population Health 
Management and Analytics

•  Mirth® Results – Retrieves an accurate, commu-

nity-wide patient view from an aggregated data 

•  NextGen Care™ – Improves overall patient popu-

repository. 

lation health while meeting value-based quality 

measures and provides collaborative care from a 

single, interoperable care management platform. 

•  NextGen® Dashboard – Delivers real-time clinical 

•  Mirth® Match – Solves challenging patient identity 

management issues between systems.

•  Mirth® Appliance – Provides cost-effi cient health 

information technology messaging capabilities 

and fi nancial practice performance for making 

and tools.

informed clinical decisions. 

QSI/NextGen Healthcare tools help to share information 

•  Mirth® Care Enterprise – Uses data integration and 

amongst those using the platform:

aggregation from disparate sources and provides 

analytics and automated interventions to help 

community care teams better manage patients and 

assess risk. 

•  NextGen® Share – Enables clients to fi nd other 

connected providers and easily send secure, direct 

messages. Clients can exchange referrals with 

clinical documents and count these transactions 

•  Mirth® Analytics – Leverages value-based analytics 

for Meaningful Use (MU) attestation. 

used for transforming data into actions for managing 

patients across disparate systems.

Revenue Cycle Management

•  NextGen® RCM – Streamlines workfl ows, identifi es 

revenue leaks, expedites payment processes and 

optimizes revenue collections. Recently ranked the 

top overall RCM services provider by KLAS, a leading, 

independent healthcare technology ratings provider.

Interoperability

Our revolutionary Mirth® solutions enable disparate 

systems across multiple organizations to connect within 

virtual networks, fostering the delivery of better care 

and improved patient outcomes:

•  Mirth® Connect – Automates interfaces and drives 

workfl ow between institutions for interoperability. 

•  NextGen® EHR Connect – Helps providers share 

standards-based data from the NextGen Ambulatory 

EHR with external systems, including laboratories, 

payers, other EHR systems and Health Information 

Exchanges (HIEs).

Dental

•  NextGen® EDR – Shares patient records from 

dentists and physicians to increase productivity and 

safety and reduce costs. Integrates seamlessly with 

NextGen® ambulatory solutions to provide a compre-

hensive community solution for healthcare entities 

such as Federally Qualifi ed Health Centers (FQHCs), 

Community Health Centers (CHCs) and tribal health 

practices.

•  QSIDental Web® – Helps decrease costs and 

streamline workfl ow using cloud-based, consoli-

•  Mirth® Mail – Fosters fast, easy, secure messaging 

dated, single-patient charts for multi-location 

between providers using community networks.

practices. Also enables access to clinical and 

patient data whenever, wherever from web-

enabled devices.

2       |     2 0 1 5   A n n u a l   R e p o r t

Ready for Regulation

The novel solutions we now offer include those 

developed to help our clients cost-effectively 

74,000 diagnosis codes at implementation, more than 

tripling the 20,000 used today. This will create a monu-

mental sea change industry wide.

manage patient populations; navigate the changing, 

ICD-10 will prompt another turning point as providers 

multi-faceted healthcare landscape; and, be 

prepared to meet regulatory changes such as the 

multiple stages of MU. 

MU refers to standards set forth by the Centers 

for Medicare and Medicaid Services EHR Incentive 

Programs for the use of EHRs, allowing eligible 

providers and hospitals to earn incentive payments 

by meeting specifi c criteria. MU currently spans 

three stages: 

•  Stage 1 set basic functionalities for EHRs. The 

requirements focused on providers’ ability to mean-

ingfully use their EHRs to meet thresholds for various 

objectives, and, capture patient data and share it, 

either with the patient or amongst other healthcare 

professionals. 

scramble to ensure their systems are ICD-10 compliant 

and ready to appropriately categorize patient diag-

noses. We believe the shift to ICD-10 could possibly 

prompt sales from the replacement market, which 

refers to those providers with older or less robust elec-

tronic platforms that may be unequipped to meet the 

next wave of the healthcare industry’s demands. These 

providers may have no other choice than to replace 

their current platforms so they can receive appropriate 

reimbursement from the government, which could 

spark revenue generation for HCIT players like QSI/

NextGen Healthcare. We believe these regulations 

could provide tailwinds for our RCM business as the 

need for outsourcing increases. 

The New Frontier

•  Stage 2 of MU, known as MU2, began in 2014, 

requiring advanced clinical processes. The 

We stand ready to face the next phase of healthcare. 

Our business units directly address the needs of our 

requirements were centered around the exchange 

clients and are headed by leaders in their respective 

of health information between providers and 

promoted patient engagement by allowing 

areas, including the ambulatory, RCM, hospital and 

dental arenas. The professionals that lead our busi-

patients secure online access to their own personal 

ness units have contributed signifi cantly to the industry 

health-related information. 

leadership position we hold today. 

•  Stage 3 of the CMS EHR Incentive Program (or MU3), 

As we enter fi scal 2016, we are keeping an open mind 

is proposed to be optional in 2017 and required in 

in identifying complementary acquisitions that are 

2018 but the rules are not yet fi nalized. The proposed 

easy to integrate and will further cement our role in 

rules should be fi nalized by the end of 2015.

helping our clients compete in this rapidly evolving 

We anticipate that the implementation of MU3 will be 

marketplace. 

a key catalyst in our future growth. Interoperability and 

For example, in April 2015, we completed the acquisi-

broad sharing of patient health information are key 

tion of Gennius, Inc., a leading provider of healthcare 

proposed elements of MU3, and we are well posi-

data analytics. Gennius is expected to enhance the 

tioned in our capabilities surrounding the exchange of 

Company’s current enterprise analytics competencies 

healthcare information.

Another key regulatory change for the HCIT market-

place is the impending switch to ICD-10, a coding 

system of clinical classifi cations established by the 

World Health Organization, used to categorize diag-

noses in medical records. ICD-10, currently slated 

to occur in October 2015, will require approximately 

while broadening our business intelligence capabilities 

for addressing new value-based care requirements. 

This will complement solutions offered through our 

Mirth business line. These types of “bolt-on” acquisi-

tion opportunities remain prevalent as consolidation 

within healthcare continues.

Q u a l i t y   S y s t e m s ,   I n c .   |       3

R E C U R R I N G   S E R V I C E   R E V E N U E

(US $ mm)

80%

$357.9

73%
$336.6 

83%

$405.2

65%

$281.0

65%

$228.8

2011

2012

2013 

2014

2015

Recurring Service 
Revenue  

Recurring service revenue as 
% of total revenue 

Sheldon Razin

Daniel J. Morefi eld

Chairman of the Board 
and Founder 

Executive Vice President 
and Chief Operating Offi cer

4       |     2 0 1 5   A n n u a l   R e p o r t

Refocusing Reaps Returns Our fi scal 2015 results refl ect the cumulative organic, core growth stemming from sales of all our products and services.For the fi scal 2015 year ended March 31, 2015, revenue reached a record $490.2 million, a 10 percent increase when compared with $444.7 million reported in the 2014 fi scal year. Our recurring revenue base reached $405.2 million for the fi scal year ended 2015, which represented 83 percent of total revenue.Net income rose 74 percent in fi scal 2015 to $27.3 million versus $15.7 for fi scal 2014. Our fi scal 2014 results included a $26.0 million special charge associated with our hospital division while our fi scal 2015 results refl ect a net increase in research and development expenses of $27.7 million relative to fi scal 2014.Cash fl ows from operations were $82.8 million during fi scal 2015, and we returned $42.8 million to share-holders in the form of dividends while improving the Company’s cash and investments position by $16.8 million. Fiscal 2015 ended with the Company remaining free of debt and with $130.6 million in cash and marketable securities, compared with $113.8 million at the end of the 2014 fi scal year. During fi scal 2015, we continued to heavily invest in research and development to further fortify our position within the HCIT marketplace. In fact, the Company’s total investment in research and development, including capitalized software, grew to $83.8 million during fi scal 2015 versus $62.3 million in fi scal 2014. We are confi dent our research and development spending initiatives will bode well for the Company as well as our clients over the longer term. Furthermore, our operations in Bangalore, India have grown to include 395 employees, and are a critical component of our research and development efforts. NextGen RCM Services, which we believe will be inte-gral to our future growth, grew 18 percent during fi scal 2015. With only a 10 percent penetration within our current installed base, we view the opportunity for RCM as signifi cant.Ready for TomorrowThe crux of healthcare remains the same – all constitu-ents are constantly trying to fi gure out how best to care for a growing population in need of services and how to manage their health cost effectively. Today, we remain committed to innovating for tomorrow. We are creating customized solutions that keep our clients poised to adapt to the many healthcare challenges ahead. Our global team of nearly 3,000 employees is dedicated to bringing the latest and greatest technologies to the providers and patients we touch each and every day. We thank our team of professionals for their tireless efforts and appreciate the chance to serve our clients’ ever-changing needs. We value our shareholders, who understand the complexity of healthcare technology and recognize our role in the marketplace. And, we take this time to acknowledge the guidance provided by our Board of Directors. All these stakeholders are central to our success. While we continue to design, develop and market solutions for the next generation of healthcare, we are also helping to defi ne what the future of healthcare entails.Respectfully,  
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549 
FORM 10-K

(cid:55)

(cid:133)

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE  
SECURITIES EXCHANGE ACT OF 1934

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QUALITY SYSTEMS, INC.

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(cid:2)

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(cid:37)(cid:81)(cid:79)(cid:79)(cid:81)(cid:80)(cid:2)(cid:53)(cid:86)(cid:81)(cid:69)(cid:77)(cid:14)(cid:2)(cid:6)(cid:18)(cid:16)(cid:18)(cid:19)(cid:2)(cid:50)(cid:67)(cid:84)(cid:2)(cid:56)(cid:67)(cid:78)(cid:87)(cid:71)(cid:2)

(cid:48)(cid:67)(cid:79)(cid:71)(cid:2)(cid:81)(cid:72)(cid:2)(cid:71)(cid:67)(cid:69)(cid:74)(cid:2)(cid:71)(cid:90)(cid:69)(cid:74)(cid:67)(cid:80)(cid:73)(cid:71)(cid:2)(cid:81)(cid:80)(cid:2)(cid:89)(cid:74)(cid:75)(cid:69)(cid:74)(cid:2)(cid:84)(cid:71)(cid:73)(cid:75)(cid:85)(cid:86)(cid:71)(cid:84)(cid:71)(cid:70) 
(cid:48)(cid:35)(cid:53)(cid:38)(cid:35)(cid:51)(cid:2)(cid:41)(cid:78)(cid:81)(cid:68)(cid:67)(cid:78)(cid:2)(cid:53)(cid:71)(cid:78)(cid:71)(cid:69)(cid:86)(cid:2)(cid:47)(cid:67)(cid:84)(cid:77)(cid:71)(cid:86)

Securities registered pursuant to Section 12(g) of the Act: None 

(cid:43)(cid:80)(cid:70)(cid:75)(cid:69)(cid:67)(cid:86)(cid:71)(cid:2)(cid:68)(cid:91)(cid:2)(cid:69)(cid:74)(cid:71)(cid:69)(cid:77)(cid:2)(cid:79)(cid:67)(cid:84)(cid:77)(cid:2)(cid:75)(cid:72)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:84)(cid:71)(cid:73)(cid:75)(cid:85)(cid:86)(cid:84)(cid:67)(cid:80)(cid:86)(cid:2)(cid:75)(cid:85)(cid:2)(cid:67)(cid:2)(cid:89)(cid:71)(cid:78)(cid:78)(cid:15)(cid:77)(cid:80)(cid:81)(cid:89)(cid:80)(cid:2)(cid:85)(cid:71)(cid:67)(cid:85)(cid:81)(cid:80)(cid:71)(cid:70)(cid:2)(cid:75)(cid:85)(cid:85)(cid:87)(cid:71)(cid:84)(cid:14)(cid:2)(cid:67)(cid:85)(cid:2)(cid:70)(cid:71)(cid:386)(cid:80)(cid:71)(cid:70)(cid:2)(cid:75)(cid:80)(cid:2)(cid:52)(cid:87)(cid:78)(cid:71)(cid:2)(cid:22)(cid:18)(cid:23)(cid:2)(cid:81)(cid:72)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:53)(cid:71)(cid:69)(cid:87)(cid:84)(cid:75)(cid:86)(cid:75)(cid:71)(cid:85)(cid:2)(cid:35)(cid:69)(cid:86)(cid:16)(cid:2)

(cid:59)(cid:71)(cid:85)(cid:2)(cid:55)   No (cid:133)

(cid:43)(cid:80)(cid:70)(cid:75)(cid:69)(cid:67)(cid:86)(cid:71)(cid:2)(cid:68)(cid:91)(cid:2)(cid:69)(cid:74)(cid:71)(cid:69)(cid:77)(cid:2)(cid:79)(cid:67)(cid:84)(cid:77)(cid:2)(cid:75)(cid:72)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:84)(cid:71)(cid:73)(cid:75)(cid:85)(cid:86)(cid:84)(cid:67)(cid:80)(cid:86)(cid:2)(cid:75)(cid:85)(cid:2)(cid:80)(cid:81)(cid:86)(cid:2)(cid:84)(cid:71)(cid:83)(cid:87)(cid:75)(cid:84)(cid:71)(cid:70)(cid:2)(cid:86)(cid:81)(cid:2)(cid:386)(cid:78)(cid:71)(cid:2)(cid:84)(cid:71)(cid:82)(cid:81)(cid:84)(cid:86)(cid:85)(cid:2)(cid:82)(cid:87)(cid:84)(cid:85)(cid:87)(cid:67)(cid:80)(cid:86)(cid:2)(cid:86)(cid:81)(cid:2)(cid:53)(cid:71)(cid:69)(cid:86)(cid:75)(cid:81)(cid:80)(cid:2)(cid:19)(cid:21)(cid:2)(cid:81)(cid:84)(cid:2)(cid:53)(cid:71)(cid:69)(cid:86)(cid:75)(cid:81)(cid:80)(cid:2)(cid:19)(cid:23)(cid:10)(cid:70)(cid:11)(cid:2)(cid:81)(cid:72)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:35)(cid:69)(cid:86)(cid:16)(cid:2) (cid:59)(cid:71)(cid:85)(cid:2)(cid:133)   No (cid:55)

(cid:43)(cid:80)(cid:70)(cid:75)(cid:69)(cid:67)(cid:86)(cid:71)(cid:2)(cid:68)(cid:91)(cid:2)(cid:69)(cid:74)(cid:71)(cid:69)(cid:77)(cid:2)(cid:79)(cid:67)(cid:84)(cid:77)(cid:2)(cid:89)(cid:74)(cid:71)(cid:86)(cid:74)(cid:71)(cid:84)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:84)(cid:71)(cid:73)(cid:75)(cid:85)(cid:86)(cid:84)(cid:67)(cid:80)(cid:86)(cid:2)(cid:10)(cid:19)(cid:11)(cid:2)(cid:74)(cid:67)(cid:85)(cid:2)(cid:386)(cid:78)(cid:71)(cid:70)(cid:2)(cid:67)(cid:78)(cid:78)(cid:2)(cid:84)(cid:71)(cid:82)(cid:81)(cid:84)(cid:86)(cid:85)(cid:2)(cid:84)(cid:71)(cid:83)(cid:87)(cid:75)(cid:84)(cid:71)(cid:70)(cid:2)(cid:86)(cid:81)(cid:2)(cid:68)(cid:71)(cid:2)(cid:386)(cid:78)(cid:71)(cid:70)(cid:2)(cid:68)(cid:91)(cid:2)(cid:53)(cid:71)(cid:69)(cid:86)(cid:75)(cid:81)(cid:80)(cid:2)(cid:19)(cid:21)(cid:2)(cid:81)(cid:84)(cid:2)(cid:19)(cid:23)(cid:10)(cid:70)(cid:11)(cid:2)(cid:81)(cid:72)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:53)(cid:71)(cid:69)(cid:87)(cid:84)(cid:75)(cid:86)(cid:75)(cid:71)(cid:85)(cid:2)(cid:39)(cid:90)-
(cid:69)(cid:74)(cid:67)(cid:80)(cid:73)(cid:71)(cid:2)(cid:35)(cid:69)(cid:86)(cid:2)(cid:81)(cid:72)(cid:2)(cid:19)(cid:27)(cid:21)(cid:22)(cid:2)(cid:70)(cid:87)(cid:84)(cid:75)(cid:80)(cid:73)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:82)(cid:84)(cid:71)(cid:69)(cid:71)(cid:70)(cid:75)(cid:80)(cid:73)(cid:2)(cid:19)(cid:20)(cid:2)(cid:79)(cid:81)(cid:80)(cid:86)(cid:74)(cid:85)(cid:2)(cid:10)(cid:81)(cid:84)(cid:2)(cid:72)(cid:81)(cid:84)(cid:2)(cid:85)(cid:87)(cid:69)(cid:74)(cid:2)(cid:85)(cid:74)(cid:81)(cid:84)(cid:86)(cid:71)(cid:84)(cid:2)(cid:82)(cid:71)(cid:84)(cid:75)(cid:81)(cid:70)(cid:2)(cid:86)(cid:74)(cid:67)(cid:86)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:84)(cid:71)(cid:73)(cid:75)(cid:85)(cid:86)(cid:84)(cid:67)(cid:80)(cid:86)(cid:2)(cid:89)(cid:67)(cid:85)(cid:2)(cid:84)(cid:71)(cid:83)(cid:87)(cid:75)(cid:84)(cid:71)(cid:70)(cid:2)(cid:86)(cid:81)(cid:2)(cid:386)(cid:78)(cid:71)(cid:2)(cid:85)(cid:87)(cid:69)(cid:74)(cid:2)(cid:84)(cid:71)(cid:82)(cid:81)(cid:84)(cid:86)(cid:85)(cid:11)(cid:14)(cid:2)
(cid:67)(cid:80)(cid:70)(cid:2)(cid:10)(cid:20)(cid:11)(cid:2)(cid:74)(cid:67)(cid:85)(cid:2)(cid:68)(cid:71)(cid:71)(cid:80)(cid:2)(cid:85)(cid:87)(cid:68)(cid:76)(cid:71)(cid:69)(cid:86)(cid:2)(cid:86)(cid:81)(cid:2)(cid:85)(cid:87)(cid:69)(cid:74)(cid:2)(cid:386)(cid:78)(cid:75)(cid:80)(cid:73)(cid:2)(cid:84)(cid:71)(cid:83)(cid:87)(cid:75)(cid:84)(cid:71)(cid:79)(cid:71)(cid:80)(cid:86)(cid:85)(cid:2)(cid:72)(cid:81)(cid:84)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:82)(cid:67)(cid:85)(cid:86)(cid:2)(cid:27)(cid:18)(cid:2)(cid:70)(cid:67)(cid:91)(cid:85)(cid:16)(cid:2)

(cid:59)(cid:71)(cid:85)(cid:2)(cid:55)   No (cid:133)

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Inter-
(cid:67)(cid:69)(cid:86)(cid:75)(cid:88)(cid:71)(cid:2)(cid:38)(cid:67)(cid:86)(cid:67)(cid:2)(cid:40)(cid:75)(cid:78)(cid:71)(cid:2)(cid:84)(cid:71)(cid:83)(cid:87)(cid:75)(cid:84)(cid:71)(cid:70)(cid:2)(cid:86)(cid:81)(cid:2)(cid:68)(cid:71)(cid:2)(cid:85)(cid:87)(cid:68)(cid:79)(cid:75)(cid:86)(cid:86)(cid:71)(cid:70)(cid:2)(cid:67)(cid:80)(cid:70)(cid:2)(cid:82)(cid:81)(cid:85)(cid:86)(cid:71)(cid:70)(cid:2)(cid:82)(cid:87)(cid:84)(cid:85)(cid:87)(cid:67)(cid:80)(cid:86)(cid:2)(cid:86)(cid:81)(cid:2)(cid:52)(cid:87)(cid:78)(cid:71)(cid:2)(cid:22)(cid:18)(cid:23)(cid:2)(cid:81)(cid:72)(cid:2)(cid:52)(cid:71)(cid:73)(cid:87)(cid:78)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:2)(cid:53)(cid:15)(cid:54)(cid:2)(cid:10)(cid:131)(cid:2)(cid:20)(cid:21)(cid:20)(cid:16)(cid:22)(cid:18)(cid:23)(cid:2)(cid:81)(cid:72)(cid:2)(cid:86)(cid:74)(cid:75)(cid:85)(cid:2)(cid:69)(cid:74)(cid:67)(cid:82)(cid:86)(cid:71)(cid:84)(cid:11)(cid:2)(cid:70)(cid:87)(cid:84)(cid:75)(cid:80)(cid:73)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)
(cid:82)(cid:84)(cid:71)(cid:69)(cid:71)(cid:70)(cid:75)(cid:80)(cid:73)(cid:2)(cid:19)(cid:20)(cid:2)(cid:79)(cid:81)(cid:80)(cid:86)(cid:74)(cid:85)(cid:2)(cid:10)(cid:81)(cid:84)(cid:2)(cid:72)(cid:81)(cid:84)(cid:2)(cid:85)(cid:87)(cid:69)(cid:74)(cid:2)(cid:85)(cid:74)(cid:81)(cid:84)(cid:86)(cid:71)(cid:84)(cid:2)(cid:82)(cid:71)(cid:84)(cid:75)(cid:81)(cid:70)(cid:2)(cid:86)(cid:74)(cid:67)(cid:86)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:84)(cid:71)(cid:73)(cid:75)(cid:85)(cid:86)(cid:84)(cid:67)(cid:80)(cid:86)(cid:2)(cid:89)(cid:67)(cid:85)(cid:2)(cid:84)(cid:71)(cid:83)(cid:87)(cid:75)(cid:84)(cid:71)(cid:70)(cid:2)(cid:86)(cid:81)(cid:2)(cid:85)(cid:87)(cid:68)(cid:79)(cid:75)(cid:86)(cid:2)(cid:67)(cid:80)(cid:70)(cid:2)(cid:82)(cid:81)(cid:85)(cid:86)(cid:2)(cid:85)(cid:87)(cid:69)(cid:74)(cid:2)(cid:386)(cid:78)(cid:71)(cid:85)(cid:11)(cid:16)(cid:2)

(cid:59)(cid:71)(cid:85)(cid:2)(cid:55) No (cid:133)

(cid:43)(cid:80)(cid:70)(cid:75)(cid:69)(cid:67)(cid:86)(cid:71)(cid:2)(cid:68)(cid:91)(cid:2)(cid:69)(cid:74)(cid:71)(cid:69)(cid:77)(cid:2)(cid:79)(cid:67)(cid:84)(cid:77)(cid:2)(cid:75)(cid:72)(cid:2)(cid:70)(cid:75)(cid:85)(cid:69)(cid:78)(cid:81)(cid:85)(cid:87)(cid:84)(cid:71)(cid:2)(cid:81)(cid:72)(cid:2)(cid:70)(cid:71)(cid:78)(cid:75)(cid:80)(cid:83)(cid:87)(cid:71)(cid:80)(cid:86)(cid:2)(cid:386)(cid:78)(cid:71)(cid:84)(cid:85)(cid:2)(cid:82)(cid:87)(cid:84)(cid:85)(cid:87)(cid:67)(cid:80)(cid:86)(cid:2)(cid:86)(cid:81)(cid:2)(cid:43)(cid:86)(cid:71)(cid:79)(cid:2)(cid:22)(cid:18)(cid:23)(cid:2)(cid:81)(cid:72)(cid:2)(cid:52)(cid:71)(cid:73)(cid:87)(cid:78)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:2)(cid:53)(cid:15)(cid:45)(cid:2)(cid:10)(cid:131)(cid:2)(cid:20)(cid:20)(cid:27)(cid:16)(cid:22)(cid:18)(cid:23)(cid:2)(cid:81)(cid:72)(cid:2)(cid:86)(cid:74)(cid:75)(cid:85)(cid:2)(cid:69)(cid:74)(cid:67)(cid:82)(cid:86)(cid:71)(cid:84)(cid:11)(cid:2)(cid:75)(cid:85)(cid:2)(cid:80)(cid:81)(cid:86)(cid:2)(cid:69)(cid:81)(cid:80)-
(cid:86)(cid:67)(cid:75)(cid:80)(cid:71)(cid:70)(cid:2)(cid:74)(cid:71)(cid:84)(cid:71)(cid:75)(cid:80)(cid:14)(cid:2)(cid:67)(cid:80)(cid:70)(cid:2)(cid:89)(cid:75)(cid:78)(cid:78)(cid:2)(cid:80)(cid:81)(cid:86)(cid:2)(cid:68)(cid:71)(cid:2)(cid:69)(cid:81)(cid:80)(cid:86)(cid:67)(cid:75)(cid:80)(cid:71)(cid:70)(cid:14)(cid:2)(cid:86)(cid:81)(cid:2)(cid:86)(cid:74)(cid:71)(cid:2)(cid:68)(cid:71)(cid:85)(cid:86)(cid:2)(cid:81)(cid:72)(cid:2)(cid:84)(cid:71)(cid:73)(cid:75)(cid:85)(cid:86)(cid:84)(cid:67)(cid:80)(cid:86)(cid:111)(cid:85)(cid:2)(cid:77)(cid:80)(cid:81)(cid:89)(cid:78)(cid:71)(cid:70)(cid:73)(cid:71)(cid:14)(cid:2)(cid:75)(cid:80)(cid:2)(cid:70)(cid:71)(cid:386)(cid:80)(cid:75)(cid:86)(cid:75)(cid:88)(cid:71)(cid:2)(cid:82)(cid:84)(cid:81)(cid:90)(cid:91)(cid:2)(cid:81)(cid:84)(cid:2)(cid:75)(cid:80)(cid:72)(cid:81)(cid:84)(cid:79)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:2)(cid:85)(cid:86)(cid:67)(cid:86)(cid:71)(cid:79)(cid:71)(cid:80)(cid:86)(cid:85)(cid:2)(cid:75)(cid:80)(cid:69)(cid:81)(cid:84)(cid:82)(cid:81)-
(cid:84)(cid:67)(cid:86)(cid:71)(cid:70)(cid:2)(cid:68)(cid:91)(cid:2)(cid:84)(cid:71)(cid:72)(cid:71)(cid:84)(cid:71)(cid:80)(cid:69)(cid:71)(cid:2)(cid:75)(cid:80)(cid:2)(cid:50)(cid:67)(cid:84)(cid:86)(cid:2)(cid:43)(cid:43)(cid:43)(cid:2)(cid:81)(cid:72)(cid:2)(cid:86)(cid:74)(cid:75)(cid:85)(cid:2)(cid:40)(cid:81)(cid:84)(cid:79)(cid:2)(cid:19)(cid:18)(cid:15)(cid:45)(cid:2)(cid:81)(cid:84)(cid:2)(cid:67)(cid:80)(cid:91)(cid:2)(cid:67)(cid:79)(cid:71)(cid:80)(cid:70)(cid:79)(cid:71)(cid:80)(cid:86)(cid:2)(cid:86)(cid:81)(cid:2)(cid:86)(cid:74)(cid:75)(cid:85)(cid:2)(cid:40)(cid:81)(cid:84)(cid:79)(cid:2)(cid:19)(cid:18)(cid:15)(cid:45)(cid:16)(cid:2)

(cid:2)(cid:55)

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DOCUMENTS INCORPORATED BY REFERENCE

 
QUALITY SYSTEMS, INC. 

TABLE OF CONTENTS 
2015 ANNUAL REPORT ON FORM 10-K 

Item 

Page 

PART I 

PART II 

Item 1. 

Business 

Item 1A. 

Risk Factors 

Item 1B. 

Unresolved Staff Comments 

Properties 

Legal Proceedings 

Mine and Safety Disclosures 

Item 2. 

Item 3. 

Item 4. 

Item 5. 

Item 6. 

Item 7. 

Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of 
Equity Securities 

Selected Financial Data 

Management’s Discussion and Analysis of Financial Condition and Results of Operations 

Item 7A. 

Quantitative and Qualitative Disclosures about Market Risks 

Item 8. 

Item 9. 

Financial Statements and Supplementary Data 

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure 

Item 9A. 

Controls and Procedures 

Item 9B. 

Other Information 

PART III 

Item 10. 

Directors, Executive Officers and Corporate Governance 

Item 11. 
Item 12. 

Executive Compensation 

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder 
Matters 

Item 13. 

Certain Relationships and Related Transactions, and Director Independence 

Item 14. 

Principal Accountant Fees and Services 

Item 15. 

Exhibits and Financial Statement Schedules 

Signatures 

PART IV 

3 

13 

25 

25 

26 

26 

27 

29 

30 

51 

51 

51 

51 

52 

53 

53 

53 

53 

53 

54 

57 

 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
  
 
 
  
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
 
 
 
 
 
 
   
 
 
   
 
 
 
 
 
 
CAUTIONARY STATEMENT 

This Annual Report on Form 10-K (this "Report") and certain information incorporated herein by reference contain forward-
looking statements within the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995. All statements 
included or incorporated by reference in this Report, other than statements that are purely historical, are forward-looking 
statements. Words such as “anticipate,” “expect,” “intend,” “plan,” “believe,” “seek,” “estimate,” “will,” “should,” “would,” “could,” 
“may,” and similar expressions also identify forward-looking statements. These forward-looking statements include, without 
limitation, discussions of our product development plans, business strategies, future operations, financial condition and 
prospects, developments in and the impacts of government regulation and legislation and market factors influencing our results. 
Our expectations, beliefs, objectives, intentions and strategies regarding our future results are not guarantees of future 
performance and are subject to risks and uncertainties, both foreseen and unforeseen, that could cause actual results to differ 
materially from results contemplated in our forward-looking statements. These risks and uncertainties include, but are not limited 
to, our ability to continue to develop new products and increase systems sales in markets characterized by rapid technological 
evolution, consolidation, and competition from larger, better-capitalized competitors. Many other economic, competitive, 
governmental and technological factors could affect our ability to achieve our goals, and interested persons are urged to review 
the risks factors discussed in “Item 1A. Risk Factors” of this Report, as well as in our other public disclosures and filings with the 
Securities and Exchange Commission (“SEC”). Because of these risk factors, as well as other variables affecting our financial 
condition and results of operations, past financial performance may not be a reliable indicator of future performance and 
historical trends should not be used to anticipate results or trends in future periods. We assume no obligation to update any 
forward-looking statements. You are cautioned not to place undue reliance on forward-looking statements, which speak only as 
of the date of the filing of this Report. 

ITEM 1. BUSINESS 

Company Overview 

PART I 

Quality Systems, Inc. and its wholly-owned subsidiaries operate as four business divisions (each, a "Division") which are 
comprised of: (i) the QSI Dental Division, (ii) the NextGen Division, (iii) the Hospital Solutions Division and (iv) the RCM Services 
Division. We also have a captive entity in India called Quality Systems India Healthcare Private Limited (“QSIH”). We primarily 
derive revenue by developing and marketing healthcare information systems that automate certain aspects of medical and 
dental practices, networks of practices such as physician hospital organizations (“PHOs”) and management service 
organizations (“MSOs”), accountable care organizations, ambulatory care centers, community health centers and medical and 
dental schools along with comprehensive systems implementation, maintenance and support and add-on complementary 
services such as revenue cycle management (“RCM”) and electronic data interchange (“EDI”). Our systems and services 
provide our customers with the ability to redesign patient care and other workflow processes while improving productivity through 
the facilitation of managed access to patient information. Utilizing our proprietary software in combination with third party 
hardware and software solutions, our products enable the integration of a variety of administrative and clinical information 
operations. Our scalable interoperability and population health offerings help to improve care collaboration, quality and safety. 
Enabled by our interoperability and enterprise analytics solutions, data-driven patient population healthcare management 
decisions can assist in creating more desirable operational, clinical, and financial outcomes that substantiate the value of 
patient-centered and accountable care models. 

Quality Systems, Inc. was incorporated in California in 1974. Our principal offices are located at 18111 Von Karman Ave., Suite 
700, Irvine, California, 92612. We operate on a fiscal year ending on March 31. 

Our Company was founded with an early focus on providing information systems to dental group practices. This focus area 
would later become the QSI Dental Division. In the mid-1980s, we capitalized on the increasing focus on medical cost 
containment and further expanded our information processing systems to serve the ambulatory market. In the mid-1990s, we 
made two acquisitions that accelerated our penetration of the ambulatory market and formed the basis for the NextGen Division. 
In the last few years, we acquired several companies, including Sphere Health Systems, Inc. ("Sphere"), Opus Healthcare 
Solutions, LLC ("Opus"), IntraNexus, Inc. ("IntraNexus"), CQI Solutions, Inc. ("CQI"), ViaTrack Systems, LLC ("ViaTrack"), Matrix 
Management Solutions, LLC (“Matrix”), and The Poseidon Group ("Poseidon"), as part of our strategy to enhance our EDI and 
RCM services capabilities as well as expand into the small and specialty hospital market. More recently we acquired Mirth 
Corporation ("Mirth") and Gennius, Inc. ("Gennius"), both of which operate under the NextGen Division. Mirth enhances our 
current enterprise interoperability initiatives and broadens our accountable and collaborative care, population health, disease 
management and clinical data exchange offerings. Gennius is expected to enhance our current enterprise healthcare data 
analytics competencies while broadening business intelligence capabilities for addressing new value-based care requirements. 
Today, we serve the dental, ambulatory, hospital and RCM services markets through each of our four business Divisions. 

A growing number of customers are simultaneously utilizing software or services from more than one of our Divisions. In an 
effort to further enhance our ability to cross sell products and services between Divisions, we are in the process of further 
integrating our ambulatory and hospital products to provide a more robust and comprehensive platform to offer our customers.  
To achieve greater efficiency and integration within in our operations, we have consolidated our divisional sales, marketing, 
information services, and software development responsibilities into single company-wide roles.  The Divisions also share the 

3 

 
 
 
 
resources of our “corporate office,” which includes a variety of accounting and other administrative functions. We continue to 
evaluate the organizational structure of the Company with the objective of achieving greater synergies and further integration of 
our products and services, including software implementation and customer support functions. 

The QSI Dental Division, NextGen Division and Hospital Solutions Division develop and market software that is designed to 
automate and streamline a number of the administrative functions required for operating a medical, dental, or hospital practice, 
such as patient scheduling and billing. Since practice management software systems have already been implemented by the 
vast majority of both the medical and dental practices, we actively compete in a replacement market by leveraging the benefits 
of our interoperable electronic health records software. With the addition of Gennius and Mirth, our combined solutions enrich 
the already strong collaborative, connected care support and set the stage for data synchronization and enterprise analytics , 
interoperability growth, and expansion of our current accountable and collaborative care, population health, disease 
management and clinical data exchange offering. These Divisions also develop and market software that automates patient 
records in physician practices, community health centers and hospital settings. In this patient records area of our business, we 
are typically competing to replace paper-based patient record alternatives as opposed to replacing previously purchased 
systems. The Hospital Solutions Division develops and markets financial management and billing software products, which 
perform administrative functions required for operating small and specialty hospitals as well as clinical offerings such as multi-
disciplinary clinical documentation and computerized physician order entry. The RCM Services Division provides technology 
solutions and outsourcing services to cover the full spectrum of healthcare providers' RCM needs, with a primary focus on 
outsourced billing and collection services. 

QSIH, located in Bangalore, India, functions as our India-based captive entity to offshore technology application development 
and business processing services. Our employee base in Bangalore has grown to nearly 400 employees with a primary focus on 
software development activities. 

We continue to pursue product and service enhancement initiatives within each of our Divisions. The majority of such 
expenditures are currently targeted to the product lines and customer base of the NextGen Division. 

The following table breaks down our reported segment revenue and segment revenue growth (decline) by Division for the fiscal 
years ended March 31, 2015, 2014 and 2013: 

Segment Revenue Breakdown 
Fiscal Year Ended March 31, 
2014 

2013 

2015 

Segment Revenue Growth (Decline) 
Fiscal Year Ended March 31, 
2014 

2015 

2013 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

3.8 % 
76.2 % 
3.7 % 
16.3 % 
100.0 % 

4.5 % 
76.7 % 
3.5 % 
15.3 % 
100.0 % 

4.3 % 
74.9 % 
6.8 % 
14.0 % 
100.0 % 

(7.0 )% 
9.6 % 
15.3 % 
17.5 % 
10.2 % 

(0.8 )% 
(0.9 )% 
(50.3 )% 
5.6 % 
(3.4 )% 

2.0 %

5.8 %

(8.9 )%

28.2 %

7.1 %

QSI Dental Division. The QSI Dental Division, co-located with our corporate headquarters in Irvine, California, focuses on 
developing, marketing and supporting software suites sold to dental group organizations located throughout the United States. 
The QSI Dental Division sells additional licenses to its legacy products as existing customers expand their operations and also 
sells its practice management and clinical software solutions to new and existing customers primarily as a cloud-based Software 
as a Service ("SaaS") model, known as QSIDental Web ("QDW").  QDW is marketed primarily to multi-location dental group 
practices in which the QSI Dental Division has historically been a dominant player.  When sold under a SaaS model, QDW offers 
a lower cost of ownership as it is a cloud-based solution that provides users with access to vital data from any web-enabled 
device.  Further, QSI Dental sells its electronic dental charting software in conjunction with NextGen® PM ("Practice 
Management") and NextGen® EHR ("Electronic Health Record"), which is marketed as NextGen® EDR (“Electronic Dental 
Record”), to federally qualified health centers (“FQHC”) and other safety-net clinics, as further defined below. 

The QSI Dental Division participates jointly with the NextGen Division in providing software and services to safety-net clinics like 
FQHCs and other safety-net health centers, including public health centers, community health centers, free clinics, as well as 
rural and tribal health centers.  FQHCs and other safety-net clinics are community-based organizations that are funded by the 
federal government, which provide medical and dental services to underprivileged and underserved communities. The Patient 
Protection and Affordable Care Act, which was signed into law in March 2010, reserved $11 billion over a multi-year period for 
FQHCs, creating unprecedented opportunities for FQHCs growth and the formation of new FQHCs. When combined and used in 
tandem, NextGen® EDR, NextGen® EHR and NextGen® PM is capable of providing an integrated patient record, which is a 
unique product in this marketplace that is accessible by both physicians and dentists. In May 2013, NextGen® EDR version 4.3, 
together with NextGen® EHR version 5.8, was ONC-ATCB certified by the Certification Commission for Health Information 
("CCHIT®") as a complete EHR and demonstrated compliance with all clinical quality measures for eligible providers. 

The QSI Dental Division's legacy practice management software suite, known as Clinical Product Suite (“CPS”), uses a UNIX® 
operating system and can be fully integrated with the customer server-based practice management software offered by each of 
our Divisions. When integrated and delivered with the NextGen® PM solution, CPS is re-branded as NextGen® EDR and 
incorporates a wide range of clinical tools including, but not limited to, periodontal charting, digital imaging and X-ray, and inter-
oral camera images, that are integrated as part of the electronic patient record. The QSI Dental Division also develops, markets, 

4 

 
 
 
 
 
 
 
 
 
and provides EDI services to dental practices, including electronic submission of claims to insurance providers as well as 
automated patient statements. 

NextGen Division. The NextGen Division, with headquarters in Horsham, Pennsylvania and significant locations in Atlanta, 
Georgia and Costa Mesa, California, provides integrated clinical, financial and connectivity solutions for ambulatory and dental 
provider organizations. The NextGen Division's major product categories include the NextGen® ambulatory product suite and 
interoperability solutions. 

The NextGen® ambulatory product suite features an integrated and interoperable solution that streamlines the business of 
running a practice as well as patient care with standardized, real-time clinical and administrative workflows within a physician’s 
practice.  Major ambulatory product lines include NextGen® EHR, NextGen® PM, NextGen® Population Health (including 
NextGen® Care), NextGen® Analytics, NextGen® Patient Portal (“NextMD.com”), NextGen® Documentation Management, 
NextGen® ePrescribing, NextGen® Mobile, and NextPen.  The interoperability solutions consist of NextGen® EHR Connect, 
NextGen® Health Information Exchange (“HIE”), and NextGen® Share.  The NextGen Division also offers hosting services, 
NextGuard data protection services, professional consulting services, such as strategic governance models and operational 
transformation, technical consulting services, such as data conversions or interface development, and physician consulting 
services.  The NextGen Division products utilize Microsoft Windows technology and can operate in a client-server environment 
as well as via private intranet, the Internet, or in an ASP environment.  The NextGen Division also provides EDI services, which 
include electronic submission of claims to insurance providers as well as automated patient statements. 

On September 9, 2013, we acquired Mirth, a global leader in health information technology that helps customers achieve 
interoperability.  Operating results associated with Mirth products and services are included in the NextGen Division. The 
acquisition of Mirth enhances our current enterprise interoperability initiatives and broadens our accountable and collaborative 
care, population health, disease management and clinical data exchange offerings. Mirth offers a wide variety of products and 
services utilized by both users of Mirth open code technology as well as a large base of domestic and international paying 
customers. Product offerings available from Mirth include Mirth Connect, Mirth Results, Mirth Match, Mirth Mail, Mirth Appliance, 
and Mirth Care Enterprise. As a direct result of the Mirth acquisition, we introduced NextGen® Share to our customer base in 
November 2013. As our first offering that integrates technologies from both NextGen Healthcare and Mirth, NextGen® Share 
provides the ability to securely and easily share patient charts and other data with other practices using NextGen Internet based 
software. 

On March 11, 2015, we acquired Gennius, a leading provider of healthcare data analytics. Gennius's operations are managed 
under the NextGen Division. The acquisition of Gennius is expected to enhance our current enterprise analytics competencies 
while broadening business intelligence capabilities for addressing new value-based care requirements. 

Hospital Solutions Division. The Hospital Solutions Division, with its primary location in Austin, Texas, provides integrated 
clinical, financial and connectivity solutions for rural, community and specialty hospitals. This Hospital Solutions Division also 
develops and markets an equivalent revenue cycle management and clinical information systems software products for the small 
and specialty hospital market, which perform the administrative functions required for operating hospitals. 

The Hospital Solutions product is a single-source, interoperable suite that helps rural, critical access hospitals improve care, 
operations, and financial results across both inpatient and ambulatory settings, which provides a robust connected suite of 
clinical, financial, enterprise scheduling, surgery management, emergency, lab, pharmacy, HIE, EDI, and Patient Portal solutions 
that work together for improved patient and financial outcomes.  Products include NextGen® Inpatient Clinicals, NextGen® 
Inpatient Financials, NextGen® Emergency Department, NextGen® Hospital Scheduling, NextGen® Surgical Management, and 
NextGen® Lab. 

RCM Services Division. The RCM Services Division, with locations in St. Louis, Missouri, North Canton, Ohio, South Jordan, 
Utah and Hunt Valley, Maryland, provides technology solutions and consulting services to cover the full spectrum of healthcare 
providers' RCM needs, from patient access through claims denials, with a primary focus on billing and collection services in 
order to optimize customers' revenue cycle results, improve cash flow, and decrease accounts receivable days. The RCM 
Services Division combines a Web-delivered SaaS model and the NextGen® PM software platform to execute its service 
offerings, which include billing and collections, claims submissions and reconciliation, coding services, electronic remittance and 
payment posting, accounts receivable management, patient customer service, advance analytics, charge entry and capture, 
enrollment credentialing, and software setup, hosting, and support. 

