Quarterlytics / Healthcare / Medical - Care Facilities / Tivity Health, Inc. / FY2008 Annual Report

Tivity Health, Inc.
Annual Report 2008

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Employees 501-1000
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FY2008 Annual Report · Tivity Health, Inc.
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2008 Annual Report

2008

HEALTHWAYS

I

2008

HEALTHWAYS

II

company profile

In the U.S. alone, the annual bill for health care and health-related lost productivity for people with chronic disease is $1.2 trillion and is 
expected to grow to nearly $4 trillion over the next eight years. Globally, the costs are multiples of the domestic expense. Healthways’ 
(NASDAQ: HWAY) business is to provide solutions to individuals, health plans, employers and governments that will reduce the size of 
that bill, both domestically and internationally.

With more than 25 years of experience helping tens of millions of individuals, we recognize that focusing solely on helping people who 
are already sick is an important, but insufficient, component of making a difference that is large enough to matter. Accordingly, our 
solutions are designed to:

•  keep healthy people healthy 
•  mitigate, delay or prevent disease progression associated with modifiable, unhealthy lifestyle risk factors; and 
•  optimize care for those with chronic disease

in an ongoing effort to help each individual in our customers’ populations achieve the World Health Organization’s definition of health: 
“… a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” 

Since our approach is focused on helping each individual to pursue, achieve or maintain this “state of health,” our solutions are uniquely 
tailored to support that effort in four distinct environments:

• 
• 

• 

• 

the Medical Home – the physicians and facilities that make up the traditional health care system people access when they’re sick 
the Health Home – the complementary health providers and venues people access when they’re undertaking health 
promoting activities or lifestyle behavior changes 
the Work Home – the locale in which a significant part of the population spends most of their waking hours and in which a 
positive focus on well-being can produce significant returns in both reduced direct cost and improved productivity; and
the Personal Home – the individual, their family and the social networks in which they choose to involve themselves

Our insight into the reality of how individuals actually choose or can be effectively motivated to pursue health, our deep understanding 
of  the  required  components  for  effective,  scalable  solutions  and  our  commitment  to  respond  to  increasing  market  demand  for 
comprehensive, integrated solutions have led to our development of a superior technology platform, an expansive service delivery 
infrastructure and a portfolio of patented intellectual property unequalled in the industry.

With  over  1,000  customers,  Healthways  is  a  trusted  partner  with  unique  insights  into  the  needs  of  the  market  for  next-generation 
solutions that are disease, age and payer agnostic while demonstrating a consistent capability to be engaging, pragmatic, convenient, 
impactful and efficient. 

Healthways – creating a healthier world, one person at a time.

2008

HEALTHWAYS

1

financial highlights

Year Ended and at August 31, 

( In thousands, except per share data )

OperatIng Data
Revenues

Net income

Diluted earnings per share

Diluted weighted average common shares and equivalents

OperatIng StatIStIcS

Billed lives

FInancIal pOSItIOn

Cash and cash equivalents

Working capital

Total assets

Long-term debt

Other long-term liabilities

Stockholders’ equity

2008

2007

$ 736,243

$ 54,815

$

1.50

36,597

$ 615,586

$ 45,121

$

$1.22

37,002

31,700

27,400

$ 35,242

$ 21,276

$ 906,813

$ 345,395

$ 31,227

$ 354,334

$ 47,655

$ 10,792

$ 828,845

$ 297,059

$ 14,388

$ 362,750

2008

HEALTHWAYS

2

financial highlights

revenue

DIluteD earnIngS 
per Share

caSh FlOw FrOm 
OperatIOnS

eBItDa(1)

BIlleD lIveS

( In millions )

.

4
5
4
2
$

.

5
2
1
3
$

.

3
2
1
4
$

.

6
5
1
6
$

.

2
6
3
7
$

( In millions )

( In millions )

( In thousands )

5
7
0
$

.

3
9
0
$

.

2
0
1
$

.

2
2
1
$

.

0
5
1
$

.

.

6
4
5
$

.

2
5
7
$

.

8
9
9
$

.

3
7
0
1
$

.

3
5
0
1
$

.

3
5
6
$

.

8
8
7
$

.

7
6
8
$

.

5
0
3
1
$

.

0
1
6
1
$

5
3
3
1

,

3
8
8
1

,

6
2
4
2

,

0
0
4
7
2

,

0
0
7
1
3

,

04  05  06  07  08

04  05  06  07  08

04  05  06  07  08

04  05  06  07  08

04  05  06  07  08

(1) See page 52 for a reconciliation of GAAP and non-GAAP results.

2008

HEALTHWAYS

3

Push limits. Expand value.

In a national health care environment focused on short-term interventions 
for acute care problems, Healthways was the first visionary in the field to 
stand up and ask, “What if?”

What  if  someone  could  get  out  there  ahead  of  illness  and  engage  more 
people  when  they  are  healthy?  What  if  someone  offered  a  radically 
different  approach  to  the  challenges  of  spiraling  health  care  costs, 
lost  productivity  and  life-long  health?  What  if  someone  provided 
a  new  and  more  powerful  way  for  employers,  governments  and 
communities  to  gauge  the  true  well-being  of  their  constituencies? 

Would the results be…provocative? Impressive? Revolutionary?

Today, Healthways is helping more people take charge of their health, 
mitigate  their  lifestyle  risk  and  proactively  optimize  their  care  than 
any  other  company.  Our  deep  insights  into  the  drivers  of  well-being, 
our  industry-leading  innovation  and  our  proven  outcomes  deliver 
unprecedented value. We are proud to be helping reframe the debate 
over the future of health care around the world.

“ we designed a very new type of program when we hired healthways. It was a huge effort to get onsite 
coaches trained and placed in facilities across the u.S. we have appreciated the company’s ability to 
be extremely flexible. ”

HEALTHWAYS

2008

4

mike taylor, m.D.
Medical Director for Health Promotion, Caterpillar Corporation

the market is nearing an inflection point

Fellow shareholders:

For  the  past  27  years,  Healthways  has  consistently  recognized  new  market  opportunities  and  moved  with  purpose  to  deliver 
solutions that reduce health care cost by improving health. Historically, these solutions were focused on enabling individuals who 
were already ill to maximize their well-being by assuring that they knew how to effectively manage their diseases in accordance 
with evidence-based standards of care. The accuracy of our market assessments, our innovation and the proven effectiveness of our 
solutions have positioned us currently as the clear market leader in our industry. 

Our  historic  solutions  have  been  effective  in  bending  the  health  care  cost  trend  for  our  employer  and  health  plan  customers. 
However, annual inflation of those medical costs at a rate that is two to three times greater than general inflation led us to conclude 
that  our  historic  solutions,  while  critical,  were  simply  not  enough. We  recognized  that  an  effective  solution  had  to  address  not 
only the needs of the sick, but also had to be effective in helping people avoid becoming sick in the first place. In short, the new 
solution had to (i) keep healthy people healthy, (ii) mitigate the risk associated with modifiable, health-related lifestyle behaviors, 
and (iii) assure that those who had already been diagnosed with a disease or condition received optimal, evidence-based care. The 
solution to drive this expanded value proposition requires a personalized approach for improving well-being for every individual – 
regardless of their past, current or future health circumstances.

Our market assessment led to the decision to acquire the nation’s leading health and wellness company, which, by itself, expanded 
the number of individuals with whom we work from approximately 2.5 million to more than 31 million today. More importantly, 
our  understanding  of  the  market’s  direction  drove  both  the  innovative  design  of  our  new WholeHealth  solution  and  our  long-
term, strategic relationship with Gallup. Our WholeHealth solution supports a major expansion of our historic value proposition by 
allowing us to share in the value of improving workforce productivity. Our 25-year partnership with Gallup has created a new official 
statistic – the Gallup-Healthways Well-Being IndexTM – for assessing a population’s physical, emotional and social health, designing 
specific solution sets to address areas of deficit and measuring the effectiveness of the solutions employed. 

Healthways’  WholeHealth solution is designed to improve the well-being of individuals. The aggregate impact of each individual’s 
improvement  is  directly  measurable,  benefiting  them,  their  families,  communities,  employers  and  countries.  We  believe  our 
WholeHealth solution will result in improvement in health and a reduction in direct health care cost, in addition to a significant 
and measurable improvement in health-impacted productivity. Creating this value for our customers requires approaches that 
produce persistent and sustained performance that is meaningful, measurable, repeatable and scalable. Our WholeHealth solution 
will meet all of those requirements with configurable components that enable an individualized plan that is agnostic to disease, 
health status, age or payer.