Industry Background 

The turbulence in the worldwide economy has impacted almost all industries. While healthcare is not immune to economic 
cycles, we believe it is more heavily influenced by U.S.-based regulatory and national health projects than by the cycles of our 
economy. The impact of the current economic conditions on our existing and prospective customers has been mixed. Various 
factors have had, and are anticipated to continue to have, a meaningful impact on the U.S. healthcare industry.  Particularly, the 
healthcare industry has been significantly impacted by the Obama Administration's broad healthcare reform efforts, including the 
Health Information Technology for Economic and Clinical Health ("HITECH") portion of the American Recovery and 
Reinvestment Act ("ARRA") and the Patient Protection and Affordable Care Act ("PPACA") that provides significant incentives to 
health care organizations for "Meaningful Use" adoption of interoperable EHR solutions, the mandate requiring individuals to 
obtain insurance, the individual state responses to the government-requested Medicaid expansion, the creation and operation of 

5 

 
 
insurance exchanges, and the increasing focus of private businesses on moving their employee health benefit offerings to a 
more wellness-based health platform. 

In April 2015, the Obama Administration passed the Medicare Access and CHIP Reauthorization Act of 2015 ("MACRA"), which 
repeals the sustainable growth rate (SGR) formula that is currently used to control spending by Medicare on physician services.  
The MACRA is the result of ongoing quality initiative efforts to transition healthcare services to a value-based, pay-for-
performance model rather than a fee-for-service model to incentivize physicians to participate in alternative payment and 
collaborative care models, such as accountable care organizations. 

Further, the Centers for Medicare and Medicaid Services ("CMS") had mandated that all providers, payers, clearinghouses and 
billing services implement the use of new patient codes for medical coding, referred to as ICD-10 codes, on or before October 1, 
2015.  The new coding standards require our customers to implement the newest release of our core software products that 
support the new ICD-10 billing requirements. 

To compete in the continually changing healthcare environment, providers are increasingly using technology to help maximize 
the efficiency of their business practices, to assist in enhancing patient care, and to maintain the privacy of patient information. 
As the reimbursement environment continues to evolve, more healthcare providers enter into contracts, often with multiple 
entities, which define the terms under which care is administered and paid. The diversity of payer organizations, as well as 
additional government regulation and changes in reimbursement models, have greatly increased the complexity of pricing, 
billing, reimbursement and records management for medical and dental practices. To operate effectively, healthcare provider 
organizations must efficiently manage patient care and other information and workflow processes, which increasingly extend 
across multiple locations, disparate systems, and business entities. 

In response, healthcare provider organizations have placed increasing demands on their information systems. The initial 
healthcare information systems were designed for limited administrative tasks such as billing and scheduling and could neither 
accommodate multiple computing environments nor operate effectively across multiple locations and entities. As it became 
necessary to manage patient flow processes, the need arose to integrate “back-office” data with such clinical information as 
patient test results and office visits. We believe information systems must facilitate management of patient information 
incorporating administrative, financial and clinical information from multiple entities, and that the practices that are able to 
leverage technology to more efficiently handle such data will be best able to enhance patient flow, pursue cost efficiencies and 
improve quality of care. As healthcare organizations transition to new computer platforms and newer technologies, we believe 
such organizations will be migrating toward the implementation of enterprise-wide, patient-centric computing systems embedded 
with automated clinical patient records. 

Our Strategy 

While we expect to benefit from the increasing demands for greater efficiency as well as government support for increased 
adoption of EHR systems, the market for physician based EHR software is becoming increasingly saturated while physician 
group practices are rapidly being consolidated by hospital, insurance payers and other entities. Hospital software providers are 
leveraging their position with their hospital customers to gain market share with hospital owned physician practices. Insurance 
providers and large physician groups are also consolidating physician offices creating additional opportunity for ambulatory 
software providers like us. Our strategy is to focus on addressing the growing needs of accountable care organizations around 
interoperability, patient engagements, population health and collaborative care management, and data analytics. 

Our acquisition of Mirth in September 2013 provides expanded capabilities around the HIE market, population health 
management, and data analytics, which we believe will be pivotal in our continual enhancement of our existing products as well 
as the development of new product and service offerings for accountable care organizations.  Our acquisition of Gennius in 
March 2015 is expected to enhance our current enterprise analytics competencies while broadening our business intelligence 
capabilities for addressing new value-based care requirements.  We expect our integrated, analytics-based solutions to provide 
healthcare providers with an in-depth, data-driven approach to care and further strengthen our ability to assist our customers in 
successfully meeting their financial goals and deliver on their population health and coordinated care initiatives.  Our ability to 
offer customers patient risk analysis, stratification, and predictive modeling tools for population health and collaborative care 
management enables providers with the capability to identify high risk patients for making better informed clinical decisions for 
managing individual patients, patient populations and their business while improving the quality and outcome of care. 

We believe that our core strength lies in the central role our software products and services play in the delivery of healthcare by 
the primary physician in an ambulatory setting. We intend to remain at the forefront of upcoming new regulatory requirements 
including ICD-10 and meaningful use requirements for stimulus payments. We believe that the expanded requirements for 
continued eligibility for incentive payments under meaningful use rules will result in an expanded replacement market for 
electronic health records software. We intend to continue the development and enhancement of our software solutions to 
support healthcare reform, such as the recently enacted MACRA, which promotes the transition from fee-for-service to value-
based, pay-for-performance, and patient-centric care and quality initiatives such as accountable care organizations. Key 
elements of our future software development will be to expand our interoperability capabilities enhancing the competitiveness of 
our software offerings, make our products more intuitive and easy to use, and to enhance our ability to deliver our software over 
the cloud with the latest technology. 

We also want to continue investments in our infrastructure, including but not limited to maintaining and expanding sales, 
marketing and product development activities in order to improve patient care and reduce healthcare costs, providing industry-

6 

 
 
leading, integrated clinical and administrative healthcare data systems, services, and expertise to clinical, medical, technology, 
and healthcare business professionals while continuing our gold-standard commitment of service in support of our customer 
satisfaction programs. These investments in our infrastructure will continue while maintaining reasonable expense discipline. We 
strive to add new customers and expand our relationship with existing customers through delivery of add-on and complementary 
products and services and believe that our growing customer base that is using our software on a daily basis is a strategic asset.  
We intend to leverage this strategic asset by expanding our product and service offerings towards this customer base. 

Products and Services 

In response to the growing need for more comprehensive, cost-effective healthcare information solutions for medical practices, 
dental practices, hospitals, health centers and other healthcare providers, our systems and services provide our customers with 
the ability to redesign patient care and other workflow processes while improving care quality and productivity through facilitation 
of managed access to patient information. Utilizing our proprietary software in combination with third party hardware and 
software solutions, our products enable the integration of a variety of administrative clinical and financial operations. Leveraging 
more than 30 years of experience in the healthcare information services industry, we believe we continue to add value by 
providing our customers with sophisticated, full-featured software systems along with comprehensive systems implementation, 
training, consultation, revenue cycle management, maintenance and support services. 

Our products consist primarily of proprietary healthcare software applications together with third party hardware and other non-
industry specific software. The systems range in capacity from one to thousands of users, allowing us to address the needs of 
both small and large organizations. The systems are modular in design and may be expanded to accommodate changing 
customer requirements. We offer both standard licenses and SaaS arrangements in our software offerings; although to date, 
SaaS arrangements do not represent a significant portion of our arrangements. 

Dental Solutions 

QSI Dental Practice Management Solutions and Clinical Systems. In fiscal year 2010, we began selling hosted SaaS 
practice management and clinical software solutions to the dental industry. This software solution is marketed primarily to the 
multi-location dental group practice market for which the Division remains a dominant player. This software solution, formerly 
called NextDDS and now named QSIDental Web to better identify it primarily as a cloud-based solution, moves the QSI Dental 
Division to the forefront of the emergence of web-enabled applications and cloud computing and represents a significant growth 
opportunity for us to sell to both our existing customer base and new customers. 

In addition to the SaaS clinical offering, our dental charting software system, known as the Clinical Product Suite (CPS), 
provides a comprehensive solution designed specifically for the dental group practice environment. CPS integrates our dental 
practice management product with a computer-based clinical information system that incorporates a wide range of clinical tools, 
including electronic charting of dental procedures, treatment planning, existing conditions, voice-activation or keyboard entry for 
full periodontal examinations and PSR scoring. In addition, CPS features digital imaging of X-ray and intra-oral camera images, 
computer-based patient education modules are viewable chair-side to enhance case presentation, full access to patient 
information, treatment plans and insurance plans via a fully integrated interface with our dental practice management product.  
All of this is supported by document and image scanning for digital storage and linkage to the electronic patient record. 

The result is a comprehensive clinical information management system that helps practices save time, reduce costs, improve 
case presentation and enhance the delivery of dental services and quality of care. Clinical information is managed and 
maintained electronically, thus forming an electronic patient record that allows for the implementation of the “chartless” office. 

CPS incorporates Windows-based client-server technology consisting of one or more file servers and is scalable from one to 
thousands of workstations. The hardware components, including the requisite operating system licenses, are purchased from 
third party manufacturers or distributors either directly by the customer or by us for resale to the customer. 

Ambulatory Solutions 

NextGen® Ambulatory Practice Management Systems. NextGen® PM is the NextGen Division’s practice management 
offering. NextGen® PM has been developed with a functional graphical user interface (“GUI”) certified for use with Windows 
2000 and Windows XP operating systems. The product leverages a relational database (Microsoft SQL Server) with support on 
both 32 and 64 bit enterprise servers. NextGen® PM is a scalable, multi-module solution that includes a master patient index, 
enterprise-wide appointment scheduling with referral tracking, clinical support and centralized or decentralized patient financial 
management based on either a managed care or fee-for-service model. The NextGen® PM product is a highly configurable, 
cost-effective proven solution that enables the effective management of both single and multi-practice settings. 

NextGen® Ambulatory Clinical Systems. The NextGen Division provides clinical software applications that are complementary 
to, and are integrated with, our medical practice management offerings and interface with many of the other leading practice 
management software systems on the market. The applications incorporated into our practice management solutions and others 
such as scheduling, eligibility, billing and claims processing are augmented by clinical information captured by NextGen® 
Ambulatory EHR, including services rendered, clinical documentation and diagnoses used for billing purposes. We believe that 
we currently provide a comprehensive information management solution for the ambulatory marketplace. 

NextGen® Ambulatory EHR version 5.8 is compliant with the ONC 2014 Edition criteria and was certified as a complete EHR in 
March 2013 by the CCHIT®, an ONC-ACB, in accordance with the applicable eligible certification criteria adopted by the 

7 

 
 
Secretary of Health and Human Services (HHS). The ONC 2014 Edition criteria support both Stage 1 and 2 meaningful use 
measures required to qualify eligible providers and hospitals for funding under the ARRA. 

NextGen® Ambulatory EHR was developed with client-server architecture, GUI and utilizes Microsoft Windows 2000, Windows 
NT or Windows XP on each workstation and either Windows 2000, Windows NT, Windows XP or UNIX on the database server. 
NextGen® Ambulatory EHR maintains data using industry standard relational database engines such as Microsoft SQL Server 
or Oracle. The system is scalable from one to thousands of workstations. NextGen® Ambulatory EHR stores and maintains 
clinical data including: 

•  

•  

•  

•  

•  

Data captured using user-customizable input “templates”; 

Scanned or electronically acquired images, including X-rays and photographs; 

Data electronically acquired through interfaces with clinical instruments or external systems; 

Other records, documents or notes, including electronically captured handwriting and annotations; and 

Digital voice recordings. 

NextGen® Ambulatory EHR offers a workflow module, prescription management, automatic document and letter generation, 
patient education, referral tracking, interfaces to billing and lab systems, physician alerts and reminders and powerful reporting 
and data analysis tools. 

NextGen® Ambulatory EHR also offers a foundation to meet Patient Centered Medical Home and Accountable Care 
Organization recognition and achieve collaborative care.  In 2012, a population health management solution named NextGen® 
Population Health ("PH") was introduced to enhance collaborative care capabilities. It features integrated, multi-modal cascading 
communication tools including interactive voice response, texting, email, NextGen® Patient Portal, and clinical data from 
NextGen® Ambulatory EHR. NextGen® PH can be fully integrated with NextGen® Health Quality Measures ("HQM") and has an 
easy-to-use, built-in population profiler to define protocols for patient outreach using billing data from NextGen® PM and clinical 
data from NextGen® Ambulatory EHR. 

Interoperability and Connectivity 

Interoperability connects patients, practices, hospitals, health systems, communities, and payers.  Effective interoperability 
solutions cross over multiple platforms and other systems, both inside and outside of organizations.  It connects disparate 
systems so providers can benefit from controlled, secure data flow, decreased costs, and reduced errors.  Interoperability makes 
all patient encounter data available in the patient record, helping to improve care collaboration, quality, and safety.  Combined 
with the NextGen® portfolio, Mirth's available solutions enhance our enterprise interoperability initiatives and will broaden our 
accountable and collaborative care, population health, disease management and clinical data exchange offering.  By integrating 
the extensive data analytics and reporting capabilities of Gennius with the NextGen® and Mirth solutions, we expect to provide 
customers with a data-driven approach to care to address the value-based care requirements and population health and 
collaborative care initiatives. 

Mirth's primary product base includes the following: 

Mirth Connect. Mirth Connect, the best-known product offering of Mirth, is a healthcare data integration engine available in its 
base form under a community-supported open-source license. 

Mirth Results. Mirth Results is a clinical data repository that collects, organizes, and aggregates clinical data from many 
different sources to produce a longitudinal patient record that is easily viewed from a web-based provider portal or access via an 
open application program interface. 

Mirth Match. Mirth Match is an entity identification service, which handles enterprise master patient index, record locator, and 
identity de-duplication services. 

Other Mirth products and solutions include Mirth Mail, Mirth Appliance, Mirth Care Enterprise, and Mirth Gateway. 

NextGen® Share, the first joint NextGen® and Mirth offering, is an interoperability solution that helps providers safely and 
securely send and manage referrals, and accurately exchange clinical content, all without leaving their NextGen® Ambulatory 
EHR application. 

The NextGen Division also markets NextGen® HIE to facilitate cross-enterprise data sharing, enabling individual physician 
practices in a given community to selectively share critical data, such as demographics, referrals, medications lists, allergies, 
diagnoses, lab results, histories and more. This is accomplished through a secure, community-wide data repository that links 
health care providers, whether they have the NextGen® Ambulatory EHR system, another compatible electronic health records 
system, together with hospitals, payers, labs and other entities. The product is designed to facilitate data exchange within an 
Integrated Delivery Network ("IDN") or Regional Health Information Organization (“RHIO”). The result is that for every health 
care encounter in the community, a patient-centric and complete record is accessible for the provider. The availability, accuracy 
and completeness of information plus the elimination of duplicate data entry can lead to significantly improved patient safety, 
enhanced decision making capabilities, time efficiencies and cost savings. Our NextGen Division maintains an internet-based 
patient health portal, NextGen® Patient Portal. NextMD.com is the URL for our vertical portal for the healthcare industry, linking 
patients with their physicians, while providing a centralized source of health-oriented information for both consumers and 
medical professionals. Patients whose physicians are linked to the portal are able to request appointments, send appointment 

8 

 
changes or cancellations, receive test results on-line, request prescription refills, view and/or pay their statements, and 
communicate with their physicians, all in a secure, on-line environment. Our NextGen® suite of information systems are or can 
be linked to NextMD.com, integrating a number of these features with physicians’ existing systems. 

Hospital Solutions 

NextGen® Hospital Solutions is a single-source, interoperable suite to help rural, critical access, or larger hospitals improve 
care, operations, and financial results across both hospital and ambulatory settings.  It provides a robust connected suite of 
clinical, financial, enterprise scheduling, surgery management, emergency department, and EHR-related applications and 
services that work together for improved patient and financial outcomes.  These solutions are designed to help improve patient 
safety, automate order entry and facilitate real-time communication of patient information throughout the hospital and across the 
patient care continuum. The hospital solutions are highly scalable, secure and easy to use with a Web 2.0-based clinical 
component that leverages full “cloud computing” capabilities.  Key NextGen® Hospital Solutions products consist of: 

NextGen® Inpatient Clinicals.  NextGen® Inpatient Clinicals is suite of CCHIT® ONC 2011-certified solutions based on a 
scalable, secure and web-based enterprise platform that leverages mobile and 'cloud computing' technology.  Clinicians can 
enter and retrieve relevant inpatient clinical information (patient vitals, lab results, allergies, medications, and imaging results) 
from bedside or remote locations. NextGen® Inpatient Clinicals' CPOE, Clinical Documentation, and Clinical Decision support 
capabilities and help enable hospitals to achieve Stage 1 through Stage 4 adoption for ARRA meaningful use reimbursement 
and the HIMSS® EMR Adoption Model.  The NextGen® Inpatient Clinicals version 2.6 is compliant with the ONC 2014 Edition 
criteria and was certified as an EHR Module in May 2013 by the CCHIT®, in accordance with the applicable Hospital certification 
criteria adopted by the Secretary of Health and Human Services. The ONC 2014 Edition criteria support both Stage 1 and 2 
Meaningful Use measures required to qualify eligible providers and hospitals for funding under ARRA. 

NextGen® Inpatient Financials. NextGen® Inpatient Financials is a financial and administrative system that helps hospitals 
streamline operations and improve financial and regulatory management of their facilities. The system is designed to automate 
and consolidate financials processes at single or multiple facilities, including critical access, rural community and specialty 
hospitals and physician offices.  NextGen® Inpatient Financials uses a common patient database and community-based master 
patient index.  It is designed to help optimize revenue management and claims results. 

NextGen® Emergency Department.  NextGen® Emergency Department is a comprehensive, web-based emergency 
department information system (EDIS) for hospital emergency departments. It consists of nurse, physician, administration, 
coding, and billing functionality to reduce costs and medical errors, enhance care, and ensure proper documentation. It offers 
templates and forms to streamline workflow and augment and enhance a hospital's existing forms set. NextGen® Emergency 
Department is interoperable and integrates with other hospital systems. 

NextGen® Hospital Scheduling.  NextGen® Hospital Scheduling is a system designed to provide hospital-wide, conflict-free 
patient scheduling for easier, more efficient patient, resource, and staff management. It can be used as a single module or 
integrated with any combination of NextGen® Inpatient Clinical Applications.  It is designed so that, whether used as a single 
module or integrated with clinical applications, hospital operations can benefit with better use of resources for increased capacity 
and patient throughput. 

NextGen® Surgical Management.  NextGen® Surgical Management is a system designed to help hospitals optimize OR 
throughput, quality, efficiency, patient safety, revenue, and compliance. Detailed reporting provides surgery directors and hospital 
administrators with information to fine tune surgical processes, quickly identify cases where costs have exceeded a normal 
range, and improve use of precious OR resources. Hidden surgical procedure cost drivers can be identified and eliminated. The 
system also helps ensure compliance with Surgical Care Improvement Project (SCIP) and National Healthcare Safety Network 
(NHSN) reporting requirements. 

Revenue Cycle Management Services 

RCM Services Division partners with private and hospital-based physicians and groups to implement the NextGen® product 
suite with best practice, customizable RCM services in order to help them optimize revenue, better leverage automation, and 
help them focus on practicing medicine.  RCM services capabilities include: 

•   Billing and Collections - A robust set of internal controls, best practice methodologies and comprehensive reporting 
ensures accuracy and addresses the entire revenue cycle: from patient registration and charge capture, to claim 
submission, payment posting, denial management and accounts receivable resolution. 

•   Electronic Claims Submission - These services generate HIPAA-compliant insurance transactions to submit customer 
insurance claims electronically to insurance payers nationwide. Automating the electronic claims submission ("ECS") 
process using the NextGen EPM application is another best practice that reduces costly manual labor. Our solutions 
support the CMS-1500, UB-04 and ADA Dental Claim Forms and also accommodate proprietary claim formats. 

•   Electronic Remittance & Payment Posting - These automated services help ensure payments are posted accurately 

and promptly. Using the NextGen® Document Management, we link an image of each explanation of benefit (“EOB”) to 
the corresponding encounter at the time of payment posting to minimize the need for storage of paper EOBs. The 
services also use electronic remittance and digital lockboxes to post payments and capture specific denial information 
for management and tracking. 

9 

 
•   Accounts Receivable Follow-Up - An accounts receivable management methodology designed in cooperation with our 
customers helps establish joint follow-up parameters, adjustment rules, standards for account elevation, as well as 
customized follow-up activities. The RCM Services team will work with the customer to replace costly manual 
processes with workflow automation tools and best practices to reduce denials and improve collections. 

•   Expertise and Support - Our team of experts consists of analysts, billing and coding specialists, auditors, customer 

service professionals, and account managers - all working for our customers to answer patients' billing questions, 
monitor RCM performance and trends, provide credentialing assistance and identify opportunities for improvement to 
optimize collected revenue.   

Electronic Data Interchange 

We make available EDI capabilities and connectivity services to our customers. The EDI/connectivity capabilities encompass 
direct interfaces between our products and external third party systems, as well as transaction-based services. EDI products are 
intended to automate a number of manual, often paper-based or telephony intensive communications between patients and/or 
providers and/or payers. Two of the more common EDI services are forwarding insurance claims electronically from providers to 
payers and assisting practices with issuing statements to patients. Most customer practices utilize at least some of these 
services from us or one of our competitors. Other EDI/connectivity services are used more sporadically by customer practices. 
We typically compete to displace incumbent vendors for claims and statements accounts and attempt to increase usage of other 
elements in our EDI/connectivity product line. The acquisition of ViaTrack, a developer and provider of information technologies 
that enhance EDI offerings, has provided us with in house EDI capabilities at lower costs as compared to third party providers. 
We believe that significant opportunities exist to leverage ViaTrack's technologies to reduce costs and enhance our EDI offerings 
to all divisions. 

Services include: 

•  

•  

•  

•  

Electronic claims submission through our relationships with a number of payers and national claims 
clearinghouses; 

Electronic patient statement processing, appointment reminder cards and calls, recall cards, patient letters and 
other correspondence; 

Electronic insurance eligibility verification; and 

Electronic posting of remittances from insurance carriers into the accounts receivable application. 

Customer Service and Support 

We believe our success is attributable in part to our customer service and support departments. We offer support to our 
customers seven days a week, 24 hours a day. 

Our customer support staff is comprised of specialists who are knowledgeable in the areas of software and hardware as well as 
in the day-to-day operations of a practice or hospital. System support activities range from correcting minor procedural problems 
in the customer’s system to performing complex database reconstructions or software updates. 

We utilize automated online support systems which assist customers in resolving minor problems and facilitate automated 
electronic retrieval of problems and symptoms following a customer’s call to the automated support system. Additionally, our 
online support systems maintain call records, available at both the customer’s facility and our offices. 

We offer our customers support services for most system components, including hardware and software, for a fixed monthly, 
quarterly or annual fee. Customers also receive access to future unspecified versions of the software, on a when-available basis, 
as part of support services. 

Professional Services 

We offer full service implementation, training, and consulting services. When a customer signs a contract for the purchase of a 
system that includes implementation and training services, that customer is assigned a customer manager and implementation 
specialist trained in the specifics of the customer's business. The implementation team is assigned to assist the customer in the 
installation of the system and the training of appropriate practice staff, and is responsible for ensuring proficiency in the use of 
the system which ultimately improves the practice's performance and quality of care. Implementation services include loading 
the software, training customer personnel, data conversion, running test data and assisting in the development and 
documentation of procedures. The Company has relationships with third party implementation providers and certain resellers to 
supplement the Company's in house implementation and training resources. 

Training may include a combination of computer assisted instruction (“CAI”) for certain of our products, remote training 
techniques and training classes conducted at the customer’s or our office(s). CAI consists of workbooks, computer interaction 
and self-paced instruction. CAI is also offered to customers, for an additional charge, after the initial training program is 
completed for the purpose of training new and additional employees. Remote training allows a trainer at our offices to train one 
or more people at a customer site via telephone and computer connection, thus allowing an interactive and customer-specific 
mode of training without the expense and time required for travel. In addition, our on-line “help” and other documentation 
features facilitate customer training as well as ongoing support. 

10 

 
In addition, NextGen® “E-learning” is an on-line learning subscription service which allows end users to train on the software on 
the internet. E-learning allows end users to self manage their own learning with their personal learning path and pace. The 
service allows users to track the status of courses taken. 

At present, our training facilities are located in (i) Horsham, Pennsylvania, (ii) Atlanta, Georgia, (iii) Costa Mesa, California, and 
(iv) Irvine, California. 

Our consulting services, including physician, professional, and technical consulting, assist customers with optimizing their 
software solutions and evaluating the workflow experience to meet the evolving requirements of healthcare reform, such as 
achievement of meaningful use and ICD-10 conversion. 

Proprietary Rights 

We rely on a combination of patents, copyrights, trademarks, service marks, trade secret laws and contractual restrictions to 
establish and protect proprietary rights in our products and services. To protect our proprietary rights, we enter into confidentiality 
agreements and invention assignment agreements with our employees with whom such controls are relevant. In addition, we 
include intellectual property protective provisions in our customer contracts. 

We rely on software that we license from third parties for certain components of our products and services.  These components 
enhance our products and services and help meet evolving customer needs. The failure to license any necessary technology, or 
to maintain our existing licenses, could result in reduced functionality of or reduced demand for our products. 

Because the software industry is characterized by rapid technological change, we believe such factors as the technological and 
creative skills of our personnel, new product developments, frequent product enhancements, name recognition, and reliable 
product maintenance are more important to establishing and maintaining a technology leadership position than the various legal 
protections of our technology. 

Although we believe our products and services, and other proprietary rights, do not infringe upon the proprietary rights of third 
parties, third parties may assert intellectual property infringement claims against us in the future. Any such claims may result in 
costly, time-consuming litigation and may require us to enter into royalty or cross-license arrangements. 

Sales and Marketing 

We sell and market our products primarily through a direct sales force and a reseller channel. Software license sales to resellers 
represented less than 10% of total revenue for the years ended March 31, 2015, 2014 and 2013. 

Our direct sales force typically makes presentations to potential customers by demonstrating the system and our capabilities on 
the prospective customer’s premises. Sales efforts aimed at smaller practices can be performed on the prospective customers’ 
premises, or remotely via telephone or Internet-based presentations. Both the direct and reseller channel sales force is 
concentrating on more multi-product sales opportunities.  These are opportunities where we might sell our ambulatory, hospital, 
dental and RCM services or some combination thereof to prospective customers. 

Our sales and marketing employees identify prospective customers through a variety of means, including referrals from existing 
customers, industry consultants, contacts at professional society meetings, trade shows and web-based seminars, trade journal 
advertising, online advertising, direct mail and email advertising and telemarketing.  Resources have shifted more heavily to 
Web-based marketing to take advantage of buyers that now tend to do more Web research before contacting a vendor.  In 
addition, we focus on more thought leadership marketing to highlight our industry knowledge, expertise and the success of our 
customer base. 

Our sales cycle can vary significantly and typically ranges from six to twenty-four months from initial contact to contract 
execution. Software licenses are normally delivered to a customer almost immediately upon receipt of an order. Implementation 
and training services are normally rendered based on a mutually agreed upon timetable. As part of the fees paid by our 
customers, we normally receive up-front licensing fees. Customers have the option to purchase maintenance services which, if 
purchased, are invoiced on a monthly, quarterly or annual basis. 

Several customers have purchased our suite of enterprise products and, in turn, are providing either time-share or billing 
services to single and group practice practitioners. Under the time-share or billing service agreements, the customer provides 
the use of our software for a fee to one or more practitioners. Although we typically do not receive a fee directly from the 
distributor’s customers, implementation of such arrangements has, from time to time, resulted in the purchase of additional 
software capacity by the distributor, as well as new software purchases made by the distributor’s customers should such 
customers decide to perform the practice management functions in-house. 

We continue to concentrate our direct sales and marketing efforts on medical and dental practices, networks of such practices 
including independent practice associations ("IPAs") and physician hospital organizations ("PHOs"), professional schools, 
community health centers and other ambulatory care settings. 

IPAs, PHOs and similar networks to which we have sold systems provide use of our software to those group and single 
physician practices associated with the organization or hospital on either a service basis or by directing us to contract with those 
practices for the sale of stand-alone systems. 

11 

 
 
 
We have also entered into marketing assistance agreements with certain of our customers pursuant to which the customers 
allow us to demonstrate to potential customers the use of systems on the existing customers’ premises. 

From time to time we assist prospective customers in identifying third party sources for financing the purchase of our systems. 
The financing is typically obtained by the customer directly from institutional lenders and typically takes the form of a loan from 
the institution secured by the system to be purchased or a leasing arrangement. We are not a party to the financing transaction. 

We have numerous customers and do not believe that the loss of any single customer would adversely affect us. No customer 
accounted for 10% or more of our net revenue during the fiscal years ended March 31, 2015, 2014 or 2013. 

Competition 

The markets for healthcare information systems and services are intensely competitive. The industry is highly fragmented and 
includes numerous competitors, none of which we believe dominates these markets. Our principal existing competitors in the 
healthcare information systems and services market include: Allscripts, athenahealth, Inc., Cerner, Computer Programs and 
Systems, Inc. (CPSI), eClinicalWorks, Epic Systems Corporation, GE Healthcare, Greenway Medical Technologies, Inc., 
Healthcare Management Systems, Inc., Healthland, McKesson, Medical Information Technology, Inc. (MEDITECH), Practice 
Fusion, Streamline Health Solutions Inc., and other competitors. 

The electronic patient records and connectivity markets, in particular, are subject to rapid changes in technology, and we expect 
that competition in these market segments will increase as new competitors enter the market. We believe our principal 
competitive advantages are the features and capabilities of our products and services, our high level of customer support and 
our extensive experience in the industry. 

The RCM market is also intensely competitive as other healthcare information systems companies, such as athenahealth, Inc., 
GE Healthcare, McKesson and Allscripts, are also in the market of selling both practice management and electronic health 
records software and medical billing and collection services. 

Product Enhancement and Development 

The healthcare information management and computer software and hardware industries are characterized by rapid 
technological change requiring us to engage in continuing investments to update, enhance and improve our systems. During 
fiscal years 2015, 2014 and 2013, we expended approximately $83.8 million, $62.3 million and $60.3 million, respectively, on 
research and development activities, including capitalized software amounts of $14.6 million, $20.8 million and $29.5 million, 
respectively. In addition, a portion of our product enhancements have resulted from software development work performed under 
contracts with our customers. 

Employees 

As of March 31, 2015, we employed approximately 2,939 persons, of which 2,915 were full-time employees. We believe that our 
future success depends in part upon recruiting and retaining qualified sales, marketing and technical personnel as well as other 
employees. 

Available Information 

Our website address is www.qsii.com. We make our periodic and current reports, together with amendments to these reports, 
filed or furnished pursuant to Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended, available on our 
website, free of charge, as soon as reasonably practicable after such material is electronically filed with, or furnished to, the 
SEC. You may access such filings under the “Investor Relations” button on our website. Members of the public may also read 
and copy any materials we file with, or furnish to, the SEC at the SEC’s Public Reference Room at 100 F Street, NE, 
Washington, DC 20549. To obtain information on the operation of the Public Reference Room, please call the SEC at 1-800-
SEC-0330. The SEC maintains an Internet site at www.sec.gov that contains the reports, proxy statements and other information 
that we file electronically with the SEC. Our website and the information contained therein or connected thereto is not intended 
to be incorporated into this Report or any other report or information we file with the SEC. 

12 

 
 
 
 
 
 
 
 
 
ITEM 1A. RISK FACTORS 

You should carefully consider the risks described below, as well as the other cautionary statements and risks described 
elsewhere and the other information contained in this Report and in our other filings with the SEC, including subsequent 
Quarterly Reports on Form 10-Q and Current Reports on Form 8-K. We operate in a rapidly changing environment that involves 
a number of risks. The risks and uncertainties described below are not the only ones we face. Additional risks and uncertainties 
not presently known to us or that we currently deem immaterial may also affect our business operations. If any of these known or 
unknown risks actually occur, our business, financial condition or results of operations could be materially and adversely 
affected, in which case the trading price of our common stock may decline and you may lose all or part of your investment. 

Risks Related to Our Business 

We face significant, evolving competition which, if we fail to properly address, could adversely affect our business, 
results of operations, financial condition and price of our stock. The markets for healthcare information systems are 
intensely competitive, and we face significant competition from a number of different sources. Several of our competitors have 
substantially greater name recognition and financial, technical, product development and marketing resources than we do. There 
has been significant merger and acquisition activity among a number of our competitors in recent years. Transaction induced 
pressures, or other related factors may result in price erosion or other negative market dynamics that could adversely affect our 
business, results of operations, financial condition and price of our stock. 

We compete in all of our markets with other major healthcare related companies, information management companies, systems 
integrators and other software developers. Competitive pressures and other factors, such as new product introductions by us or 
our competitors, may result in price or market share erosion that could adversely affect our business, results of operations and 
financial condition. Also, there can be no assurance that our applications will achieve broad market acceptance or will 
successfully compete with other available software products. 

Saturation or consolidation in the healthcare industry could result in the loss of existing customers, a reduction in our 
potential customer base and downward pressure on the prices for our products and services. As the healthcare 
information systems market evolves, saturation of this market with our products or our competitors' products could limit our 
revenues and opportunities for growth. There has also been increasing consolidation amongst healthcare industry participants in 
recent years, creating integrated healthcare delivery systems with greater market power. As provider networks and managed 
care organizations consolidate, the number of market participants decreases and competition to provide products and services 
like ours will become more intense. The importance of establishing relationships with key industry participants will become 
greater and our inability to make initial sales of our systems to, or maintain relationships with, newly formed groups and/or 
healthcare providers that are replacing or substantially modifying their healthcare information systems could adversely affect our 
business, results of operations and financial condition.  These consolidated industry participants may also try to use their 
increased market power to negotiate price reductions for our products and services. If we were forced to reduce our prices, our 
business would become less profitable unless we were able to achieve corresponding reductions in our expenses. 

Many of our competitors have greater resources than we do. In order to compete successfully, we must keep pace with 
our competitors in anticipating and responding to the rapid changes involving the industry in which we operate, or our 
business, results of operations and financial condition may be adversely affected. The software market generally is 
characterized by rapid technological change, changing customer needs, frequent new product introductions and evolving 
industry standards. The introduction of products incorporating new technologies and the emergence of new industry standards 
could render our existing products obsolete and unmarketable. There can be no assurance that we will be successful in 
developing and marketing new products that respond to technological changes or evolving industry standards. New product 
development depends upon significant research and development expenditures which depend ultimately upon sales growth. Any 
material shortfall in revenue or research funding could impair our ability to respond to technological advances or opportunities in 
the marketplace and to remain competitive. If we are unable, for technological or other reasons, to develop and introduce new 
products in a timely manner in response to changing market conditions or customer requirements, our business, results of 
operations and financial condition may be adversely affected. 

In response to increasing market demand, we are currently developing new generations of targeted software products. There 
can be no assurance that we will successfully develop these new software products or that these products will operate 
successfully, or that any such development, even if successful, will be completed concurrently with or prior to introduction of 
competing products. Any such failure or delay could adversely affect our competitive position or could make our current products 
obsolete. 

The ongoing uncertainty in global economic conditions may negatively impact our business, operating results or 
financial condition. The continuing unfavorable global economic conditions and uncertainty have caused a general tightening 
in the credit markets, lower levels of liquidity, increases in the rates of default and bankruptcy and extreme volatility in credit, 
equity and fixed income markets. These macroeconomic conditions could negatively affect our business, operating results or 
financial condition in a number of ways. For example, current or potential customers may be unable to fund software purchases, 
which could cause them to delay, decrease or cancel purchases of our products and services or to not pay us or to delay paying 
us for previously purchased products and services. Our customers may cease business operations or conduct business on a 
greatly reduced basis. Finally, our investment portfolio is generally subject to general credit, liquidity, counterparty, market and 
interest rate risks that may be exacerbated by these global financial conditions. If the banking system or the fixed income, credit 

13 

 
or equity markets continue to deteriorate or remain volatile, our investment portfolio may be impacted and the values and 
liquidity of our investments could be adversely affected as well. 

We face risk and/or the possibility of claims from activities related to strategic partners, which could be expensive and 
time-consuming, divert personnel and other resources from our business and result in adverse publicity that could 
harm our business. We rely on third parties to provide services for our business. For example, we use national clearinghouses 
in the processing of some insurance claims and we outsource some of our hardware services and the printing and delivery of 
patient statements for our customers. These third parties could raise their prices and/or be acquired by our competitors, which 
could potentially create short and long-term disruptions to our business, negatively impacting our revenue, profit and/or stock 
price. We also have relationships with certain third parties where these third parties serve as sales channels through which we 
generate a portion of our revenue. Due to these third party relationships, we could be subject to claims as a result of the 
activities, products, or services of these third party service providers even though we were not directly involved in the 
circumstances leading to those claims. Even if these claims do not result in liability to us, defending and investigating these 
claims could be expensive and time-consuming, divert personnel and other resources from our business and result in adverse 
publicity that could harm our business. 

We may engage in future acquisitions, which may be expensive, time consuming, subject to inherent risks and from 
which we may not realize anticipated benefits. We may acquire additional businesses, technologies and products if we 
determine that these additional businesses, technologies and products are likely to serve our strategic goals. We acquired Opus 
and Sphere during fiscal year 2010, IntraNexus and CQI during fiscal year 2012 and Poseidon during fiscal year 2013, all of 
which are developers of software and services for the hospital market. We also acquired ViaTrack during fiscal year 2012 which 
develops information technologies that enhance EDI offerings, Matrix during fiscal year 2013 which provides revenue cycle 
management services, and Mirth during fiscal year 2014 which develops health information technology that helps customers 
achieve interoperability. During fiscal year 2015, we acquired Gennius, Inc. which develops analytics based information 
technology that helps customers deliver accountable care. Acquisitions have inherent risks, which may have a material adverse 
effect on our business, financial condition, operating results or prospects, including, but not limited to the following: 

•  

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failure to achieve projected synergies and performance targets; 

potentially dilutive issuances of our securities, the incurrence of debt and contingent liabilities and amortization 
expenses related to intangible assets with indefinite useful lives, which could adversely affect our results of 
operations and financial condition; 

using cash as acquisition currency may adversely affect interest or investment income, which may in turn 
adversely affect our earnings and /or earnings per share; 

difficulty in fully or effectively integrating the acquired technologies, software products, services, business practices 
or personnel, which would prevent us from realizing the intended benefits of the acquisition; 

failure to maintain uniform standard controls, policies and procedures across acquired businesses; 

difficulty in predicting and responding to issues related to product transition such as development, distribution and 
customer support; 

the possible adverse effect of such acquisitions on existing relationships with third party partners and suppliers of 
technologies and services; 

the possibility that staff or customers of the acquired company might not accept new ownership and may transition 
to different technologies or attempt to renegotiate contract terms or relationships, including maintenance or support 
agreements; 

the assumption of known and unknown liabilities; 

the possibility that the due diligence process in any such acquisition may not completely identify material issues 
associated with product quality, product architecture, product development, intellectual property issues, key 
personnel issues or legal and financial contingencies, including any deficiencies in internal controls and procedures 
and the costs associated with remedying such deficiencies; 

difficulty in entering geographic and/or business markets in which we have no or limited prior experience; 

difficulty in integrating acquired operations due to geographical distance and language and cultural differences; 

diversion of management's attention from other business concerns; and 

the possibility that acquired assets become impaired, requiring us to take a charge to earnings which could be 
significant. 

A failure to successfully integrate acquired businesses or technology could, for any of these reasons, have an adverse effect on 
our financial condition and results of operations. 

14 

 
 
 
Our failure to manage growth could harm our business, results of operations and financial condition. We have in the 
past experienced periods of growth which have placed, and may continue to place, a significant strain on our non-cash 
resources. We also anticipate expanding our overall software development, marketing, sales, customer management and 
training capacity. In the event we are unable to identify, hire, train and retain qualified individuals in such capacities within a 
reasonable timeframe, such failure could have an adverse effect on the operation of our business. In addition, our ability to 
manage future increases, if any, in the scope of our operations or personnel will depend on significant expansion of our research 
and development, marketing and sales, management and administrative and financial capabilities. The failure of our 
management to effectively manage expansion in our business could have an adverse effect on our business, results of 
operations and financial condition. 

Our operations are dependent upon our key personnel. If such personnel were to leave unexpectedly, we may not be 
able to execute our business plan. Our future performance depends in significant part upon the continued service of our key 
development and senior management personnel and successful recruitment of new talent. These personnel have specialized 
knowledge and skills with respect to our business and our industry. Because we have a relatively small number of employees 
when compared to other leading companies in our industry, our dependence on maintaining our relationships with key 
employees and successful recruiting is particularly significant. 

The industry in which we operate is characterized by a high level of employee mobility and aggressive recruiting of skilled 
personnel. There can be no assurance that our current employees will continue to work for us. Loss of services of key 
employees could have an adverse effect on our business, results of operations and financial condition. Furthermore, we may 
need to grant additional equity incentives to key employees and provide other forms of incentive compensation to attract and 
retain such key personnel. Equity incentives may be dilutive to our per share financial performance. Failure to provide such 
types of incentive compensation could jeopardize our recruitment and retention capabilities. 

The integration of our Chief Financial Officer into our management team may interfere with our operations. We have 
appointed an Interim Chief Financial Officer as a result of the recent resignation of our former Chief Financial Officer. Our Interim 
Chief Financial Officer, and the individual who is appointed as our replacement Chief Financial Officer, will be required to spend 
a significant amount of time on certain integration and transition efforts in addition to performing his or her regular duties and 
responsibilities. If we fail to complete this integration in an efficient manner, our business and prospects may suffer. 

Continuing worldwide political and economic uncertainties may adversely affect our revenue and profitability. The last 
several years have been periodically marked by concerns including but not limited to inflation, decreased consumer confidence, 
the lingering effects of international conflicts, energy costs and terrorist and military activities. Although certain indices and 
economic data have shown signs of stabilization in the United States and certain global markets, there can be no assurance that 
these improvements will be broad-based or sustainable. This instability can make it extremely difficult for our customers, our 
vendors and us to accurately forecast and plan future business activities, and could cause constrained spending on our products 
and services, delays and a lengthening of our sales cycles and/or difficulty in collection of our accounts receivable.  Bankruptcies 
or similar insolvency events affecting our customers may cause us to incur bad debt expense at levels higher than historically 
experienced. Further, an ongoing economic stability in the global markets could limit our ability to access the capital markets at a 
time when we would like, or need, to raise capital, which could have an impact on our ability to react to changing business 
conditions or new opportunities. Accordingly, if worldwide political and economic uncertainties continue or worsen, our business, 
results of operations and financial condition could be materially and adversely affected. 

If we are unable to manage our growth in the new markets we may enter, our business and financial results could 
suffer. Our future financial results will depend in part on our ability to profitably manage our business in new markets that we 
may enter. We are engaging in the strategic identification of, and competition for, growth and expansion opportunities in new 
markets or offerings, including but not limited to the areas of interoperability, patient engagements, data analytics and population 
health. In order to successfully execute on these future initiatives, we will need to, among other things, manage changing 
business conditions and develop expertise in areas outside of our business's traditional core competencies. Difficulties in 
managing future growth in new markets could have a significant negative impact on our business, financial condition and results 
of operations. 

We may not be successful in developing or launching our new software products and services, which could have a 
negative impact on our financial condition and results of operations. We invest significant resources in the research and 
development of new and enhanced software products and services. Over the last few years we have incurred, and will continue 
to incur, significant internal research and development expenses that are recorded as capitalized software costs. We cannot 
provide assurances that we will be successful in our efforts to develop or sell new software products, which could result in an 
impairment of the value of the related capitalized software costs, an adverse effect on our financial condition and operating 
results and a negative impact the future of our business. 