The market is nearing an inflection point. The demand for WholeHealth solutions will, over the next few years, surpass demand for 
less comprehensive solutions that address only components of the value proposition. Evidence for this transition is reflected in the 

2008

HEALTHWAYS

5

Flexibility. Strength. Adaptability.

When it comes to well-being solutions, one size definitely does not fit all.

Each individual approaches health optimization with unique circumstances 
and objectives – as does each employer, government or community. In 
fact,  the  term “health”  itself  can  be  dangerously  misleading.  Is  physical 
health  all  there  is  to  well-being?  What  about  work  life,  home  life  and 
political or economic conditions?

There is one fundamental truth when it comes to well-being – no one can 
go it alone. Without the integrated knowledge, tools, programs, systems, 
resources, encouragement and support needed to make informed choices, 

drive  healthy  behaviors  and  guide  strategic  investment,  individuals, 
governments,  employers  and  communities  cannot  achieve  their  true 
potential – and the result of that failure can be catastrophic for individuals 
and societies.

Healthways is in the forefront of changing the health care equation. From 
first to market with disease management and total population solutions 
to the WholeHealth approach of tomorrow, Healthways continues to lead 
the way. The opportunity is extraordinary.

“ as the leading integrated healthcare company in Brazil, we are proud to be allied with healthways 
to provide the best-in-class disease management services to the Brazilian market.  we could not have 
chosen a more strategic, innovative and experienced partner. ”

HEALTHWAYS

2008

6

mauro Figueiredo 
Chief Executive Officer, Fleury Group

Healthways has entered markets on three additional 
continents in the past twelve months

letter to shareholders

current growth of Requests for Proposal (RFPs) for comprehensive and integrated solutions. Fully satisfying this emerging demand 
will require a proven ability to measure the performance of our solution by the improvement in outcomes with regard both to well-
being and medical and productivity-related cost savings. In addition to our current capabilities, we believe the Gallup-Healthways 
Well-Being Index, built on the largest and most comprehensive database of its kind, will substantially enhance our ability to prove 
to  health  plans,  employers  and  governments  that  our  solutions  produce  the  best  performance.  As  a  result,  Healthways  is  well-
positioned  to  meet  the  emerging  needs  of  our  domestic  and  international  markets,  irrespective  of  the  ultimate  shape  of  likely 
health care reform initiatives, which generally call for greater focus on health, wellness, prevention and disease management. 

Fiscal 2008: Substantial profitable growth in a challenging environment – Healthways produced 23% growth in earnings per 
diluted share for fiscal 2008 to $1.50 from $1.22 for fiscal 2007.  Revenue increased 20% to $736 million for fiscal 2008 from $616 
million for the prior year. As anticipated, our operating margins remained consistent, with EBITDA(1) for fiscal 2008 increasing 23% 
to $161 million, or 22% of revenue, from $131 million, or 21% of revenue, for fiscal 2007.

Demand for our services remained strong for fiscal 2008, reflected in a significant increase in the number of RFPs for the fiscal year. 
Due to the challenging national economic environment and uncertainty about its duration, some of these RFPs were withdrawn 
or remained pending at the fiscal year end. In addition, during our second fiscal quarter, we revised our financial guidance for the 
fiscal year due to an enrollment issue in a new program for a large existing health plan customer and to new programs that did not 
materialize as expected with two other existing long-term customers. While we met our revised guidance for fiscal 2008, the further 
deterioration of the economy since our fiscal year end creates ongoing, near-term challenges for both our existing and potential 
customers. Although our decision to change to a December fiscal year end beginning in 2009 will better align our management 
processes  and  sales  cycles  with  those  of  our  customers,  we  are  realistic  in  our  expectation  that  these  challenges  will  affect  the 
certainty of timing for converting industry demand into new business.

central  growth  Initiatives  Drive  current  results  and  long-term  potential  –  We  made  tangible  progress  in  each  of  our  three 
central growth initiatives during fiscal 2008. First, we increased our domestic commercial business by adding 4.3 million billed lives, 
primarily from expanded business with existing customers, but also as a result of a record number of new customer contracts. With 
total billed lives of 31.7 million at our fiscal year end, penetration of our more than 190 million available commercial domestic lives 
increased to 16.5%. We believe our relatively low penetration rate for current customers highlights the tremendous opportunity we 
have to grow our domestic commercial business.

Second, we expanded our addressable markets with the launch of our first international contracts in Germany and Brazil.  With the 
December signing of a contract to provide services in Australia, Healthways has entered markets on three additional continents in 
the past twelve months. Through our business development activities around the world, we are confident that the urgent health 

(1) See page 52 for a reconciliation of GAAP and non-GAAP results.

2008

HEALTHWAYS

7

Improve well-being. Drive performance.

Healthways’  purpose  is  to  create  a  healthier 
world, one person at a time.

We want to change the way people feel, the way 
they work, the way their needs are understood, 
and the way they interact with family members, 
neighbors,  providers,  health  plans,  employers 
and policy makers.

It’s  also  a  statement  of  the  readiness  of  all  the 
parts of a community or nation to contribute to 
the  whole. The  costs  of  disease  and  unhealthy 
lifestyles can be counted in coins other than lives 
impacted  and  benefits  paid.  They  can  also  be 
measured in lost workdays, reduced productivity, 
lost opportunity and diminished GDP.

It’s  not  just  an  altruistic  goal,  it’s  an  economic 
and  social  imperative.  Well-being  is  neither  a 
personal  definition  nor  an  isolated  condition. 

Worse, this economic impact compounds over 
time and is expected to more than double over 
the next decade. Employers and policy makers, 

both domestically and abroad, are demanding 
solutions. The company able to provide them 
will  gain  commanding  market  share  and  a 
considerable competitive advantage.

Healthways believes when people feel good 
they can do great things. When the potential 
of  individuals  is  fully  unleashed,  we  are  all 
the beneficiaries.

“ One of the things we pride ourselves on here in Iowa is the importance of relationships, trust, and open 
honest dialogue. we have developed a vision at wellmark. we’re very excited about that vision, and we’re 
excited that healthways shares that vision. ”

HEALTHWAYS

2008

8

Dale andringa, m.D.
Vice President & Chief Medical Officer, Wellmark Blue Cross, Blue Shield

we achieved a critical milestone with the launch 
of the Gallup-Healthways Well-Being IndexTM

letter to shareholders

care issues we address domestically are common to many other countries. We also completed our participation in the Medicare 
Health Support pilots during fiscal 2008.  We do not yet know if the final reconciliation of our pilots will enable us to improve the 
net financial impact already recorded from the pilots or if evaluation of the pilots will lead to Phase II expansion by the Centers 
for  Medicare  and  Medicaid  Services. We  do  know  that  our  experience  in  these  pilots  has  already  been  applied  to  improve  our 
performance in our German contract and in contracts serving Medicare Advantage populations domestically. Further, it is clear 
to us that any effective reform solution is going to focus on both prevention and chronic care management solutions. While we 
don’t yet know what structure will emerge from the pending reform debate, we believe that we are optimally positioned to take 
advantage of the business growth opportunities resulting from the very real needs of Federal and state governments with respect 
to the nearly 75 million Medicare and Medicaid participants for whom they are responsible.

Third,  we enhanced our value proposition during fiscal  2008 through  further  development and refinement  of  our WholeHealth 
solution. We achieved a critical milestone with the launch of the Gallup-Healthways Well Being Index. We expect to achieve new 
milestones beginning in 2009 through the migration of all our current-state business to our next generation technology platform. 
We  also  expect  to  sign  our  first WholeHealth  contract  that  will  include  measures  of  improved  productivity  as  part  of  targeted 
outcomes. This enhancement to our value proposition will further our ability to expand our domestic commercial business and our 
addressable markets.

Questions asked and answered – Given an economic environment unprecedented in recent history and an increasing number 
of  entrants  into  the “prevention”  and “disease  management”  space,  many  shareholders  and  industry  analysts  commonly  ask  us 
questions about our financial strength and liquidity, our short-term outlook and competitive threats. 