We own a captive facility, located in India that subjects us to regulatory, economic, social and political uncertainties in 
India. We are subject to several risks associated with having a portion of our assets and operations located in India. Many US 
companies have benefited from many policies of the Government of India and the Indian state governments in the states in 
which we operate, which are designed to promote foreign investment generally and the business process services industry in 
particular, including significant tax incentives, relaxation of regulatory restrictions, liberalized import and export duties and 
preferential rules on foreign investment and repatriation. There is no assurance that such policies will continue. Various factors, 
such as changes in the current Government of India, could trigger significant changes in India’s economic liberalization and 
deregulation policies and disrupt business and economic conditions in India generally and our business in particular. In addition, 

15 

 
our financial performance and the market price of our common stock may be adversely affected by general economic conditions 
and economic and fiscal policy in India, including changes in exchange rates and controls, interest rates and taxation policies, as 
well as social stability and political, economic or diplomatic developments affecting India in the future. In particular, India has 
experienced significant economic growth over the last several years, but faces major challenges in sustaining that growth in the 
years ahead. These challenges include the need for substantial infrastructure development and improving access to healthcare 
and education. Our ability to recruit, train and retain qualified employees, develop and operate our captive facility could be 
adversely affected if India does not successfully meet these challenges. 

We could suffer further charges due to asset impairment that could reduce our income. We test our goodwill for 
impairment annually during our first fiscal quarter, and on interim dates should events or changes in circumstances indicate the 
carrying value of goodwill may not be recoverable in accordance with the relevant accounting guidance. During the quarter 
ended March 31, 2013, we recorded a $17.4 million goodwill impairment charge relating to our Hospital Solutions Division and 
during the quarter ended December 31, 2013, we recorded a $26.0 million impairment charge relating to certain long-lived 
assets of our Hospital Solutions Division. Declines in business performance or other factors could cause the fair value of any of 
our operating segments to be revised downward, resulting in further impairment charges. If the financial outlook for any of our 
operating segments warrants additional impairments of goodwill, the resulting write-downs could materially affect our reported 
net earnings. 

We face the risks and uncertainties that are associated with litigation against us, which may adversely impact our 
marketing, distract management and have a negative impact upon our business, results of operations and financial 
condition. We face the risks associated with litigation concerning the operation of our business. For example, companies in our 
industry, including many of our competitors, have been subject to litigation based on allegations of patent infringement or other 
violations of intellectual property rights. In particular, patent holding companies often engage in litigation to seek to monetize 
patents that they have obtained. As the number of competitors, patents and patent holding companies in our industry increases, 
the functionality of our products and services expands, and we enter into new geographies and markets, the number of 
intellectual property rights-related actions against us is likely to continue to increase. The uncertainty associated with substantial 
unresolved litigation may have an adverse effect on our business. In particular, such litigation could impair our relationships with 
existing customers and our ability to obtain new customers. Defending such litigation may result in a diversion of management's 
time and attention away from business operations, which could have an adverse effect on our business, results of operations 
and financial condition. Such litigation may also have the effect of discouraging potential acquirers from bidding for us or 
reducing the consideration such acquirers would otherwise be willing to pay in connection with an acquisition. 

There can be no assurance that such litigation will not result in liability in excess of our insurance coverage, that our insurance 
will cover such claims or that appropriate insurance will continue to be available to us in the future at commercially reasonable 
rates. 

We may be impacted by IT system failures or other disruptions.  We may be subject to IT systems failures and network 
disruptions. These may be caused by natural disasters, accidents, power disruptions, telecommunications failures, acts of 
terrorism or war, computer viruses, physical or electronic break-ins, or other events or disruptions. System redundancy may be 
ineffective or inadequate, and our disaster recovery planning may not be sufficient for all eventualities. Such failures or 
disruptions could prevent access to or the delivery of certain of our products or services, compromise our data or our customers’ 
data, or result in delayed or cancelled orders as well as potentially expose us to third party claims. System failures and 
disruptions could also impede our transactions processing services and financial reporting. 
Our business operations are subject to interruption by, among other, natural disasters, fire, power shortages, terrorist attacks, 
and other hostile acts, labor disputes, public health issues, and other issues beyond our control. Such events could decrease our 
demand for our products or services or make it difficult or impossible for us to develop and deliver our products or services to our 
customers. A significant portion of our research and development activities, our corporate headquarters, our IT systems, and 
certain of our other critical business operations are concentrated in a few geographic areas. In the event of a business disruption 
in one or more of those areas, we could incur significant losses, require substantial recovery time, and experience significant 
expenditures in order to resume operations, which could materially and adversely impact our business, financial condition, and 
operating results. 

We face risks related to litigation advanced by a former director and shareholder of ours, a putative class action and a 
shareholder derivative claim. On October 7, 2013, a complaint was filed against us and certain of our officers and directors in 
the Superior Court of the State of California for the County of Orange, captioned Ahmed D. Hussein v. Sheldon Razin, Steven 
Plochocki, Quality Systems, Inc. and Does 1-10, inclusive, No. 30-2013-00679600-CU-NP-CJC, by Ahmed Hussein, a former 
director and significant shareholder of ours.  The complaint generally alleges fraud and deceit, constructive fraud, negligent 
misrepresentation and breach of fiduciary duty in connection with statements made to our shareholders regarding our financial 
condition and projected future performance. On November 19, 2013, a complaint was filed against the Company and certain of 
the Company’s officers and directors in the United States District Court for the Central District of California, captioned Deerfield 
Beach Police Pension Fund, individually and on behalf of all others similarly situated, v. Quality Systems, Inc., Steven T. 
Plochocki, Paul A. Holt and Sheldon Razin, No. SACV13-01818-CJC-JPRx, by the Deerfield Beach Police Pension Fund, a 
shareholder of the Company. The complaint is a putative class action filed on behalf of the shareholders of the Company other 
than the defendants. The complaint, which is substantially similar to the complaint filed by Mr. Hussein described above, 
generally alleges that statements made to the Company’s shareholders regarding the Company’s financial condition and 
projected future performance were false and misleading in violation of the Exchange Act, and that the individual defendants are 
liable for such statements because they are controlling persons under Section 20(a) of the Exchange Act. On January 24, 2014, 

16 

 
a complaint was filed against the Company and certain of the Company’s officers and current and former directors in the United 
States District Court for the Central District of California, captioned Timothy J. Foss, derivatively on behalf of himself and all 
others similarly situated, vs. Craig A. Barbarosh, George H. Bristol, James C. Malone, Peter M. Neupert, Morris Panner, D. 
Russell Pflueger, Steven T. Plochocki, Sheldon Razin, Lance E. Rosenzweig and Quality Systems, Inc., No. SACV14-00110-
DOC-JPPx, by Timothy J. Foss, a shareholder of the Company. The complaint arises from the same allegations described above 
related to the complaints filed by Mr. Hussein and the Deerfield Beach Police Pension Fund and generally alleges breach of 
fiduciary duties, abuse of control and gross mismanagement by the Company’s directors, in addition to unjust enrichment and 
insider selling by individual directors. Although we believe the claims to be without merit, our operating results and share price 
may be negatively impacted due to the negative publicity, expenses incurred in connection with our defense, management 
distraction, and/or other factors related to this litigation. In addition, litigation of this nature may negatively impact our ability to 
attract and retain customers and strategic partners, as well as qualified board members and management personnel. 

Risks Related to Our Products and Services 

If our principal products, new product developments or implementation, training and support services fail to meet the 
needs of our customers, we may fail to realize future growth, suffer reputational harm and face the risk of losing 
existing customers. We currently derive substantially all of our net revenue from sales of our healthcare information systems 
and related services. We believe that a primary factor in the market acceptance of our systems has been our ability to meet the 
needs of users of healthcare information systems. Our future financial performance will depend in large part on our ability to 
continue to meet the increasingly sophisticated needs of our customers through the timely development and successful 
introduction of new and enhanced versions of our systems and other complementary products, as well as our ability to provide 
high quality implementation, training and support services for our products. We have historically expended a significant 
percentage of our net revenue on product development and believe that significant continuing product development efforts will 
be required to retain our existing customers and sustain our growth. Continued investment in our sales staff and our customer 
implementation, training and support staffs will also be required to retain and grow our customer base. 

There can be no assurance that we will be successful in our customer satisfaction or product development efforts, that the 
market will continue to accept our existing products and services, or that new products or product enhancements will be 
developed and implemented in a timely manner, meet the requirements of healthcare providers, or achieve market acceptance. 
If new products or product enhancements are delayed or do not achieve market acceptance, or if our implementation, training 
and support services do not achieve a high degree of customer satisfaction, our reputation, business, results of operations and 
financial condition could be adversely affected. At certain times in the past, we have also experienced delays in purchases of our 
products by customers anticipating our launch, or the launch of our competitors, of new products. There can be no assurance 
that material order deferrals in anticipation of new product introductions from ourselves or other entities will not occur. 

If the emerging technologies and platforms of Microsoft and others upon which we build our products do not gain or 
continue to maintain broad market acceptance, or if we fail to develop and introduce in a timely manner new products 
and services compatible with such emerging technologies, we may not be able to compete effectively and our ability to 
generate revenue will suffer. Our software products are built and depend upon several underlying and evolving relational 
database management system platforms such as those developed by Microsoft. To date, the standards and technologies upon 
which we have chosen to develop our products have proven to have gained industry acceptance. However, the market for our 
software products is subject to ongoing rapid technological developments, quickly evolving industry standards and rapid 
changes in customer requirements, and there may be existing or future technologies and platforms that achieve industry 
standard status, which are not compatible with our products. 

We are dependent on our license rights and other services from third parties, which may cause us to discontinue, delay 
or reduce product shipments. We depend upon licenses for some of the technology used in our products as well as other 
services from third party vendors. Most of these arrangements can be continued/renewed only by mutual consent and may be 
terminated for any number of reasons. We may not be able to continue using the products or services made available to us 
under these arrangements on commercially reasonable terms or at all. As a result, we may have to discontinue, delay or reduce 
product shipments or services provided until we can obtain equivalent technology or services. Most of our third party licenses 
are non-exclusive. Our competitors may obtain the right to use any of the business elements covered by these arrangements 
and use these elements to compete directly with us. In addition, if our vendors choose to discontinue providing their technology 
or services in the future or are unsuccessful in their continued research and development efforts, we may not be able to modify 
or adapt our own products. 

We may experience interruption at our data centers or customer support facilities. We perform data center and/or hosting 
services for certain customers, including the storage of critical patient and administrative data at company-owned facilities and 
through third party hosting arrangements. In addition, we provide support services to our customers through various customer 
support facilities. We have invested in reliability features such as multiple power feeds, multiple backup generators and 
redundant telecommunications lines, as well as technical (such as multiple overlapping security applications, access control and 
other countermeasures) and physical security safeguards, and structured our operations to reduce the likelihood of disruptions. 
However, complete failure of all local public power and backup generators, impairment of all telecommunications lines, a 
concerted denial of service cyber-attack, a significant data breach, damage, injury or impairment (environmental, accidental, 
intentional or pandemic) to the buildings, the equipment inside the buildings housing our data centers, the personnel operating 
such facilities or the customer data contained therein, or errors by the personnel trained to operate such facilities could cause a 
disruption in operations and negatively impact customers who depend on us for data center and system support services. Any 

17 

 
 
interruption in operations at our data centers and/or customer support facilities could damage our reputation, cause us to lose 
existing customers, hurt our ability to obtain new customers, result in significant revenue loss, create potential liabilities for our 
customers and us and increase insurance and other operating costs. 

We face the possibility of having to adopt new pricing strategies, such as subscription pricing or bundling. In April 2009, 
we announced a new subscription based software as a service delivery model which includes monthly subscription pricing. This 
model is designed for smaller practices to quickly access the NextGen® Ambulatory EHR or NextGen® PM products at a 
modest monthly per provider price. We currently derive substantially all of our systems revenue from traditional software license, 
implementation and training fees, as well as the resale of computer hardware. Today, the majority of our customers pay an initial 
license fee for the use of our products, in addition to a periodic maintenance fee. While the intent of the new subscription based 
delivery model is to further penetrate the smaller practice market, there can be no assurance that this delivery model will not 
become increasingly popular with both small and large customers. In addition, we have experienced increasing demand for 
bundling our software and systems with RCM service arrangements, which has required us to modify our standard upfront 
license fee pricing model. If the marketplace increasingly demands subscription or bundled pricing, we may be forced to further 
adjust our sales, marketing and pricing strategies accordingly, by offering a higher percentage of our products and services 
through these means. Shifting to a significantly greater degree of subscription or bundled pricing could adversely affect our 
financial condition, cash flows and quarterly and annual revenue and results of operations, as our revenue would initially 
decrease substantially. 

We face the possibility of claims based upon our website content, which may cause us expense and management 
distraction. We could be subject to third party claims based on the nature and content of information supplied on our website by 
us or third parties, including content providers or users. We could also be subject to liability for content that may be accessible 
through our website or third party websites linked from our website or through content and information that may be posted by 
users in chat rooms, bulletin boards or on websites created by professionals using our applications. Even if these claims do not 
result in liability to us, investigating and defending against these claims could be expensive and time consuming and could divert 
management’s attention away from our operations. 

If our security measures are breached or fail and unauthorized access is obtained to a customer’s data, our services 
may be perceived as not being secure, customers may curtail or stop using our services, and we may incur significant 
liabilities. Our services involve the storage and transmission of customers’ proprietary information and protected health 
information of patients. Because of the sensitivity of this information, security features of our software are very important. If our 
security measures are breached or fail as a result of third party action, employee error, malfeasance, insufficiency, defective 
design, or otherwise, someone may be able to obtain unauthorized access to customer or patient data. As a result, our 
reputation could be damaged, our business may suffer, and we could face damages for contract breach, penalties for violation of 
applicable laws or regulations and significant costs for remediation and remediation efforts to prevent future occurrences. We 
rely upon our customers as users of our system for key activities to promote security of the system and the data within it, such 
as administration of customer-side access credentialing and control of customer-side display of data. On occasion, our 
customers have failed to perform these activities. Failure of customers to perform these activities may result in claims against us 
that this reliance was misplaced, which could expose us to significant expense and harm to our reputation. Because techniques 
used to obtain unauthorized access or to sabotage systems change frequently and generally are not recognized until launched 
against a target, we may be unable to anticipate these techniques or to implement adequate preventive measures. If an actual or 
perceived breach of our security occurs, the market perception of the effectiveness of our security measures could be harmed 
and we could lose sales and customers. In addition, our customers may authorize or enable third parties to access their 
customer data or the data of their patients on our systems. Because we do not control such access, we cannot ensure the 
complete propriety of that access or integrity or security of such data in our systems. 

Failure by our customers to obtain proper permissions and waivers may result in claims against us or may limit or 
prevent our use of data, which could harm our business. We require our customers to provide necessary notices and to 
obtain necessary permissions and waivers for use and disclosure of the information that we receive, and we require contractual 
assurances from them that they have done so and will do so. If they do not obtain necessary permissions and waivers, then our 
use and disclosure of information that we receive from them or on their behalf may be limited or prohibited by state or federal 
privacy laws or other applicable laws. This could impair our functions, processes and databases that reflect, contain, or are 
based upon such data and may prevent use of such data. In addition, this could interfere with or prevent creation or use of rules 
and analyses or limit other data-driven activities that are beneficial to our business. Moreover, we may be subject to claims or 
liability for use or disclosure of information by reason of lack of valid notice, permission or waiver. These claims or liabilities could 
subject us to unexpected costs and adversely affect our operating results. 

We face the possibility of damages resulting from internal and external security breaches. In the course of our business 
operations, we compile and transmit confidential information, including patient health information, in our processing centers and 
other facilities. A breach of security in any of these facilities could damage our reputation and result in damages being assessed 
against us. In addition, the other systems with which we may interface, such as the Internet and related systems may be 
vulnerable to security breaches, viruses, programming errors, or similar disruptive problems. The effect of these security 
breaches and related issues could disrupt our ability to perform certain key business functions and could potentially reduce 
demand for our services. Accordingly, we have expended significant resources toward establishing and enhancing the security of 
our related infrastructures, although no assurance can be given that they will be entirely free from potential breach. Maintaining 
and enhancing our infrastructure security may require us to expend significant capital in the future. 

18 

 
The success of our strategy to offer our EDI services and Internet solutions depends on the confidence of our customers in our 
ability to securely transmit confidential information. Our EDI services and Internet solutions rely on encryption, authentication 
and other security technology licensed from third parties to achieve secure transmission of confidential information. We may not 
be able to stop unauthorized attempts to gain access to or disrupt the transmission of communications by our customers. 
Anyone who is able to circumvent our security measures could misappropriate confidential user information or interrupt our, or 
our customers’, operations. In addition, our EDI and Internet solutions may be vulnerable to viruses, physical or electronic break-
ins and similar disruptions. 

Any failure to provide secure infrastructure and/or electronic communication services could result in a lack of trust by our 
customers causing them to seek out other vendors and/or damage our reputation in the market, making it difficult to obtain new 
customers. 

Our business depends on continued and unimpeded access to the Internet by us and our customers, which is not 
within our control. We deliver Internet-based services and, accordingly, depend on our ability and the ability of our customers 
to access the Internet. This access is currently provided by third parties that have significant market power in the broadband and 
Internet access marketplace, including incumbent telephone companies, cable companies, mobile communications companies 
and government-owned service provides -- all of whom are outside of our control. In the event of any difficulties, outages and 
delays by Internet service providers, we may be impeded from providing services, resulting in a loss of potential or existing 
customers. 

We may be subject to claims for system errors, warranties or product liability, which could have an adverse effect on 
our business, results of operations and financial condition. Our software solutions are intended for use in collecting, storing 
and displaying clinical and healthcare-related information used in the diagnosis and treatment of patients and in related 
healthcare settings such as admissions and billing.  Therefore, users of our software solutions have a greater sensitivity to errors 
than the market for software products generally.  Any failure by our products to provide accurate and timely information 
concerning patients, their medication, treatment and health status, generally, could result in claims against us which could 
materially and adversely impact our financial performance, industry reputation and ability to market new system sales. In 
addition, a court or government agency may take the position that our delivery of health information directly, including through 
licensed practitioners, or delivery of information by a third party site that a consumer accesses through our websites, exposes us 
to assertions of malpractice, other personal injury liability, or other liability for wrongful delivery/handling of healthcare services or 
erroneous health information. We maintain insurance to protect against claims associated with the use of our products as well as 
liability limitation language in our end-user license agreements, but there can be no assurance that our insurance coverage or 
contractual language would adequately cover any claim asserted against us. A successful claim brought against us in excess of 
or outside of our insurance coverage could have an adverse effect on our business, results of operations and financial condition. 
Even unsuccessful claims could result in our expenditure of funds for litigation and management time and resources. 

Certain healthcare professionals who use our Internet-based products will directly enter health information about their patients 
including information that constitutes a record under applicable law that we may store on our computer systems. Numerous 
federal and state laws and regulations, the common law and contractual obligations, govern collection, dissemination, use and 
confidentiality of patient-identifiable health information, including: 

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state and federal privacy and confidentiality laws; 

our contracts with customers and partners; 

state laws regulating healthcare professionals; 

Medicaid laws; 

the HIPAA and related rules proposed by CMS; and 

CMS standards for Internet transmission of health data. 

HIPAA establishes elements including, but not limited to, federal privacy and security standards for the use and protection of 
Protected Health Information. Any failure by us or by our personnel or partners to comply with applicable requirements may 
result in a material liability to us. 

Although we have systems and policies in place for safeguarding Protected Health Information from unauthorized disclosure, 
these systems and policies may not preclude claims against us for alleged violations of applicable requirements. Also, third party 
sites and/or links that consumers may access through our web sites may not maintain adequate systems to safeguard this 
information, or may circumvent systems and policies we have put in place. In addition, future laws or changes in current laws 
may necessitate costly adaptations to our policies, procedures, or systems. 

There can be no assurance that we will not be subject to product liability claims, that such claims will not result in liability in 
excess of our insurance coverage, that our insurance will cover such claims or that appropriate insurance will continue to be 
available to us in the future at commercially reasonable rates. Such product liability claims could adversely affect our business, 
results of operations and financial condition. 

19 

 
 
 
We are subject to the effect of payer and provider conduct which we cannot control and accordingly, there is no 
assurance that revenue for our services will continue at historic levels. We offer certain electronic claims submission 
products and services as part of our product line. While we have implemented certain product features designed to maximize the 
accuracy and completeness of claims submissions, these features may not be sufficient to prevent inaccurate claims data from 
being submitted to payers. Should inaccurate claims data be submitted to payers, we may be subject to liability claims. 

Electronic data transmission services are offered by certain payers to healthcare providers that establish a direct link between 
the provider and payer. This process reduces revenue to third party EDI service providers such as us. As a result of this, and 
other market factors, we are unable to ensure that we will continue to generate revenue at or in excess of prior levels for such 
services. 

A significant increase in the utilization of direct links between healthcare providers and payers could adversely affect our 
transaction volume and financial results. In addition, we cannot provide assurance that we will be able to maintain our existing 
links to payers or develop new connections on terms that are economically satisfactory to us, if at all. 

Proprietary rights are material to our success, and the misappropriation of these rights could adversely affect our 
business and our financial condition. We are heavily dependent on the maintenance and protection of our intellectual 
property and we rely largely on technical security measures, license agreements, confidentiality procedures and employee 
nondisclosure agreements to protect our intellectual property. The majority of our software is not patented and existing copyright 
laws offer only limited practical protection. 

There can be no assurance that the legal protections and precautions we take will be adequate to prevent misappropriation of 
our technology or that competitors will not independently develop technologies equivalent or superior to ours. Further, the laws 
of some foreign countries do not protect our proprietary rights to as great an extent as do the laws of the United States and are 
often not enforced as vigorously as those in the United States. 

We do not believe that our operations or products infringe on the intellectual property rights of others. However, there can be no 
assurance that others will not assert infringement or trade secret claims against us with respect to our current or future products 
or that any such assertion will not require us to enter into a license agreement or royalty arrangement or other financial 
arrangement with the party asserting the claim. Responding to and defending any such claims may distract the attention of our 
management and adversely affect our business, results of operations and financial condition. In addition, claims may be brought 
against third parties from which we purchase software, and such claims could adversely affect our ability to access third party 
software for our systems. 

If we are deemed to infringe on the proprietary rights of third parties, we could incur unanticipated expense and be 
prevented from providing our products and services. We have been, and may be in the future, subject to intellectual 
property infringement claims as the number of our competitors grows and our applications' functionality is viewed as similar or 
overlapping with competitive products. We do not believe that we have infringed or are infringing on any proprietary rights of 
third parties. However, claims are occasionally asserted against us, and we cannot assure you that infringement claims will not 
be asserted against us in the future. Also, we cannot assure you that any such claims will be unsuccessful. We could incur 
substantial costs and diversion of management resources defending any infringement claims - even if we are ultimately 
successful in the defense of such matters. Furthermore, a party making a claim against us could secure a judgment awarding 
substantial damages, as well as injunctive or other equitable relief that could effectively block our ability to provide products or 
services. In addition, we cannot assure you that licenses for any intellectual property of third parties that might be required for 
our products or services will be available on commercially reasonable terms, or at all. 

We face risks related to the periodic maintenance and upgrades that need to be made to our products. As we continue to 
develop and improve upon our technology and offerings, we need to periodically upgrade and maintain the products deployed to 
our customers. This process can require a significant amount of our internal time and resources, and be complicated and time 
consuming for our customers. Certain upgrades may also pose the risk of system delays or failure. If our periodic upgrades and 
maintenance cause disruptions to our customers, we may lose revenue-generating transactions, our customers may elect to use 
other solutions and we may also be the subject of negative publicity that may adversely affect our business and reputation. 

Risks Related to Regulation 

There is significant uncertainty in the healthcare industry in which we operate, and the current governmental laws and 
regulations as well as any future modifications to the regulatory environment, may adversely impact our business, 
financial condition and results of operations. The healthcare industry is subject to changing political, economic and 
regulatory influences that may affect the procurement processes and operation of healthcare facilities. During the past several 
years, the healthcare industry has been subject to an increase in governmental regulation of, among other things, 
reimbursement rates and certain capital expenditures. 

For example, the Health Insurance Portability and Accountability Act of 1996, as modified by HITECH provisions of the ARRA 
(collectively, “HIPAA”), continues to have a direct impact on the health care industry by requiring national provider identifiers and 
standardized transactions/code sets, operating rules and necessary security and privacy measures in order to ensure the 
appropriate level of privacy of protected health information. These regulatory factors affect the purchasing practices and 
operation of health care organizations. 

20 

 
 
The PPACA, which was amended by the Health Care and Education Reconciliation Act of 2010, became law in 2010. This 
comprehensive health care reform legislation included provisions to control health care costs, improve health care quality, and 
expand access to affordable health insurance. Together with ongoing statutory and budgetary policy developments at a federal 
level, this health care reform legislation could include changes in Medicare and Medicaid payment policies and other health care 
delivery administrative reforms that could potentially negatively impact our business and the business of our customers. 
Because not all the administrative rules implementing health care reform under the legislation have been finalized, and because 
of ongoing federal fiscal budgetary pressures yet to be resolved for federal health programs, the full impact of the health care 
reform legislation and of further statutory actions to reform healthcare payment on our business is unknown, but there can be no 
assurances that health care reform legislation will not adversely impact either our operational results or the manner in which we 
operate our business. Health care industry participants may respond by reducing their investments or postponing investment 
decisions, including investments in our solutions and services. 

Various legislators have announced that they intend to examine further proposals to reform certain aspects of the U.S. 
healthcare system. Healthcare providers may react to these proposals, and the uncertainty surrounding such proposals, by 
curtailing or deferring investments, including those for our systems and related services. Cost-containment measures instituted 
by healthcare providers as a result of regulatory reform or otherwise could result in a reduction in the allocation of capital funds. 
Such a reduction could have an adverse effect on our ability to sell our systems and related services. On the other hand, 
changes in the regulatory environment have increased and may continue to increase the needs of healthcare organizations for 
cost-effective data management and thereby enhance the overall market for healthcare management information systems. We 
cannot predict what effect, if any, such proposals or healthcare reforms might have on our business, financial condition and 
results of operations. 

As existing regulations mature and become better defined, we anticipate that these regulations will continue to directly affect 
certain of our products and services, but we cannot fully predict the effect at this time. We have taken steps to modify our 
products, services and internal practices as necessary to facilitate our compliance with the regulations, but there can be no 
assurance that we will be able to do so in a timely or complete manner. Achieving compliance with these regulations could be 
costly and distract management’s attention and divert other company resources, and any noncompliance by us could result in 
civil and criminal penalties. 

Developments of additional federal and state regulations and policies have the potential to positively or negatively affect our 
business. 

Other specific risks include, but are not limited to, risks relating to: 

Privacy and Security of Patient Information. As part of the operation of our business, we may have access to or our 
customers may provide to us individually-identifiable health information related to the treatment, payment, and operations of 
providers’ practices. Government and industry legislation and rulemaking, especially HIPAA, HITECH and standards and 
requirements published by industry groups such as the Joint Commission require the use of standard transactions, standard 
identifiers, security and other standards and requirements for the transmission of certain electronic health information. These 
standards and requirements impose additional obligations and burdens on us, limiting the use and disclosure of individually-
identifiable health information, and require us to enter into business associate agreements with our customers and vendors. Our 
business associates may interpret HIPAA requirements differently than we do, and we may not be able to adequately address 
the risks created by such interpretations. These new rules, and any future changes to privacy and security rules, may increase 
the cost of compliance and could subject us to additional enforcement actions, which could further increase our costs and 
adversely affect the way in which we do business. 

Implementation of ICD-10 Coding for Medical Coding. The CMS has mandated that all providers, payers, clearinghouses and 
billing services implement the use of new patient codes for medical coding, referred to as ICD-10 codes, on or before October 1, 
2015. The ICD-10 transition mandate substantially increases the number of medical billing codes by which providers will seek 
reimbursement, increasing the complexity of submitting claims for reimbursement. Our efforts to provide services and solutions 
that enable our customers to comply with the ICD-10 mandate could be time consuming and expensive. In addition, due to the 
effort and expense of complying with the ICD-10 mandate, our customers may postpone or cancel decisions to purchase our 
solutions and services. Either of the foregoing, or any future delay in the ICD-10 transition, could have a material adverse effect 
on our business, financial condition and results of operations. 

Interoperability Standards. Our customers are concerned with and often require that our software solutions and health care 
devices be interoperable with other third party health care information technology suppliers. Market forces or 
governmental/regulatory authorities could create software interoperability standards that would apply to our solutions, health 
care devices or solutions, and if our software solutions, health care devices or services are not consistent with those standards, 
we could be forced to incur substantial additional development costs to conform. 

FDA Regulation. Our software may potentially be subject to regulation by the U.S. Food and Drug Administration (“FDA”) as a 
medical device. Such regulation could require the registration of the applicable manufacturing facility and software and hardware 
products, application of detailed record-keeping and manufacturing standards, and FDA approval or clearance prior to 
marketing. An approval or clearance requirement could create delays in marketing, and the FDA could require supplemental 
filings or object to certain of these applications, the result of which could adversely affect our business, financial condition and 
results of operations. 

21 

 
Health Reform. The health reform laws discussed above and that may be enacted in the future contain and may contain various 
provisions which may impact us and our customers. Some of these provisions may have a positive impact, by expanding the use 
of electronic health records in certain federal programs, for example, while others, such as reductions in reimbursement for 
certain types of providers, may have a negative impact due to fewer available resources. Increases in fraud and abuse penalties 
may also adversely affect participants in the health care sector, including us. 

We may not see the benefits from government funding programs initiated to accelerate the adoption and utilization of 
health information technology. While government programs have been implemented to improve the efficiency and quality of 
the healthcare sector, including expenditures to stimulate business and accelerate the adoption and utilization of healthcare 
technology, we may not see the anticipated benefits of such programs. Under the ARRA and the PPACA, unprecedented 
government financial resources are being invested in healthcare, including significant financial incentives to healthcare providers 
who can demonstrate meaningful use of certified EHR technology since 2011. While we expect the ARRA and the PPACA to 
continue to create significant sales opportunities over the next several years, we are unsure of the immediate or long-term 
impact of these government actions. 

HITECH established the Medicare and Medicaid EHR Incentive Programs to provide incentive payments for eligible 
professionals, hospitals, and critical access hospitals as they adopt, implement, upgrade, or demonstrate meaningful use of 
certified EHR technology. HITECH also authorized CMS to apply payment adjustments, or penalties, to Medicare eligible 
professionals and eligible hospitals that are not meaningful users under the Medicare EHR Incentive Program. 

Although we believe that our service offerings will meet the requirements of HITECH to allow our customers to qualify for 
financial incentives for implementing and using our services, there can be no guaranty that our customers will achieve 
meaningful use or actually receive such planned financial incentives for our services. We also cannot predict the speed at which 
healthcare providers will adopt electronic health record systems in response to these government incentives, whether healthcare 
providers will select our products and services or whether healthcare providers will implement an electronic health record system 
at all. In addition, the financial incentives associated with the meaningful use program are tied to provider participation in 
Medicare and Medicaid, and we cannot predict whether providers will continue to participate in these programs. Any delay in the 
purchase and implementation of electronic health records systems by healthcare providers in response to government 
programs, or the failure of healthcare providers to purchase an electronic health record system, could have an adverse effect on 
our business, financial condition and results of operations. It is also possible that additional regulations or government programs 
related to electronic health records, amendment or repeal of current healthcare laws and regulations or the delay in regulatory 
implementation could require us to undertake additional efforts to meet meaningful use standards, materially impact our ability to 
compete in the evolving healthcare IT market, materially impact healthcare providers' decisions to implement electronic health 
records systems or have other impacts that would be unfavorable to our business. 

We may be subject to false or fraudulent claim laws. There are numerous federal and state laws that forbid submission of 
false information or the failure to disclose information in connection with submission and payment of physician claims for 
reimbursement. In some cases, these laws also forbid abuse of existing systems for such submission and payment. Any failure 
of our RCM services to comply with these laws and regulations could result in substantial liability including, but not limited to, 
criminal liability, could adversely affect demand for our services and could force us to expend significant capital, research and 
development and other resources to address the failure. Errors by us or our systems with respect to entry, formatting, 
preparation or transmission of claim information may be determined or alleged to be in violation of these laws and regulations. 
Determination by a court or regulatory agency that our services violate these laws could subject us to civil or criminal penalties, 
invalidate all or portions of some of our customer contracts, require us to change or terminate some portions of our business, 
require us to refund portions of our services fees, cause us to be disqualified from serving customers doing business with 
government payers and have an adverse effect on our business. 

In most cases where we are permitted to do so, we calculate charges for our RCM services based on a percentage of the 
collections that our customers receive as a result of our services. To the extent that violations or liability for violations of these 
laws and regulations require intent, it may be alleged that this percentage calculation provides us or our employees with 
incentive to commit or overlook fraud or abuse in connection with submission and payment of reimbursement claims. The U.S. 
Centers for Medicare and Medicaid Services has stated that it is concerned that percentage-based billing services may 
encourage billing companies to commit or to overlook fraudulent or abusive practices. 

A portion of our business involves billing of Medicare claims on behalf of its customers. In an effort to combat fraudulent 
Medicare claims, the federal government offers rewards for reporting of Medicare fraud which could encourage others to subject 
us to a charge of fraudulent claims, including charges that are ultimately proven to be without merit. 

If our products fail to comply with evolving government and industry standards and regulations, we may have difficulty 
selling our products. We may be subject to additional federal and state statutes and regulations in connection with offering 
services and products via the Internet. On an increasingly frequent basis, federal and state legislators are proposing laws and 
regulations that apply to Internet commerce and communications. Areas being affected by these regulations include user privacy, 
pricing, content, taxation, copyright protection, distribution, and quality of products and services. To the extent that our products 
and services are subject to these laws and regulations, the sale of our products and services could be harmed. 

We are subject to changes in and interpretations of financial accounting matters that govern the measurement of our 
performance, one or more of which could adversely affect our business, financial condition, cash flows, revenue and 
results of operations. Based on our reading and interpretations of relevant guidance, principles or concepts issued by, among 
other authorities, the American Institute of Certified Public Accountants, the Financial Accounting Standards Board and the 

22 

 
Commission, we believe our current sales and licensing contract terms and business arrangements have been properly 
reported. However, there continue to be issued interpretations and guidance for applying the relevant standards to a wide range 
of sales and licensing contract terms and business arrangements that are prevalent in the software industry. Future 
interpretations or changes by the regulators of existing accounting standards or changes in our business practices could result in 
changes in our revenue recognition and/or other accounting policies and practices that could adversely affect our business, 
financial condition, cash flows, revenue and results of operations. 

Failure to maintain effective internal controls in accordance with Section 404 of the Sarbanes-Oxley Act of 2002 could 
have an adverse effect on our business, and our per share price may be adversely affected. Pursuant to Section 404 of 
the Sarbanes-Oxley Act of 2002 (“Section 404”) and the rules and regulations promulgated by the SEC to implement 
Section 404, we are required to include in our Form 10-K a report by our management regarding the effectiveness of our internal 
control over financial reporting. The report includes, among other things, an assessment of the effectiveness of our internal 
control over financial reporting. The assessment must include disclosure of any material weakness in our internal control over 
financial reporting identified by management. 

As part of the evaluation undertaken by management and our independent registered public accountants pursuant to 
Section 404, our internal control over financial reporting was effective as of March 31, 2015. However, if we fail to maintain an 
effective system of disclosure controls or internal controls over financial reporting, we may discover material weaknesses that we 
would then be required to disclose. Any material weaknesses identified in our internal controls could have an adverse effect on 
our business. We may not be able to accurately or timely report on our financial results, and we might be subject to investigation 
by regulatory authorities. This could result in a loss of investor confidence in the accuracy and completeness of our financial 
reports, which may have an adverse effect on our stock price. 

No evaluation process can provide complete assurance that our internal controls will detect and correct all failures within our 
company to disclose material information otherwise required to be reported. The effectiveness of our controls and procedures 
could also be limited by simple errors or faulty judgments. In addition, if we continue to expand, through either organic growth or 
through acquisitions (or both), the challenges involved in implementing appropriate controls will increase and may require that 
we evolve some or all of our internal control processes. 

It is also possible that the overall scope of Section 404 may be revised in the future, thereby causing ourselves to review, revise 
or reevaluate our internal control processes which may result in the expenditure of additional human and financial resources. 

Risks Related to Ownership of Our Common Stock 

The unpredictability of our quarterly operating results may cause the price of our common stock to fluctuate or decline. 
Our revenue may fluctuate in the future from quarter to quarter and period to period, as a result of a number of factors including, 
without limitation: 

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•  

•  

•  

the size and timing of orders from customers; 

the specific mix of software, hardware and services in customer orders; 

the length of sales cycles and installation processes; 

the ability of our customers to obtain financing for the purchase of our products; 

changes in pricing policies or price reductions by us or our competitors; 

the timing of new product announcements and product introductions by us or our competitors; 

changes in revenue recognition or other accounting guidelines employed by us and/or established by the Financial 
Accounting Standards Board ("FASB") or other rule-making bodies; 

accounting policies concerning the timing of the recognition of revenue; 

the availability and cost of system components; 

the financial stability of customers; 

market acceptance of new products, applications and product enhancements; 

our ability to develop, introduce and market new products, applications and product enhancements; 

our success in expanding our sales and marketing programs; 

deferrals of customer orders in anticipation of new products, applications, product enhancements, or public/private 
sector initiatives; 

execution of or changes to our strategy; 

personnel changes; and 

general market/economic factors. 

23 

 
 
Our software products are generally shipped as orders are received and accordingly, we have historically operated with a 
minimal backlog of license fees. As a result, revenue in any quarter is dependent on orders booked and shipped in that quarter 
and is not predictable with any degree of certainty. Furthermore, our systems can be relatively large and expensive, and 
individual systems sales can represent a significant portion of our revenue and profits for a quarter such that the loss or deferral 
of even one such sale can adversely affect our quarterly revenue and profitability. 

Customers often defer systems purchases until our quarter end, so quarterly results generally cannot be predicted and 
frequently are not known until after the quarter has concluded. 

Our sales are dependent upon customers’ initial decisions to replace or substantially modify their existing information systems, 
and subsequently, their decision concerning which products and services to purchase. These are major decisions for healthcare 
providers and, accordingly, the sales cycle for our systems can vary significantly and typically ranges from six to twenty-four 
months from initial contact to contract execution/shipment. 

Because a significant percentage of our expenses are relatively fixed, a variation in the timing of systems sales, implementations 
and installations can cause significant variations in operating results from quarter to quarter. As a result, we believe that interim 
period-to-period comparisons of our results of operations are not necessarily meaningful and should not be relied upon as 
indications of future performance. Further, our historical operating results are not necessarily indicative of future performance for 
any particular period. 

We currently recognize revenue in accordance with the applicable accounting guidance as defined by the FASB. 

There can be no assurance that application and subsequent interpretations of these pronouncements will not further modify our 
revenue recognition policies, or that such modifications would not adversely affect our operating results reported in any particular 
quarter or year. 

Due to all of the foregoing factors, it is possible that our operating results may be below the expectations of public market 
analysts and investors. In such event, the price of our common stock would likely be adversely affected. 

Our common stock price has been volatile, which could result in substantial losses for investors purchasing shares of 
our common stock and in litigation against us. Volatility may be caused by a number of factors including but not limited to: 

•  

•  

•  

•  

•  

•  

•  

•  

•  

•  

•  

actual or anticipated quarterly variations in operating results; 

rumors about our performance, software solutions, or merger and acquisition activity; 

changes in expectations of future financial performance or changes in estimates of securities analysts; 

governmental regulatory action; 

health care reform measures; 

customer relationship developments; 

purchases or sales of company stock; 

activities by one or more of our major shareholders concerning our policies and operations; 

changes occurring in the markets in general; 

macroeconomic conditions, both nationally and internationally; and 

other factors, many of which are beyond our control. 

Furthermore, the stock market in general, and the market for software, healthcare and high technology companies in particular, 
has experienced extreme volatility that often has been unrelated to the operating performance of particular companies. These 
broad market and industry fluctuations may adversely affect the trading price of our common stock, regardless of actual 
operating performance. 

Moreover, in the past, securities class action litigation has often been brought against a company following periods of volatility in 
the market price of its securities. We may in the future be the target of similar litigation. Securities litigation could result in 
substantial costs and divert management’s attention and resources. 

Two current and former directors are significant shareholders, which makes it possible for them to have significant 
influence over the outcome of all matters submitted to our shareholders for approval and which influence may be 
alleged to conflict with our interests and the interests of our other shareholders. One of our directors is a significant 
shareholder who beneficially owns approximately 16.9% of the outstanding shares of our common stock at March 31, 2015.  
Another former director, who owns approximately 9.4% (based on publicly filed information) of the outstanding shares of our 
common stock at March 31, 2015, likely maintains a large enough ownership stake to reelect himself to our Board of Directors 
under cumulative voting. California law and our Bylaws permit our shareholders to cumulate their votes, the effect of which is to 
provide shareholders with sufficiently large concentrations of our shares the opportunity to assure themselves one or more seats 
on our Board of Directors. The amounts required to assure a seat on our Board of Directors can vary based upon the number of 
shares outstanding, the number of shares voting, the number of directors to be elected, the number of “broker non-votes,” and 
the number of shares held by the shareholder exercising the cumulative voting rights. In the event that cumulative voting is 

24 

 
invoked, it is likely that these two individuals that are significant shareholders will each have sufficient votes to assure 
themselves of one or more seats on our Board of Directors. With or without cumulative voting, these two significant shareholders 
will have substantial influence over the outcome of all matters submitted to our shareholders for approval, including the election 
of our directors and other corporate actions. This influence may be alleged to conflict with our interests and the interests of our 
other shareholders. For example, in fiscal year 2013, the former director launched a proxy contest to elect a different slate of 
directors than what our Company proposed to shareholders. We spent approximately $1.3 million to defend against the proxy 
contest and elect the Company's slate of directors. In addition, such influence by one or both of these shareholders could have 
the effect of discouraging others from attempting to acquire our Company or create actual or perceived governance instabilities 
that could adversely affect the price of our common stock. 

Our future practice concerning the payment of dividends is uncertain, which could adversely affect the price of our 
stock. We  announced our intention to pay a quarterly dividend commencing with the conclusion of our first fiscal quarter of 
2008 (June 30, 2007) and pursuant to this practice our Board of Directors has declared a quarterly cash dividend ranging from 
$0.125 to its most recent level of $0.175 per share on our outstanding shares of common stock, each quarter thereafter. We 
anticipate that future quarterly dividends, if and when declared by our Board of Directors pursuant to this practice, would likely be 
distributable on or about the fifth day of each of the months of October, January, April and July. There can be no guarantees that 
we will have the financial ability to fund this dividend in perpetuity or to pay it at historic rates. Further, our Board of Directors 
may decide not to pay the dividend at some future time for financial or non-financial reasons. Unfulfilled expectations regarding 
future dividends could adversely affect the price of our stock. 

ITEM 1B. UNRESOLVED STAFF COMMENTS 

None. 

ITEM 2. PROPERTIES 

Our corporate headquarters, the QSI Dental Division and the NextGen Division training operations are located in Irvine, 
California. We believe that our present facilities are adequate for our current needs. Should we continue to grow, we may be 
required to lease or acquire additional space. We believe that suitable additional or substitute space is available, if needed, at 
market rates. 