With  respect  to  our  financial  strength  and  liquidity,  we  completed  fiscal  2008  in  a  strong  financial  position,  reflected  in  the 
percentage of our debt to total capital of 49.6%. We supported our financial position with substantial cash flow from operations, 
which, at $105.3 million, was almost double net income for the fiscal year. The ratio of our debt to EBITDA for fiscal 2008 was 2.2 after 
repurchasing $94 million of our stock. Our planned capital expenditures for fiscal 2009 are relatively modest, following unusually 
high capital expenditures in fiscal 2008 of $82.5 million, which included approximately $40 million for four new call centers and our 
move into a new corporate headquarters. We believe our financial position and ongoing cash generation will enable us to continue 
to aggressively pursue our central growth initiatives.

While our visibility regarding the short-term impact of the current economic environment is limited, our domestic and international 
contract pipelines are active, and industry analysts expect employer health care costs to continue rising at a rate significantly higher 
than  overall  inflation  in  both  2009  and  2010.  During  fiscal  2008,  our  largest  heath  plan  contract,  accounting  for  approximately 
20% of fiscal 2008 revenue, renewed early under essentially the same economic terms and conditions and extended the term of 

2008

HEALTHWAYS

9

Bridging to the future.

Fiscal  2008  was  a  difficult  year.  With  global 
financial  markets  in  turmoil,  employers  and 
institutions  returned  to  a  focus  on  core 
competencies  and  delayed  strategic  decision 
making  and  investment.  November  witnessed 
the beginning of regime change in Washington 
and the uncertainty that inevitably goes with it.
The  financial  system  and  government  that 
emerges  in  the  coming  months  may  differ 
markedly from those of the past, but the goals 
of  our  health  care  system,  communities  and 

employers will remain to: lower costs, increase 
productivity, improve outcomes, expand value, 
enhance  competitiveness  and  –  in  the  end  – 
help individuals feel good so they can do great.
Our  ability  to  achieve  those  objectives  will 
be  felt  across  entire  populations,  but  our 
fundamental  and  collective  starting  point 
will  be  far  more  humble.  It  all  begins  with  the 
individual. People at home, in their communities 
and at work must be empowered, encouraged 
and  emboldened  to  make  the  choices  needed 

to advance themselves, their families and their 
nations.  The  conversation  in  this  country  and 
around the world must change. The debate can 
no longer focus wholly on medical care. It must 
also focus on the health and well-being of the 
whole person.
Progress will take courage. It will take vision. It will 
take  leadership,  innovation,  science,  discipline, 
perseverance  and  experience.  In  short,  it  will 
take Healthways. That is both our challenge and 
opportunity as we look to 2009 and beyond.

“ healthways really understands how to support behavior change on an individual level. as the first 
direct-to-consumer customer, I am thrilled with the customized attention to my needs. healthways 
has helped me work towards my personal goals and I am already seeing the results. ”
10

HEALTHWAYS

2008

chris Sassouni
Direct-to-Consumer Customer

Healthways has the proven solutions 
to meet the market’s needs

letter to shareholders

our relationship through February 2013. While we announced that one health plan accounting for approximately 3% of fiscal 2008 
revenue will terminate at the end of December 2008, we have already renewed two of four other material health plan contracts up 
for renewal in 2009. The remaining two contracts totaled approximately 6% of fiscal 2008 revenue. We expect to have improved 
short-term  visibility  when  we  provide  guidance  for  2009  in  February. We  remain  optimistic  about  our  long-term  prospects  for 
growth  domestically  and  internationally  given  both  the  increasing  incidence  and  prevalence  of  disease  and  the  increased  risk 
associated with unhealthy life style choices. 