As of March 31, 2015, we leased an aggregate of approximately 453,800 square feet of space with lease agreements expiring at 
various dates. Significant locations are as follows: 

QSI Dental Division and corporate offices 

Irvine, California 

Augusta, Georgia 

Other locations 

NextGen Division 

Horsham, Pennsylvania 

Atlanta, Georgia 

Costa Mesa, California 

Other locations 

Hospital Solutions Division 

Austin, Texas 

RCM Services Division 

St. Louis, Missouri 

Hunt Valley, Maryland 

North Canton, Ohio 

South Jordan, Utah 

Quality Systems India Healthcare Private Limited 

Total leased properties 

25 

Square Feet 

47,900 
7,300 
1,500 

110,000 
34,800 
21,900 
7,600 

43,700 

62,300 
34,000 
22,100 
7,300 
53,400 
453,800 

 
 
 
 
 
 
 
 
 
 
 
ITEM 3. LEGAL PROCEEDINGS 

We have experienced legal claims by customers regarding product and contract disputes, by other third parties asserting that we 
have infringed their intellectual property rights, by current and former employees regarding certain employment matters and by 
certain shareholders. We believe that these claims are without merit and intend to defend against them vigorously; however, we 
could incur substantial costs and diversion of management resources defending any such claim, even if we are ultimately 
successful in the defense of such matter. Litigation is inherently uncertain and always difficult to predict. We refer you to the 
discussion of infringement and litigation risks within “Item 1A. Risk Factors" and to Note 13, "Commitments, Guarantees and 
Contingencies" of our notes to consolidated financial statements included elsewhere in this Report for a discussion of current 
legal proceedings. 

ITEM 4. MINE AND SAFETY DISCLOSURES 

Not applicable 

26

 
 
 
 
 
PART II 

ITEM 5. MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER 
PURCHASES OF EQUITY SECURITIES 

Market Price and Holders 

Our common stock is traded on the NASDAQ Global Select Market under the symbol “QSII.” 

The following table sets forth for the quarters indicated the high and low sales prices for each period indicated, as reported on 
the NASDAQ Global Select Market: 

Three Months Ended 

June 30, 2013 

September 30, 2013 

December 31, 2013 

March 31, 2014 

June 30, 2014 

September 30, 2014 

December 31, 2014 

March 31, 2015 

High 

Low 

$19.47 

$23.58 

$24.15 

$21.07 

$18.89 

$16.63 

$15.99 

$18.75 

$17.01 

$18.63 

$20.29 

$16.28 

$14.10 

$13.69 

$13.01 

$15.31 

At May 19, 2015, there were approximately 140 holders of record of our common stock. 

Dividends 

In January 2007, our Board of Directors adopted a practice whereby we intend to pay a regular quarterly dividend on our 
outstanding common stock, subject to further review and approval, sufficiency of funds and the establishment of record and 
distribution dates by our Board of Directors prior to the declaration of each such quarterly dividend. We anticipate that future 
quarterly dividends, if and when declared by our Board of Directors pursuant to this practice, would likely be distributable on or 
about the fifth day of each of the months of October, January, April and July. 

On May 20, 2015, the Board of Directors approved a quarterly cash dividend of $0.175 per share on the Company’s outstanding 
shares of Common Stock, payable to shareholders of record as of June 12, 2015 with an expected distribution date on or about 
July 6, 2015. 

Our Board of Directors declared the following dividends during the periods presented: 

Declaration Date 

May 28, 2014 

July 23, 2014 

October 22, 2014 

January 21, 2015 

Fiscal year 2015 

May 22, 2013 

July 24, 2013 

October 23, 2013 

January 22, 2014 

Fiscal year 2014 

May 24, 2012 

July 25, 2012 

October 25, 2012 

January 23, 2013 

Fiscal year 2013 

  Record Date 

  June 13, 2014 

  September 12, 2014 

  December 12, 2014 

  March 13, 2015 

  June 14, 2013 

  September 13, 2013 

  December 13, 2013 

  March 14, 2014 

  June 15, 2012 
  September 14, 2012 
  December 14, 2012 
  March 15, 2013 

27 

  Payment Date 

  July 3, 2014 

  October 3, 2014 

  January 2, 2015 

  April 3, 2015 

  July 5, 2013 

  October 4, 2013 

  January 3, 2014 

  April 4, 2014 

  July 3, 2012 
  October 5, 2012 
  December 28, 2012 
  April 5, 2013 

Per Share 
Dividend 

0.175  
0.175 
0.175 
0.175 
0.70  
0.175  
0.175 
0.175 
0.175 
0.70  
0.175  
0.175 
0.175 
0.175 
0.70  

 $

 $

 $

 $

 $

 $

 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
   
   
Payment of future dividends, if any, will be at the discretion of our Board of Directors after taking into account various factors, 
including without limitation, our financial condition, operating results, current and anticipated cash needs and plans for 
expansion.

Securities Authorized for Issuance Under Equity Compensation Plans

The information included under Item 12 of this Report, "Security Ownership of Certain Beneficial Owners and Management and 
Related Stockholder Matters," is incorporated herein by reference.

Performance Graph

The following graph compares the cumulative total returns of our common stock, the NASDAQ Composite Index and the 
NASDAQ Computer & Data Processing Services Stock Index over the five-year period ended March 31, 2015 assuming $100 
was invested on March 31, 2010 with all dividends, if any, reinvested. This performance graph shall not be deemed to be 
“soliciting material” or “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange 
Act”) or otherwise subject to the liabilities under that Section and shall not be deemed to be incorporated by reference into any 
filing of the Company under the Securities Act of 1933, as amended or the Exchange Act.

COMPARISON OF 5 YEAR CUMULATIVE TOTAL RETURN*
Among Quality Systems, Inc., The NASDAQ Composite Index
And The NASDAQ Computer & Data Processing Index

$250

$200

$150

$100

$50

$0
Mar-10

Mar-11

Mar-12

Mar-13

Mar-14

Mar-15

Quality Systems, Inc.

Nasdaq Composite

Nasdaq Computer & Data Processing

____________________
* 

$100 invested on 3/31/2010 in stock or index, including reinvestment of dividends. Fiscal year ended March 31.

The last trade price of our common stock on each of March 31, 2011, 2012, 2013, 2014 and 2015 was published by NASDAQ 
and, accordingly for the periods ended March 31, 2011, 2012, 2013, 2014 and 2015, the reported last trade price was utilized to 
compute the total cumulative return for our common stock for the respective periods then ended. Shareholder returns over the 
indicated periods should not be considered indicative of future stock prices or shareholder returns.

28

ITEM 6. SELECTED FINANCIAL DATA 

The following selected financial data, with respect to our consolidated statements of income data for each of the five years in the 
period ended March 31, 2015 and the consolidated balance sheets data as of the end of each such fiscal year, are not 
necessarily indicative of results of future operations and should be read in conjunction with our consolidated financial statements 
and the related notes thereto and “Item 7. Management’s Discussion and Analysis of Financial Condition and Results of 
Operations” included elsewhere herein.  

The following consolidated balance sheets data for the fiscal years ended March 31, 2014, 2013, and 2012 has been 
retrospectively revised to reflect certain immaterial misclassifications of noncurrent deferred income taxes and other noncurrent 
liabilities.  In addition, the following consolidated balance sheet data for the fiscal year ended March 31, 2014 has been 
retrospectively revised to reflect certain immaterial misclassifications of accounts receivable and other current liabilities. In 
aggregate, the revisions resulted in a $6.3 million increase in total assets with a corresponding $6.3 million increase to total 
liabilities for the year ended March 31, 2014, a $9.1 million increase in total assets with a corresponding $9.1 million increase to 
total liabilities for the year ended March 31, 2013, and an $8.5 million increase in total assets with a corresponding $8.5 million 
increase to total liabilities for the year ended March 31, 2012. In addition, working capital increased by $9.8 million, $11.2 million, 
and $8.5 million for the fiscal years ended March 31, 2014, 2013, and 2012, respectively. Refer to Note 2, "Summary of 
Significant Accounting Policies" of our notes to consolidated financial statements included elsewhere in this Report for more 
information. 

Consolidated Financial Data 
(In thousands, except per share data) 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

2012 

2011 

Statements of Income Data: 

Revenue 

Cost of revenue 

Gross profit 

Selling, general and administrative 

Research and development costs 

Amortization of acquired intangible assets 

Impairment of goodwill 

Income from operations 

Interest income (expense), net 

Other income (expense), net 

Income before provision for income taxes 

Provision for income taxes 

Net income 

Basic net income per share 

Diluted net income per share 

Basic weighted average shares outstanding 

Diluted weighted average shares outstanding 

Dividends declared per common share 

189,652  
270,577  
148,353  
30,865  
4,859  
17,400  
69,100  
(107)  

223,164  
267,061  
158,172  
69,240  
3,693  
—  
35,956  
(230)  

$ 490,225    $ 444,667    $ 460,229    $ 429,835    $ 353,363  
127,482 
225,881 
108,310 
21,797 
1,682 
— 
94,092 
263 
61 
94,416 
32,810 
61,606  
1.06  
1.06  
57,894 
58,236 
0.625  

151,223  
278,612  
128,846  
31,369  
2,198  
—  
116,199  
247  
(139)  
116,307  
40,650  
75,657    $
1.29    $
1.28    $
58,729  
59,049  
0.70    $

220,163  
224,504  
149,214  
41,524  
4,805  
5,873  
23,088  
269  
(356)  
23,001  
7,321  
15,680    $
0.26    $
0.26    $
59,918  
60,134  
0.70    $

(62)  
35,664  
8,332  
27,332    $
0.45    $
0.45    $
60,259  
60,849  
0.70    $

(79)  
68,914  
26,190  
42,724    $
0.72    $
0.72    $
59,392  
59,462  
0.70    $

$

$

$

$

Balance Sheet Data: 

Cash, cash equivalents, and marketable securities 

Working capital 

Total assets 

Total liabilities 

Total shareholders’ equity 

March 31, 
 2015 

March 31, 
 2014 

March 31, 
 2013 

March 31, 
 2012 

March 31, 
 2011 

$ 130,585    $ 113,801    $
118,011    $ 139,431    $ 117,737  
$ 124,973    $ 146,313    $ 181,569    $ 191,763    $ 145,758  
$ 460,521    $ 451,351    $ 452,126    $ 448,838    $ 378,686  
$ 176,981    $ 156,261    $ 145,077    $ 153,661    $ 154,016  
$ 283,540    $ 295,090    $ 307,049    $ 295,177    $ 224,670  

29 

 
 
 
 
 
 
 
 
   
   
   
   
 
 
 
 
 
 
 
   
   
   
   
 
ITEM 7. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS 

Except for the historical information contained herein, the matters discussed in this management’s discussion and analysis of 
financial condition and results of operations (“MD&A”), including discussions of our product development plans, business 
strategies and market factors influencing our results, may include forward-looking statements that involve certain risks and 
uncertainties. Actual results may differ from those anticipated by us as a result of various factors, both foreseen and unforeseen, 
including, but not limited to, our ability to continue to develop new products and increase systems sales in markets characterized 
by rapid technological evolution, consolidation and competition from larger, better-capitalized competitors. Many other economic, 
competitive, governmental and technological factors could affect our ability to achieve our goals and interested persons are 
urged to review any risks that may be described in “Item 1A. Risk Factors” as set forth herein, as well as in our other public 
disclosures and filings with the Securities and Exchange Commission ("SEC"). 

Overview 

This MD&A is provided as a supplement to the consolidated financial statements and notes thereto included elsewhere in this 
Annual Report on Form 10-K ("Report") in order to enhance your understanding of our results of operations and financial 
condition and should be read in conjunction with, and is qualified in its entirety by, the consolidated financial statements and 
related notes thereto included elsewhere in this Report. Historical results of operations, percentage margin fluctuations and any 
trends that may be inferred from the discussion below are not necessarily indicative of the operating results for any future period. 

Our MD&A is organized as follows: 

•  

•  

•  

•  

•  

•  

Management Overview. This section provides a general description of our Company and operating segments, a 
discussion as to how we derive our revenue, background information on certain trends and developments affecting 
our Company, a summary of our acquisition transactions and a discussion on management’s strategy for driving 
revenue growth. 

Critical Accounting Policies and Estimates. This section discusses those accounting policies that are considered 
important to the evaluation and reporting of our financial condition and results of operations, and whose application 
requires us to exercise subjective or complex judgments in making estimates and assumptions. In addition, all of 
our significant accounting policies, including our critical accounting policies, are summarized in Note 2, “Summary 
of Significant Accounting Policies,” of our notes to consolidated financial statements included elsewhere in this 
Report. 

Company Overview. This section provides a more detailed description of our Company, its operating segments, 
and the products and services we offer. 

Overview of Results of Operations and Results of Operations by Operating Divisions. These sections provide our 
analysis and outlook for the significant line items on our consolidated statements of income, as well as other 
information that we deem meaningful to understand our results of operations on both a consolidated basis and an 
operating division basis. 

Liquidity and Capital Resources. This section provides an analysis of our liquidity and cash flows and discussions 
of our contractual obligations and commitments as of March 31, 2015. 

New Accounting Pronouncements. This section provides a summary of the most recent authoritative accounting 
standards and guidance that have either been recently adopted by our Company or may be adopted in the future. 

Management Overview 

Quality Systems, Inc. and its wholly-owned subsidiaries operate as four business divisions (each, a "Division") which are 
comprised of: (i) the QSI Dental Division, (ii) the NextGen Division, (iii) the Hospital Solutions Division and (iv) the RCM Services 
Division. We also have a captive entity in India called Quality Systems India Healthcare Private Limited (“QSIH”). We primarily 
derive revenue by developing and marketing healthcare information systems that automate certain aspects of medical and 
dental practices, networks of practices such as physician hospital organizations (“PHOs”) and management service 
organizations (“MSOs”), accountable care organizations, ambulatory care centers, community health centers and medical and 
dental schools along with comprehensive systems implementation, maintenance and support and add on complementary 
services such as revenue cycle management (“RCM”) and electronic data interchange (“EDI”). Our systems and services 
provide our customers with the ability to redesign patient care and other workflow processes while improving productivity through 
the facilitation of managed access to patient information. Utilizing our proprietary software in combination with third party 
hardware and software solutions, our products enable the integration of a variety of administrative and clinical information 
operations. Our scalable interoperability and population health offerings help to improve care collaboration, quality and safety. 
Enabled by our interoperability and enterprise analytics solutions, data-driven patient population healthcare management 
decisions assist in creating more desirable operational, clinical, and financial outcomes that substantiate the value of patient-
centered and accountable care models. 

We have benefited and hope to continue to benefit from the increased demands on healthcare providers for greater efficiency 
and lower costs, financial incentives from the Health Information Technology for Economic and Clinical Health ("HITECH") 
portion of the American Recovery and Reinvestment Act ("ARRA") to physicians who adopt electronic health records, as well as 

30 

 
 
increased adoption rates for electronic health records and other technology in the healthcare arena. We also believe that 
healthcare reform, including the repeal of the sustainable growth rate (SGR) formula as part of the Medicare Access and CHIP 
Reauthorization Act of 2015 ("MACRA"), and a movement towards a value-based, pay-for-performance model and quality 
initiative efforts will stimulate demand for robust electronic health record solutions as well as new health information technology 
solutions from bundled billing capabilities to patient engagement and population health management. 

While we expect to benefit from the increasing demands for greater efficiency as well as government support for increased 
adoption of electronic health records, the market for physician based electronic health records software is becoming increasingly 
saturated while physician group practices are rapidly being consolidated by hospitals, insurance payers and other entities. 
Hospital software providers are leveraging their position with their hospital customers to gain market share with hospital owned 
physician practices. Insurance providers and large physician groups are also consolidating physician offices creating additional 
opportunity for ambulatory software providers like us. Our strategy is to focus on addressing the growing needs of accountable 
care organizations around interoperability, patient engagements, population health, and data analytics. 

We believe that our core strength lies in the central role our software products and services play in the delivery of healthcare by 
the primary physician in an ambulatory setting. We intend to remain at the forefront of upcoming new regulatory requirements 
including ICD-10 and meaningful use requirements for stimulus payments. We believe that the expanded requirements for 
continued eligibility for incentive payments under meaningful use rules will result in an expanded replacement market for 
electronic health records software. We intend to continue the development and enhancement of our software solutions to 
support healthcare reform and the transition from fee-for-service to pay-for-performance and quality initiatives such as 
accountable care organizations. Key elements of our future software development will be to expand our interoperability 
capabilities enhancing the competitiveness of our software offerings, make our products more intuitive and easy to use, and to 
enhance our ability to deliver our software over the cloud with the latest technology. 

We also want to continue investments in our infrastructure, including but not limited to maintaining and expanding sales, 
marketing and product development activities in order to improve patient care and reduce healthcare costs, providing industry-
leading, integrated clinical and administrative healthcare data systems, services, and expertise to clinical, medical, technology, 
and healthcare business professionals while continuing our gold-standard commitment of service in support of our customer 
satisfaction programs. These investments in our infrastructure will continue while maintaining reasonable expense discipline. We 
strive to add new customers and expand our relationship with existing customers through delivery of add-on and complementary 
products and services and believe that our growing customer base that is using our software on a daily basis is a strategic asset.  
We intend to leverage this strategic asset by expanding our product and service offerings towards this customer base. 

Critical Accounting Policies and Estimates 

The discussion and analysis of our consolidated financial statements and results of operations is based upon our consolidated 
financial statements, which have been prepared in accordance with accounting principles generally accepted in the United 
States of America. The preparation of these consolidated financial statements requires us to make estimates and judgments that 
affect the reported amounts of assets, liabilities, revenue and expenses, and related disclosures of contingent assets and 
liabilities. On an on-going basis, we evaluate estimates (including but not limited to those related to revenue recognition, 
accounts receivable reserves, software development costs, contingent consideration liabilities, goodwill, and intangible assets) 
for reasonableness. We base our estimates on historical experience and on various other assumptions that management 
believes 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. Actual results may differ from these 
estimates under different assumptions or conditions. 

We believe that the significant accounting policies, as described in Note 2 of our consolidated financial statements, “Summary of 
Significant Accounting Policies” should be read in conjunction with management’s discussion and analysis of financial condition 
and results of operations. We believe the following table depicts the most critical accounting policies that affect our consolidated 
financial statements: 

Revenue Recognition 

Judgments and Uncertainties 

We generate revenue from the sale of 
licensing rights to use our software products 
sold directly to end-users and value-added 
resellers. We also generate revenue from 
sales of hardware and third party software, 
implementation and training, EDI, RCM, 
maintenance, and other services, including 
subscriptions, consulting, and hosting 
services, performed for customers who 
license our products. 

A typical system contract contains multiple elements of the items 
discussed. Revenue earned on software arrangements involving multiple 
elements is allocated to each element based on the relative fair values of 
those elements. The fair value of an element is based on vendor-specific 
objective evidence (“VSOE”). We limit our assessment of VSOE for each 
element to the price charged when the same element is sold separately. 
VSOE calculations are updated and reviewed quarterly or annually 
depending on the nature of the product or service. We generally establish 
VSOE for the related undelivered elements based on the bell-shaped 
curve method. Maintenance VSOE for our largest customers is based on 
stated renewal rates only if the rate is determined to be substantive and 
falls within our customary pricing practices. 

31 

 
 
 
 
 
 
 
Revenue Recognition (continued) 

Judgments and Uncertainties 

Revenue from services are recognized as the 
corresponding services are performed. 
Maintenance revenue is recognized ratably 
over the contractual maintenance period. 
Revenue from EDI and other transaction 
processing services are recognized at the 
time services are provided and billed to 
customers. RCM revenue is derived from 
service fees, which include amounts charged 
for ongoing billing, collections, and other 
related services and are generally billed to the 
customer as a percentage of total customer 
collections. We do not recognize revenue for 
RCM services fees until these collections are 
made by the customer, as the services fees 
are not fixed or determinable until such time. 

Accounts Receivable Reserves 
We maintain reserves for potential sales 
returns and other uncollectible accounts 
receivable.  In aggregate, such reserves 
reduce our gross accounts receivable to its 
estimated net realizable value. 

When evidence of fair value exists for the delivered and undelivered 
elements of a transaction, then discounts for individual elements are 
aggregated and the total discount is allocated to the individual elements in 
proportion to the elements' fair value relative to the total contract fair value.  

When evidence of fair value exists for the undelivered elements only, the 
residual method is used. Under the residual method, we defer revenue 
related to the undelivered elements in a system sale based on VSOE of 
fair value of each of the undelivered elements and allocates the remainder 
of the contract price net of all discounts to revenue recognized from the 
delivered elements. If VSOE of fair value of any undelivered element does 
not exist, all revenue is deferred until VSOE of fair value of the undelivered 
element is established or the element has been delivered.  

Provided the fees are fixed or determinable and collection is considered 
probable, revenue from licensing rights and sales of hardware and third 
party software is generally recognized upon physical or electronic 
shipment and transfer of title. In certain transactions where collection risk 
is high, the revenue is deferred until collection occurs. If the fee is not fixed 
or determinable, then the revenue recognized in each period (subject to 
application of other revenue recognition criteria) will be the lesser of the 
aggregate of amounts due and payable or the amount of the arrangement 
fee that would have been recognized if the fees were being recognized 
using the residual method. Fees which are considered fixed or 
determinable at the inception of our arrangements must be negotiated at 
the outset of an arrangement and generally be based on the specific 
volume of products to be delivered without being subject to change based 
on variable pricing mechanisms such as the number of units copied or 
distributed or the expected number of users. 

We have historically offered short-term rights of return in certain sales 
arrangements. If we are able to estimate returns for these types of 
arrangements, revenue is recognized, net of an allowance for returns, and 
these arrangements are recorded in the consolidated financial statements. 
If we are unable to estimate returns for these types of arrangements, 
revenue is not recognized until the rights of return expire, provided also, 
that all other criteria for revenue recognition have been met. 

Effect if Actual Results Differ from Assumptions 

Although we believe that our approach to estimates and judgments as 
described herein is reasonable, actual results could differ and we may be 
exposed to increases or decreases in revenue that could be material. 

Judgments and Uncertainties 
Sales return reserves, which include reserves for returns and other credits, 
are established based upon the rate of historical returns by revenue type 
in relation to the corresponding gross revenues. Allowances for doubtful 
accounts and other uncollectible accounts receivable related to estimated 
losses resulting from our customers’ inability to make required payments 
are established based on our historical experience of bad debt expense 
and the aging of our accounts receivable balances, net of deferred 
revenue and specifically reserved accounts. Specific reserves are based 
on our estimate of the probability of collection for certain troubled 
accounts. If the financial condition of our customers were to deteriorate 
resulting in an impairment of their ability to make payments, additional 
allowances would be required. 

Effect if Actual Results Differ from Assumptions 
Although we believe that our approach to estimates and judgments as 
described herein is reasonable, actual results could differ and we may be 
exposed to increases or decreases in required reserves that could be 
material. 

32 

 
 
 
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Software Development Costs 

Judgments and Uncertainties 

Development costs, consisting primarily of 
employee salaries and benefits, incurred in 
the research and development of new 
software products and enhancements to 
existing software products for external use 
are expensed as incurred until technological 
feasibility has been established. After 
technological feasibility is established, any 
additional external software development 
costs are capitalized.  Amortization of 
capitalized software is recorded using the 
greater of the ratio of current revenues to the 
total of current and expected revenues of the 
related product or the straight-line method 
over the estimated economic life of the 
related product, which is typically three years. 

We periodically reassess the estimated economic life and the 
recoverability of such capitalized software costs. If a determination is 
made that capitalized amounts are not recoverable based on the 
estimated cash flows to be generated from the applicable software, any 
remaining capitalized amounts are written off. 

Effect if Actual Results Differ from Assumptions 

Although we believe that our approach to estimates and judgments as 
described herein is reasonable, actual results could differ and we may be 
exposed to increases or decreases in revenue that could be material. 

Goodwill 

Judgments and Uncertainties 

Goodwill acquired in a business combination 
is measured as the excess of the purchase 
price, or consideration transferred, over the 
net acquisition date fair values of the assets 
acquired and the liabilities assumed. Goodwill 
is not amortized as it has been determined to 
have an indefinite useful life. 

We test goodwill for impairment annually during our first fiscal quarter, 
referred to as the annual test date. We will also test for impairment 
between annual test dates if an event occurs or circumstances change 
that would indicate the carrying amount may be impaired. Impairment 
testing for goodwill is performed at a reporting-unit level, which is defined 
as an operating segment or one level below an operating segment 
(referred to as a component). A component of an operating segment is a 
reporting unit if the component constitutes a business for which discrete 
financial information is available and segment management regularly 
reviews the operating results of that component. 

Effect if Actual Results Differ from Assumptions 

We do not believe there is a reasonable likelihood that there will be a 
material change in the future estimates or assumptions we use to test for 
impairment losses on goodwill. However, if actual results are not 
consistent with our estimates or assumptions, we may be exposed to 
future impairment charges that could be material. 

Business Combinations — Purchase Price 
Allocations 

Judgments and Uncertainties 

During the last three fiscal years, we 
completed four acquisitions, including 
Gennius, Mirth, Poseidon and Matrix, which 
were each accounted for as a purchase 
business combination. 

In accordance with the accounting for business combinations, we allocate 
the purchase price of acquired businesses to the tangible and intangible 
assets acquired and liabilities assumed based on estimated fair values. 
Our purchase price allocation methodology contains uncertainties because 
it requires us to make assumptions and to apply judgment to estimate the 
fair value of acquired assets and liabilities, including, but not limited to, 
intangible assets, goodwill, and contingent consideration liabilities. We 
estimate the fair value of assets and liabilities based upon quoted market 
prices, the carrying value of the acquired assets and widely accepted 
valuation techniques, including discounted cash flows and market multiple 
analyses depending on the nature of the assets being sold. We estimate 
the fair value of the contingent consideration liabilities based on the 
probability of achieving certain business milestones and/or management's 
forecast of expected results. Unanticipated events or circumstances may 
occur which could affect the accuracy of our fair value estimates, including 
assumptions regarding industry economic factors and business strategies.  
Any adjustments to fair value subsequent to the measurement period are 
reflected in the consolidated statements of comprehensive income. 

Effect if Actual Results Differ from Assumptions 

We do not believe there is a reasonable likelihood that there will be a 
material change in the future estimates or assumptions we use to 
complete the purchase price allocation and estimate the fair value of 
acquired assets and liabilities. However, if actual results are not consistent 
with our estimates or assumptions, we may be exposed to losses or gains 
that could be material. 

33 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Intangible Assets 

Judgments and Uncertainties 

Intangible assets consist of trade names and 
contracts, customer relationships, and 
software technology, all of which arose in 
connection with our acquisitions. 

These intangible assets are recorded at fair value and are stated net of 
accumulated amortization. We currently amortize intangible assets using a 
method that reflects the pattern in which the economic benefits of the 
intangible asset are consumed. 

Effect if Actual Results Differ from Assumptions 

Although we believe that our approach to estimates and judgments as 
described herein is reasonable, actual results could differ and we may be 
exposed to decreases in the fair value of our intangible assets, resulting in 
impairment charges that could be material. We test intangible assets for 
impairment if we believe indicators of impairment exist. 

Share-Based Compensation 

Judgments and Uncertainties 

We record share-based compensation related 
to our employee stock options plans, 
employee share purchase plans, restricted 
stock awards, and restricted performance 
shares under our executive compensation 
plans. See Note 12, “Share-Based Awards,” 
of our notes to consolidated financial 
statements included elsewhere in this Report 
for a complete discussion of our stock-based 
compensation plans. 

We estimate the fair value of stock options on the date of grant using the 
Black Scholes option-pricing model. Expected term is estimated based 
upon the historical exercise behavior and represents the period of time 
that options granted are expected to be outstanding. Volatility is estimated 
by using the weighted-average historical volatility of our common stock, 
which approximates expected volatility. The risk free rate is the implied 
yield available on the U.S. Treasury zero-coupon issues with remaining 
terms equal to the expected term. The expected dividend yield is the 
average dividend rate during a period equal to the expected term of the 
option. The Black Scholes model utilizes those inputs to determine the 
estimated fair value. The fair value of the portion of the award that is 
ultimately expected to vest is recognized ratably as expense over the 
requisite service period in our consolidated statements of comprehensive 
income. 

Share-based compensation expense associated with the restricted 
performance shares under our executive compensations plans is based on 
the grant date fair value measured at the underlying closing share price on 
the date of grant using a Monte Carlo-based valuation model. 

Share-based compensation expense associated with the options under 
our equity incentive plans are initially based on the number of options 
expected to vest after assessing the probability that the performance 
criteria will be met(cid:17)(cid:3)(cid:38)(cid:88)(cid:80)(cid:88)(cid:79)(cid:68)(cid:87)(cid:76)(cid:89)(cid:72)(cid:3)(cid:68)(cid:71)(cid:77)(cid:88)(cid:86)(cid:87)(cid:80)(cid:72)(cid:81)(cid:87)(cid:86)(cid:3)(cid:68)(cid:85)(cid:72)(cid:3)(cid:85)(cid:72)(cid:70)(cid:82)(cid:85)(cid:71)(cid:72)(cid:71)(cid:3)(cid:84)(cid:88)(cid:68)(cid:85)(cid:87)(cid:72)(cid:85)(cid:79)(cid:92)(cid:3)(cid:87)(cid:82)(cid:3)
(cid:85)(cid:72)(cid:73)(cid:79)(cid:72)(cid:70)(cid:87)(cid:3)(cid:86)(cid:88)(cid:69)(cid:86)(cid:72)(cid:84)(cid:88)(cid:72)(cid:81)(cid:87)(cid:3)(cid:70)(cid:75)(cid:68)(cid:81)(cid:74)(cid:72)(cid:86)(cid:3)(cid:76)(cid:81)(cid:3)(cid:87)(cid:75)(cid:72)(cid:3)(cid:72)(cid:86)(cid:87)(cid:76)(cid:80)(cid:68)(cid:87)(cid:72)(cid:71)(cid:3)(cid:82)(cid:88)(cid:87)(cid:70)(cid:82)(cid:80)(cid:72)(cid:3)(cid:82)(cid:73)(cid:3)(cid:83)(cid:72)(cid:85)(cid:73)(cid:82)(cid:85)(cid:80)(cid:68)(cid:81)(cid:70)(cid:72)(cid:16)
(cid:85)(cid:72)(cid:79)(cid:68)(cid:87)(cid:72)(cid:71)(cid:3)(cid:70)(cid:82)(cid:81)(cid:71)(cid:76)(cid:87)(cid:76)(cid:82)(cid:81)(cid:86)(cid:17) 

Effect if Actual Results Differ from Assumptions 

We do not believe there is a reasonable likelihood there will be a material 
change in the future estimates or assumptions we use to determine 
share-based compensation expense. However, if actual results are not 
consistent with our estimates or assumptions, we may be exposed to 
changes in share-based compensation expense that could be material. 

34 

Overview of Our Results 

•   Consolidated revenue increased 10.2% in the year ended March 31, 2015, as compared to the prior year period.  The 

increase reflects a 13.2% growth in recurring services revenue (i.e. maintenance, EDI, RCM and other services revenues), 
partially offset by a 2.0% decline in system sales revenue. The increase in recurring services revenue is due to an increase 
across all categories of recurring services, including a substantial increase in subscription revenue of $17.3 million in the 
year ended March 31, 2015 as compared to the prior year period. Subscription revenue included in other revenue was 
$44.6 million in the year ended March 31, 2015 versus $27.3 million in the prior year period. The increase in subscription 
revenue reflects increases in Mirth related interoperability subscription revenue as well as increases in subscription revenue 
related to our NextGen® Patient Portal product offering. The decline in system sales revenue reflects the increasingly 
saturated markets in which our core software products are sold. 

•   For the year ended March 31, 2015, recurring services revenue comprised 82.7% of consolidated revenue, as compared to 

80.5% in the prior year period. 

•   Consolidated gross profit as a percentage of revenue increased to 54.5% in the year ended March 31, 2015, as compared 
to 50.5% in the prior year period. The change is primarily the result of $20.1 million in impairment charges recorded to cost 
of software revenue in the prior year period related to the Hospital Solutions Division. 

•   Consolidated operating income increased 55.7%, or $12.9 million, in the year ended March 31, 2015 as compared to the 

prior year period. The increase is mostly the result of $20.1 million and $5.9 million in Hospital impairment charges recorded 
in the prior year period to cost of revenue and operating expenses, respectively, which was offset by a substantial increase 
of $27.7 million in research and development costs as compared to the prior year period resulting from both higher gross 
expenditures and lower capitalization rates of software development costs due to shorter development cycles. Refer to the 
table below in the "Corporate and unallocated amounts" section for a comparative analysis of gross expenditures and 
capitalized software costs.   

QSI Dental Division 

•   QSI Dental Division revenue decreased 7.0% in the year ended March 31, 2015. Divisional operating income (excluding 
Corporate and unallocated amounts) was $5.2 million in the year ended March 31, 2015, a decrease of 15.1%, as 
compared to the same prior year period. The decrease in operating income was primarily the result of a 2.8% decrease in 
recurring service revenue, combined with a 13.2% increase in related cost of revenue.  Further, since the division's current 
cloud-based software solution, QSIDental Web ("QDW"), is being sold primarily as a Software as a Service ("SaaS") 
solution, revenue is recognized over an extended period of time rather than upfront, resulting in a recent decline to divisional 
system sales revenues. SaaS revenue recognized from QDW in the year ended March 31, 2015 grew to approximately $0.8 
million from $0.7 million in the prior year period. 

•   The QSI Dental Division is well-positioned to sell to the federally qualified health centers ("FQHCs") market and intends to 

continue leveraging the NextGen Division's sales force to sell its dental electronic medical records software to practices that 
provide both medical and dental services, such as FQHCs, which are receiving grants as part of the ARRA.  

•   Our goal for the QSI Dental Division is to continue to invest in the new cloud-based QDW platform while aggressively 

marketing QDW to both new and existing customers. The company is in the early stages of implementing QDW to several 
key customers of the QSI Dental Division.  

NextGen Division 

•   NextGen Division revenue increased 9.6% in the year ended March 31, 2015, as compared to the prior year period. This 

variance reflects a 13.7% growth in recurring service revenue, including an increase of 6.6% in maintenance, 14.5% in EDI 
revenue and 29.7% in other services revenue. The significant growth in other services revenue was driven by a 67.4% 
growth in subscriptions as compared to the prior year period. As noted above, subscriptions revenue growth was due to 
increases in Mirth related interoperability subscription revenue as well as increases in subscription revenue related to our 
NextGen® Patient Portal product offering. Recurring service revenue increased to $297.3 million and accounted for 79.5% 
of total NextGen Division revenue for the year ended March 31, 2015. In the same prior year period, recurring service 
revenue of $261.5 million represented 76.7% of total NextGen Division revenue. 

•   NextGen Division operating income (excluding Corporate and unallocated amounts) increased by 14.8% in the year ended 
March 31, 2015, as compared to the prior year period. The increase in operating income is primarily the result of the 
increase in total revenue and a 10.5% decline in overall operating expenses, including decreases in sales commissions and 
bad debt expense. Sales commissions decreased, despite an increase in total divisional revenue, due to the change in 
revenue mix towards recurring service revenue, which has a lower commissions rate than system sales. Bad debt expense 
has decreased as a result of improved collections from greater emphasis on working capital management. 

35 

 
 
 
•   Our goals include taking maximum advantage of benefits related to the ARRA and continuing to further enhance our existing 
products, including continued efforts to maintain our status as a qualified vendor under the ARRA, expanding our software 
and service offerings to support healthcare reform, such as the recently enacted MACRA that promotes pay-for-
performance initiatives around accountable care organizations, bringing greater ease of use and intuitiveness to our 
software products, expanding our interoperability and enterprise analytics capabilities, integrating our hospital and 
ambulatory software products and further development and enhancements of our portfolio of specialty focused templates 
within our electronic health records software. We intend to remain at the forefront of upcoming new regulatory requirements, 
including ICD-10 and meaningful use requirements for stimulus payments. We believe that the expanded requirements for 
continued eligibility for incentive payments under meaningful use rules will result in an expanded replacement market for 
electronic health records software. We also intend to continue selling additional software and services to existing customers, 
expanding penetration of connectivity and other services to new and existing customers, and capitalizing on growth and 
cross selling opportunities within the RCM Services Division. Our acquisitions of Gennius and Mirth provide improved 
capabilities around population health and collaborative care management, interoperability, and enterprise analytics for 
addressing new value-based care requirements, which improves our market competitiveness  and provides new customers 
and expanded markets for the NextGen Division. 

•   The NextGen Division’s growth is attributed to a strong brand name and reputation within the marketplace for healthcare 
information technology software and services and investments in sales and marketing activities, including new marketing 
campaigns, Internet advertising investments, trade show attendance and other expanded advertising and marketing 
expenditures. We have also recently expanded our relationship with certain value added resellers with significant resources 
both domestically and internationally.  

Hospital Solutions Division 

•   Hospital Solutions Division revenue increased 15.3% in the year ended March 31, 2015. Revenue was positively impacted 
by an 87.7% increase in system sales and a 2.4% increase in recurring service revenue. The significant increase in system 
sales is primarily reflective of lower sales returns and related reserves in the current period. 

•   Divisional operating loss (excluding Corporate and unallocated amounts) was $2.8 million for the year ended March 31, 

2015 as compared to a $7.5 million loss for the prior year period. The improvement in operating results is due to an increase 
in gross profit, driven by the increase in system sales noted above and significantly lower implementations payroll costs. 

•   The Hospital Solutions Division has incurred losses in the last several quarters.  During the year ended March 31, 2014, our 
expectations about the future performance of this Division resulted in the full impairment of significant long-term assets of 
the Division. Along with recording the impairment charge, we have also ceased capitalization and amortization of software 
development costs related to the Hospital Solutions Division's software products.  We expect a decline in future software 
sales and a corresponding decrease in implementations revenue for the Hospital Solutions Division as sales efforts will be 
focused only on a limited number of software products, including Surgical Scheduling and Emergency Department.  The 
Division may continue to incur losses in the near future while we continue to invest in and support our existing customer 
base. 

RCM Services Division 

•   RCM Services Division revenue increased 17.5% in the year ended March 31, 2015. The RCM Services Division benefited 
from new customers added during the year ended March 31, 2015 as well as organic growth achieved through cross selling 
RCM services to NextGen Division customers. 

•   Operating income increased 37.8% in the year ended March 31, 2015 as compared to the prior year period primarily due to 

an increase in divisional gross profit compared to the prior year period.  

•   The Company believes that a significant opportunity exists to continue cross selling RCM services to existing customers. 

The portion of existing NextGen customers who are using the RCM Services Division's services is less than 10%. 
Management is actively pursuing efforts to achieve faster growth from expanded efforts to leverage the existing NextGen 
Division's sales force towards selling RCM services. We also believe that the increased complexity related to the billing and 
collections process, expected to go into effect with ICD-10, will create additional opportunities for our RCM Services 
Division.   

•   Although actual and expected customer turnover may impact short term revenue for the division, we are encouraged by the 

RCM market opportunity and our position within the market. 

36 

 
 
 
Corporate and unallocated amounts (costs not allocated to the operating segments) 

•   Effective April 1, 2014, we refined the measurement of our segment data to better reflect an organizational structure 

whereby certain expenses managed by functional area leadership are no longer classified within the operating segments but 
rather as a component of Corporate and unallocated. Such classification is consistent with the disaggregated financial 
information used by the chief decision making group. As a result, we no longer classify the amortization of capitalized 
software costs within the operating segments. The Company has retroactively reclassified the prior year gross margin and 
cost of revenue amounts included in the MD&A to present all segment information on a comparable basis. For additional 
details, refer to Note 14, “Operating Segment Information,” of our notes to consolidated financial statements included 
elsewhere in this Report. 

•   Research and development costs increased by 66.7% to $69.2 million for the year ended March 31, 2015 as compared to 
$41.5 million for the prior year period due primarily to a reduction in the capitalization rate of software costs due to shorter 
development cycles, as well as higher gross expenditures on research and development. We anticipate an increase in gross 
research and development expenditures including both amounts expensed and capitalized due to a growing rate of 
investment to concurrently develop major new products while continuing to create significant new enhancements to our 
existing product lines. As we release the next major version of our flagship software platform, expected to occur in late fiscal 
2016, we expect a decline in the amount of software cost capitalization related to this product. Additionally, we have noted a 
trend towards a more agile development approach that inherently shortens the time frame during which development costs 
may be capitalized and impacts our software capitalization rate. Although lower capitalization rates have no impact on our 
overall cash flows, it results in a higher portion of our software development costs being expensed up front, resulting in 
increased research and development costs as compared to prior periods. As summarized in the table below, the amount of 
software costs capitalized in proportion to the amount of total research and development expenditures, including both 
amounts expensed and capitalized, has declined significantly for year ended March 31, 2015 as compared to the same prior 
year periods: 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

Gross expenditures 

Capitalized software costs 

Research and development costs, as reported 

$ 

$ 

 $

83,841  
(14,601 )   
69,240  

 $

 $ 

62,308  
(20,784)   
41,524  

 $ 

60,320  

(29,455 ) 
30,865  

Capitalized software costs as a percentage of gross expenditures 

17.4 %  

33.4%  

48.8 % 

•   Amortization of capitalized software costs increased by 3.9% to $12.8 million for the year ended March 31, 2015 as 

compared to $12.3 million for the prior year period. The increase in amortization of capitalized software costs is due to the 
general release of the latest significant versions of our ambulatory software products during the third quarter of fiscal 2014. 
The upcoming general release of the next major version of our flagship software platform expected to occur during late 
fiscal 2016 will result in even significantly higher rates of amortization relative to previously capitalized software 
development costs reflected in our recent historical operating results. Amortization of capitalized software costs are reflected 
as cost of revenue on our consolidated statements of comprehensive income. Refer to Note 8, “Capitalized Software Costs” 
of our notes to the consolidated financial statements included elsewhere in this Report for an estimate of future amortization 
of capitalized software costs. 

•   Other Corporate and overhead costs decreased by $12.5 million to $64.1 million for the year ended March 31, 2015 as 

compared to $76.6 million for the prior year period primarily due to the $26.0 million Hospital Solutions Division impairment 
charge recorded in the prior year, partially offset by increases in salaries and benefits, legal expense, and acquisition related 
costs. In addition, an increase in marketing headcount plus added utilization of online advertising and media placement has 
resulted in a 17.7% increase in marketing expense to $11.9 million for the year ended March 31, 2015 as compared to 
$10.1 million for the prior year period. 

37 

 
 
 
 
 
 
 
   
   
 
 
The following table sets forth for the periods indicated the percentage of net revenue represented by each item in our 
consolidated statements of income (certain percentages below may not sum due to rounding): 

Revenues: 

Software and hardware 

Implementation and training services 

System sales 

Maintenance 

Electronic data interchange services 

Revenue cycle management and related services 

Other services 

Maintenance, EDI, RCM and other services 

Total revenues 

Cost of revenue: 

Software and hardware 

Implementation and training services 

Total cost of system sales 

Maintenance 

Electronic data interchange services 

Revenue cycle management and related services 

Other services 

Total cost of maintenance, EDI, RCM and other services 

Total cost of revenue 

Gross profit 

Operating expenses: 

Selling, general and administrative 

Research and development costs 

Amortization of acquired intangible assets 

Impairment of goodwill 

Total operating expenses 

Income from operations 

Interest income, net 

Other income (expense), net 

Income before provision for income taxes 

Provision for income taxes 

Net income 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

12.5 % 

13.7 % 

19.2 %

4.8  

17.3  

34.5  

15.6  

15.1  

17.4  

82.7  

5.8  

19.5  

36.0  

15.1  

14.2  

15.2  

80.5  

7.6 

26.9 

34.1 

13.0 

12.9 

13.2 

73.1 

100.0  

100.0  

100.0 

5.0  

4.9  

9.9  

5.9  

9.8  

11.1  

8.8  

35.6  

45.5  

54.5  

32.3  

14.1  

0.8  

0.0  

47.1  

7.3  

0.0  

0.0  

7.3  

1.7  

5.6 % 

9.9  

6.7  

16.6  

5.1  

9.6  

10.4  

7.8  

32.9  

49.5  

50.5  

33.6  

9.3  

1.1  

1.3  

45.3  

5.2  

0.1  

(0.1)  

5.2  

1.6  

3.5 % 

4.7 

6.7 

11.4 

4.4 

8.3 

9.4 

7.6 

29.8 

41.2 

58.8 

32.2 

6.7 

1.1 

3.8 

43.8 

15.0 

0.0 

0.0 

15.0 

5.7 

9.3 %

38 

 
 
 
 
 
 
   
   
 
   
   
 
   
   
 
 
 
 
Comparison of the Fiscal Years Ended March 31, 2015 and March 31, 2014  

Net Income. Our net income for the year ended March 31, 2015 was $27.3 million, or $0.45 per share on both a basic and fully 
diluted basis. In comparison, we earned $15.7 million, or $0.26 per share on both a basic and fully diluted basis for the year 
ended March 31, 2014. The change in net income for the year ended March 31, 2015 was primarily attributed to the following: 

•  

•  

•  

•  

•  

the prior year period included a $26.0 million impairment charge related to our Hospital Solutions Division while 
the current period does not include any such impairment charge; 

revenue and gross profit benefited from an increase of $47.3 million, or 13.2%, in consolidated recurring services 
revenue including maintenance, RCM, EDI, and other services revenue. Other services revenue benefited from 
$17.3 million, or 63.1%, increase in subscription revenue. Gross profit related to recurring services revenue grew 
$19.0 million or 9.0%, as a result of revenue growth; 

this was partially offset by a 2.0% decline in consolidated system sales revenue related to a number of factors, 
including higher adoption rates by large physician groups resulting in a lower number of new opportunities, the 
consolidation of physician offices by hospitals and other large enterprises thereby reducing the number of 
potential opportunities, and an extension of the deadline to adopt stage two meaningful use requirements. The 
decline in consolidated system sales was partially offset by a benefit from fewer sales credits in the current 
period for the Hospital Solutions Division and lower related reserves for potential sales credits, which contributed 
to an increase in software revenue of $6.0 million as compared to the prior year period; 

a $29.7 million, or 14.7%, increase in total operating expenses compared to the prior year period. This increase 
is primarily due to a 66.7% increase in research and development expenses in the current year primarily due to 
higher gross expenditures in conjunction with lower capitalization rates of software development costs; and 

an increase of $1.0 million in the provision for income taxes, primarily a result of increased income before 
provision for income taxes and a decline in the effective tax rate as compared to the prior year period. 

Revenue. Revenue for the year ended March 31, 2015 increased 10.2% to $490.2 million from $444.7 million for the year ended 
March 31, 2014. NextGen Division revenue increased 9.6% to $373.8 million from $341.1 million in the year ended March 31, 
2015, QSI Dental Division revenue decreased 7.0% to $18.5 million from $19.8 million, RCM Services Division revenue 
increased 17.5% to $80.0 million from $68.1 million, and the Hospital Solutions Division revenue increased 15.3% to $18.0 
million from $15.6 million in the prior year period.  

System Sales. Revenue from consolidated system sales for the year ended March 31, 2015 decreased 2.0% to $85.0 million 
from $86.8 million in the prior year period. 

The following table breaks down our reported system sales into software, hardware and third party software, and implementation 
and training services components on a consolidated and divisional basis for the years ended March 31, 2015 and 2014 (in 
thousands): 

Fiscal Year Ended March 31, 2015 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Fiscal Year Ended March 31, 2014 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Software 

Hardware and 
Third 
Party Software 

Implementation 
and Training 
Services 

Total System 
Sales 

$

$

$

$

1,417    $ 
52,637   
2,540   
413   
57,007    $ 

1,883    $ 
55,854   
(3,492 )  
391   
54,636    $ 

1,118    $
3,840   
(604 )  
12   
4,366    $

1,228    $
4,776   
194   
—   
6,198    $

926    $ 

20,018   
2,499   
205   
23,648    $ 

1,300    $ 
18,988   
5,660   
—   
25,948    $ 

3,461 
76,495  
4,435  
630  
85,021 

4,411 
79,618  
2,362  
391  
86,782 

The decrease in system sales was driven primarily by lower sales of software, hardware and third party software to both new 
and existing customers for the NextGen Division and QSI Dental Divisions. NextGen Division sales in this category decreased 
3.9%, or $3.1 million, to $76.5 million during the year ended March 31, 2015 from $79.6 million during the same prior year period 
while the QSI Dental Division experienced a 20.5%, or $0.9 million, decrease in category revenue to $3.5 million in the year 
ended March 31, 2015 as compared to $4.4 million in the prior year period. 

NextGen Division software license revenue decreased 5.8% in the year ended March 31, 2015 versus the same period last year. 
The Division's software license revenue accounted for 68.8% of divisional system sales revenue during the year ended 

39 

 
 
 
 
 
 
   
   
   
 
   
   
   
March 31, 2015 compared to 70.2% during the same period a year ago resulting from lower sales to both new and existing 
customers due to the increasingly saturated markets in which our core software products are sold. Implementation and training 
revenue related to system sales at the NextGen Division increased 5.4% in the year ended March 31, 2015 compared to the 
same prior year period. The amount of implementation and training services revenue is dependent on several factors, including 
timing of customer implementations, the availability of qualified staff and the mix of services being rendered. 

Software license revenue for the QSI Dental Division decreased 24.7% in the year ended March 31, 2015 versus the same 
period last year largely because the Division's current software solution, QDW, is being sold primarily as a SaaS solution for 
which revenue is recognized over an extended period of time as other services revenue rather than upfront as software revenue. 

Total system sales for the Hospital Solutions Division increased 87.7%, or $2.1 million, to $4.4 million in the year ended 
March 31, 2015 as compared to $2.4 million in the same prior year period. The increase in divisional category revenue is 
primarily due to lower software sales credits and related reserves for potential sales credits, resulting in a $6.0 million increase in 
Hospital Solutions software sales in the year ended March 31, 2015 versus the same period last year. Implementation and 
training revenue related to system sales at the Hospital Solutions Division decreased 55.8%, in the year ended March 31, 2015 
as compared to the same prior year period due to the recent decline in new software sales. 

During the year ended March 31, 2015, 5.1% of consolidated system sales revenue was represented by hardware and third 
party software compared to 7.1% during the same period a year ago. The number of customers who purchase hardware and 
third party software and the dollar amount of hardware and third party software revenue fluctuates each quarter depending on 
the needs of customers. The inclusion of hardware and third party software in our sales arrangements is typically at the request 
of our customers. 

We expect to benefit from the growth of a replacement market driven by an expected consolidation of electronic health records 
vendors. We also believe many new opportunities will be created by the evolution of healthcare from a fee-for-services 
reimbursement model to a pay-for-performance model around the management of patient populations. Additionally, the Gennius 
and Mirth acquisitions provided us with new products and services around HIE, population health and collaborative care 
management, interoperability and enterprise analytics, which we intend to utilize to drive future growth. It is difficult to assess the 
relative impact as well as the timing of positive and negative trends; however, we believe we are well positioned to support the 
ever increasing need for healthcare information technology. 

Maintenance, EDI, RCM and Other Services. For the year ended March 31, 2015, our consolidated revenue from 
maintenance, EDI, RCM and Other services grew 13.2% to $405.2 million from $357.9 million in the same prior year period. The 
increase is due to an increase across all categories of recurring service revenue.  

The following table details maintenance, EDI, RCM and Other services revenue by category on a consolidated and divisional 
basis for the years ended March 31, 2015 and 2014 (in thousands): 

Fiscal Year Ended March 31, 2015 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Fiscal Year Ended March 31, 2014 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Maintenance 

EDI 

RCM 

Other 

Total 

$ 

$ 

$ 

$ 

8,084   $
150,384   
10,181   
570   
169,219   $

8,401   $
141,026   
9,981   
652   
160,060   $

4,784    $
70,511  
113  
950  
76,358    $

5,463    $
61,606  
144  
82  
67,295    $

—    $
—  
—  
74,237  
74,237    $

—    $
—  
—  
62,976  
62,976    $

14,990  
2,122    $
297,270 
76,375  
13,569 
3,275  
3,618  
79,375 
85,390    $ 405,204  

15,429  
1,565    $
261,502 
58,870  
13,252 
3,127  
3,992  
67,702 
67,554    $ 357,885  

Total category revenue for the NextGen Division for the year ended March 31, 2015 increased by 13.7% to $297.3 million from 
$261.5 million for the prior year period. NextGen Division maintenance revenue for the year ended March 31, 2015 grew 6.6% to 
$150.4 million from $141.0 million for the same prior year period primarily as a result of net additional licenses from both new 
and existing customers and a full year impact of maintenance revenue for the year ended March 31, 2015 from the acquisition of 
Mirth in September 2013. NextGen Division EDI revenue grew 14.5% to $70.5 million compared to $61.6 million in the same 
prior year period. The growth in NextGen EDI revenue has come from new customers and from further penetration to the 
Division’s existing customer base. Other services revenue for the NextGen Division, which consists primarily of third party 
annual software license renewals, consulting services, SaaS fees, hosting services, and other subscriptions, increased 29.7% to 
$76.4 million for the year ended March 31, 2015 from $58.9 million in the prior year period. Other services revenue benefited 
significantly from a $16.1 million increase in customer subscriptions, including Mirth related interoperability subscriptions and our 
NextGen® Patient Portal subscriptions. 

40 

 
 
 
 
 
 
 
   
   
   
   
 
   
   
   
   
For the year ended March 31, 2015, RCM revenue for the RCM Services Division grew $11.3 million, or 17.9%, to $74.2 million 
compared to $63.0 million in the prior year period. The growth in RCM revenue is primarily attributable to organic growth 
achieved through cross selling RCM services to existing NextGen Division customers, as well as the addition of new customers. 
For the Hospital Solutions Division, maintenance, EDI and other services revenue for the years ended March 31, 2015 and 2014 
remained fairly consistent at $13.6 million and $13.3 million, respectively. QSI Dental Division maintenance, EDI and other 
services revenue for the year ended March 31, 2015 was $15.0 million compared to $15.4 million for the same prior year period 
due to a decrease in EDI revenue resulting from a decline in the amount of services provided to existing customers.  The recent 
decline in software license sales at the QSI Dental Division has resulted in a decrease in related maintenance revenue, which is 
offset by growth in other services revenue due to the shift in sales to QDW, for which the SaaS-related revenues are recognized 
as other services. 

We intend to continue to promote maintenance, EDI and RCM services to both new and existing customers. 

Cost of Revenue. Cost of revenue for the year ended March 31, 2015 increased 1.4% to $223.2 million from $220.2 million in 
the same prior year period and the cost of revenue as a percentage of revenue decreased to 45.5% from 49.5%. The decrease 
in cost of revenue as a percentage of revenue is primarily due to the $20.1 million Hospital Solutions Division impairment charge 
recorded to cost of software revenue in the prior year period, which is partially offset by an increase in cost of revenue related to 
a change in the mix of revenues toward recurring services revenue, which have historically experienced a lower profit margin 
than system sales. For the year ended March 31, 2015, recurring services revenue comprised 82.7% of consolidated revenue, 
as compared to 80.5% in the prior year period. 

The following table details revenue and cost of revenue on a consolidated and divisional basis for the years ended March 31, 
2015 and 2014 (in thousands): 

QSI Dental Division 

Revenue 

Cost of revenue 

Gross profit 

NextGen Division 

Revenue 

Cost of revenue 

Gross profit 

Hospital Solutions Division 

Revenue 

Cost of revenue 

Gross profit (loss) 

RCM Services Division 

Revenue 

Cost of revenue 

Gross profit 

Unallocated cost of revenue 

Consolidated 

Revenue 

Cost of revenue 

Gross profit 

Fiscal Year Ended March 31, 

2015 

% 

2014 

% 

$

$

18,451   
9,462  
8,989   

100.0 %  $

51.3 % 

48.7 %  $

19,840   
9,362  
10,478   

$ 373,765   
127,858  
$ 245,907   

100.0 %  $ 341,120   
110,468  
34.2 % 
65.8 %  $ 230,652   

$

$

$

$

$

18,004   
13,128  
4,876   

80,005   
56,466  
23,539   
16,250   

100.0 %  $

72.9 % 

27.1 %  $

100.0 %  $

70.6 % 

29.4 %  $

N/A   $

15,614   
17,187  
(1,573 )  

68,093   
47,934  
20,159   
35,212   

$ 490,225   
223,164  
$ 267,061   

100.0 %  $ 444,667   
220,163  
45.5 % 
54.5 %  $ 224,504   

100.0 %

47.2 %

52.8 %

100.0 %

32.4 %

67.6 %

100.0 %

110.1 %

(10.1 )%

100.0 %

70.4 %

29.6 %

N/A 

100.0 %

49.5 %

50.5 %

Gross margins for the QSI Dental Division and NextGen Division decreased for the year ended March 31, 2015 compared to the 
same prior year period primarily due to decreases in total divisional system sales. Gross margin for the RCM Services Division 
remained consistent compared to the prior year period. The gross margin for the Hospital Solutions Division in the year ended 
March 31, 2015 benefited from an increase in software sales resulting from lower returns and lower related reserves for potential 
sales returns in the current period, combined with a decline in cost of revenue due to lower payroll and related benefits costs and 
the cessation of capitalized software cost amortization subsequent to the Hospital impairment. The decrease in unallocated cost 
of revenue is primarily due to the $20.1 million Hospital impairment charge recorded in the prior year period. 

41 

 
 
 
 
 
 
 
   
   
   
 
   
   
   
 
   
   
   
 
   
   
   
 
   
   
   
 
The following table details the individual components of cost of revenue and gross profit (loss) as a percentage of total revenue 
on a consolidated and divisional basis for the years ended March 31, 2015 and 2014: 

Fiscal Year Ended March 31, 2015 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Fiscal Year Ended March 31, 2014 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Hardware 
and 
Third Party 
Software 

Payroll and 
Related 
Benefits 

Software 

EDI 

Other 

Total Cost 
of Revenue   

Gross 
Profit 
(Loss) 

0.1 %  

1.3 %  

— %  

— %  

4.3 %  

2.1 %  

0.7 %  

2.3 %  

— %  

8.6 %  

4.5 % 

0.7 % 

0.2 % 

— % 

0.7 % 

5.3 % 

1.3 % 

2.9 % 

— % 

1.3 % 

29.5 %  

13.0 %  

58.2 %  

45.8 %  

20.7 %  

21.9 %  

12.5 %  

78.6 %  

46.3 %  

20.4 %  

7.4 %  

11.4 %  

0.4 %  

1.0 %  

9.1 %  

13.7 %  

10.8 %  

0.5 %  

0.8 %  

9.0 %  

9.8 % 

7.8 % 

14.1 % 

23.8 % 

10.7 % 

4.2 % 

7.1 % 

25.8 % 

23.3 % 

10.2 % 

51.3 %  

34.2 %  

72.9 %  

70.6 %  

45.5 %  

48.7 %

65.8 %

27.1 %

29.4 %

54.5 %

47.2 %  

32.4 %  

52.8 %

67.6 %

110.1 %  

(10.1 )%

70.4 %  

49.5 %  

29.6 %

50.5 %

During the year ended March 31, 2015, hardware and third party software constituted a slightly lower portion of cost of revenue 
compared to the same prior year period. The number of customers who purchase hardware and third party software and the 
dollar amount of hardware and third party software purchased fluctuates each quarter depending on the needs of our customers. 

Gross margin for the Hospital Solutions Division increased to 27.1%  for the year ended March 31, 2015 as compared to a 
negative gross margin of 10.1% reported in the prior year period. This is primarily a result of an increase in software sales 
resulting from lower returns and lower related reserves for potential sales returns in the current period. 

Our payroll and benefits expense associated with delivering our products and services increased slightly to 20.7% of 
consolidated revenue in the year ended March 31, 2015 compared to 20.4% during the same period last year. The absolute level 
of consolidated payroll and benefit expenses grew from $90.8 million in the year ended March 31, 2014 to $101.3 million in the 
year ended March 31, 2015. The increase is primarily due to a $6.1 million increase in payroll and benefits expenses within the 
NextGen Division, resulting from increased headcount compared to the prior year period, partially due to the inclusion of Mirth, a 
$5.1 million increase within the RCM Services Division, as RCM is a service business which inherently has higher payroll costs 
as a percentage of revenue, a $1.1 million increase within the QSI Dental Division, and a $1.8 million decrease within the 
Hospital Solutions Division. Share-based compensation expense included in cost of revenue was approximately $0.4 million and 
$0.3 million for the years ended March 31, 2015 and 2014, respectively, and is included in the aforementioned amounts.  

Other cost of revenue, which primarily consists of third party annual licenses, hosting costs and outsourcing costs, increased to 
10.7% of total revenue during the year ended March 31, 2015 as compared to 10.2% for the prior year period. The increase is 
due to a change in mix of other services revenue sold as compared to the prior year period. 

Cost of software revenue decreased to 4.3% of total revenue during the year ended March 31, 2015 as compared to 8.6% for 
the prior year period mainly as a result of the $20.1 million Hospital Solutions Division impairment charge recorded in the prior 
year period. 

As a result of the foregoing events and activities, our gross profit percentage increased to 54.5% for the year ended March 31, 
2015 versus 50.5% for the same prior year period.  

Selling, General and Administrative Expenses. Selling, general and administrative expenses for the year ended March 31, 
2015 increased 6.0% to $158.2 million as compared to $149.2 million for the prior year period. The increase in these expenses 
is partially due to the inclusion of a full year of expenses for Mirth, acquired on September 9, 2013, in the results for the year 
ended March 31, 2015. The increase in selling, general and administrative expenses, including the impact of Mirth, consists 
primarily of:  

•  

•  

•  

$4.6 million increase in salaries and benefits due to increased headcount and higher bonus expense;  

$2.2 million increase in legal expenses due mostly to increased costs for shareholder litigation defense; 

$1.5 million increase in advertising costs as a result of our increased focus on heightened brand awareness plus 
added utilization of online advertising and media placement; and 

42 

 
 
 
 
 
 
 
 
   
   
   
   
   
   
 
   
   
   
   
   
   
 
•  

•  

$1.5 million increase in acquisition costs due mostly to post-acquisition fair value adjustments to contingent 
consideration related to Mirth, offset by 

$0.8 million net decrease in other selling and administrative expenses. 

Share-based compensation expense included in selling, general and administrative expenses was approximately $2.7 million 
and $1.8 million for the years ended March 31, 2015 and 2014, respectively, and is included in the aforementioned amounts. 
Selling, general and administrative expenses as a percentage of revenue decreased from 33.6% in the year ended March 31, 
2014 to 32.3% in the year ended March 31, 2015.  

Research and Development Costs. Research and development costs for the years ended March 31, 2015 and 2014 were 
$69.2 million and $41.5 million, respectively. Research and development costs as a percentage of revenue increased to 14.1% 
in the year ended March 31, 2015 from 9.3% for the prior year period. The increase in research and development costs is 
primarily due to the reduction in the capitalization rate of software costs in the current period, the acquisition of Mirth, as well as 
the continued investment in enhancements to our specialty template development, preparation for ICD-10 requirements, new 
product development, and other enhancements to our existing products. The decrease in software capitalization rate reflects a 
trend towards a more agile development approach that inherently shortens the time frame during which development costs may 
be capitalized. 

The capitalization of software development costs results in a reduction to reported research and development costs. For the 
years ended March 31, 2015 and 2014, our additions to capitalized software were $14.6 million and $20.8 million, respectively. 
The decrease in additions to capitalized software is primarily due to the lower capitalization rates of software development costs 
mentioned above. For the years ended March 31, 2015 and 2014, total research and development expenditures, including costs 
expensed and costs capitalized, were $83.8 million and $62.3 million, respectively.  We intend to continue to invest heavily in 
research and development expenses as we continue to bring additional functionality and features to the medical community and 
develop a new integrated inpatient and outpatient, web-based software platform.  

Share-based compensation expense included in research and development costs was approximately $0.4 million and $0.3 
million for the years ended March 31, 2015 and 2014, respectively.  

Amortization of Acquired Intangible Assets. Amortization included in operating expense related to acquired intangible assets 
decreased to $3.7 million for the year ended March 31, 2015 from $4.8 million in the prior year period due mostly to the 
cessation of amortization of acquired intangible assets related to the Hospital Solutions Division that were fully impaired in prior 
year. 

Provision for Income Taxes. The provision for income taxes for the years ended March 31, 2015 and 2014 was $8.3 million 
and $7.3 million, respectively. The effective tax rates were 23.4% and 31.8% for the years ended March 31, 2015 and 2014, 
respectively. The effective tax rate for the year ended March 31, 2015 decreased as compared to the prior year period primarily 
due to an increase in benefit from the federal research and development tax credit and an increase in the qualified production 
activities deduction. The federal research and development tax credit statute, which had expired on December 31, 2013, was 
retroactively extended through December 31, 2014 in December 2014. The non-deductible portion of the Hospital impairment 
charge in the prior year also resulted in a non-recurring, incremental decrease in the effective tax rate for the year ended March 
31, 2015 as compared to the prior year period. 

During the years ended March 31, 2015 and 2014, we recognized research and development tax credits of approximately $1.9 
million and $1.4 million, respectively. The Company also claimed the qualified production activities deduction under Section 199 
of the Internal Revenue Code (“IRC”) of approximately $5.5 million and $3.2 million (pre-tax) during the years ended March 31, 
2015 and 2014, respectively. Research and development credits and the qualified production activities income deduction 
calculated by us involve certain assumptions and judgments regarding qualification of expenses under the relevant tax code 
provision. We expect to receive the full benefit of the deferred tax assets recorded with the exception of a specific state tax credit 
for which we have recorded a valuation allowance. 

Comparison of the Fiscal Years Ended March 31, 2014 and March 31, 2013 

Effective April 1, 2014, we refined the measurement of our segment data to better reflect an organizational structure whereby 
certain expenses managed by functional area leadership are no longer classified within the operating segments but rather as a 
component of Corporate and unallocated. Such classification is consistent with the disaggregated financial information used by 
the chief decision making group. As a result, we no longer classify the amortization of capitalized software costs within the 
operating segments. The Company has retroactively reclassified the prior year gross margin and cost of revenue amounts 
included in the MD&A to present all segment information on a comparable basis. For additional details, refer to Note 14, 
“Operating Segment Information,” of our notes to consolidated financial statements included elsewhere in this Report. 

Net Income. Our net income for the year ended March 31, 2014 was $15.7 million, or $0.26 per share on both a basic and fully 
diluted basis. In comparison, we earned $42.7 million, or $0.72 per share on both a basic and fully diluted basis for the year 
ended March 31, 2013. The change in net income for the year ended March 31, 2014 was primarily attributed to the following: 

•  

an 81.8% decrease in consolidated system sales gross profit as a result of a $20.1 million impairment charge 
recorded to cost of software sales related to the Hospital Solutions Division and reduced software license sales 
due to a number of factors, including higher adoption rates by large physician groups resulting in a lower number 
of new opportunities, the consolidation of physician offices by hospitals and other large enterprises thereby 

43 

 
 
reducing the number of potential opportunities, and an extension of the deadline to adopt stage two meaningful 
use requirements; 

a 191.0% decline in implementation and training services gross profit (loss) from $4.1 million for the year ended 
March 31, 2013 to $(3.8) million for the year ended March 31, 2014 as a result of reduced utilization rates due to 
the lack of expected demand from our customers related to upgrade assistance for ICD-10, for which the 
deadline to comply with its requirements was delayed from October 2014 to October 2015; offset by 

an increase in gross profit from recurring service revenue, including maintenance, RCM and EDI which grew 
1.0%, 6.0% and 16.0%, respectively, compared to the prior year period; and 

an $18.9 million decrease in the provision for income taxes due to lower taxable income in comparison to the 
prior year period. 

•  

•  

•  

Revenue. Revenue for the year ended March 31, 2014 decreased 3.4% to $444.7 million from $460.2 million for the year ended 
March 31, 2013. NextGen Division revenue decreased 0.9% to $341.1 million from $344.3 million in the year ended March 31, 
2014, QSI Dental Division revenue decreased 0.8% to $19.8 million from $20.0 million, and the Hospital Solutions Division 
revenue decreased 50.3% to $15.6 million from $31.4 million in the same prior year period. These decreases in revenue were 
partially offset by an increase in revenue for the RCM Services Division, which increased 5.6% to $68.1 million from $64.5 
million. 

System Sales. Revenue earned from company-wide sales of systems for the year ended March 31, 2014 decreased 29.8% to 
$86.8 million from $123.6 million in the prior year period. 

The decrease in system sales was driven primarily by lower sales of software to both new and existing customers for both the 
NextGen and Hospital Solutions Divisions. For the NextGen Division, revenue from system sales decreased 23.1%, or $23.9 
million, to $79.6 million during the year ended March 31, 2014 from $103.5 million during the same prior year period while 
system sales revenues at the Hospital Solutions Division decreased $11.6 million to $2.4 million in the year ended March 31, 
2014 as compared to $14.0 million in the same prior year period. 

The following table breaks down our reported system sales into software, hardware and third party software, and implementation 
and training services components on a consolidated and divisional basis for the years ended March 31, 2014 and 2013 (in 
thousands): 

Fiscal Year Ended March 31, 2014 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Fiscal Year Ended March 31, 2013 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Software 

Hardware and 
Third 
Party Software 

Implementation 
and Training 
Services 

Total System 
Sales 

$

$

$

$

1,883    $ 
55,854   
(3,492 )  
391   
54,636    $ 

2,085    $ 
71,862   
5,717   
431   
80,095    $ 

1,228    $
4,776   
194   
—   
6,198    $

1,733    $
5,697   
1,045   
2   
8,477    $

1,300    $ 
18,988   
5,660   
—   
25,948    $ 

1,599    $ 
26,002   
7,207   
200   
35,008    $ 

4,411 
79,618  
2,362  
391  
86,782 

5,417 
103,561  
13,969  
633  
123,580 

NextGen Division software license revenue decreased 22.3% in the year ended March 31, 2014 versus the same prior year 
period. The Division's software revenue accounted for 70.2% of divisional system sales revenue during the year ended 
March 31, 2014 compared to 69.4% during the same prior year period. 

Hospital Solutions Division software license revenue decreased 161.1%  in the year ended March 31, 2014 versus the same 
prior year period due to higher write-offs and accruals for anticipated sales credits, combined with significantly lower software 
sales to new and existing customers. 

Our decline in software revenue was related to a number of factors including higher adoption rates by large physician groups 
which resulted in a smaller number of new opportunities, the consolidation of physician offices by hospitals and other large 
enterprises thereby reducing the number of potential opportunities, and an extension to the deadline to adopt stage two 
meaningful use requirements. 

During the year ended March 31, 2014, 6.0% of the NextGen Division's system sales revenue was represented by hardware and 
third party software compared to 5.5% during the same prior year period. The number of customers who purchase hardware and 

44 

 
 
 
 
 
 
 
   
   
   
 
   
   
   
third party software and the dollar amount of hardware and third party software revenue fluctuates each period depending on the 
needs of customers. The inclusion of hardware and third party software in the NextGen Division's sales arrangements is typically 
at the request of our customers. 

Implementation and training revenue related to system sales at the NextGen Division decreased 27.0% in the year ended 
March 31, 2014 compared to the same prior year period. Implementation and training revenue related to system sales at the 
Hospital Solutions Division decreased 21.5%, in the year ended March 31, 2014 as compared to the same prior year period. The 
amount of implementation and training services revenue is dependent on several factors, including timing of customer 
implementations, the availability of qualified staff and the mix of services being rendered. The decline in the level of systems 
sales has resulted in a decline in the amount of implementation services sold. 

Maintenance, EDI, RCM and Other Services. For the year ended March 31, 2014, our company-wide revenue from 
maintenance, EDI, RCM and other services grew 6.3% to $357.9 million from $336.6 million in the same prior year period. The 
increase was primarily due to an increase in maintenance, EDI and other services revenue from the NextGen Division and an 
increase in revenue from the RCM Services Division. 

Total NextGen Division maintenance revenue for the year ended March 31, 2014 grew 5.3% to $141.0 million from $133.9 
million for the same prior year period while NextGen Division EDI revenue grew 13.5% to $61.6 million compared to $54.3 
million in the same prior year period.  Maintenance revenue for the NextGen Division increased by $7.1 million for the year 
ended March 31, 2014 as compared to the same prior year period. The growth in maintenance revenue was primarily a result of 
increases related to net additional licenses from new and existing customers.  The NextGen Division’s EDI revenue growth came 
from new customers and from further penetration of the Division’s existing customer base while the growth in RCM revenue was 
primarily attributable to organic growth. 

Other services revenue for the NextGen Division, which consists primarily of third party annual software license renewals, 
consulting services, SaaS fees and hosting services, increased 11.9% to $58.9 million in the year ended March 31, 2014 from 
$52.6 million in the same prior year period. Other services revenue benefited from a strong increase in consulting revenue to 
existing NextGen Division customers as well as the addition of Mirth subscription revenue in the year ended March 31, 2014. 

QSI Dental Division maintenance, EDI and other services revenue for the year ended March 31, 2014 was $15.4 million 
compared to $14.6 million for the same prior year period.  For the year ended March 31, 2014, RCM revenue for the RCM 
Services Division grew $3.8 million, or 6.3%, to $63.0 million compared to $59.2 million in the same prior year period.   For the 
Hospital Solutions Division, maintenance, EDI and other services revenue for the year ended March 31, 2014 decreased 24.0% 
as compared to the same prior year period due to a decline in maintenance revenue related to higher accruals for anticipated 
sales credits and lower amounts of maintenance services provided to existing customers. 

The following table details maintenance, EDI, RCM and other services revenue by category on a consolidated and divisional 
basis for the years ended March 31, 2014 and 2013 (in thousands): 

Fiscal Year Ended March 31, 2014 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Fiscal Year Ended March 31, 2013 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Maintenance 

EDI 

RCM 

Other 

Total 

$ 

$ 

$ 

$ 

8,401   $
141,026   
9,981   
652   
160,060   $

7,902   $
133,904   
14,126   
839   
156,771   $

5,463    $
61,606  
144  
82  
67,295    $

5,152    $
54,281  
41  
235  
59,709    $

—    $
—  
—  
62,976  
62,976    $

—    $
—  
—  
59,219  
59,219    $

15,429  
1,565    $
261,502 
58,870  
13,252 
3,127  
3,992  
67,702 
67,554    $ 357,885  

14,573  
1,519    $
240,754 
52,569  
17,444 
3,277  
3,585  
63,878 
60,950    $ 336,649  

45 

 
 
 
 
 
 
 
   
   
   
   
 
   
   
   
   
 
 
 
Cost of Revenue. Cost of revenue for the year ended March 31, 2014 increased 16.1% to $220.2 million from $189.7 million in 
the same prior year period and the cost of revenue as a percentage of revenue increased to 49.5% from 41.2% driven primarily 
by the following factors: (a) the $20.1 million impairment charge recorded to cost of software sales related to the Hospital 
Solutions Division, (b) higher percentage of lower margin revenue streams such as EDI and RCM services and (c) slight cost 
increases across all revenue categories, except for implementation and training services. 

The following table details revenue and cost of revenue on a consolidated and divisional basis for the years ended March 31, 
2014 and 2013 (in thousands): 

QSI Dental Division 

Revenue 

Cost of revenue 

Gross profit 

NextGen Division 

Revenue 

Cost of revenue 

Gross profit 

Hospital Solutions Division 

Revenue 

Cost of revenue 

Gross profit (loss) 

RCM Services Division 

Revenue 

Cost of revenue 

Gross profit 

Unallocated cost of revenue 

Consolidated 

Revenue 

Cost of revenue 

Gross profit 

Fiscal Year Ended March 31, 

2014 

% 

2013 

% 

$

$

19,840   
9,362  
10,478   

100.0 %  $

47.2 % 

52.8 %  $

19,990   
9,204  
10,786   

$ 341,120   
110,468  
$ 230,652   

100.0 %  $ 344,315   
106,881  
32.4 % 
67.6 %  $ 237,434   

$

$

$

$

$

15,614   
17,187  
(1,573 )  

68,093   
47,934  
20,159   
35,212   

100.0 %  $

110.1 % 

(10.1 )%  $

100.0 %  $

70.4 % 

29.6 %  $

N/A   $

31,413   
16,191  
15,222   

64,511   
45,008  
19,503   
12,368   

$ 444,667   
220,163  
$ 224,504   

100.0 %  $ 460,229   
189,652  
49.5 % 
50.5 %  $ 270,577   

100.0 %

46.0 %

54.0 %

100.0 %

31.0 %

69.0 %

100.0 %

51.5 %

48.5 %

100.0 %

69.8 %

30.2 %

N/A 

100.0 %

41.2 %

58.8 %

Consolidated gross profit margin decreased for the year ended March 31, 2014 compared to the same prior year period primarily 
due to a $20.1 million impairment charge that is reflected in unallocated cost of revenue for the year ended March 31, 2014. 
Additionally, the gross profit margin was impacted by the significant decrease in software sales during the year ended March 31, 
2014. 

Gross profit (loss) for the Hospital Solutions Division decreased to a negative gross margin of 10.1% for the year ended 
March 31, 2014 as compared to 48.5% for the same prior year period primarily due to significant declines in system sales 
revenues, implementation and training, and maintenance gross profit. The change in maintenance gross profit was primarily a 
result of increased accruals for anticipated sales credits in the year ended March 31, 2014. 

Gross profit margin for the NextGen and RCM Services Divisions remained consistent compared to the same prior year period 
with a change of less than 2.0% in each Division's respective gross margin percentages. 

46 

 
 
 
 
 
 
 
   
   
   
 
   
   
   
 
   
   
   
 
   
   
   
 
   
   
   
The following table details the individual components of cost of revenue and gross profit as a percentage of total revenue on a 
consolidated and divisional basis for the years ended March 31, 2014 and 2013: 

Fiscal Year Ended March 31, 2014 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Fiscal Year Ended March 31, 2013 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated 

Hardware 
and 
Third 
Party 
Software 

Payroll 
and 
Related 
Benefits 

Software   

EDI 

  Other 

Total Cost 
of 
Revenue 

Gross 
Profit 
(Loss) 

2.1% 
0.7% 
2.3% 
—% 
8.6% 

—% 
0.3% 
0.4% 
—% 
2.9% 

5.3 %  
1.3 %  
2.9 %  
— %  
1.3 %  

8.7 %  
1.6 %  
3.4 %  
— %  
1.8 %  

21.9 %  
12.5 %  
78.6 %  
46.3 %  
20.4 %  

19.8 %  
12.1 %  
28.9 %  
45.3 %  
18.3 %  

13.7 %  
10.8 %  
0.5 %  
0.8 %  
9.0 %  

13.6 %  
9.3 %  
0.1 %  
1.0 %  
7.7 %  

4.2 % 
7.1 % 
25.8 % 
23.3 % 
10.2 % 

3.9 % 
7.7 % 
18.7 % 
23.5 % 
10.5 % 

47.2 %  
32.4 %  
110.1 %  
70.4 %  
49.5 %  

52.8 %

67.6 %

(10.1 )%

29.6 %

50.5 %

46.0 %  
31.0 %  
51.5 %  
69.8 %  
41.2 %  

54.0 %

69.0 %

48.5 %

30.2 %

58.8 %

During the year ended March 31, 2014, hardware and third party software constituted a slightly lower portion of cost of revenue 
compared to the same prior year period in the NextGen Division. The number of customers who purchase hardware and third 
party software and the dollar amount of hardware and third party software purchased fluctuates each quarter depending on the 
needs of our customers. 

Our payroll and benefits expense associated with delivering our products and services increased to 20.4% of consolidated 
revenue in the year ended March 31, 2014 compared to 18.3% during the same prior year period. The absolute level of 
consolidated payroll and benefit expenses grew from $84.1 million in the year ended March 31, 2013 to $90.8 million in the year 
ended March 31, 2014, an increase of 8.0%, or approximately $6.7 million. Of the $6.7 million increase, approximately $2.3 
million of the increase was related to the RCM Services Division as RCM is a service business, which inherently has higher 
percentage of payroll costs as a percentage of revenue. Increases of $0.8 million in the NextGen Division and $3.2 million for the 
Hospital Solutions Division for the year ended March 31, 2014 were primarily due to headcount additions and increased payroll 
and benefits expense associated with delivering products and services. The QSI Dental Division experienced a slight $0.4 
million increase in payroll and benefits expense compared to the same prior year period. Share-based compensation expense 
included in cost of revenue was approximately $0.3 million and $0.2 million for the years ended March 31, 2014 and 2013, 
respectively, and is included in the aforementioned amounts.  

Other cost of revenue, which primarily consists of third party annual license, hosting costs, third party implementation and 
consulting services, and outsourcing costs, decreased slightly to 10.2% of total revenue during the year ended March 31, 2014 
as compared to 10.5% for the same prior year period. 

As a result of the foregoing events and activities, our gross profit percentage decreased to 50.5% for the year ended March 31, 
2014 versus 58.8% for the same prior year period. 

Selling, General and Administrative Expenses. Selling, general and administrative expenses for the year ended March 31, 
2014 increased 0.6% to $149.2 million as compared to $148.4 million for the same prior year period. The increase in these 
expenses resulted primarily from: 

•  

•  

•  

•  

•  

•  

•  

$2.8 million increase in rent and other facilities costs;  

$2.4 million increase in salaries and related benefit expenses primarily as a result of headcount additions; 

$1.6 million increase in equipment depreciation expense; 

$1.3 million increase in legal expenses; and 

$0.9 million net increase in other selling and administrative expenses, partially offset by 

$5.4 million decrease in bad debt expense as a result of improved collections and fewer customers with specific 
reserves for bad debt; and 

$2.7 million decrease in sales commissions as a result of lower sales. 

47 

 
 
 
 
 
 
 
   
   
   
   
   
   
 
   
   
   
   
   
   
Share-based compensation expense was approximately $1.8 million and $1.9 million for the years ended March 31, 2014 and 
2013, respectively, and is included in the aforementioned amounts. Selling, general and administrative expenses as a 
percentage of revenue increased from 32.2% in the year ended March 31, 2013 to 33.6% in the year ended March 31, 2014. 

Research and Development Costs. Research and development costs for the years ended March 31, 2014 and 2013 were 
$41.5 million and $30.9 million, respectively. Research and development costs as a percentage of revenue increased to 9.3% in 
the year ended March 31, 2014 from 6.7% for the prior year period. The increase in research and development expenses was 
primarily due to the reduction in capitalized software costs for the year ended March 31, 2014, resulting from the releases of the 
latest versions of ambulatory software products, a trend towards shorter development cycles resulting in lower rates of software 
development costs capitalization, the inclusion of research and development costs for Mirth, as well as the continued investment 
in enhancements to our specialty template development, preparation for ICD-10 requirements, new products, and other 
enhancements to our existing products. 

The capitalization of software development costs results in a reduction to reported research and development costs. For the 
years ended March 31, 2014 and 2013, our additions to capitalized software were $20.8 million and $29.5 million, respectively, 
as we continued to enhance our software to meet the Meaningful Use definitions under the ARRA. The decrease in capitalized 
software added in the year ended March 31, 2014 was primarily the result of the releases of the latest versions of ambulatory 
software products and a trend towards shorter development cycles, as mentioned above, as well as the cessation of software 
development costs capitalization at the Hospital Solutions Division as a result of the impairment charge. For the years ended 
March 31, 2014 and 2013, total research and development expenditures including costs expensed and costs capitalized were 
$62.3 million and $60.4 million, respectively. 

Share-based compensation expense included in research and development costs was approximately $0.3 million and $0.2 
million for the years ended March 31, 2014 and 2013, respectively.  

Amortization of Acquired Intangible Assets. Amortization included in operating expense related to acquired intangible assets 
for the years ended March 31, 2014 and 2013 was $4.8 million and $4.9 million, respectively. 

Impairment of Goodwill and Other Assets. Refer to the "Overview of Our Results - Impairment of Goodwill and Other Assets" 
section in our Annual Report on Form 10-K for the year ended March 31, 2014 for details on the $26.0 million impairment charge 
recorded in the year ended March 31, 2014. 

Provision for Income Taxes. The provision for income taxes for the years ended March 31, 2014 and 2013 was $7.3 million 
and $26.2 million, respectively. The effective tax rates were 31.8% and 38.0% for the years ended March 31, 2014 and 2013, 
respectively. The effective rate for the year ended March 31, 2014 decreased as compared to the prior year period due to a net 
benefit from the federal research and development tax credit and a benefit in qualified production activities deduction resulting 
from reduced profits in fiscal 2014.  The federal research and development tax credit statute expired on December 31, 2011 and 
was retroactively enacted through December 31, 2013 in January 2013. 

During the years ended March 31, 2014 and 2013, we recognized research and development tax credits of approximately $1.2 
million and $1.5 million, respectively. The Company also claimed the qualified production activities deduction under Section 199 
of the IRC of approximately $3.2 million and $9.0 million (pre-tax) during the years ended March 31, 2014 and 2013, 
respectively. Research and development credits and the qualified production activities income deduction calculated by us involve 
certain assumptions and judgments regarding qualification of expenses under the relevant tax code provision. We expect to 
receive the full benefit of the deferred tax assets recorded with the exception of a specific state tax credit for which we have 
recorded a valuation allowance. 

Liquidity and Capital Resources 

The following table presents selected financial statistics and information for the years ended March 31, 2015, 2014 and 2013 (in 
thousands): 

Cash and cash equivalents and marketable securities 

Net increase (decrease) in cash and cash equivalents and marketable 
securities 

Net income 

Net cash provided by operating activities 

Number of days of sales outstanding (1) 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

130,585    $

113,801    $

118,011  

  $
16,784 
27,332    $
82,758    $
77  

(4,210 )   $
15,680    $
104,051    $
87  

(21,420 ) 
42,724  
68,065  
122 

$

$

$

$

___________________________ 
(1) Days sales outstanding is equal to accounts receivable divided by average daily revenue. 

48 

 
 
 
 
 
 
 
 
 
 
Cash Flows from Operating Activities 

Cash provided by operations has historically been our primary source of cash and has primarily been driven by our net income. 

The following table summarizes our consolidated statements of cash flows for the years ended March 31, 2015, 2014 and 2013 
(in thousands): 

Net income 

Non-cash expenses 

Cash from net income (as adjusted) 

Change in accounts receivable 

Change in other assets and liabilities 

Net cash provided by operating activities 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

27,332    $
23,546  
50,878  
4,744  
27,136  
82,758    $

15,680    $
54,791  
70,471  
37,461  
(3,881)  
104,051    $

42,724  
42,824 
85,548 
(7,988) 

(9,495) 
68,065  

$

$

Net cash provided by operating activities for the year ended March 31, 2015 decreased by $21.3 million to $82.8 million as 
compared to $104.1 million for the year ended March 31, 2014.  The decrease was primarily due to a $32.8 million decline in 
cash attributable to changes in accounts receivable resulting from a substantial decline in accounts receivable in the prior year 
due to improved collections and aggressive working capital management and a $19.6 million decline in cash attributable to net 
income excluding non-cash expenses resulting mostly from the Hospital Solutions Division impairment charge recorded in the 
prior year period, offset by a $31.0 million increase in cash attributable to changes in other assets and liabilities, related mostly 
to changes in income taxes receivable and payable.   