We are also questioned about the competitive threat posed by new entrants to our industry and potential insourcing of our services 
by  health  plans.  At  the  most  basic  level,  our  answer  is  that  outcomes  -  the  ability  to  improve  health  and  lower  costs  at  a  large 
enough scale to matter - are the determining measure of success. Healthways has created an unsurpassed record of performance 
with regard to outcomes, and we are well positioned to continue raising the industry’s performance bar with innovative solutions 
of increasing power, sophistication, breadth and integration. While we remain a leading provider of individual health, wellness and 
disease-specific programs, market demand for fully integrated solutions is undeniable. As the aggregate outcomes these solutions 
produce across given populations continue to become demonstrably more meaningful, we expect payers to increasingly recognize 
that  our  superior  performance  enhances  their  ability  to  create  and  sustain  meaningful  competitive  advantage,  whether  their 
markets are regional, national or international in scope.

closing thoughts – Fiscal 2008 was a year of many challenges and much progress. Despite the current economic environment, 
we are confident that Healthways has the proven solutions that meet the market’s needs today. We also expect to maintain our 
status as the industry leader in the future through the effective execution and delivery of solutions to meet the market’s expanded 
objectives for tomorrow. We thank our colleagues throughout the Company for their resiliency under trying conditions and for 
their passionate commitment that has created our strong, differentiated market position. Through them, we will continue making 
the world a healthier place, one person at a time. 

Sincerely,

Ben R. Leedle, Jr.
Chief Executive Officer

2008

HEALTHWAYS

11

Selected Financial Data

Year ended and at August 31,

( In thousands, except per share data )

Operating results: (1)
Revenues
Cost of services (exclusive of depreciation and

amortization included below)

Selling, general and administrative expenses
Depreciation and amortization
Operating income
Interest expense

Income before income taxes
Income tax expense
Net income

Basic income per share: (2)

Diluted income per share: (2)

Weighted average common shares and equivalents: 
Basic
Diluted

Balance Sheet Data: (1)
Cash and cash equivalents
Working capital
Total assets
Long-term debt
Other long-term liabilities
Stockholders’ equity

Other Operating Data: 
Billed lives
Annualized revenue in backlog

2008

(2) (3)

2007

(2) (3)

2006

(2)

2005

2004

$

736,243

$

615,586 

$

412,308

$

312,504

$

245,410

503,940
71,342
47,479
113,482
20,927

92,555
37,740
54,815

1.57

1.50

34,977
36,597

35,242
21,276
906,813
345,395
31,227
354,334

$

$

$

$

417,721
67,352
37,044
93,469
18,185

75,284
30,163
45,121

1.29

1.22

35,049
37,002

47,655
10,792
828,845
297,059
14,388
362,750

$

$

$

$

281,161
44,417
24,517
62,213
1,053

61,160
24,009
37,151

1.08

1.02

34,348
36,379

154,792
124,469
382,386
236
10,853
274,873

$

$

$

$

205,253
28,418
22,408
56,425
1,630

54,795
21,711
33,084

1.00

0.93

33,241
35,691

63,467
70,644
270,954
416
9,055
206,930

$

$

$

$

156,462
23,686
18,450
46,812
3,509

43,303
17,245
26,058

0.81

0.75

32,264
34,632

45,147
55,462
253,449
36,562
7,694
155,435

$

$

$

$

31,700
13,600

$

27,400
39,900

$

2,426
6,625

1,883
32,578

$

1,335
15,200

$

$

(1)  Certain items in prior periods have been reclassified to conform to current classifications.
(2)  Includes $18.1 million, $21.0 million, and $15.3 million in fiscal 2008, 2007, and 2006, respectively, of costs related to equity-based awards expensed under Statement 
of Financial Accounting Standards (“SFAS”) No. 123(R) and cash-based awards issued in lieu of equity-based awards that were historically granted to certain levels 
of management. These cash-based awards are a result of changes in the design of the Company’s long-term incentive compensation program in preparation for 
adopting SFAS No. 123(R) on September 1, 2005.

(3)  Includes operating results, balance sheet data, and other operating data of Axia Health Management, Inc. since the date of the acquisition, which was December 1, 2006.

2008

HEALTHWAYS

12

management’s Discussion and analysis of Financial condition and results of Operation

Overview

 Founded in 1981, Healthways, Inc. (the “Company”) provides specialized, comprehensive Health and Care SupportSM solutions to 
help people maintain or improve their health and, as a result, reduce both direct healthcare costs and costs associated with the loss of 
health-related employee productivity.

Designed to provide highly specific and personalized interventions for each individual in a population, irrespective of health status, 
age, or payor, our evidence-based services are made available to consumers by phone, mail, internet, and face-to-face interactions. To 
expand our Health Support offerings, on December 1, 2006, we acquired Axia Health Management, Inc. (“Axia”), a national provider of 
health and wellness programs.

We  deliver  our  programs  to  customers,  which  include  health  plans,  governments,  employers,  and  hospitals,  in  all  50  states,  the 
District of Columbia, and Puerto Rico. We began delivering our Health and Care Support programs in Germany and Brazil in January 
2008 and June 2008, respectively. Our services include:

• 

fostering wellness and disease prevention through total population screening, health risk assessments, and supportive 
interventions;

•  providing access to health improvement programs such as fitness, weight management, complementary and alternative 

medicine and smoking cessation;

•  promoting the reduction of lifestyle behaviors that lead to poor health or chronic conditions;
•  providing educational materials and personal interactions with highly trained nurses and other healthcare professionals 

that are designed to create and sustain healthier behaviors to members with chronic conditions;
incorporating current evidence-based clinical guidelines into interventions to optimize patient health outcomes;

• 
•  developing Care Support plans and motivating members to set attainable goals for themselves;
•  providing local market resources to address acute episodic interventions; 
•  coordinating members’ care with their healthcare providers; and
•  providing software licensing and management consulting in support of health and care support services.
Our programs focus on prevention, education, physical fitness, health coaching, behavior change and evidence-based interventions 
to drive adherence to proven standards of care, medication regimens and physicians’ plans of care. The programs are designed to support 
better health and assist in providing more effective care, which we believe will optimize the health status of member populations and 
reduce both the short-term and long-term direct healthcare costs for participants, including costs associated with the loss of health-
related employee productivity.

Health and Care Support services enable health plans and employers to reach and engage everyone in their covered populations 
through interventions that are both sensitive to and specific to each individual’s health risks and needs. Health Support products are 
designed to motivate people to make positive lifestyle changes and accomplish individual goals, such as becoming more physically 
active through the Healthways SilverSneakers® Fitness Program, staying fit using on-line tools and a vast network of fitness centers, 
and quitting smoking through an on-line smoking cessation community, QuitNet®. The Care Support product line includes programs 
for people with chronic diseases or persistent conditions, including diabetes, coronary artery disease, heart failure, asthma, chronic 
obstructive  pulmonary  disease,  end-stage  renal  disease,  cancer,  chronic  kidney  disease,  depression,  high-risk  obesity,  metabolic 
syndrome,  acid-related  stomach  disorders,  atrial  fibrillation,  decubitus  ulcer,  fibromyalgia,  hepatitis  C,  inflammatory  bowel  disease, 
irritable  bowel  syndrome,  low-back  pain,  osteoarthritis,  osteoporosis,  and  urinary  incontinence.  We  also  provide  high-risk  care 

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management’s Discussion and analysis of Financial condition and results of Operation

management  through  our  StatusOne®  product  for  members  at  risk  for  hospitalization  due  to  complex  conditions. We  believe  that 
creating real and sustainable behavior change generates measurable long-term cost savings.

Predicated on the fundamental belief that healthier people cost less and are more productive, Healthways’ programs are designed 
to help keep healthy individuals healthy, mitigate and delay the progression to disease associated with family or lifestyle risk factors, 
and promote the best possible health habits for those who are already affected by disease. At the same time, we recognize that each 
individual plays a variety of roles in his or her pursuit of health, often simultaneously. By providing the full spectrum of Health and Care 
Support services to meet each individual’s needs, we believe that our interventions can be delivered both at scale and in a manner 
that reflects the unique needs of each consumer over time. Further, Healthways’ extensive and fully accredited complementary and 
alternative provider network offers convenient access to the significant number of individuals who seek health services outside of the 
traditional healthcare system.

highlights of Fiscal 2008 performance

•	 Revenues  for  fiscal  2008,  which  included  a  full  year  of  operations  related  to  the  acquisition  of  Axia  on  December  1,  2006, 

increased 19.6% over fiscal 2007, which included nine months of operations related to the Axia acquisition.