Net cash provided by operating activities for the year ended March 31, 2014 increased by $36.0 million as compared to $68.1 
million for the year ended March 31, 2013.  The increase was primarily due to the substantial decrease in accounts receivable 
during the year ended March 31, 2014 as compared to the year ended March 31, 2013 due to the improved collections and 
aggressive working capital management noted above.  

The Company continues to place strong emphasis on working capital management and collections as reflected by a reduction of 
days sales outstanding (“DSO”) in comparison to the prior year period. Specifically, DSO decreased to 77 days for the year 
ended March 31, 2015, as compared to 87 days for the year ended March 31, 2014 and 122 days for the year ended March 31, 
2013. 

Cash Flows from Investing Activities 

Net cash used in investing activities for the years ended March 31, 2015, 2014 and 2013 was $24.5 million, $63.7 million and 
$53.7 million, respectively. The $39.1 million decrease in net cash used in investing activities for the year ended March 31, 2015 
as compared to the prior year period is primarily due to the $35.0 million of cash paid for the acquisition of Mirth in the prior year, 
a $6.2 million decrease in additions to capitalized software, a $3.3 million decrease in purchases of marketable securities, 
partially offset by a $4.4 million decrease in proceeds from the sales and maturities of marketable securities. 

The $10.0 million increase in net cash used in investing activities for the year ended March 31, 2014 as compared to the year 
ended March 31, 2013 is primarily due to the $35.0 million of cash paid for the acquisition of Mirth, partially offset by a decrease 
in additions to capitalized software and equipment and improvements and cash paid for the acquisitions of Poseidon and Matrix 
in the year ended March 31, 2013. 

Cash Flows from Financing Activities 

Net cash used in financing activities for the years ended March 31, 2015, 2014 and 2013 was $42.4 million, $43.2 million and 
$42.9 million, respectively. During the year ended March 31, 2015, we received proceeds of $0.4 million from issuance of shares 
under employee plans and paid $42.8 million in dividends to shareholders compared to proceeds of $2.2 million from issuance of 
shares under employee plans, payment of $42.2 million in dividends to shareholders, and payment of $3.4 million in contingent 
consideration during the year ended March 31, 2014 and proceeds of $0.9 million from issuance of shares under employee 
plans, payment of $41.5 million in dividends to shareholders and payment of $2.4 million in contingent consideration during the 
year ended March 31, 2013. 

49 

 
 
 
 
 
 
 
 
Cash and Cash Equivalents and Marketable Securities 

At March 31, 2015, we had combined cash and cash equivalents and marketable securities of $130.6 million, compared to 
$113.8 million as of March 31, 2014. The increase principally reflects a decline in DSO as compared to the prior year period and 
a positive impact from changes in other assets and liabilities, related mostly to income taxes receivable and payable.  

We may use a portion of these funds towards future acquisitions, although the timing and amount of funds to be used has not 
been determined. We intend to expend some of these funds for the development of products complementary to our existing 
product line as well as new versions of certain of our products. These developments are intended to take advantage of more 
powerful technologies and to increase the integration of our products. Such expenditures will be funded from cash on hand and 
cash flows from operations. 

Our investment policy is determined by our Board of Directors. We currently maintain our cash and investments in very liquid 
short term assets including tax exempt and taxable money market funds, certificates of deposit and short term municipal bonds 
with average maturities of 365 days or less at the time of purchase. Our Board of Directors continues to review alternate uses for 
our cash including, but not limited to, payment of a special dividend, initiation of a stock buyback program, an expansion of our 
investment policy and other items. Additionally, it is possible that we will utilize some or all of our cash to fund acquisitions or 
other similar business activities. Any or all of these programs could significantly impact our investment income in future periods. 

In January 2007, our Board of Directors adopted a practice whereby we intend to pay a regular quarterly dividend on our 
outstanding common stock, subject to further review and approval, sufficiency of funds and the establishment of record and 
distribution dates by our Board of Directors prior to the declaration of each such quarterly dividend. We anticipate that future 
quarterly dividends, if and when declared by our Board of Directors pursuant to this practice, would likely be distributable on or 
about the fifth day of each January, April, July and October. The Board of Directors has historically shown a strong commitment 
to the payment of a regular dividend and will continue to evaluate the continued payment of dividends based on our operating 
cash flows and future capital requirements. 

On May 20, 2015, the Board of Directors approved a quarterly cash dividend of $0.175 per share on our outstanding shares of 
common stock, payable to shareholders of record as of June 12, 2015 with an expected distribution date on or about July 6, 
2015.  

Our Board of Directors declared the following dividends during the periods presented: 

Declaration Date 

May 28, 2014 

July 23, 2014 

October 22, 2014 

January 21, 2015 

Fiscal year 2015 

May 22, 2013 

July 24, 2013 

October 23, 2013 

January 22, 2014 

Fiscal year 2014 

May 24, 2012 

July 25, 2012 

October 25, 2012 

January 23, 2013 

Fiscal year 2013 

  Record Date 

  June 13, 2014 
  September 12, 2014 
  December 12, 2014 
  March 13, 2015 

  June 14, 2013 
  September 13, 2013 
  December 13, 2013 
  March 14, 2014 

  June 15, 2012 
  September 14, 2012 
  December 14, 2012 
  March 15, 2013 

  Payment Date 

  July 3, 2014 
  October 3, 2014 
  January 2, 2015 
  April 3, 2015 

  July 5, 2013 
  October 4, 2013 
  January 3, 2014 
  April 4, 2014 

  July 3, 2012 
  October 5, 2012 
  December 28, 2012 
  April 5, 2013 

Per Share 
Dividend 

  $ 

  $ 

  $ 

  $ 

  $ 

  $ 

0.175 
0.175  
0.175  
0.175  
0.70 
0.175 
0.175  
0.175  
0.175  
0.70 
0.175 
0.175  
0.175  
0.175  
0.70 

Management believes that its cash, cash equivalents and marketable securities on hand at March 31, 2015, together with its 
cash flows from operations will be sufficient to meet its working capital and capital expenditure requirements as well as any 
dividends to be paid in the ordinary course of business for the next twelve months. Our Board of Directors will continue to 
evaluate the strategic use of our cash towards payment of dividends in light of both working capital and capital expenditure 
requirements.  

50 

 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
   
   
 
 
 
Contractual Obligations 

The following table summarizes our significant contractual obligations at March 31, 2015 and the effect that such obligations are 
expected to have on our liquidity and cash in future periods: 

For the year ended March 31, 

Contractual Obligations 

Operating lease obligations 
Contingent consideration and other acquisition related 
liabilities (excluding share-based payments) 

Total 

Total 

2017 
$  47,784  $  7,461  $ 7,602  $  7,641  $  4,628 $ 

2016 

2018 

2019 

2020 

2021 and 
beyond 
3,572  $  16,880  

1,400 

700 

700 

— 

— 

$  49,184  $  8,161  $ 8,302  $  7,641  $  4,628 $ 

— 

— 
3,572  $  16,880  

The deferred compensation liability as of March 31, 2015 was $5.8 million, which is not included in the table above as the timing 
of future benefit payments to employees is not readily determinable. 

The uncertain tax position liability as of March 31, 2015 was $3.8 million, which is not included in the table above as the timing of 
expected payments is not readily determinable. 

New Accounting Pronouncements 

Refer to Note 2, “Summary of Significant Accounting Policies,” of our notes to consolidated financial statements included 
elsewhere in this Report for a discussion of new accounting standards. 

ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISKS 

There is little to no market risk as we currently maintain our cash and investments in very liquid short term assets including tax 
exempt and taxable money market funds, certificates of deposit and short term municipal bonds with average maturities of 365 
days or less at the time of purchase. 

Although we have international operations, the impact of foreign currency fluctuations has not been material to our financial 
position or operating results. 

ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA 

See our consolidated financial statements identified in the Index to Financial Statements appearing under “Item 15. Exhibits and 
Financial Statement Schedules” of this Report. 

ITEM 9. CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE 

None. 

ITEM 9A. CONTROLS AND PROCEDURES 

Evaluation of Disclosure Controls and Procedures 
Our Chief Executive Officer and Interim Chief Financial Officer (our principal executive officer and principal financial officer, 
respectively) have evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 
15d-15(e) under the Security Exchange Act of 1934, as amended, the "Exchange Act") as of March 31, 2015, the end of the 
period covered by this Report (the “Evaluation Date”).  They have concluded that, as of the Evaluation Date, these disclosure 
controls and procedures were effective to ensure that material information relating to the Company and its consolidated 
subsidiaries would be made known to them by others within those entities and would be disclosed on a timely basis.  The Chief 
Executive Officer and Interim Chief Financial Officer have concluded that our disclosure controls and procedures are designed, 
and are effective, to give reasonable assurance that the information required to be disclosed by us in reports that we file under 
the Exchange Act is recorded, processed, summarized and reported within the time period specified in the rules and forms of the 
SEC.  They have also concluded that the our disclosure controls and procedures are effective to ensure that information required 
to be disclosed in the reports that are filed or submitted under the Exchange Act are accumulated and communicated to our 
management, including the Chief Executive Officer and Interim Chief Financial Officer, to allow timely decisions regarding 
required disclosure. 

51 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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. Internal control over financial reporting is a process designed by, or under the 
supervision and with the participation of our management, including our principal executive officer and principal financial officer, 
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. 

Our internal control over financial reporting is supported by written policies and procedures, that: 

(1) 

(2) 

(3) 

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 generally accepted accounting principles, and that receipts and expenditures of our company are 
being made only in accordance with authorizations of our management and 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. 

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 risks that controls may become inadequate 
because of changes in conditions or that the degree of compliance with the policies or procedures may deteriorate. 

Management of the Company has assessed the effectiveness of the Company’s internal control over financial reporting as of 
March 31, 2015 in making our assessment of internal control over financial reporting, management used the criteria set forth in 
Internal Control — Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway 
Commission. Based on our evaluation, our management concluded that our internal control over financial reporting was effective 
as of March 31, 2015. 

The effectiveness of the Company’s internal control over financial reporting as of March 31, 2015 has been audited by 
PricewaterhouseCoopers LLP, an independent registered public accounting firm, as stated in their report contained in Item 15 of 
Part IV of this Report, "Exhibits and Financial Statement Schedules." 

Changes in Internal Control over Financial Reporting 

During the quarter ended March 31, 2015, there were no changes in our “internal control over financial reporting” (as defined in 
Rule 13a-15(f) under the Exchange Act) that have materially affected, or are reasonably likely to materially affect, our internal 
control over financial reporting. 

Management, including our Chief Executive Officer and Interim Chief Financial Officer, has concluded that our disclosure 
controls and procedures and internal control over financial reporting are designed to provide reasonable assurance of achieving 
their objectives and are effective at that reasonable assurance level.  However, management can provide no assurance that our 
disclosure controls and procedures or our internal control over financial reporting can prevent all errors and all fraud under all 
circumstances.  A control system, no matter how well conceived and operated, can provide only reasonable, not absolute, 
assurance that the objectives of the control system are met.  Further, the design of a control system must reflect the fact that 
there are resource constraints, and the benefits of controls must be considered relative to their costs.  Because of the inherent 
limitations in all control systems, no evaluation of controls can provide absolute assurance that all control issues and instances 
of fraud, if any, within the Company have been or will be detected.  The design of any system of controls also is based in part 
upon certain assumptions about the likelihood of future events, and there can be no assurance that any design will succeed in 
achieving its stated goals under all potential future conditions; over time, controls may become inadequate because of changes 
in conditions, or the degree of compliance with policies or procedures may deteriorate.  Because of the inherent limitations in a 
cost-effective control system, misstatements due to error or fraud may occur and not be detected. 

ITEM 9B. OTHER INFORMATION 

None. 

52 

 
 
 
 
 
 
ITEM 10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE 

The information required by Item 10 is incorporated herein by reference from our definitive proxy statement for our 2015 Annual 
Shareholders’ Meeting to be filed with the SEC. 

PART III 

ITEM 11. EXECUTIVE COMPENSATION 

The information required by Item 11 is incorporated herein by reference from our definitive proxy statement for our 2015 Annual 
Shareholders’ Meeting to be filed with the SEC. 

ITEM 12.  SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED 
STOCKHOLDER MATTERS 

The information required by Item 12 is incorporated herein by reference from our definitive proxy statement for our 2015 Annual 
Shareholders’ Meeting to be filed with the SEC. 

ITEM 13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE 

The information required by Item 13 is incorporated herein by reference from our definitive proxy statement for our 2015 Annual 
Shareholders’ Meeting to be filed with the SEC. 

ITEM 14. PRINCIPAL ACCOUNTANT FEES AND SERVICES 

The information required by Item 14 is incorporated herein by reference from our definitive proxy statement for our 2015 Annual 
Shareholders’ Meeting to be filed with the SEC.  

53 

 
 
 
 
 
 
 
 
ITEM 15. EXHIBITS AND FINANCIAL STATEMENT SCHEDULES 

PART IV 

(1) Index to Financial Statements: 

Report of Independent Registered Public Accounting Firm 

Consolidated Balance Sheets as of March 31, 2015 and 2014 

Consolidated Statements of Comprehensive Income — Years Ended March 31, 2015, 2014 and 2013 

Consolidated Statements of Shareholders’ Equity — Years Ended March 31, 2015, 2014 and 2013 

Consolidated Statements of Cash Flows — Years Ended March 31, 2015, 2014 and 2013 

Notes to Consolidated Financial Statements 

(2) The following supplementary financial statement schedule of Quality Systems, Inc., required to be 
included in Item 15(a)(2) on Form 10-K is filed as part of this Report. 

Schedule II — Valuation and Qualifying Accounts 

Schedules other than that listed above have been omitted since they are either not required, not 
applicable, or because the information required is included in the Consolidated Financial Statements or 
the notes thereto. 

(3) The exhibits listed in the Index to Exhibits hereof are attached hereto or incorporated herein by 
reference and filed as a part of this Report. 

Index to Exhibits 

Page 

58 

59 

60 

61 

62 

64 

86 

87 

54 

 
 
 
 
 
 
 
 
INDEX TO EXHIBITS 

Exhibit 
Number 

2.1 

3.1 

3.2 

3.3 

3.4 

3.5 

3.6 

10.1* 

10.2* 

Exhibit Description 

Share Purchase Agreement by and among Quality Systems, 
Inc., each of the shareholders of Mirth Corporation identified 
on Annex A thereto, and Jon Teichrow dated as of 
September 9, 2013 

Restated Articles of Incorporation of Quality Systems, Inc. 
filed with the Secretary of State of California on 
September 8, 1989(Registration No. 333-00161) 

Certificate of Amendment to Articles of Incorporation of 
Quality Systems, Inc. filed with the Secretary of State of 
California effective March 4, 2005 

Certificate of Amendment to Articles of Incorporation of 
Quality Systems, Inc. filed with the Secretary of State of 
California effective October 6, 2005 

Certificate of Amendment to Articles of Incorporation of 
Quality Systems, Inc. filed with the Secretary of State of 
California effective March 3, 2006 

Amended and Restated Bylaws of Quality Systems, Inc., 
effective October 30, 2008 

Certificate of Amendment to Articles of Incorporation of 
Quality Systems, Inc. filed with the Secretary of State of 
California effective October 6, 2011 

Form of Non-Qualified Stock Option Agreement for 
Amended and Restated 1998 Stock Option Plan 

Form of Incentive Stock Option Agreement for Amended and 
Restated 1998 Stock Option Plan 

Incorporated by Reference 

Filed 
Herewith 

Form 

Exhibit 

Filing Date 

10-Q 

2.1 

October 31, 2013 

S-1 

3.1 

January 11, 1996 

10-K 

3.1.1 

June 14, 2005 

8-K 

3.01 

October 11, 2005 

8-K 

3.1 

March 6, 2006 

8-K 

3.1 

October 31, 2008 

8-K 

3.1 

October 6, 2011 

10-Q 

10.2 

10-Q 

10.1 

December 23, 
2004 

December 23, 
2004 

10.3* 

Amended and Restated 1998 Stock Option Plan 

10-K 

10.10.1 

June 14, 2005 

10.4* 

10.5* 

10.6* 

Second Amended and Restated 2005 Stock Option and 
Incentive Plan 

Form of Nonqualified Stock Option Agreement for 2005 
Stock Incentive Plan 

Form of Incentive Stock Option Agreement for 2005 Stock 
Incentive Plan 

10.7* 

Employment Agreement with Steven Plochocki 

10.8* 

10.9* 

2009 Quality Systems, Inc. Amended and Restated Deferred 
Compensation Plan. 

Form of Outside Directors Amended and Restated 
Restricted Stock Agreement 

10.10* 

Form of Outside Director's Restricted Stock Unit Agreement 

10.11* 

Employment Arrangement dated September 19, 2012 
between Quality Systems, Inc., and Daniel Morefield 

10.12* 

Form of Indemnification Agreement 

10.13* 

Form of Executive Officer Restricted Stock Agreement 

10.14*  Description of 2014 Director Compensation Program 

10.15 

Agreement by and among Quality Systems, Inc., the Clinton 
Group, Inc. and certain of its affiliates, dated as of July 17, 
2013 

DEF14A  Appendix I 

July 1, 2011 

8-K 

10.2 

June 5, 2007 

8-K 

8-K 

10.3 

June 5, 2007 

10.1 

August 12, 2008 

10-K 

10.8 

May 30, 2013 

8-K 

8-K 

8-K 

8-K 

8-K 

8-K 

10.2 

February 2, 2010 

10.1 

August 15, 2011 

10.1 

September 25, 
2012 

10.1 

January 28, 2013 

10.2 

10.3 

May 28, 2013 

May 28, 2013 

8-K 

10.1 

July 17, 2013 

10.16*  Description of 2015 Director Compensation Program 

8-K 

10.1 

May 29, 2014 

10.17* 

Form of Performance-Based Restricted Stock Unit 
Agreement. 

10-K 

10.17 

May 29, 2014 

55 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
21 

List of subsidiaries. 

23.1 

31.1 

31.2 

32.1 

Consent of Independent Registered Public Accounting Firm 
— PricewaterhouseCoopers LLP. 

Certification of Principal Executive Officer Required by 
Rule 13a-14(a) of the Securities Exchange Act of 1934, as 
amended, as Adopted Pursuant to Section 302 of the 
Sarbanes-Oxley Act of 2002. 

Certification of Principal Financial Officer Required by 
Rule 13a-14(a) of the Securities Exchange Act of 1934, as 
amended, as Adopted Pursuant to Section 302 of the 
Sarbanes-Oxley Act of 2002. 

Certification of Chief Executive Officer and Chief Financial 
Officer Pursuant to 18 U.S.C. Section 1350, as Adopted 
Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. 

X 

X 

X 

X 

X 

101.INS**  XBRL Instance 

101.SCH**  XBRL Taxonomy Extension Schema 

101.CAL**  XBRL Taxonomy Extension Calculation 

101.DEF**  XBRL Taxonomy Extension Definition 

101.LAB**  XBRL Taxonomy Extension Label 

101.PRE**  XBRL Taxonomy Extension Presentation 
____________________ 
* 

This exhibit is a management contract or a compensatory plan or arrangement. 

** 

XBRL information is furnished and not filed or a part of a registration statement or prospectus for purposes of section 11 
or 12 of the Securities and Exchange Act of 1933, as amended, is deemed not filed for purposes of section 18 of the 
Securities and Exchange Act of 1934, as amended, and otherwise is not subject to liability under these section. 

56 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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. 

SIGNATURES 

By: 

/s/ Steven T. Plochocki 

Steven T. Plochocki 

Chief Executive Officer (Principal Executive Officer) 

By: 

/s/ John K. Stumpf 

John K. Stumpf 

Interim Chief Financial Officer (Principal Accounting Officer) 

Date: May 22, 2015  

KNOW ALL PERSONS BY THESE PRESENTS, that each of the persons whose signature appears below hereby constitutes 

and appoints Steven T. Plochocki and John K. Stumpf, each of them acting individually, as his attorney-in-fact, each with the full 
power of substitution, for him in any and all capacities, to sign any and all amendments to this Annual Report on Form 10-K, and 
to file the same, with all exhibits thereto and other documents in connection therewith, with the Securities and Exchange 
Commission, granting unto said attorneys-in-fact, and each of them, full power and authority to do and perform each and every 
act and thing requisite and necessary to be done in and about the premises as fully to all intents and purposes as he might or 
could do in person, hereby ratifying and confirming our signatures as they may be signed by our said attorney-in-fact and any 
and all amendments to this Annual Report on Form 10-K. 

Pursuant to the requirement of the Securities Exchange Act of 1934, this Report has been signed by the following persons 

on our behalf in the capacities and on the dates indicated. 

Signature 

/s/ Sheldon Razin 

Sheldon Razin 

/s/ Steven T. Plochocki 

Steven T. Plochocki 

/s/ John K. Stumpf 

John K. Stumpf 

/s/ Craig Barbarosh 

Craig Barbarosh 

/s/ George Bristol 

George Bristol 

/s/ James Malone 

James Malone 

 /s/ Morris Panner 

Morris Panner 

/s/ Russell Pflueger 

Russell Pflueger 

/s/ Lance Rosenzweig 

Lance Rosenzweig 

/s/ Jeffrey H. Margolis 

Jeffrey H. Margolis 

  Title 

  Chairman of the Board and Director 

  Date 

  May 22, 2015 

  Chief Executive Officer (Principal Executive Officer) and Director 

  May 22, 2015 

  Interim Chief Financial Officer (Principal Accounting Officer) 

  May 22, 2015 

  Director 

  Director 

  Director 

  Director 

  Director 

  Director 

  Director 

57 

  May 22, 2015 

  May 22, 2015 

  May 22, 2015 

  May 22, 2015 

  May 22, 2015 

  May 22, 2015 

  May 22, 2015 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
To the Board of Directors and Shareholders of Quality Systems, Inc. 

Report of Independent Registered Public Accounting Firm 

In our opinion, the accompanying consolidated balance sheets and the related consolidated statements of comprehensive 
income, shareholders’ equity, and cash flows present fairly, in all material respects, the financial position of Quality Systems, Inc. 
and its subsidiaries at March 31, 2015 and March 31, 2014, and the results of their operations and their cash flows for each of 
the three years in the period ended March 31, 2015 in conformity with accounting principles generally accepted in the United 
States of America.  In addition, in our opinion, the financial statement schedule listed in the index appearing under Item 15(a)(2), 
presents fairly, in all material respects, the information set forth therein when read in conjunction with the related consolidated 
financial statements.  Also in our opinion, the Company maintained, in all material respects, effective internal control over 
financial reporting as of March 31, 2015, based on criteria established in Internal Control - Integrated Framework (2013) issued 
by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). The Company's management is 
responsible for these financial statements and financial statement schedule, for maintaining effective internal control over 
financial reporting and for its assessment of the effectiveness of internal control over financial reporting, included in 
Management's Report on Internal Control over Financial Reporting appearing under Item 9A.  Our responsibility is to express 
opinions on these financial statements, on the financial statement schedule, and on the Company's internal control over financial 
reporting based on our integrated 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 audits to obtain reasonable 
assurance about whether the financial statements are free of material misstatement and whether effective internal control over 
financial reporting was maintained in all material respects.  Our audits of the financial statements included 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, and evaluating the overall financial statement presentation.  Our audit of 
internal control over financial reporting 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 audits also included performing such other procedures as we considered necessary in the 
circumstances. We believe that our audits provide a reasonable basis for our opinions. 

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 
(i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions 
of the assets of the company; (ii) 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 (iii) 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. 

/s/ PricewaterhouseCoopers LLP 

Orange County, California 
May 22, 2015  

58 

 
 
 
 
 
 
 
 
QUALITY SYSTEMS, INC. 
CONSOLIDATED BALANCE SHEETS 
(In thousands, except per share data) 

ASSETS 
Current assets: 

Cash and cash equivalents 
Restricted cash and cash equivalents (Note 2) 
Marketable securities 
Accounts receivable, net (Note 9) 
Inventories 
Income taxes receivable 
Deferred income taxes, net 
Other current assets 

Total current assets 

Equipment and improvements, net 
Capitalized software costs, net 
Intangibles, net 
Goodwill 
Other assets 

Total assets 

LIABILITIES AND SHAREHOLDERS’ EQUITY 
Current liabilities: 

Accounts payable 
Deferred revenue 
Accrued compensation and related benefits 
Income taxes payable 
Dividends payable 
Other current liabilities 

Total current liabilities 

Deferred revenue, net of current 
Deferred compensation 
Other noncurrent liabilities 

Total liabilities 

Commitments and contingencies (Note 13) 
Shareholders’ equity: 

Common stock 

$0.01 par value; authorized 100,000 shares; issued and outstanding 60,303 and 60,206 
shares at March 31, 2015 and 2014, respectively 

Additional paid-in capital 
Accumulated other comprehensive loss 
Retained earnings 

Total shareholders’ equity 
Total liabilities and shareholders’ equity 

March 31, 
 2015 

March 31, 
 2014 

118,993    $
2,419  
11,592  
107,669  
622  
3,147  
24,080  
11,535  
280,057  
20,807  
40,397  
27,689  
73,571  
18,000  
460,521    $

10,018    $
66,343  
24,051  
10,048  
10,700  
33,924  
155,084  
1,349  
5,750  
14,798  
176,981  

103,145  
4,351 
10,656 
113,268 
834 
8,366 
21,531 
11,135 
273,286 
22,801 
39,152 
33,016 
72,804 
10,292 
451,351  

7,888  
71,077 
15,953 
— 
10,686 
21,369 
126,973 
2,187 
4,809 
22,292 
156,261 

603
198,650  
(192)  
84,479  
283,540  
460,521    $

602
194,739 
(182) 
99,931 
295,090 
451,351  

$

$

$

$

The accompanying notes are an integral part of these consolidated financial statements. 

59 

 
 
 
 
   
 
   
 
   
 
   
 
  
 
   
 
   
 
 
 
 
QUALITY SYSTEMS, INC. 
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME 
(In thousands, except per share data) 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

Revenues: 

Software and hardware 

Implementation and training services 

System sales 

Maintenance 

Electronic data interchange services 

Revenue cycle management and related services 

Other services 

Maintenance, EDI, RCM and other services 

Total revenues 

Cost of revenue: 

Software and hardware 

Implementation and training services 

Total cost of system sales 

Maintenance 

Electronic data interchange services 

Revenue cycle management and related services 

Other services 

Total cost of maintenance, EDI, RCM and other services 

Total cost of revenue 

Gross profit 

Operating expenses: 

Selling, general and administrative 

Research and development costs 

Amortization of acquired intangible assets 

Impairment of goodwill and other assets 

Total operating expenses 

Income from operations 
Interest income (expense), net 

Other expense, net 

Income before provision for income taxes 
Provision for income taxes 

Net income 

Other comprehensive income (loss): 

Foreign currency translation (net of tax) 

Unrealized gain (loss) on marketable securities (net of tax) 

Comprehensive income 

Net income per share: 

Basic 

Diluted 

Weighted-average shares outstanding: 

Basic 

Diluted 

Dividends declared per common share 

$

$

$

$

$

$

61,373    $
23,648  
85,021  
169,219  
76,358  
74,237  
85,390  
405,204  
490,225  

24,693  
23,902  
48,595  
28,866  
48,244  
54,406  
43,053  
174,569  
223,164  
267,061  

158,172  
69,240  
3,693  
—  
231,105  
35,956  
(230)  
(62)  
35,664  
8,332  
27,332    $

(117)  
107   
27,322    $

0.45    $
0.45    $

60,259  
60,849  

0.70    $

60,834    $
25,948  
86,782  
160,060  
67,295  
62,976  
67,554  
357,885  
444,667  

44,226  
29,681  
73,907  
22,590  
42,567  
46,203  
34,896  
146,256  
220,163  
224,504  

149,214  
41,524  
4,805  
5,873  
201,416  
23,088  
269  
(356)  
23,001  
7,321  
15,680    $

(107)  
(64)  
15,509    $

0.26    $
0.26    $

59,918  
60,134  

0.70    $

88,572  
35,008 
123,580 
156,771 
59,709 
59,219 
60,950 
336,649 
460,229 

21,750 
30,896 
52,646 
20,316 
38,350 
43,324 
35,016 
137,006 
189,652 
270,577 

148,353 
30,865 
4,859 
17,400 
201,477 
69,100 
(107) 

(79) 
68,914 
26,190 
42,724  

34 
— 
42,758  

0.72  
0.72  

59,392 
59,462 
0.70  

The accompanying notes are an integral part of these consolidated financial statements. 

60 

 
 
 
 
 
 
   
   
 
   
   
 
   
   
 
 
   
   
 
   
   
 
   
   
 
   
   
 
 
 
QUALITY SYSTEMS, INC. 
CONSOLIDATED STATEMENTS OF SHAREHOLDERS’ EQUITY 
(In thousands) 

Balance, March 31, 2012 
Common stock issued under stock plans, net of 
shares withheld for employee taxes 
Common stock issued for earnout settlement 
Common stock issued for acquisitions 

Tax deficiency resulting from exercise of stock 
options 
Stock-based compensation 
Dividends declared 
Components of other comprehensive income: 

Translation adjustments 

Net income 

Balance, March 31, 2013 
Common stock issued under stock plans, net of 
shares withheld for employee taxes 
Common stock issued for earnout settlement 
Common stock issued for acquisitions 

Tax deficiency resulting from exercise of stock 
options 
Stock-based compensation 
Dividends declared 
Components of other comprehensive loss: 

Unrealized loss on marketable securities 
Translation adjustments 

Net income 

Balance, March 31, 2014 
Common stock issued under stock plans, net of 
shares withheld for employee taxes 
Common stock issued for earnout settlement 

Tax deficiency resulting from exercise of stock 
options 
Stock-based compensation 
Dividends declared 
Components of other comprehensive gain (loss): 
Unrealized gain on marketable securities 
Translation adjustments 

Net income 

Balance, March 31, 2015 

Common Stock 

  Additional 
 Paid-in 
Capital 

Retained 
 Earnings 

Shares    Amount   
59,180    $  592    $  169,033    $125,597    $ 

Accumulated 
Other 
Comprehensive 
Loss 

Total 
Shareholders’ 
Equity 
295,177  

(45)   $

83 
165   
115   

— 
—   
—   

1 
1   
1   

— 
—   
—   

947 
2,999   
4,594   

(157 )  
2,327   
—   

— 
—   
—   

— 
—   
(41,599 )  

—   
—   
59,543   

—   
—   
595   

—   
—   

—   
42,724   
179,743    126,722   

167 
62   
434   

— 
—   
—   

2 
1   
4   

— 
—   
—   

2,199 
1,375   
9,269   

(337 )  
2,490   
—   

— 
—   
—   

— 
—   
(42,471 )  

—   
—   
—   
60,206   

—   
—   
—   
602   

—   
—   
—   
194,739   

—   
—   
15,680   
99,931   

79 
18   

— 
—   
—   

—   
—   
—   

1 
—   

— 
—   
—   

—   
—   
—   

383 
284   

— 
—   

(228 )  
3,472   
—   

— 
—   
(42,784 )  

—   
—   
—   

—   
—   
27,332   

60,303    $  603    $  198,650    $ 84,479    $ 

— 
—   
—   

— 
—   
—   

34   
—   
(11 )  

— 
—   
—   

— 
—   
—   

(64 )  
(107 )  
—   
(182 )  

— 
—   

— 
—   
—   

107   
(117 )  
—   
(192)   $

948
3,000 
4,595 

(157) 
2,327 
(41,599) 

34 
42,724 
307,049 

2,201
1,376 
9,273 

(337) 
2,490 
(42,471) 

(64) 
(107) 
15,680 
295,090 

384
284 

(228) 
3,472 
(42,784) 

107 
(117) 
27,332 
283,540  

The accompanying notes are an integral part of these consolidated financial statements. 

61 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
 
 
QUALITY SYSTEMS, INC. 
CONSOLIDATED STATEMENTS OF CASH FLOWS 
(In thousands) 

Fiscal Year Ended March 31, 
2014 

2015 

2013 

Cash flows from operating activities: 

Net income 

Adjustments to reconcile net income to net cash provided by operating 
activities: 

$ 

27,332   $ 

15,680   $ 

42,724 

Depreciation 
Amortization of capitalized software costs 
Amortization of other intangibles 
Loss on disposal of equipment and improvements 
Provision for bad debts 
Provision for inventory obsolescence 
Share-based compensation 
Deferred income taxes 
Excess tax benefit from share-based compensation 
Change in fair value of contingent consideration 
Impairment of goodwill and other assets 

Changes in assets and liabilities, net of amounts acquired: 

Accounts receivable 
Inventories 
Other current assets 
Other assets 
Accounts payable 
Deferred revenue 
Accrued compensation and related benefits 
Income taxes receivable and payable 
Other current liabilities 
Deferred compensation 
Other noncurrent liabilities 

Net cash provided by operating activities 
Cash flows from investing activities: 

Additions to capitalized software costs 
Additions to equipment and improvements 
Proceeds from sales and maturities of marketable securities 
Purchases of marketable securities 
Purchase of Poseidon 
Purchase of Matrix 
Purchase of Mirth 
Purchase of Gennius 

Net cash used in investing activities 
Cash flows from financing activities: 

Excess tax benefit from share-based compensation 
Proceeds from issuance of shares under employee plans 
Dividends paid 
Payment of contingent consideration related to acquisitions 

Net cash used in financing activities 
Net increase (decrease) in cash and cash equivalents 
Cash and cash equivalents at beginning of period 

Cash and cash equivalents at end of period 

$ 

62 

9,323  
12,817  
7,127  
51  
855  
25  
3,472  
(12,061)  
—  
1,937  
—  

4,744  
187  
35  
(1,052)  
1,281  
(5,610)  
8,098  
18,178  
5,081  
941  
(3)  
82,758  

(14,601)  
(6,531)  
11,077  
(12,123)  
—  
—  
—  
(2,345)  
(24,523)  

8,069  
12,338  
8,330  
192  
1,467  
—  
2,490  
(3,984)  
(183)  
101  
25,971  

37,461  
(81)  
3,985  
(1,662)  
(4,170)  
1,036  
4,038  
(9,227)  
211  
1,000  
989  
104,051  

(20,784)  
(7,934)  
15,475  
(15,386)  
—  
—  
(35,033)  
—  
(63,662)  

—  
383  
(42,770)  
—  
(42,387)  
15,848  
103,145  
118,993   $ 

183  
2,200  
(42,203)  
(3,423)  
(43,243)  
(2,854)  
105,999  
103,145   $ 

6,928 
9,668 
7,559 
— 
6,885 
193 
2,327 
(9,565) 
157 
1,272 
17,400 

(7,988) 
339 
(4,049) 
(2,777) 
6,223 
(17,993) 
45 
3,710 
9,079 
312 
(4,384) 
68,065 

(29,455) 
(9,969) 
4,960 
(12,084) 
(2,033) 
(5,073) 
— 
— 
(53,654) 

84 
948 
(41,535) 
(2,353) 

(42,856) 
(28,445) 
134,444 
105,999 

 
 
 
 
 
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
QUALITY SYSTEMS, INC. 
CONSOLIDATED STATEMENTS OF CASH FLOWS — (Continued) 
(In thousands) 

Supplemental disclosures of cash flow information: 

Cash paid during the period for income taxes, net of refunds 

Non-cash investing and financing activities: 

Tenant improvement allowance received from landlord 

Common stock issued at fair value for ViaTrack earnout settlement 
Dividends declared but not paid 
Unpaid additions to equipment and improvements 
Effective March 11, 2015, the Company acquired Gennius in a transaction 
summarized as follows: 

Fair value of assets acquired 
Cash paid 

Liabilities assumed 

Effective September 9, 2013, the Company acquired Mirth in a transaction 
summarized as follows: 

Fair value of assets acquired 
Cash paid 
Common stock issued at fair value 
Fair value of contingent consideration 

Liabilities assumed 

Effective May 1, 2012, the Company acquired Poseidon in a transaction 
summarized as follows: 

Fair value of assets acquired 
Cash paid 
Purchase price holdback 

Liabilities assumed 

Effective April 16, 2012, the Company acquired Matrix in a transaction 
summarized as follows: 

Fair value of assets acquired 
Cash paid 
Common stock issued at fair value 
Purchase price holdback 
Fair value of contingent consideration 
Fair value of non-compete agreement (liability) 

Liabilities assumed 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

2,523    $ 

20,443   $

31,656  

—    $ 
—    $ 
10,700    $ 
849    $ 

—   $
—   $
10,686   $
419   $

965  
3,000  
10,418  
—  

2,571    $ 
(2,345 )  
226    $ 

—   $
—    
—   $

—    $ 
—    
—    
—    
—    $ 

—    $ 
—   
—   
—    $ 

—    $ 
—   
—   
—   
—   
—   
—    $ 

62,787   $
(35,033 )  
(7,882 )  
(13,307 )  
6,565   $

—   $
—   
—   
—   $

—   $
—   
—   
—   
—   
—   
—   $

—  
— 
—  

—  
— 
— 
— 
—  

2,551  
(2,033) 
(500) 
18  

14,587  
(5,073) 
(3,953) 
(853) 
(2,862) 
(1,100) 
746  

$ 

$ 

$ 
$ 
$ 

$ 

$ 

$ 

$ 

$ 

$ 

$ 

$ 

The accompanying notes are an integral part of these consolidated financial statements. 

63 

 
 
 
 
 
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
QUALITY SYSTEMS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS 
MARCH 31, 2015 and 2014 
(In thousands, except shares and per share data) 

1. Organization of Business 

Description of Business 

Quality Systems, Inc. ("QSI") and its wholly-owned subsidiaries operate as four business divisions (each, a "Division") which are 
comprised of: (i) the QSI Dental Division, (ii) the NextGen Division, (iii) the Hospital Solutions Division and (iv) the RCM Services 
Division. QSI also includes a captive entity in India called Quality Systems India Healthcare Private Limited (“QSIH”) (collectively, 
with QSI and the four Divisions, the "Company"). The Company primarily derives revenue by developing and marketing 
healthcare information systems that automate certain aspects of medical and dental practices, networks of practices such as 
physician hospital organizations (“PHOs”) and management service organizations (“MSOs”), ambulatory care centers, 
community health centers and medical and dental schools along with comprehensive systems implementation, maintenance and 
support and add-on complementary services such as revenue cycle management (“RCM”) and electronic data interchange 
(“EDI”). The Company's systems and services provide its customers with the ability to redesign patient care and other workflow 
processes while improving productivity through the facilitation of managed access to patient information. Utilizing its proprietary 
software in combination with third party hardware and software solutions, the Company's products enable the integration of a 
variety of administrative and clinical information operations.  The Company's scalable interoperability and population health 
offerings help to improve care collaboration, quality and safety.  Enabled by the Company's interoperability solutions, data-driven 
patient population healthcare management decisions can assist in creating more desirable operational, clinical, and financial 
outcomes that substantiate the value of patient-centered and accountable care models. 

The Company was founded with an early focus on providing information systems to dental group practices. This focus area 
would later become the QSI Dental Division. In the mid-1980’s, the Company capitalized on the increasing focus on medical cost 
containment and further expanded its information processing systems to serve the ambulatory market. In the mid-1990’s, the 
Company made two acquisitions that accelerated its penetration of the ambulatory market and formed the basis for the NextGen 
Division. In the last few years, the Company acquired several companies, including Sphere Health Systems, Inc. ("Sphere"), 
Opus Healthcare Solutions, LLC ("Opus"), IntraNexus, Inc. ("IntraNexus"), CQI Solutions, Inc. ("CQI"), ViaTrack Systems, LLC 
("ViaTrack"), Matrix Management Solutions, LLC (“Matrix”), and The Poseidon Group ("Poseidon"), as part of its strategy to 
enhance its EDI and RCM services capabilities as well as expand into the small and specialty hospital market.  More recently the 
Company acquired Mirth Corporation ("Mirth") and Gennius, Inc. ("Gennius"), both of which operate under the NextGen Division. 
Mirth enhances the Company's current enterprise interoperability initiatives and broadens its accountable and collaborative care, 
population health, disease management and clinical data exchange offerings. Gennius is expected to enhance the Company's 
current healthcare data enterprise analytics competencies while broadening business intelligence capabilities for addressing 
new value-based care requirements. Today, the Company serves the dental, ambulatory, hospital and RCM services markets 
through its four business Divisions. 

The QSI Dental Division, co-located with the Corporate Headquarters in Irvine, California, currently focuses on developing, 
marketing and supporting software suites sold to dental organizations located throughout the US. 

The NextGen Division, with headquarters in Horsham, Pennsylvania and significant locations in Atlanta, Georgia and Costa 
Mesa, California, provides integrated clinical, financial and connectivity solutions for ambulatory and dental provider 
organizations. 

The Hospital Solutions Division, with its primary location in Austin, Texas, provides integrated clinical, financial and connectivity 
solutions for rural and community hospitals. 

The RCM Services Division, with locations in St. Louis, Missouri, North Canton, Ohio, South Jordan, Utah and Hunt Valley, 
Maryland, focuses primarily on providing physician practices with RCM services, primarily billing and collection services for 
medical practices. This Division combines a web-delivered Software as a Service ("SaaS") model and the Company's practice 
management software platform to execute its service offerings. 

QSIH, located in Bangalore, India, functions as the Company's India-based captive entity to offshore technology application 
development and business processing services. 

A growing number of customers are simultaneously utilizing software or services from more than one of the Company's four 
Divisions. In an effort to further enhance the Company's ability to cross sell products and services between Divisions, the 
Company in the process of further integrating its ambulatory and hospital products to provide a more robust and comprehensive 
platform to offer customers.  To achieve greater efficiency and integration within the Company's operations, the divisional sales, 
marketing, information services, and software development responsibilities have been consolidated into single company-wide 
roles.  The Divisions also share the resources of a “corporate office,” which includes a variety of accounting and other 
administrative functions. The Company continues to evaluate its organizational structure with the objective of achieving greater 
synergies and further integration of its products and services, including software implementation and customer support functions. 

64 

 
 
 
 
2. Summary of Significant Accounting Policies 

Principles of Consolidation. The consolidated financial statements include the accounts of Quality Systems, Inc. and its 
wholly-owned subsidiaries, which consists of NextGen Healthcare Information Systems, LLC (“NextGen”), NextGen RCM 
Services, LLC, QSI Management, LLC, Quality Systems India Healthcare Private Limited (“QSIH”), ViaTrack Systems, LLC 
(“ViaTrack”), Matrix Management Solutions, LLC ("Matrix"), Mirth LLC and Mirth Limited ("Mirth"), and Gennius, Inc. ("Gennius") 
(collectively, the “Company”). Gennius is included in the consolidated financial statements from the date of acquisition (March 11, 
2015). All intercompany accounts and transactions have been eliminated. 

Business Segments. The Company has prepared operating segment information based on the manner in which management 
disaggregates the Company’s operations for making internal operating decisions. See Note 14. 

Basis of Presentation. The accompanying consolidated financial statements have been prepared in accordance with 
accounting principles generally accepted in the United States of America (“GAAP”). 

References to amounts in the consolidated financial statement sections are in thousands, except shares and per share data, 
unless otherwise specified. 

Revision. The accompanying consolidated statements of cash flows for the years ended March 31, 2014 and 2013 have been 
retrospectively revised to reflect proceeds from sales and maturities of marketable securities and purchases of marketable 
securities as investing activities rather than operating activities, which resulted in a decrease of $89 in cash provided by 
operating activities for the year ended March 31, 2014 and a corresponding decrease in cash used in investing activities and an 
increase of $24 in cash provided by operating activities for the year ended March 31, 2013 and a corresponding increase in cash 
used in investing activities. The Company has evaluated the impact of the revision and determined that it did not have a material 
impact on any of its prior period annual and interim consolidated financial statements. 

The accompanying consolidated balance sheet and notes to the consolidated financial statements as of and for the year ended 
March 31, 2014 have been retrospectively revised to correct the immaterial misclassification of certain noncurrent deferred 
income taxes, previously reported within other assets, as current deferred income taxes, and other noncurrent liabilities, which 
resulted in a $3,206 increase in total assets with a corresponding $3,206 increase to total liabilities.  In addition, the Company 
has retrospectively revised the accompanying consolidated balance sheet, consolidated statement of cash flows, and notes to 
the consolidated financial statements as of and for the year ended March 31, 2014 for certain immaterial misclassifications 
affecting accounts receivable and other current liabilities.  As a result, total assets and total liabilities increased by $3,087 on the 
consolidated balance sheet as of March 31, 2014. The revision had no net impact on cash provided by operating activities on the 
consolidated statement of cash flows for the year ended March 31, 2014.  The Company has evaluated the impact of the 
revision and determined that it did not have a material impact on any of its prior period annual and interim consolidated financial 
statements. 

Revenue Recognition. The Company generates revenue from the sale of licensing rights to its software products directly to 
end-users and value-added resellers. The Company also generates revenue from sales of hardware and third party software, 
implementation and training, electronic data interchange (“EDI”), revenue cycle management ("RCM"), maintenance, and other 
services, including subscriptions, consulting, and hosting services, performed for customers who license its products. 

A typical system contract contains multiple elements of the above items. Revenue earned on software arrangements involving 
multiple elements is allocated to each element based on the relative fair values of those elements. The fair value of an element 
is based on vendor-specific objective evidence (“VSOE”). The Company limits its assessment of VSOE for each element to the 
price charged when the same element is sold separately. VSOE calculations are updated and reviewed quarterly or annually 
depending on the nature of the product or service. The Company generally establishes VSOE for the related undelivered 
elements based on the bell-shaped curve method. VSOE is established on maintenance for the Company's largest customers 
based on stated renewal rates only if the rate is determined to be substantive and falls within the Company's customary pricing 
practices. 

When evidence of fair value exists for the delivered and undelivered elements of a transaction, then discounts for individual 
elements are aggregated and the total discount is allocated to the individual elements in proportion to the elements' fair value 
relative to the total contract fair value. 

When evidence of fair value exists for the undelivered elements only, the residual method is used. Under the residual method, 
the Company defers revenue related to the undelivered elements in a system sale based on VSOE of fair value of each of the 
undelivered elements and allocates the remainder of the contract price net of all discounts to revenue recognized from the 
delivered elements. If VSOE of fair value of any undelivered element does not exist, all revenue is deferred until VSOE of fair 
value of the undelivered element is established or the element has been delivered. 

Provided the fees are fixed or determinable and collection is considered probable, revenue from licensing rights and sales of 
hardware and third party software is generally recognized upon physical or electronic shipment and transfer of title. In certain 
transactions where collection risk is high, the revenue is deferred until collection occurs. If the fee is not fixed or determinable, 
then the revenue recognized in each period (subject to application of other revenue recognition criteria) will be the lesser of the 
aggregate amounts due and payable or the amount of the arrangement fee that would have been recognized if the fees were 
being recognized using the residual method. Fees which are considered fixed or determinable at the inception of the Company's 
arrangements must be negotiated at the outset of an arrangement and generally be based on the specific volume of products to 

65 

 
be delivered without being subject to change based on variable pricing mechanisms such as the number of units copied or 
distributed or the expected number of users. 

The Company ensures that the following criteria have been met prior to recognition of revenue: 

(cid:2)(cid:3) 

(cid:2)(cid:3) 

(cid:2)(cid:3) 

(cid:2)(cid:3) 

(cid:2)(cid:3) 

(cid:2)(cid:3) 

the price is fixed or determinable; 

the customer is obligated to pay and there are no contingencies surrounding the obligation or the payment; 

the customer's obligation would not change in the event of theft or damage to the product;  

the customer has economic substance;  

the amount of returns can be reasonably estimated; and  

the Company does not have significant obligations for future performance in order to bring about resale of the product 
by the customer.  

The Company has historically offered short-term rights of return in certain sales arrangements. If the Company is able to 
estimate returns for these types of arrangements, revenue is recognized, net of an allowance for returns, and these 
arrangements are recorded in the consolidated financial statements. If the Company is unable to estimate returns for these types 
of arrangements, revenue is not recognized until the rights of return expire, provided also, that all other criteria for revenue 
recognition have been met. 

Revenue related to sales arrangements that include hosting or the right to use software stored on the Company's hardware is 
recognized in accordance to the same revenue recognition criteria discussed above only if the customer has the contractual right 
to take possession of the software without incurring a significant penalty and it is feasible for the customer to either host the 
software themselves or through another third party. Otherwise, the arrangement is accounted for as a service contract in which 
the entire arrangement is deferred and recognized over the period that the hosting services are being performed. 

From time to time, the Company offers future purchase discounts on its products and services as part of its sales arrangements. 
Such discounts that are incremental to the range of discounts reflected in the pricing of the other elements of the arrangement, 
that are incremental to the range of discounts typically given in comparable transactions, and that are significant, are treated as 
an additional element of the contract to be deferred. Amounts deferred related to future purchase options are not recognized 
until either the customer exercises the discount offer or the offer expires. 

Revenue from services are recognized as the corresponding services are performed. Maintenance revenue is recognized ratably 
over the contractual maintenance period. Revenue from EDI and other transaction processing services are recognized at the 
time services are provided and billed to customers.  RCM service revenue is derived from services fees, which include amounts 
charged for ongoing billing, collections, and other related services, and are generally billed to the customer as a percentage of 
total customer collections. The Company does not recognize revenue for services fees until these collections are made by the 
customer as the services fees are not fixed or determinable until such time. 

Revenue is divided into two categories, “system sales” and “maintenance, EDI, RCM and other services.” Revenue in the 
system sales category includes software license fees, third party hardware and software and implementation and training 
services related to the purchase of the Company's software systems. Revenue in the maintenance, EDI, RCM and other 
services category includes maintenance, EDI, RCM services, consulting services, annual third party license fees, subscriptions, 
hosting services, SaaS fees and other services revenue. 

Cash and Cash Equivalents. Cash and cash equivalents generally consist of cash, money market funds and short-term U.S. 
Treasury securities with maturities of 90 days or less at the time of purchase. The Company had cash deposits at U.S. banks 
and financial institutions at March 31, 2015 of which $117,909 was in excess of the Federal Deposit Insurance Corporation 
insurance limit of $250 per owner. The Company is exposed to credit loss for amounts in excess of insured limits in the event of 
nonperformance by the institutions; however, the Company does not anticipate nonperformance by these institutions. 

The money market fund in which the Company holds a portion of its cash invests in only investment grade money market 
instruments from a variety of industries, and therefore bears relatively low market risk. 

Restricted Cash and Cash Equivalents. Restricted cash and cash equivalents consist of cash which is being held by the 
Company acting as an agent for the disbursement of certain state social services programs. The Company records an offsetting 
“Care Services liability” (see also Note 9) when it initially receives such cash from the government social service programs and 
relieves both restricted cash and cash equivalents and the Care Services liability when amounts are disbursed. The Company 
earns an administrative fee which is based on a percentage of funds disbursed on behalf of certain government social service 
programs. 

Marketable Securities. Marketable securities are classified as available-for-sale and are recorded at fair value, based on 
quoted market rates when observable or valuation analysis when appropriate. Unrealized gains and losses, are included in 
shareholders’ equity. Realized gains and losses on investments are included in other income (expense). 

66 

 
 
 
Accounts Receivable Reserves. The Company maintains reserves for potential sales returns and other uncollectible accounts 
receivable.  In aggregate, such reserves reduce the Company's gross accounts receivable to its estimated net realizable value. 

Sales return reserves, which include reserves for returns and other credits, are established based upon the rate of historical 
returns by revenue type in relation to the corresponding gross revenues. Allowances for doubtful accounts and other 
uncollectible accounts receivable related to estimated losses resulting from customers’ inability to make required payments are 
established based on our historical experience of bad debt expense and the aging of accounts receivable balances, net of 
deferred revenue and specifically reserved accounts. Specific reserves are based on an estimate of the probability of collection 
for certain troubled accounts.  Accounts are written off as uncollectible only after the Company has expended extensive 
collection efforts. 

Inventories. Inventories consist of hardware for specific customer orders and spare parts and are valued at lower of cost (first-
in, first-out) or market. The Company provides a reserve to reduce inventory to its net realizable value. 

Equipment and Improvements. Equipment and improvements are stated at cost less accumulated depreciation and 
amortization. Repair and maintenance costs that do not improve service potential or extend economic life are expensed as 
incurred. Depreciation and amortization of equipment and improvements are recorded over the estimated useful lives of the 
assets, or the related lease terms if shorter, by the straight-line method. Useful lives generally have the following ranges: 

(cid:2)(cid:3)  Computer equipment 

(cid:2)(cid:3)  Furniture and fixtures 

3-5 years 

3-7 years 

(cid:2)(cid:3)  Leasehold improvements 

lesser of lease term or estimated useful life of asset 

Costs incurred to develop internal-use software during the application development stage are capitalized, stated at cost, and 
amortized using the straight-line method over the estimated useful lives of the assets, which is typically three to seven years. 
Application development stage costs generally include costs associated with internal-use software configuration, coding, 
installation and testing. Costs of significant upgrades and enhancements that result in additional functionality are also 
capitalized, whereas costs incurred for maintenance and minor upgrades and enhancements are expensed as incurred. 

Software Development Costs. Development costs, consisting primarily of employee salaries and benefits, incurred in the 
research and development of new software products and enhancements to existing software products for external use are 
expensed as incurred until technological feasibility has been established. After technological feasibility is established, any 
additional external software development costs are capitalized.  Amortization of capitalized software is recorded using the 
greater of the ratio of current revenues to the total of current and expected revenues of the related product or the straight-line 
method over the estimated economic life of the related product, which is typically three years. The Company provides support 
services on the current and prior two versions of its software. The Company performs ongoing reviews of the estimated 
economic life and the recoverability of such capitalized software costs. If a determination is made that capitalized amounts are 
not recoverable based on the estimated cash flows to be generated from the applicable software, any remaining capitalized 
amounts are written off.  In addition to the recoverability assessment, the Company routinely reviews the remaining estimated 
lives of its capitalized software costs. 

Business Combinations. In accordance with the accounting for business combinations, the Company allocates the purchase 
price of acquired businesses to the tangible and intangible assets acquired and liabilities assumed based on estimated fair 
values. The purchase price allocation methodology contains uncertainties because it requires the Company to make 
assumptions and to apply judgment to estimate the fair value of acquired assets and liabilities, including, but not limited to, 
intangible assets, goodwill, and contingent consideration liabilities. The Company estimates the fair value of assets and liabilities 
based upon quoted market prices, the carrying value of the acquired assets and widely accepted valuation techniques, including 
discounted cash flows and market multiple analyses depending on the nature of the assets being sold. The Company estimates 
the fair value of the contingent consideration liabilities based on the probability of achieving certain business milestones and/or 
management's forecast of expected results. Unanticipated events or circumstances may occur which could affect the accuracy 
of our fair value estimates, including assumptions regarding industry economic factors and business strategies.  Any 
adjustments to fair value subsequent to the measurement period are reflected in the consolidated statements of comprehensive 
income. 

Goodwill. Goodwill acquired in a business combination is measured as the excess of the purchase price, or consideration 
transferred, over the net acquisition date fair values of the assets acquired and the liabilities assumed. Goodwill is not amortized 
as it has been determined to have an indefinite useful life.  The Company tests goodwill for impairment annually during its first 
fiscal quarter, referred to as the annual test date, and determined that there was no impairment to its goodwill as of June 30, 
2014. The Company will also test for impairment between annual test dates if an event occurs or circumstances change that 
would indicate the carrying amount may be impaired. Impairment testing for goodwill is performed at a reporting-unit level, which 
is defined as an operating segment or one level below an operating segment (referred to as a component). A component of an 
operating segment is a reporting unit if the component constitutes a business for which discrete financial information is available 
and segment management regularly reviews the operating results of that component. An impairment loss would generally be 
recognized when the carrying amount of the reporting unit's net assets exceeds the estimated fair value of the reporting unit. 

During the year ended March 31, 2015, the Company has not identified any events or circumstances that would require an 
interim goodwill impairment test. See Note 6. 

67 

 
 
 
 
 
 
Intangible Assets. Intangible assets consist of customer relationships, trade names and contracts and certain software 
technology. These intangible assets are recorded at fair value and are stated net of accumulated amortization. The Company 
currently amortizes the intangible assets over periods ranging from six months to ten years using a method that reflects the 
pattern in which the economic benefits of the intangible asset are consumed. The Company assesses the recoverability of 
intangible assets at least annually or whenever adverse events or changes in circumstances indicate that impairment may have 
occurred. If the future undiscounted cash flows expected to result from the use of the related assets are less than the carrying 
value of such assets, impairment has been incurred and a loss is recognized to reduce the carrying value of the intangible 
assets to fair value, which is determined by discounting estimated future cash flows. In addition to the impairment assessment, 
the Company routinely reviews the remaining estimated lives of its intangible assets. 

The Company has determined that there was no impairment to its intangible assets during the year ended March 31, 2015.  

Long-Lived Assets. The Company assesses the recoverability of long-lived assets at least annually or whenever adverse 
events or changes in circumstances indicate that impairment may have occurred. If the future undiscounted cash flows expected 
to result from the use of the related assets are less than the carrying value of such assets, impairment has been incurred and a 
loss is recognized to reduce the carrying value of the long-lived assets to fair value, which is determined by discounting 
estimated future cash flows. In addition to the impairment assessment, the Company routinely reviews the remaining estimated 
lives of its long-lived assets. 

The Company has determined that there was no impairment to its long-lived assets during the year ended March 31, 2015.  

Income Taxes. Income taxes are provided based on current taxable income and the future tax consequences of temporary 
differences between the basis of assets and liabilities for financial and tax reporting. The deferred income tax assets and 
liabilities represent the future state and federal tax return consequences of those differences, which will either be taxable or 
deductible when the assets and liabilities are recovered or settled. Deferred income taxes are also recognized for operating 
losses that are available to offset future taxable income and tax credits that are available to offset future income taxes. At each 
reporting period, the Company assesses the realizable value of deferred tax assets based on, among other things, estimates of 
future taxable income and adjusts the related valuation allowance as necessary. The Company makes a number of assumptions 
and estimates in determining the appropriate amount of expense to record for income taxes. The assumptions and estimates 
consider the taxing jurisdiction in which the Company operates as well as current tax regulations. Accruals are established for 
estimates of tax effects for certain transactions and future projected profitability based on the Company's interpretation of 
existing facts and circumstances. 

Advertising Costs. Advertising costs are charged to operations as incurred. The Company does not have any direct-response 
advertising. Advertising costs, which include trade shows and conventions, were approximately $7,079, $5,600 and $6,499 for 
the years ended March 31, 2015, 2014 and 2013, respectively, and were included in selling, general and administrative 
expenses in the accompanying consolidated statements of comprehensive income. 

Earnings per Share. The Company provides dual presentation of “basic” and “diluted” earnings per share (“EPS”). Shares 
below are in thousands. 

Net income 

Basic net income per share: 

Weighted-average shares outstanding — Basic 

Basic net income per common share 

Net income 

Diluted net income per share: 

Weighted-average shares outstanding — Basic 

Effect of potentially dilutive securities 

Weighted-average shares outstanding — Diluted 

Diluted net income per common share 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

27,332    $

15,680    $

42,724  

60,259  
0.45    $
27,332    $

60,259  
590  
60,849  

59,918  
0.26    $
15,680    $

59,918  
216  
60,134  

0.45    $

0.26    $

59,392 
0.72  
42,724  

59,392 
70 
59,462 
0.72  

$

$

$

$

The computation of diluted net income per share does not include 1,656, 1,355 and 966 options for the years ended March 31, 
2015, 2014 and 2013, respectively, because their inclusion would have an anti-dilutive effect on net income per share. 

Share-Based Compensation. The Company estimates the fair value of stock options on the date of grant using the Black 
Scholes option-pricing model. Expected term is estimated based upon the historical exercise behavior and represents the period 
of time that options granted are expected to be outstanding. Volatility is estimated by using the weighted-average historical 
volatility of the Company’s common stock, which approximates expected volatility. The risk free rate is the implied yield available 
on the U.S. Treasury zero-coupon issues with remaining terms equal to the expected term. The expected dividend yield is the 
average dividend rate during a period equal to the expected term of the option. The Black Scholes model utilizes those inputs to 

68 

 
 
 
 
 
 
   
   
 
   
   
 
determine the estimated fair value. The fair value of the portion of the award that is ultimately expected to vest is recognized 
ratably as expense over the requisite service period in the Company’s consolidated statements of comprehensive income. 

Share-based compensation is adjusted on a monthly basis for changes to estimated forfeitures based on a review of historical 
forfeiture activity. To the extent that actual forfeitures differ, or are expected to differ, from the estimate, share-based 
compensation expense is adjusted accordingly. The effect of the forfeiture adjustments for years ended March 31, 2015, 2014 
and 2013 was not significant. 

Share-based compensation expense associated with the restricted performance shares with market conditions under our 
executive compensations plans is based on the grant date fair value measured at the underlying closing share price on the date 
of grant using a Monte Carlo-based valuation model. 

See Note 12 for additional details regarding the Company's share-based awards. 

The following table shows total share-based compensation expense included in the consolidated statements of comprehensive 
income for years ended March 31, 2015, 2014 and 2013: 

Costs and expenses: 

Cost of revenue 

Research and development costs 

Selling, general and administrative 

Total share-based compensation 

Income tax benefit 

Decrease in net income 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

$

$

373    $
396  
2,703  
3,472  
(1,054)  
2,418    $

348    $
323  
1,819  
2,490  
(794)  
1,696    $

201  
230 
1,896 
2,327 
(726) 
1,601  

Sales Taxes. The Company records revenue net of sales tax obligation in the consolidated statements of income. 

Use of Estimates. The preparation of consolidated financial statements in conformity with GAAP requires the Company to make 
estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent liabilities at the 
date of the financial statements and the reported amounts of revenue and expenses during the reporting period. On an ongoing 
basis, the Company evaluates its estimates, including those related to revenue recognition, VSOE, accounts receivable 
reserves, software development costs, contingent consideration liabilities, goodwill, intangible assets, and income taxes and 
related credits and deductions. The Company bases its estimates on historical experience and on various other assumptions 
that are believed 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 are not readily apparent from other sources. Actual results may differ from these 
estimates under different assumptions or conditions. 

New Accounting Standards. New accounting pronouncements implemented by the Company during the current year or 
requiring implementation in future periods are discussed below or in the notes, where applicable. 

In May 2014, the FASB, along with the International Accounting Standards Board, issued Accounting Standards Update No. 
2014-09, Revenue from Contracts with Customers ("ASU 2014-09"), which supersedes the revenue recognition requirements in 
ASC 605, Revenue Recognition. ASU 2014-09 provides enhancements to the quality and consistency of how revenue is 
reported while also improving comparability in the financial statements of companies reporting using International Financial 
Reporting Standards and GAAP.  The core principle of this updated guidance is that an entity should recognize revenue to depict 
the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects 
to be entitled in exchange for those goods or services. The new standard also requires additional disclosure about revenue and 
provides improved guidance for multiple element arrangements. ASU 2014-09 is effective for annual reporting periods beginning 
after December 15, 2016, including interim periods within that reporting period. Companies are permitted to adopt this new 
guidance following either a full retrospective or modified retrospective approach.  ASU 2014-09 is effective for the Company in 
the first quarter of fiscal 2018.  The Company is currently evaluating the potential impact of implementation of this updated 
authoritative guidance on its consolidated financial statements. 

In August 2014, the FASB issued Accounting Standards Update No. 2014-15, Disclosure of Uncertainties about an Entity’s 
Ability to Continue as a Going Concern ("ASU 2014-15"), which incorporates and expands upon certain principles that currently 
exist in U.S. auditing standards. ASU 2014-15 provides guidance regarding management's responsibility to evaluate whether 
there is substantial doubt about an organization's ability to continue as a going concern and to provide related footnote 
disclosures. The new standard requires management to perform interim and annual evaluations and sets forth principles for 
considering the mitigating effect of management's plans. The standard mandates certain disclosures when conditions give rise to 
substantial doubt about a company’s ability to continue as a going concern within one year from the financial statement issuance 
date. ASU 2014-15 is effective for annual reporting periods ending after December 15, 2016, and all annual and interim periods 
thereafter. Early adoption is permitted. ASU 2014-15 is effective for the Company for fiscal year ending March 31, 2017. The 
Company does not expect the adoption of this new standard to have a material impact on its consolidated financial statements. 

69 

 
 
 
 
 
 
   
   
 
 
3. Cash and Cash Equivalents 

At March 31, 2015 and 2014, the Company had cash and cash equivalents of $118,993 and $103,145, respectively. Cash and 
cash equivalents consist of cash, money market funds and short-term U.S. Treasury securities with original maturities of less 
than 90 days. The money market fund in which the Company holds a portion of its cash invests in only investment grade money 
market instruments from a variety of industries, and therefore bears relatively low market risk.  

4. Fair Value Measurements 

The following tables set forth by level within the fair value hierarchy the Company's financial assets and liabilities that were 
accounted for at fair value on a recurring basis at March 31, 2015 and March 31, 2014:  

ASSETS 

Cash and cash equivalents (1) 

Restricted cash and cash equivalents 

Marketable securities (2) 

LIABILITIES 

Contingent consideration related to acquisitions 

ASSETS 

Cash and cash equivalents (1) 

Restricted cash and cash equivalents 

Marketable securities (2) 

LIABILITIES 

Contingent consideration related to acquisitions 

Quoted Prices 
in Active 
Markets for 
Identical 
Assets 
(Level 1) 

Significant 
Other 
Observable 
Inputs 
(Level 2) 

Balance at 
March 31, 
2015 

Unobservable 
Inputs 
(Level 3) 

118,993    $ 
2,419  
11,592  
133,004    $ 

16,155   
16,155    $ 

118,993   $ 
2,419  
11,592  
133,004   $ 

—   $ 
—   $ 

—   $ 
—  
—  
—   $ 

—   $ 
—   $ 

— 
— 
— 
— 

16,155 
16,155 

Quoted Prices 
in Active 
Markets for 
Identical 
Assets 
(Level 1) 

Significant 
Other 
Observable 
Inputs 
(Level 2) 

Balance at 
March 31, 
2014 

Unobservable 
Inputs 
(Level 3) 

103,145    $ 
4,351   
10,656   
118,152    $ 

14,913    $ 
14,913    $ 

103,145    $ 
4,351   
10,656   
118,152    $ 

—    $ 
—    $ 

—    $ 
—   
—   
—    $ 

—    $ 
—    $ 

—  
—  
—  
—  

14,913  
14,913  

$

$

$

$

$ 

$ 

$ 

$ 

____________________ 
(1)  Cash equivalents consist of money market funds. 
(2)  Marketable securities consist of money market instruments and fixed-income securities, including certificates of deposit, corporate bonds 

and notes, and municipal securities. 

The Company's contingent consideration liability is accounted for at fair value on a recurring basis and is adjusted to fair value 
when the carrying value differs from fair value. Key assumptions include discount rates and probability-adjusted achievement of 
revenue and strategic targets that are not observable in the market.  The categorization of the framework used to measure fair 
value of the contingent consideration liability is considered Level 3 due to the subjective nature of the unobservable inputs used. 
The fair values of the contingent consideration liability were estimated based on the probability of achieving certain business 
milestones. 

70 

 
 
 
 
 
 
 
   
   
   
 
 
   
   
   
 
 
 
 
 
 
 
   
   
   
 
 
   
   
   
 
 
 
The following table presents activity in the Company's financial assets and liabilities measured at fair value using significant 
unobservable inputs (Level 3), as of March 31, 2015:  

Balance at March 31, 2013 

Acquisitions 

Earnout payments 

Fair value adjustments 

Balance at March 31, 2014 

Earnout payments 

Fair value adjustments 

Balance at March 31, 2015 

$

Total Liabilities 
5,336  
13,307 
(3,831) 
101 
14,913  
(695) 
1,937 
16,155  

$

$

Non-Recurring Fair Value Measurements 

The Company has certain assets, including goodwill and other intangible assets, which are measured at fair value on a non-
recurring basis and are adjusted to fair value only if an impairment charge is recognized. The categorization of the framework 
used to measure fair value of the assets is considered Level 3 due to the subjective nature of the unobservable inputs used. 
During the year ended March 31, 2015, there were no adjustments to fair value of such assets, except for the intangible assets 
acquired from Gennius (see Note 5). 

5. Business Combinations 

Acquisition of Gennius 

On March 11, 2015, the Company acquired Gennius, a leading provider of healthcare data analytics. The preliminary Gennius 
purchase price totaled $2,345. The Company accounted for the Gennius acquisition as a purchase business combination. The 
preliminary purchase price was allocated to the tangible and intangible assets acquired and liabilities assumed based on their 
estimated fair values as of the acquisition date. The fair values of acquired assets and liabilities assumed represent 
management’s estimate of fair value. The estimated fair value of the acquired tangible and intangible assets and liabilities 
assumed were determined using multiple valuation approaches depending on the type of tangible or intangible asset acquired, 
including but not limited to the income approach, the excess earnings method and the relief from royalty method approach.  
Goodwill arising from the acquisition of Gennius was determined as the excess of the preliminary purchase price over the net 
acquisition date fair values of the acquired assets and the liabilities assumed, and is not deductible for tax purposes.  The 
Gennius goodwill represents the expected future synergies resulting from the integration of the Gennius healthcare data 
analytics technology, which will enhance the Company's current enterprise analytics competencies and broaden its business 
intelligence capabilities for addressing new value-based care requirements. Gennius operates under the NextGen Division. 

The total preliminary purchase price for the Gennius acquisition during the year ended March 31, 2015 is summarized as 
follows: 

Total preliminary cash purchase price 

The following table summarizes the preliminary purchase price allocation for the Gennius acquisition: 

Fair value of the net tangible assets acquired and liabilities assumed: 

Other assets 

Deferred revenues 

Other liabilities 

Total net tangible assets acquired and liabilities assumed 

Fair value of identifiable intangible assets acquired: 

Software technology 

Goodwill 

Total identifiable intangible assets acquired 

Total preliminary purchase price 

71 

Gennius 

$ 

2,345  

Gennius 

$ 

$ 

4  
(37 ) 

(189 ) 

(222 ) 

1,800  
767  
2,567  
2,345  

 
 
 
 
 
 
 
 
 
 
The actual results to date and pro forma effects of the Gennius acquisition would not have been material to the Company’s 
results of operations and are therefore not presented. 

Acquisition of Mirth 

On September 9, 2013, the Company acquired 100% of the outstanding capital stock of Mirth, a global leader in health 
information technology that helps clients achieve interoperability. The acquisition enhances the Company’s current enterprise 
interoperability initiatives and broadens its accountable and collaborative care, population health, disease management and 
clinical data exchange offerings. The Mirth purchase price totaled $56,222, which included share-based contingent consideration 
with an estimated fair value of $13,307 payable over a three year period subject to achievement of certain strategic milestones.  
The share-based contingent consideration was adjusted by a $5,239 fair value discount, which is being amortized over the three 
year achievement period.  The goodwill arising from the acquisition of Mirth represents the opportunity for the Company to sell 
Mirth-powered health information technology solutions as a complement to its other products as well as other expected future 
market participant synergies and is expected to be deductible for income tax purposes over a period of 15 years. Mirth operates 
under the NextGen Division.  

The Company accounted for the Mirth acquisition as a purchase business combination.  The purchase price was allocated to the 
tangible and intangible assets acquired and liabilities assumed based on their estimated fair values as of the acquisition date.  
The fair values of acquired assets and liabilities assumed represent management’s estimate of fair value. The estimated fair 
value of the acquired tangible and intangible assets and liabilities assumed were determined using multiple valuation 
approaches depending on the type of tangible or intangible asset acquired, including but not limited to the income approach, the 
excess earnings method and the relief from royalty method approach. 

The total purchase price for the Mirth acquisition during the year ended March 31, 2014 is summarized as follows: 

Cash paid 

Common stock issued at fair value 

Contingent consideration 

Total purchase price 

The following table summarizes the final purchase price allocation for the Mirth acquisition: 

Fair value of the net tangible assets acquired and liabilities assumed: 

Current assets (including accounts receivable of $3,939) 

Equipment and improvements 

Accounts payable and accrued liabilities 

Deferred revenues 

Total net tangible assets acquired and liabilities assumed 

Fair value of identifiable intangible assets acquired: 

Trade name 

Customer relationships 

Software technology 

Goodwill 

Total identifiable intangible assets acquired 

Total purchase price 

Mirth 

35,033  
7,882  
13,307  
56,222  

Mirth 

4,231  
822  
(764 ) 

(5,802 ) 

(1,513 ) 

1,350  
2,800  
22,200  
31,385  
57,735  
56,222  

$ 

$ 

$ 

$ 

The pro forma effects of the Mirth acquisition would not have been material to the Company’s results of operations and are 
therefore not presented. 

72 

 
 
 
 
 
 
 
 
 
 
 
6. Goodwill 

The Company does not amortize goodwill as it has been determined to have an indefinite useful life. 

Goodwill by reportable segment consists of the following: 

QSI Dental Division (1) 

NextGen Division 

Hospital Solutions Division (2) 

RCM Services Division 

Total goodwill 

March 31, 
2014 

  Acquisitions 

March 31, 
2015 

$ 

$ 

7,289    $ 
33,225   
—   
32,290   
72,804    $ 

—    $ 
767   
—   
—   
767    $ 

7,289 
33,992 
— 
32,290 
73,571 

_______________________ 
(1)  QSI Dental Division goodwill is presented on a basis consistent with that of the management reporting structures within QSI.  For the 
purposes of testing goodwill for impairment annually and as otherwise may be required; however, the QSI Dental Division goodwill is 
allocated to all business units that derive cash flows from the products associated with the acquired goodwill.  For all periods presented in 
this report, the allocation resulted in substantially all of such goodwill being ascribed to the NextGen Division. 

(2)  The gross carrying amount of goodwill and corresponding accumulated impairment losses for the Hospital Solutions division were $21,323 

for the years ended March 31, 2015 and 2014. 

7. Intangible Assets 

In connection with the Gennius acquisition, the Company recorded  $1,800 of intangible assets related to software technology. 
The Company is amortizing the software technology over ten years. The weighted average amortization period for the total 
amount of intangible assets acquired is 10 years. 

The Company’s definite-lived intangible assets, other than capitalized software development costs, are summarized as follows: 

March 31, 2015 

Gross carrying amount 

Accumulated amortization 

Net intangible assets 

Gross carrying amount 

Accumulated amortization 

Net intangible assets 

$

$

$

$

Customer 
Relationships 

Trade Name 
and Contracts   
3,368    $
(2,159)  
1,209    $

Software 
Technology 

25,310    $
(5,894)  
19,416    $

Total 

50,728  

(23,039) 
27,689  

22,050    $
(14,986)  

7,064    $

March 31, 2014 

Customer 
Relationships 

Trade Name 
and Contracts   
3,368    $
(1,599)  
1,769    $

Software 
Technology 

23,510    $
(2,476)  
21,034    $

Total 

48,928  
(15,912) 
33,016  

22,050    $
(11,837)  
10,213    $

Amortization expense related to customer relationships and trade name and contracts that is included as operating expenses in 
the consolidated statements of comprehensive income was $3,709, $4,671 and $4,633 for the years ended March 31, 2015, 
2014 and 2013, respectively.  Amortization expense related to software technology that is included in cost of revenue for 
software and hardware was $3,418, $3,659 and $2,926 for the years ended March 31, 2015, 2014 and 2013, respectively. 

73 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following table represents the remaining estimated amortization of definite-lived intangible assets as of March 31, 2015: 

For the year ended March 31, 

2016 

2017 

2018 

2019 

2020 

2021 and beyond 

Total 

8. Capitalized Software Costs 

The Company’s capitalized software development costs are summarized as follows: 

Gross carrying amount 

Accumulated amortization 

Net capitalized software costs 

$

$

$

7,204  
6,733 
4,481 
3,697 
3,352 
2,222  
27,689  

March 31, 
 2015 

March 31, 
 2014 

$

$

113,955    $
(73,558)  
40,397    $

100,455  

(61,303) 
39,152  

Amortization expense related to capitalized software costs was $12,817, $12,338 and $9,668 for the years ended March 31, 
2015, 2014 and 2013, respectively. 

The following table represents the remaining estimated amortization of capitalized software costs as of March 31, 2015. The 
estimated amortization is comprised of (i) amortization of released products and (ii) the expected amortization for products that 
are not yet available for sale based on their estimated economic lives and projected general release dates. 

For the year ended March 31, 

2016 

2017 

2018 

2019 

2020 

2021 and beyond 

Total 

$

$

$

11,200  
10,600 
5,500 
4,800 
4,700 
3,597  
40,397  

9. Composition of Certain Financial Statement Captions 

Accounts receivable include amounts related to maintenance and services that were billed but not yet rendered at each period 
end. Undelivered maintenance and services are included as a component of the deferred revenue balance on the accompanying 
consolidated balance sheets. 

Accounts receivable, gross 

Sales return reserve 

Allowance for doubtful accounts 

Accounts receivable, net 

Inventories are summarized as follows: 

Computer systems and components 

74 

March 31, 
 2015 

March 31, 
 2014 

119,807    $
(8,835)  

(3,303)  
107,669    $

130,093  

(10,530) 

(6,295) 
113,268  

March 31, 
 2015 

March 31, 
 2014 

622    $

834  

$

$

$

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Equipment and improvements are summarized as follows: 

Computer equipment 

Furniture and fixtures 

Leasehold improvements 

Accumulated depreciation and amortization 

Equipment and improvements, net 

Current and non-current deferred revenue are summarized as follows: 

Maintenance 

Professional services 

Annual license services 

Undelivered software and other (1) 

Deferred revenue 

Deferred revenue, net of current 

_______________________ 
(1) 

Includes deferred revenue for Software as a Service ("SaaS") and other subscriptions. 

Accrued compensation and related benefits are summarized as follows: 

Payroll, bonus and commission 

Vacation 

Accrued compensation and related benefits 

Other current and non-current liabilities are summarized as follows: 

Contingent consideration and other liabilities related to acquisitions 

Customer credit balances and deposits 

Accrued legal expense 

Accrued consulting 

Care services liabilities 

Accrued EDI expense 

Self insurance reserve 

Accrued royalties 

Other accrued expenses 

Other current liabilities 

Contingent consideration and other liabilities related to acquisitions 

Deferred rent 

Uncertain tax position and related liabilities 

Deferred income taxes, net 

Other noncurrent liabilities 

75 

March 31, 
 2015 

March 31, 
 2014 

42,668    $
10,408  
9,767  
62,843  
(42,036)  
20,807    $

37,322  
9,395 
8,874 
55,591 

(32,790) 
22,801  

March 31, 
 2015 

March 31, 
 2014 

15,077    $
30,340  
11,130  
9,796  
66,343    $
1,349    $

15,482  
36,634 
11,176 
7,785 
71,077  
2,187  

March 31, 
 2015 

March 31, 
 2014 

13,505    $
10,546  
24,051    $

6,193  
9,760 
15,953  

March 31, 
 2015 

March 31, 
 2014 

9,124    $
4,760  
3,527  
2,603  
2,381  
2,322  
2,290  
2,063  
4,854  
33,924    $

7,581    $
3,122  
4,095  
—  
14,798    $

1,052  
3,163 
170 
1,707 
4,351 
1,702 
2,090 
1,418 
5,716 
21,369  

14,736  
3,509 
841 
3,206 
22,292  

$

$

$

$

$

$

$

$

$

$

$

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
10. Income Tax 

The provision for income taxes consists of the following components: 

Current: 

Federal taxes 

State taxes 

Foreign taxes 

Total current taxes 

Deferred: 

Federal taxes 

State taxes 

Foreign taxes 

Total deferred taxes 

Provision for income taxes 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

$

$

$

18,055    $
1,887  
262  
20,204  

8,673    $
2,380  
252  
11,305  

30,382  
5,019 
190 
35,591 

(9,804 )   $

(2,894 )   $

(8,469 ) 

(1,771)  

(297)  

(11,872)  

8,332    $

(897)  

(193)  

(3,984)  
7,321    $

(742) 

(190) 

(9,401) 
26,190  

The provision for income taxes differs from the amount computed at the federal statutory rate as follows: 

Current: 

Federal income tax statutory rate 

Increase (decrease) resulting from: 

State income taxes, net of Federal benefit 

Research and development tax credits 

Qualified production activities income deduction 

Impairment of goodwill 

Other non-recurring adjustments for State taxes 

Other 

Effective income tax rate 

Fiscal Year Ended March 31, 
2014 

2013 

2015 

35.0 %  

35.0 %  

35.0 %

2.0    
(4.4 )   
(5.4 )   
—    
(1.8 )   
(2.0 )   

23.4 %  

4.2    
(5.3 )   
(4.9 )   
5.7    
—    
(2.9 )   

31.8 %  

4.0  
(2.1 ) 

(4.6 ) 
7.5  
—  
(1.8 ) 

38.0 %

During the years ended March 31, 2015, 2014, and 2013, the Company recognized federal research and development tax 
credits of $1,560, $1,196 and $1,461, respectively, and state research and development tax credits of approximately $380, $251 
and $145, respectively. The Internal Revenue Service (“IRS”) statute related to research and development credits expired on 
December 31, 2013 and was retroactively reinstated through December 31, 2014 in December 2014.  The research and 
development credits claimed by the Company for the year ended March 31, 2015 represent credits for the nine-month period 
from April 1, 2014 through December 31, 2014.  

The Company also claimed the qualified production activities deduction under Section 199 of the Internal Revenue Code (“IRC”) 
for $5,528, $3,189, and $9,032 (pre-tax) during the years ended March 31, 2015, 2014, and 2013, respectively. The research 
and development credits and the qualified production activities income deduction calculated by the Company involve certain 
assumptions and judgments regarding qualification of expenses under the relevant tax code provisions.  

76 

 
 
 
 
 
 
   
   
 
   
   
 
 
 
 
 
 
   
   
 
   
   
 
 
 
The net deferred tax assets and liabilities in the accompanying consolidated balance sheets consist of the following: 

Deferred tax assets: 

Deferred revenue 

Inventory valuation 

Accrued compensation and benefits 

Deferred compensation 

Compensatory stock option expense 

Allowance for doubtful accounts 

Intangible assets 

Research and development credit 

Net operating loss 

Other 

Total deferred tax assets 

Deferred tax liabilities: 

Accelerated depreciation 

Capitalized software 

Prepaid expense 

State income taxes 

Total deferred tax liabilities 

Valuation allowance 

Deferred tax assets, net 

March 31, 
 2015 

March 31, 
 2014 

$

11,970    $
56  
7,744  
2,342  
2,852  
4,944  
7,603  
1,988  
512  
3,561  
43,572  

$

(756 )   $

(8,728)  

(1,321)  

(730)  

(11,535)  

(1,840)  
30,197    $

$

10,144  
46 
5,219 
1,941 
2,094 
6,791 
6,086 
2,434 
— 
2,992 
37,747 

(1,582 ) 

(13,919) 

(1,199) 

(433) 

(17,133) 

(2,288) 
18,326  

The deferred tax assets and liabilities have been shown net in the accompanying consolidated balance sheets based on the 
long-term or short-term nature of the items that give rise to the deferred amount. The Company expects to receive the full benefit 
of the deferred tax assets recorded with the exception of a specific state tax credit for which the Company has recorded a 
valuation allowance. 

Uncertain tax positions 

A reconciliation of the beginning and ending amount of unrecognized tax benefits, which is recorded within other noncurrent 
liabilities in the Company’s consolidated balance sheet, is as follows: 

Balance at March 31, 2013 

Additions for current/prior year tax positions 

Reductions for prior year tax positions 

Balance at March 31, 2014 

Additions for prior year tax positions 

Reductions for prior year tax positions 

Balance at March 31, 2015 

$

$

$

733  
405 
(263) 
875  
3,106 
(218) 
3,763  

During the year ended March 31, 2015, the Company recorded additional liabilities of $3,106 mostly related to various state tax 
planning benefits recorded in the current year for prior year tax positions.  The total amount of unrecognized tax benefit that, if 
recognized, would decrease the income tax provision is $3,763. 

The Company’s practice is to recognize estimated interest and/or penalties related to income tax matters in selling, general and 
administrative expenses. The Company had approximately $332 and $80 of accrued interest related to income tax matters at 
March 31, 2015 and 2014, respectively. No penalties were accrued. 

The Company is no longer subject to U.S. federal income tax examinations for tax years before 2014. With a few exceptions, the 
Company is no longer subject to state or local income tax examinations for tax years before 2010. The Company does not 
anticipate that total unrecognized tax benefits will significantly change due to the settlement of audits or the expiration of statute 
of limitations within the next twelve months.  

77 

 
 
 
 
   
 
   
 
 
 
11. Employee Benefit Plans 

The Company has a 401(k) plan available to substantially all of its employees. Participating employees may defer up to the IRS 
limit based on the IRC per year. The annual contribution is determined by a formula set by the Company’s Board of Directors 
and may include matching and/or discretionary contributions. The amount of the Company match is discretionary and subject to 
change. The retirement plans may be amended or discontinued at the discretion of the Board of Directors. Contributions of $949, 
$820 and $889 were made by the Company to the 401(k) plan for the years ended March 31, 2015, 2014 and 2013, 
respectively. 

The Company has a deferred compensation plan (the “Deferral Plan”) for the benefit of those employees who qualify. 
Participating employees may defer up to 75% of their salary and 100% of their annual bonus for a Deferral Plan year. In addition, 
the Company may, but is not required to, make contributions into the Deferral Plan on behalf of participating employees, and the 
amount of the Company match is discretionary and subject to change. Each employee's deferrals together with earnings thereon 
are accrued as part of the long-term liabilities of the Company. Investment decisions are made by each participating employee 
from a family of mutual funds. The deferred compensation liability was $5,750 and $4,809 at March 31, 2015 and 2014, 
respectively. To offset this liability, the Company has purchased life insurance policies on some of the participants. The Company 
is the owner and beneficiary of the policies and the cash values are intended to produce cash needed to help make the benefit 
payments to employees when they retire or otherwise leave the Company. The Company intends to hold the life insurance policy 
until the death of the plan participant. The net cash surrender value of the life insurance policies for deferred compensation was 
$6,004 and $4,865 at March 31, 2015 and 2014, respectively. The values of the life insurance policies and the related Company 
obligation are included on the accompanying consolidated balance sheets in long-term other assets and long-term deferred 
compensation, respectively. The Company made contributions of $86, $62 and $49 to the Deferral Plan for the years ended 
March 31, 2015, 2014 and 2013, respectively. 

12. Share-Based Awards 

Employee Stock Option Plans 

In October 2005, the Company's shareholders approved a stock option and incentive plan (the “2005 Plan”) under which 
4,800,000 shares of common stock were reserved for the issuance of awards, including incentive stock options and non-
qualified stock options, stock appreciation rights, restricted stock, unrestricted stock, restricted stock units, performance shares, 
performance units (including performance options) and other share-based awards.  The 2005 Plan provides that employees and 
directors of the Company may, at the discretion of the Board of Directors or a duly designated compensation committee, be 
granted certain share-based awards. In the case of option awards granted under the 2005 Plan, the exercise price of each 
option is determined based on the date of grant and expires no later than 10 years from the date of grant. Awards granted 
pursuant to the 2005 Plan are subject to the vesting schedule or performance metrics set forth in the agreements pursuant to 
which they are granted.  Upon a change of control of the Company, as such term is defined in the 2005 Plan, awards under the 
2005 Plan will fully vest under certain circumstances.  The 2005 Plan expires on May 25, 2015, unless terminated earlier by the 
Board of Directors.  As of March 31, 2015, there were 1,636,176 outstanding options, 78,205 outstanding shares of restricted 
stock, restricted stock units and performance based restricted stock, and 2,298,488 shares available for future grant under the 
2005 Plan. On May 20, 2015, the Board of Directors approved a stock option and incentive plan (the “2015 Plan”) subject to 
shareholder approval at the Company’s 2015 Annual Shareholders’ Meeting. The full text the 2015 Plan will be attached to the 
Company’s definitive proxy statement for the Company’s 2015 Annual Shareholders’ Meeting to be filed with the Securities and 
Exchange Commission. 

78 

 
 
 
 
A summary of stock option transactions during the years ended March 31, 2015, 2014 and 2013 is as follows: 

Outstanding, March 31, 2012 

Granted 

Exercised 

Forfeited/Canceled 

Outstanding, March 31, 2013 

Granted 

Exercised 

Forfeited/Canceled 

Outstanding, March 31, 2014 

Granted 

Forfeited/Canceled 

Outstanding, March 31, 2015 

Vested and expected to vest, March 31, 2015 

Exercisable, March 31, 2015 

Weighted- 
Average 
Exercise 
Price 
per Share 

Weighted- 
Average 
Remaining 
Contractual 
Life (years) 

Aggregate 
Intrinsic 
Value 
(in thousands) 

Number of 
Shares 

988,337   $
556,500  
(56,366)  

(329,288)  
1,159,183   $
469,000  
(111,272)  

(146,810)  
1,370,101   $
469,650  
(203,575)  
1,636,176   $
1,533,192   $
567,886   $

32.09     
27.78    
16.81    
31.42    
30.54     
18.78    
19.78    
30.28    
27.85   
15.97  
24.85  
24.82   
25.03   
30.81   

 $

 $

5.8    

7.2    

4.9    

5.5   $

5.5   $

4.1   $

82  

264  

8  
8  
—  

The Company utilizes the Black-Scholes valuation model for estimating the fair value of stock options and related share-based 
compensation with the following assumptions: 

Expected life 

Expected volatility 

Expected dividends 

Risk-free rate 

Year Ended 
March 31, 2015   

 4.8 years 

Year Ended 
March 31, 2014   
  4.9 years 

Year Ended 
March 31, 2013 

  5.0 years 

36.1% - 36.6%    43.4% - 43.7%    41.3% - 45.1% 

4.3% - 4.4% 

3.1% - 3.9% 

2.4% - 4.0% 

1.6% - 1.7% 

1.0% - 1.5% 

0.7% - 0.8% 

The weighted-average grant date fair value of stock options granted during the years ended March 31, 2015, 2014 and 2013 
was $3.50, $5.20 and $8.22 per share, respectively. 

79 

 
 
 
 
 
   
   
   
   
   
  
 
 
 
 
 
 
 
 
 
During the years ended March 31, 2015, 2014 and 2013, a total of 469,650, 469,000 and 556,500 options, respectively, were 
granted under the 2005 Plan at an exercise price equal to the market price of the Company’s common stock on the date of 
grant. A summary of stock options granted under the 2005 Plan during the years ended March 31, 2015, 2014 and 2013 is as 
follows: 

Option Grant Date 

March 11, 2015 

September 2, 2014 

June 3, 2014 

Fiscal year 2015 option grants 

August 15, 2013 

July 30, 2013 

May 29, 2013 

Fiscal year 2014 option grants 

January 23, 2013 

November 5, 2012 

September 25, 2012 

May 24, 2012 

May 24, 2012 

May 23, 2012 

Fiscal year 2013 option grants 

Number of 
Shares 

Exercise 
Price 

Vesting 
Terms (1) 

  Expires 

10,000    $ 
20,000    $ 
439,650    $ 
469,650     
85,000    $ 
28,000    $ 
356,000    $ 
469,000     
40,000    $ 
5,000    $ 
20,000    $ 
346,000    $ 
30,000    $ 
115,500    $ 
556,500     

15.84   
15.63   
15.99   

20.85   
22.59   
17.95   

19.00   
17.68   
18.42   
29.17   
29.17   
29.45   

Five years 

  March 11, 2023 

Five years 

  September 2, 2022 

Five years 

  June 3, 2022 

Five years 

Five years 

Five years 

  August 15, 2021 
  July 30, 2021 
  May 29, 2021 

Five years 

  January 23, 2021 

Five years 

  November 5, 2020 

Five years 

  September 25, 2020 

Five years 

  May 24, 2020 

Four years 

  May 24, 2020 

Five years 

  May 23, 2020 

____________________ 
(1)  Options vest in equal annual installments on each grant anniversary date commencing one year following the date of grant. 

Employee Share Purchase Plan 

On August 11, 2014, the Company’s shareholders approved an Employee Share Purchase Plan (the “Purchase Plan”) under 
which 4,000,000 shares of common stock were reserved for future grant.  The Purchase Plan allows eligible employees to 
purchase shares through payroll deductions of up to 15% of total base salary at a price equal to 90% of the lower of the fair 
market values of the shares as of the beginning or the end of the corresponding offering period.  Any shares purchased under 
the Purchase Plan are subject to a six-month holding period.  Employees are limited to purchasing no more than 1,500 shares 
on any single purchase date and no more than $25,000 in total fair market value of shares during any one calendar year. As of 
March 31, 2015, the Company has issued 33,609 shares under the Purchase Plan and 3,966,391 shares are available for future 
issuance.  The amount of share-based compensation expense recorded for this plan was insignificant for the year ended 
March 31, 2015. 

Performance-Based Awards 

On May 27, 2014, the Compensation Committee of the Board of Directors approved the Company's fiscal year 2015 Executive 
Compensation Program (the "Program") under which the Company's named executive officers are eligible to receive cash 
bonuses based on meeting certain target increases in revenue and non-GAAP financial targets, as defined in the Program (i.e. 
non-GAAP earnings per share and a measure of free cash flow) for fiscal year 2015.  Under the Program, the named executive 
officers also received certain equity incentive awards issued under the 2005 Plan. These equity awards included (i) an aggregate 
of 105,000 options to purchase the Company's common stock, which were granted on the first day of the next open trading 
window under the Company's Insider Trading Policy (June 3, 2014), have an exercise price equal to the closing price of the 
Company's shares on the date of grant, a term of eight years and a vesting schedule of five equal annual installments 
commencing one year following the date of grant; and (ii) a potential award of up to an aggregate of 170,000 restricted 
performance shares of the Company's common stock vesting over a three year period based on the achievement of target 
average daily share prices for the ninety calendar day period ending May 31st of each of the subsequent three fiscal years.  In 
addition, under the Program, a target pool of up to 390,000 options is available for new hires, promotions, and certain for high-
performing, non-executive employees based on achievement of performance targets. 

Share-based compensation expense associated with the restricted performance shares with market conditions under the 
Program is based on the grant date fair value measured at the underlying closing share price on the date of grant using a Monte 
Carlo-based valuation model. 

80 

 
 
 
 
 
 
 
 
   
   
 
 
 
 
   
   
 
 
 
 
 
 
 
   
   
 
 
Share-based compensation expense associated with the options under the Program are initially based on the number of options 
expected to vest after assessing the probability that the performance targets will be met.  Cumulative adjustments are recorded 
quarterly to reflect subsequent changes in the estimated outcome of performance-related conditions. The Company utilizes the 
Black-Scholes option valuation model with the assumptions in the table below to calculate the share-based compensation 
expense related to the options. 

Share-based compensation expense recorded for these performance-based awards was $463 for the year ended March 31, 
2015 and was insignificant for the years ended March 31, 2014 and 2013. 

Expected life 

Expected volatility 

Expected dividends 

Risk-free rate 

Year Ended 
March 31, 2015   

Year Ended 
March 31, 2014  

Year Ended 
March 31, 2013 

 4.8 years 

  4.9 years 

  5.0 years 

35.9% - 36.5%    36.9% - 43.5%    41.7% - 45.0% 

4.3% - 5.0% 

3.2% - 4.1% 

2.5% - 4.0% 

1.4% - 1.8% 

1.4% - 1.8% 

0.6% - 0.7% 

Non-vested stock option award activity, including employee stock options and performance-based awards, during the years 
ended March 31, 2015, 2014 and 2013 is summarized as follows: 

Outstanding, March 31, 2012 

Granted 

Vested 

Forfeited/Canceled 

Outstanding, March 31, 2013 

Granted 

Vested 

Forfeited/Canceled 

Outstanding, March 31, 2014 

Granted 

Vested 

Forfeited/Canceled 

Outstanding, March 31, 2015 

Non-Vested 
Number of 
Shares 

Weighted- 
Average 
Grant-Date 
Fair Value 
per Share 

778,319   $
556,500  
(201,191)  

(329,288)  
804,340   $
469,000  
(134,970)  

(146,810)  
991,560   $
469,650  
(269,785)  

(123,135)  
1,068,290   $

10.76  
8.22 
8.43 
9.92 
9.89  
5.20 
9.30 
9.33 
7.73  
3.50 
8.24 
6.57 
5.81  

As of March 31, 2015, $4,293 of total unrecognized compensation costs related to stock options is expected to be recognized 
over a weighted-average period of 3.2 years. This amount does not include the cost of new options that may be granted in future 
periods or any changes in the Company’s forfeiture percentage. The total fair value of options vested during the years ended 
March 31, 2015, 2014 and 2013 was $2,224, $1,255 and $1,696, respectively. 

Director Awards 

On May 28, 2014, the Board of Directors approved its 2015 Director Compensation Program, pursuant to which each non-
employee director is to be granted shares of restricted stock upon election or re-election to the Board of Directors. The shares of 
restricted stock are awarded under the 2005 Plan.  Such shares of restricted stock vest in two equal, annual installments on the 
first and second anniversaries of the grant date and are nontransferable for one year following vesting.  The weighted-average 
grant date fair value for the restricted stock was estimated using the market price of the common stock on the date of grant.  The 
fair value of the restricted stock is amortized on a straight-line basis over the vesting period. 

81 

 
 
 
 
 
 
 
 
 
 
 
 
 
The Company recorded compensation expense related to restricted stock of approximately $877, $629 and $566 for the years 
ended March 31, 2015, 2014 and 2013, respectively. Restricted stock activity for the years ended March 31, 2015, 2014 and 
2013 is summarized as follows:   

Outstanding, March 31, 2012 

Granted 

Vested 

Outstanding, March 31, 2013 

Granted 

Vested 

Canceled 

Outstanding, March 31, 2014 

Granted 

Vested 

Outstanding, March 31, 2015 

Weighted- 
Average 
Grant-Date 
Fair Value 
per Share 

Number of 
Shares 

30,001   $
18,939  
(18,555)  
30,385   $
57,324  
(16,302)  
(6,836)   $
64,571   $
48,414  
(34,780)  
78,205   $

36.32  
19.32 
32.14 
27.09  
20.75 
30.64 
22.59  
20.74  
15.77 
21.33 
17.94  

As of March 31, 2015, $760 of total unrecognized compensation costs related to restricted stock is expected to be recognized 
over a weighted-average period of 1.0 years. This amount does not include the cost of new restricted stock that may be granted 
in future periods.  

13. Commitments, Guarantees and Contingencies 

The Company leases facilities and offices under irrevocable operating lease agreements expiring at various dates with rent 
escalation clauses. Rent expense related to these leases is recognized on a straight-line basis over the lease terms. Rent 
expense for the years ended March 31, 2015, 2014 and 2013 was $7,416, $7,604 and $5,753, respectively.  

The following table summarizes our significant contractual obligations at March 31, 2015 and the effect that such obligations are 
expected to have on our liquidity and cash in future periods: 

For the year ended March 31, 

Contractual Obligations 

Operating lease obligations 
Contingent consideration and other acquisition related 
liabilities (excluding share-based payments) 

Total 

Total 

2017 
$  47,784  $  7,461  $ 7,602  $  7,641  $  4,628 $ 

2019 

2016 

2018 

2020 

2021 and 
beyond 
3,572  $  16,880  

1,400 

700 

700 

— 

— 

$  49,184  $  8,161  $ 8,302  $  7,641  $  4,628 $ 

— 

— 
3,572  $  16,880  

The deferred compensation liability as of March 31, 2015 was $5,750, which is not included in the table above as the timing of 
future benefit payments to employees is not readily determinable. 

The uncertain tax position liability as of March 31, 2015 was $3,763, which is not included in the table above as the timing of 
expected payments is not readily determinable. 

Commitments and Guarantees 

The Company's software license agreements include a performance guarantee that the Company's software products will 
substantially operate as described in the applicable program documentation for a period of 365 days after delivery. To date, the 
Company has not incurred any significant costs associated with its performance guarantee or other related warranties and does 
not expect to incur significant warranty costs in the future. Therefore, no accrual has been made for potential costs associated 
with these warranties. Certain arrangements also include performance guarantees related to response time, availability for 
operational use, and other performance-related guarantees. Certain arrangements also include penalties in the form of 
maintenance credits should the performance of the software fail to meet the performance guarantees. To date, the Company has 
not incurred any significant costs associated with these warranties and does not expect to incur significant warranty costs in the 
future. Therefore, no accrual has been made for potential costs associated with these warranties.  

The Company has historically offered short-term rights of return in certain sales arrangements. If the Company is able to 
estimate returns for these types of arrangements and all other criteria for revenue recognition have been met, revenue is 
recognized and these arrangements are recorded in the consolidated financial statements. If the Company is unable to estimate 

82 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
returns for these types of arrangements, revenue is not recognized in the consolidated financial statements until the rights of 
return expire, provided also, that all other criteria of revenue recognition have been met. 

Certain standard sales agreements contain a money back guarantee providing for a performance guarantee that is already part 
of the software license agreement as well as training and support. The money back guarantee also warrants that the software 
will remain robust and flexible to allow participation in the federal health incentive programs. The specific elements of the 
performance guarantee pertain to aspects of the software, which the Company has already tested and confirmed to consistently 
meet using the Company's existing software without any modifications or enhancements. To date, the Company has not incurred 
any costs associated with this guarantee and does not expect to incur significant costs in the future. Therefore, no accrual has 
been made for potential costs associated with this guarantee. 

The Company's standard sales agreements contain an indemnification provision pursuant to which it shall indemnify, hold 
harmless, and reimburse the indemnified party for losses suffered or incurred by the indemnified party in connection with any 
U.S. patent, any copyright or other intellectual property infringement claim by any third party with respect to its software. As the 
Company has not incurred any significant costs to defend lawsuits or settle claims related to these indemnification agreements, 
the Company believes that its estimated exposure on these agreements is currently minimal. Accordingly, the Company has no 
liabilities recorded for these indemnification obligations. 

Hussein Litigation 

On October 7, 2013, a complaint was filed against the Company and certain of the Company’s officers and directors in the 
Superior Court of the State of California for the County of Orange, captioned Ahmed D. Hussein v. Sheldon Razin, Steven 
Plochocki, Quality Systems, Inc. and Does 1-10, inclusive, No. 30-2013-00679600-CU-NP-CJC, by Ahmed Hussein, a former 
director and significant shareholder of the Company.  The Company filed a demurrer to the complaint, which the court granted on 
April 10, 2014. An amended complaint was filed on April 25, 2014. The amended complaint generally alleges fraud and deceit, 
constructive fraud, negligent misrepresentation and breach of fiduciary duty in connection with statements made to the 
Company’s shareholders regarding the Company’s financial condition and projected future performance. The amended 
complaint seeks actual damages, exemplary and punitive damages and costs. The Company filed a demurrer to the amended 
complaint. On July 29, 2014, the court sustained the demurrer with respect to the breach of fiduciary duty claim, and overruled 
the demurrer with respect to the fraud and deceit claims. On August 28, 2014, the Company filed an answer and cross-
complaint. The Company believes that plaintiff’s claims are without merit and continues to defend against them vigorously. 

Federal Securities Class Action 

On November 19, 2013, a putative class action complaint was filed on behalf of the shareholders of the Company other than the 
defendants against the Company and certain of the Company’s officers and directors in the United States District Court for the 
Central District of California by a shareholder of the Company. After the court appointed lead plaintiffs and lead counsel for this 
action, and recaptioned the action In re Quality Systems, Inc. Securities Litigation, No. 8L13-cv-01818-CJC(JPRx), lead plaintiffs 
filed an amended complaint on April 7, 2014. The amended complaint, which is substantially similar to the litigation described 
above under the caption “Hussein Litigation,” generally alleges that statements made to the Company’s shareholders regarding 
the Company’s financial condition and projected future performance were false and misleading in violation of Section 10(b) of 
the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and that the individual defendants are liable for such 
statements because they are controlling persons under Section 20(a) of the Exchange Act. The complaint seeks compensatory 
damages, court costs and attorneys' fees. The Company filed a motion to dismiss the amended complaint on June 20, 2014, 
which the court granted on October 20, 2014, dismissing the complaint with prejudice. Plaintiffs filed a motion for reconsideration 
of the Court's order, which the court denied on January 5, 2015. On January 30, 2015, Plaintiffs filed a notice of appeal to the 
United States Court of Appeals for the Ninth Circuit, captioned In re Quality Systems, Inc. Securities Litigation, No. 15-55173. 
Briefing on the appeal is scheduled to be completed in the fall of 2015. The Company believes that plaintiff’s claims are without 
merit and continues to defend against them vigorously. 

Shareholder Derivative Litigation 

On January 24, 2014, a complaint was filed against the Company and certain of the Company’s officers and current and former 
directors in the United States District Court for the Central District of California, captioned Timothy J. Foss, derivatively on behalf 
of himself and all others similarly situated, vs. Craig A. Barbarosh, George H. Bristol, James C. Malone, Peter M. Neupert, Morris 
Panner, D. Russell Pflueger, Steven T. Plochocki, Sheldon Razin, Lance E. Rosenzweig and Quality Systems, Inc., No. 
SACV14-00110-DOC-JPPx, by Timothy J. Foss, a shareholder of the Company. The complaint arises from the same allegations 
described above under the captions “Hussein Litigation” and “Federal Securities Class Action” and generally alleges breach of 
fiduciary duties, abuse of control and gross mismanagement by the Company’s directors, in addition to unjust enrichment and 
insider selling by individual directors. The complaint seeks compensatory damages, restitution and disgorgement of all profits, 
court costs, attorneys’ fees and implementation of enhanced corporate governance procedures. The parties have agreed to stay 
this litigation until the United States Court of Appeals for the Ninth Circuit issues a ruling on the pending appeal described above 
under the caption “Federal Securities Class Action.”. The Company believes that plaintiff’s claims are without merit and intends 
to defend against them vigorously. 

83 

 
 
 
 
14. Operating Segment Information 

The Company has four reportable segments that are evaluated regularly by its chief decision making group (consisting of the 
Chief Executive Officer, Interim Chief Financial Officer and Chief Operating Officer) in deciding how to allocate resources and in 
assessing performance.  The chief operating decision making group evaluates performance based upon stand-alone segment 
operating income. Since assets by segment are not reported to or used by the Company’s chief operating decision making group 
to allocate resources, or to assess performance, total assets by segment are not disclosed. 

Effective April 1, 2014, the Company refined the measurement of its segment data to better reflect an organizational structure 
whereby certain expenses managed by functional area leadership are no longer classified within the operating segments but rather 
as a component of Corporate and unallocated.  Such classification is consistent with the disaggregated financial information used by 
the Company's chief operating decision making group.   The amounts classified as Corporate and unallocated have historically 
consisted primarily of corporate general and administrative costs and other centrally managed overhead costs, including accounting 
and finance, human resources, and legal costs, as well as non-recurring acquisition costs and the post-acquisition amortization of 
certain intangible assets.  Currently, as a result of the refinement of its segment data, the Company no longer classifies the costs of 
the marketing and research and development functional areas and the amortization of capitalized software costs within the operating 
segments.  The Company has retroactively reclassified the prior years' operating income in the table below to present all segment 
information on a comparable basis. 

Operating segment data is as follows: 

Revenue: 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Consolidated revenue 

Operating income (loss): 

QSI Dental Division 

NextGen Division 

Hospital Solutions Division 

RCM Services Division 

Unallocated corporate expense 

Consolidated operating income 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

$

$

$

$

18,451    $
373,765  
18,004  
80,005  
490,225    $

5,228    $
178,680  
(2,790)  
12,873  
(158,035)  

35,956    $

19,840    $
341,120  
15,614  
68,093  
444,667    $

6,155    $
155,578  
(7,453)  
9,343  
(140,535)  

23,088    $

19,990  
344,315 
31,413 
64,511 
460,229  

5,819  
158,110 
2,997 
8,417 
(106,243) 
69,100  

The major components of the Corporate and unallocated amounts are summarized in the table below: 

Research and development costs 

Amortization of capitalized software costs 

Marketing expense 

Other Corporate and overhead costs (1) 

Total Corporate and unallocated 

Fiscal Year Ended March 31, 

2015 

2014 

2013 

69,240    
12,817    
11,913    
64,065    
158,035    

41,524    
12,338    
10,123    
76,550    
140,535    

30,865 
9,668 
7,012 
58,698 
106,243 

___________________________________ 
(1) 

Includes the $25,971 Hospital Solutions Division impairment charge recorded in the year ended March 31, 2014. 

15. Subsequent Events 

On May 20, 2015, the Board of Directors approved a quarterly cash dividend of $0.175 per share on the Company’s outstanding 
shares of common stock, payable to shareholders of record as of June 12, 2015 with an expected distribution date on or about 
July 6, 2015. 

84 

 
 
 
 
 
 
   
   
 
   
   
 
 
 
 
 
 
 
16. Selected Quarterly Operating Results 

The following table presents quarterly unaudited consolidated financial information for the eight quarters preceding March 31, 
2015. Such information is presented on the same basis as the annual information presented in the accompanying consolidated 
financial statements. In management’s opinion, this information reflects all adjustments that are necessary for a fair statement of 
the results for these periods. 

(Unaudited) 

Revenues: 

Software and hardware 

Implementation and training services 

System sales 

Maintenance 

Electronic data interchange services 

Revenue cycle management and related 
services 

Other services 

Maintenance, EDI, RCM and other 
services 

Total revenues 

Cost of revenue: 

Software and hardware 

Implementation and training services 

Total cost of system sales 

Maintenance 

Electronic data interchange services 

Revenue cycle management and related 
services 

Other services 

Total cost of maintenance, EDI, RCM and 
other services 

Total cost of revenue 

Gross profit 

Operating expenses: 

Selling, general and administrative 

Research and development costs 

Amortization of acquired intangible assets 

Impairment of goodwill and other assets 

Total operating expenses 

Income (loss) from operations 

Interest income (expense), net 

Other income (expense), net 

Income (loss) before provision for income 
taxes 

Provision for (benefit of) income taxes 

Net income (loss) 

Net income (loss) per share: 

Basic* 

Diluted* 

Weighted-average shares outstanding: 

Basic 

Diluted 

6/30/2013    9/30/2013    12/31/2013    3/31/2014    6/30/2014    9/30/2014    12/31/2014    3/31/2015 

Quarter Ended 

$  15,972    $  15,562    $ 

6,575   
22,547   
38,608   
16,692   

7,809   
23,371   
40,313   
16,545   

14,114    $  15,186    $  14,743    $  14,230    $  16,339   $  16,061  
6,684  
5,046   
22,745  
19,160   
43,234  
39,763   
20,082  
16,637   

7,040   
21,270   
42,135   
18,906   

6,518   
21,704   
41,376   
17,421   

6,266   
21,009   
40,805   
18,319   

3,658  
19,997  
43,045  
19,051  

16,015 
15,667   

15,467 
15,385   

16,178 
17,116   

15,316 
19,386   

16,693 
21,068   

17,432 
20,776   

20,392
20,939  

19,720 
22,607  

86,982 
109,529   

87,710 
111,081   

99,249 
89,694 
108,854    115,203    117,894    120,519   

96,885 

93,499 

  105,643 
103,427
123,424   128,388  

4,934   
7,134   
12,068   
5,302   
10,796   

4,779   
6,972   
11,751   
5,262   
10,650   

27,398   
7,466   
34,864   
5,642   
10,276   

7,115   
8,109   
15,224   
6,384   
10,845   

6,641   
7,151   
13,792   
6,914   
11,999   

6,521   
6,688   
13,209   
6,785   
12,015   

6,127  
4,584  
10,711  
7,365  
11,956  

5,404  
5,479  
10,883  
7,802  
12,274  

11,401 
8,505   

11,007 
9,012   

11,736 
8,537   

12,059 
8,842   

12,706 
10,779   

13,202 
11,562   

14,246
10,082  

14,252 
10,630  

36,004 
48,072   
61,457   

35,096   
5,614   
1,194   
—   
41,904   
19,553   
31   
(254 )  

35,931 
47,682   
63,399   

38,578   
7,615   
1,260   
—   
47,453   
15,946   
(205 )  
(155 )  

36,191 
71,055   
37,799   

36,864   
13,175   
1,219   
5,873   
57,131   
(19,332 )  
121   
18   

38,130 
53,354   
61,849   

38,676   
15,120   
1,132   
—   
54,928   
6,921   
322   
35   

42,398 
56,190   
61,704   

36,730   
16,236   
983   
—   
53,949   
7,755   
54   
9   

43,564 
56,773   
63,746   

38,681   
16,898   
908   
—   
56,487   
7,259   
69   
(26 )  

43,649
54,360  
69,064  

41,482  
18,468  
904  
—  
60,854  
8,210  
(82)  
—  

44,958 
55,841  
72,547  

41,279  
17,638  
898  
—  
59,815  
12,732  
(271 ) 

(45 ) 

19,330 
6,385   

15,586 
5,465   

$  12,945    $  10,121    $ 

(19,193 )  
(6,606 )  
(12,587 )   $ 

7,278 
2,077   
5,201    $ 

7,818 
2,655   
5,163    $ 

7,302 
2,552   
4,750    $ 

12,416 
8,128
1,452  
1,673  
6,676   $  10,743  

$ 

$ 

0.22    $ 
0.22    $ 

0.17    $ 
0.17    $ 

(0.21 )   $ 
(0.21 )   $ 

0.09    $ 
0.09    $ 

0.09    $ 
0.08    $ 

0.08    $ 
0.08    $ 

0.11   $ 
0.11   $ 

0.18  
0.18  

59,559   
59,572   
0.175    $ 

59,734   
59,751   
0.175    $ 

60,173   
60,173   
0.175    $ 

60,208   
60,592   
0.175    $ 

60,230   
60,770   
0.175    $ 

60,247   
60,788   
0.175    $ 

60,272  
60,855  
0.175   $ 

60,288  
60,956  
0.175  

Dividends declared per common share 

$ 

____________________ 
* 

Quarterly EPS may not sum to annual EPS due to rounding 

85 

 
 
 
 
   
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
 
   
   
   
   
   
   
   
 
SCHEDULE II — VALUATION AND QUALIFYING ACCOUNTS 

Sales Return Reserve 

Balance at 
Beginning of 
Year 

Additions 
Charged 
Against 
Revenue 

Deductions 

10,530    $ 
6,506    $ 
2,229    $ 

8,038    $ 
17,966    $ 
10,783    $ 

(9,733)   $

(13,942)   $

(6,506)   $

Balance at 
End of Year 
8,835 
10,530 
6,506 

Allowance for Doubtful Accounts 

Balance at 
Beginning of 
Year 

Additions 
Charged to 
Costs and 
Expenses 

Deductions 

6,295    $ 
11,823    $ 
8,481    $ 

855    $ 
1,467    $ 
6,885    $ 

(3,847)   $

(6,995)   $

(3,543)   $

Balance at 
End of Year 
3,303 
6,295 
11,823 

Valuation Allowance on Deferred Tax Assets 

Balance at 
Beginning of 
Year 

Additions 
Charged to 
Costs and 
Expenses 

Deductions 

2,288    $ 
2,003    $ 
1,446    $ 

—    $ 
285    $ 
557    $ 

(448 )   $ 
—    $ 
—    $ 

Balance at 
End of Year 
1,840  
2,288  
2,003  

$

$

$

$

$

$

$

$

$

(in thousands) 
For the year ended 

March 31, 2015 

March 31, 2014 

March 31, 2013 

(in thousands) 
For the year ended 

March 31, 2015 

March 31, 2014 

March 31, 2013 

(in thousands) 
For the year ended 

March 31, 2015 

March 31, 2014 

March 31, 2013 

86 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
INDEX TO EXHIBITS ATTACHED TO THIS REPORT 

Exhibit 
Number 

  Description 

21 

23.1 

31.1 

31.2 

32.1 

  List of subsidiaries. 

  Consent of Independent Registered Public Accounting Firm — PricewaterhouseCoopers LLP. 

Certification of Principal Executive Officer Required by Rule 13a-14(a) of the Securities Exchange Act of 
1934, as amended, as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. 

Certification of Principal Financial Officer Required by Rule 13a-14(a) of the Securities Exchange Act of 1934, 
as amended, as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. 

Certification of Chief Executive Officer and Chief Financial Officer Pursuant to 18 U.S.C. Section 1350, as 
Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. 

101.INS* 

  XBRL Instance 

101.SCH* 

  XBRL Taxonomy Extension Schema 

101.CAL* 

  XBRL Taxonomy Extension Calculation 

101.DEF* 

  XBRL Taxonomy Extension Definition 

101.LAB* 

  XBRL Taxonomy Extension Label 

101.PRE* 

  XBRL Taxonomy Extension Presentation 

____________________ 
* 

XBRL information is furnished and not filed or a part of a registration statement or prospectus for purposes of section 11 
or 12 of the Securities and Exchange Act of 1933, as amended, is deemed not filed for purposes of section 18 of the 
Securities and Exchange Act of 1934, as amended, and otherwise is not subject to liability under these section. 

87 

 
 
 
 
 
 
 
 
QUALITY SYSTEMS, INC. 
LIST OF SUBSIDIARIES 

EXHIBIT 21 

1. 
2. 
3. 
4. 
5. 
6. 
7. 
8. 
9. 

NextGen Healthcare Information Systems, LLC 
NextGen RCM Services, LLC 
QSI Management, LLC 
Quality Systems India Healthcare Pvt. Ltd. 
ViaTrack Systems, LLC 
Matrix Management Solutions, LLC 
Mirth, LLC 
Mirth Limited 
Gennius, Inc. 

88 

 
 
 
 
CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM 

We hereby consent to the incorporation by reference in the Registration Statements on Form S-8 (No. 333-63131, No. 333-
67115, No. 333-129752, and No. 333-198181) and Form S-3 (No. 333-173818 and No. 333-178169) of Quality Systems, Inc. of 
our report dated May 22, 2015 relating to the financial statements, financial statement schedules, and the effectiveness of 
internal control over financial reporting, which appears in this Form 10-K. 

EXHIBIT 23.1 

/s/ PricewaterhouseCoopers LLP 
Orange County, California 
May 22, 2015  

89 

 
 
 
 
 
 
CERTIFICATION OF PRINCIPAL EXECUTIVE OFFICER REQUIRED BY 
RULE 13A-14(A) OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED, 
AS ADOPTED PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002 

EXHIBIT 31.1 

I, Steven T. Plochocki, certify that: 

1. 

I have reviewed this Annual Report on Form 10-K of Quality Systems, Inc.; 

2.  Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact 

necessary to make the statements made, in light of the circumstances under which such statements were made, not 
misleading with respect to the period covered by this report; 

3.  Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all 
material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods 
presented in this report; 

4.  The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and 

procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as 
defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have: 

a.  Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed 

under our supervision, to ensure that material information relating to the registrant, including its consolidated 
subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is 
being prepared; 

b.  Designed such internal control over financial reporting, or caused such internal control over financial reporting to be 

designed under our supervision, 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; 

c.  Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our 

conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by 
this report based on such evaluation; and 

d.  Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the 
registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has 
materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; 
and 

5.  The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over 
financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons 
performing the equivalent functions): 

a.  All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting 
which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial 
information; and 

b.  Any fraud, whether or not material, that involves management or other employees who have a significant role in the 

registrant’s internal control over financial reporting. 

Date:  May 22, 2015 

By:  /s/ Steven T. Plochocki 

Steven T. Plochocki 
Chief Executive Officer 
(Principal Executive Officer) 

90 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CERTIFICATION OF PRINCIPAL FINANCIAL OFFICER REQUIRED BY 
RULE 13A-14(a) OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED, 
AS ADOPTED PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002 

EXHIBIT 31.2 

I, John K. Stumpf, certify that: 

1. 

I have reviewed this Annual Report on Form 10-K of Quality Systems, Inc.; 

2.  Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact 

necessary to make the statements made, in light of the circumstances under which such statements were made, not 
misleading with respect to the period covered by this report; 

3.  Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all 
material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods 
presented in this report; 

4.  The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and 

procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as 
defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have: 

c.  Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed 

under our supervision, to ensure that material information relating to the registrant, including its consolidated 
subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is 
being prepared; 

d.  Designed such internal control over financial reporting, or caused such internal control over financial reporting to be 

designed under our supervision, 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; 

e.  Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our 

conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by 
this report based on such evaluation; and 

f.  Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the 
registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has 
materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; 
and 

5.  The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over 
financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons 
performing the equivalent functions): 

a.  All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting 
which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial 
information; and 

b.  Any fraud, whether or not material, that involves management or other employees who have a significant role in the 

registrant’s internal control over financial reporting. 

Date:  May 22, 2015 

By:  /s/ John K. Stumpf 

John K. Stumpf 
Interim Chief Financial Officer 
(Principal Accounting Officer) 

91 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CERTIFICATION OF CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER 
PURSUANT TO 18 U.S.C. SECTION 1350, 
AS ADOPTED PURSUANT TO 
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002 

EXHIBIT 32.1 

In connection with the Annual Report on Form 10-K of Quality Systems, Inc. (the “Company”) for the year ended March 31, 2015 
(the “Report”), the undersigned hereby certify in their capacities as Chief Executive Officer and Interim Chief Financial Officer of 
the Company, respectively, pursuant to 18 U.S.C. section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act 
of 2002, that:  

1. the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended; 
and 

2. the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations 
of the Company. 

Date:  May 22, 2015 

By:  /s/ Steven T. Plochocki 

Steven T. Plochocki 
Chief Executive Officer 
(Principal Executive Officer) 

Date:  May 22, 2015 

By:  /s/ John K. Stumpf 

John K. Stumpf 
Interim Chief Financial Officer 
(Principal Accounting Officer) 

92 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
C O M P A N Y   P R O F I L E

C O R P O R A T E   I N F O R M A T I O N

Quality Systems, Inc. (NASDAQ:QSII) and its NextGen Healthcare subsidiary 

B O A R D   O F   D I R E C T O R S

A N N U A L   M E E T I N G

(QSI/NextGen Healthcare) develop and market a wide range of cutting-edge healthcare 

information technology software and services, including practice management solutions, 

electronic health records, revenue cycle management services and patient engagement 

tools along with connectivity and interoperability applications. The Company serves 

medical and dental group practices as well as rural and community hospitals. The 

QSI/NextGen Healthcare solution suite is designed to address the changing healthcare 

landscape and evolving models.

Fiscal Year 2015

Revenue: $490.2 million

Diluted Non-GAAP EPS: $0.62*

Revenue: 

$373.8 million

(76% of Total)

Revenue: 

Revenue: 

$80.0 million

(16% of Total)

Revenue: 

Market 

Served: 

Ambulatory  

Practices

Market 

Served: 

Dental

Practices

Market 

Served: 

Ambulatory

Practices

Market 

Served: 

Small

Hospitals

$18.5 million

(4% of Total)

~ 10,000

Dentists

• Practice

  Management

• Electronic

  Health Records

~ 6,500

Providers

• Revenue Cycle

  Management

• Other Services

$18.0 million

(4% of Total)

~ 300

Hospitals

• Financials

• Clinical

• Surgery

  Scheduling

~ 85,000

Providers

• Practice

  Management

• EHR

• Population 

  Health

   Management

• Patient Portal

*  This is a non-GAAP (Generally Accepted Accounting Principles) fi nancial measure, which is being provided only as supplemental information. Investors 

should consider this non-GAAP fi nancial measure only in conjunction with the comparable GAAP fi nancial measure. This non-GAAP fi nancial measure 

is not in accordance with or a substitute for U.S. GAAP. Pursuant to the requirements of Regulation G, we have provided a reconciliation of this non-

GAAP fi nancial measure to the most directly comparable GAAP fi nancial measure in the fi nancial tables accompanying our press release announcing 

our fi nancial performance for the period ended March 31, 2015, a copy of which is furnished as Exhibit 99.1 of the Form 8-K fi led on May 21, 2015 with 

the Securities and Exchange Commission. Other companies may calculate this non-GAAP measure differently than we do, which limits comparability 

between companies. We believe that the presentation of non-GAAP diluted earnings per share provides useful supplemental information to investors 

and management regarding our fi nancial condition and results. We calculate non-GAAP diluted earnings per share by excluding acquisition costs, 

amortization of acquired intangible assets, impairment of goodwill and other assets, securities litigation defense costs, share-based compensation, 

and other non-run-rate expenses from GAAP income before provision for income taxes. The non-GAAP provision for income taxes is calculated by 

excluding the income tax effect of the non-GAAP adjustments.

Sheldon Razin
Chairman of the Board and Founder 
Quality Systems, Inc.

Steven T. Plochocki
President and Chief Executive Officer 
Quality Systems, Inc. (Retiring June 30, 2015)

Craig A. Barbarosh
Partner, Katten Muchin Rosenman LLP

George H. Bristol
Managing Director, Janas Associates

James C. Malone
Executive Vice President and 
Chief Financial Officer, XIFIN, Inc.

Jeffrey H. Margolis
Chairman and Chief Executive Officer, Welltok, Inc.

Morris Panner
Chief Executive Officer, DICOM Grid

D. Russell Pflueger
Chairman and Chief Executive Officer 
Quiescence Medical, Inc.

Lance E. Rosenzweig
Operating Partner, Marlin Equity Partners

O F F I C E R S   O F   T H E   C O M PA N Y

Steven T. Plochocki
President and Chief Executive Officer
(Retiring June 30, 2015)

Rusty Frantz
Incoming President and Chief Executive Officer
(Effective July 1, 2015)

Jocelyn A. Leavitt
Executive Vice President, General Counsel 
and Secretary

Daniel J. Morefield
Executive Vice President, Chief Operating Officer

Stephen K. Puckett
Executive Vice President, Chief Technology Officer

John K. Stumpf
Interim Chief Financial Officer

I N D E P E N D E N T   A U D I T O R S

PricewaterhouseCoopers LLP
Irvine, California

S T O C K   T R A N S F E R   A G E N T 
&   R E G I S T R A R

Computershare
Glendale, California

2015 Annual Shareholders’ Meeting is scheduled to 
be held on Tuesday, August 11, 2015 at 1:00 PM 
Pacific Time.

The meeting will be held at:
The Center Club
650 Town Center Drive
Costa Mesa, California 92626

The meeting may be subject to change or 
postponement by Quality Systems’ Board of Directors. 

F O R M   1 0 - K

A copy of the Company’s Annual Report on Form 10-K, 
filed with the Securities and Exchange Commission, is 
available on the Company’s website at www.qsii.com 
or by contacting the Company at:

Quality Systems, Inc.
Attention: Investor Relations
18111 Von Karman Avenue, Suite 700
Irvine, California 92612
949.255.2600

F O R W A R D - L O O K I N G   S TAT E M E N T S

Statements made in this Annual Report to Shareholders and 
in our Annual Report on Form 10-K (“Form 10-K”) contained 
herein (collectively, this “Report”), other reports and proxy 
statements fi led with the Securities and Exchange Commission 
(“Commission”),  communications  to  shareholders,  press 
releases  and  oral  statements  made  by  our  representatives 
that are not historical in nature, or that state our or manage-
ment’s intentions, hopes, beliefs, expectations or predictions 
of the future, may constitute “forward-looking statements” 
within  the  meaning  of  Section  21E  of  the  Securities  and 
Exchange Act of 1934, as amended. Forward-looking state-
ments can often be identifi ed by the use of forward-looking 
terminology, such as “could,” “should,” “will,” “will be,” “will 
lead,” “will assist,” “intended,” “continue,” “believe,” “may,” 
“expect,”  “hope,”  “anticipate,”  “goal,”  “forecast,”  “plan,” 
“potentially”  or  “estimate”  or  variations  thereof  or  similar 
expressions. Forward-looking statements are not guarantees 
of future performance. Forward-looking statements involve 
risks, uncertainties and assumptions. It is important to note 
that any such performance and actual results, fi nancial condi-
tion or business, could differ materially from those expressed 
in such forward-looking statements. Factors that could cause 
or contribute to such differences include, but are not limited 
to, the risk factors discussed in Item 1A of our Form 10-K as 
well as factors discussed elsewhere in this and other reports 
and documents we fi le with the Commission. Other unforeseen 
factors not identifi ed herein could also have such an effect. We 
undertake no obligation to update or revise forward-looking 
statements to refl ect changed assumptions, the occurrence of 
unanticipated events or changes in future operating results, 
fi nancial condition or business over time unless required by 
law. Interested persons are urged to review the risks described 
under Item 1A, “Risk Factors” and in Item 7, “Management’s 
Discussion and Analysis of Financial Condition and Results of 
Operations” in our Form 10-K, as well as in our other public 
disclosures and fi lings with the Commission.

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C O R P O R AT E   H E A D Q U A R T E R S   &
Q S I D E N TA L   L O C AT I O N

18111 Von Karman Avenue, Suite 700

Irvine, California 92612

949.255.2600

Q S I / N E X T G E N   L O C AT I O N S

3340 Peachtree Road NE, Suite 2700

1155 F Street NW, Suite 1050

Atlanta, Georgia 30326

Washington, DC 20004

11350 McCormick Road

2795 E. Cottonwood Parkway

Hunt Valley, Maryland 21031

Salt Lake City, Utah 84121

1836 Lackland Hill Parkway

St. Louis, Missouri 63146

611 Anton Boulevard, Suite 500

Costa Mesa, California 92626

5200 Stoneham Road, Suite 210

3200 Park Center Drive, Suite 310

North Canton, Ohio 44720

Costa Mesa, California 92626

795 Horsham Road

Horsham, Pennsylvania 19044

12301-B Riata Trace Parkway, Suite 200

Austin, Texas 78727

Q S I   H E A LT H C A R E   P R I VAT E   L I M I T E D   L O C AT I O N

Pritech Park SEZ

Block 11, First Floor

Outer Ring Road, Bellandur Post

Bangalore – 560103

Karnataka India

www.qsii.com         www.nextgen.com

2 0 1 5   A N N U A L   R E P O R T

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O F   H E A LT H C A R E