•		 Net income for fiscal 2008, which included a full year of operations related to the acquisition of Axia, increased 21.5% over fiscal 

2007, which included nine months of operations related to the Axia acquisition.

recent Developments

In August 2008, our Board of Directors approved a change in our fiscal year-end from August 31 to December 31. Accordingly, our 
next full fiscal year will begin on January 1, 2009 following a four-month transition period ending December 31, 2008. We will file a 
report covering the transition period on Form 10-QT.

We also recently began a process to streamline our management structure to deliver more effectively on our existing business and 
to better support our next generation of fully integrated solutions. We expect this process to be substantially complete by the end 
of calendar year 2008. We expect to incur a significant amount of costs related to this process, such as severance and other related 
restructuring charges. We expect the process to be largely completed by December 31, 2008.

Forward-looking Statements

Management’s  Discussion  and  Analysis  of  Financial  Condition  and  Results  of  Operations  contains  forward-looking  statements, 
which are based upon current expectations and involve a number of risks and uncertainties. Forward-looking statements include all 
statements that do not relate solely to historical or current facts, and can be identified by the use of words like “may,” “believe,” “will,” 
“expect,” “project,” “estimate,” “anticipate,” “plan,” or “continue.” In order for us to use the “safe harbor” provisions of the Private Securities 
Litigation Reform Act of 1995, we caution you that the following important factors, among others, may affect these forward-looking 
statements. Consequently, actual operations and results may differ materially from those expressed in the forward-looking statements.

The important factors include but are not limited to:
•  our ability to sign and implement new contracts for Health and Care Support solutions;
•  our  ability  to  accurately  forecast  performance  and  the  timing  of  revenue  recognition  under  the  terms  of  our  customer 

• 

contracts ahead of data collection and reconciliation in order to provide forward-looking guidance;
the effect of any new or proposed legislation, regulations and interpretations relating to the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003, including the potential expansion to Phase II for Medicare Health Support 
programs and any legislative or regulatory changes with respect to Medicare Advantage;

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management’s Discussion and analysis of Financial condition and results of Operation

•  our  ability  to  reach  mutual  agreement  with  CMS  with  respect  to  results  necessary  to  achieve  success  as  defined  under 

Phase I of Medicare Health Support;

•  our  ability  to  anticipate  the  rate  of  market  acceptance  of  Health  and  Care  Support  solutions  and  the  individual  market 

dynamics in potential international markets;

•  our ability to accurately forecast the costs necessary to implement our strategy of establishing a presence in international 

• 
• 

markets;
the risks associated with foreign currency exchange rate fluctuations and our ability to hedge against such fluctuations;
the potential adverse effects of additional regulatory requirements imposed by foreign governments and other regulatory 
bodies;

•  our ability to effectively manage any growth that we might experience;
•  our  ability  to  retain  existing  health  plan  customers  if  they  decide  to  take  programs  in-house  or  are  acquired  by  other 

health plans which already have or are not interested in Health and Care Support programs;
the risks associated with a significant concentration of our revenues with a limited number of customers;

• 
•  our ability to effect cost savings and clinical outcomes improvements under Health and Care Support contracts and reach 
mutual agreement with customers with respect to cost savings, or to effect such savings and improvements within the time 
frames contemplated by us;

•  our ability to achieve estimated annualized revenue in backlog in the manner and within the timeframe we expect, which 

is based on certain estimates regarding the implementation of our services;

•  our ability and/or the ability of our customers to enroll participants in our Health and Care Support programs in a manner 

and within the timeframe anticipated by us;

•  our ability to collect contractually earned performance incentive bonuses;
• 

the ability of our customers to provide timely and accurate data that is essential to the operation and measurement of our 
performance under the terms of our contracts;

•  our ability to favorably resolve contract billing and interpretation issues with our customers;
•  our ability to service our debt and make principal and interest payments as those payments become due;
• 

the  risks  associated  with  changes  in  macroeconomic  conditions,  which  may  reduce  the  demand  and/or  the  timing  of 
purchases  for  our  services  from  customers  or  potential  customers,  reduce  the  number  of  covered  lives  of  our  existing 
customers, restrict our ability to obtain additional financing, or impact the availability of credit under our Third Amended 
Credit Agreement;

•  counterparty risk associated with our interest rate swap agreements;
•  our ability to integrate the operations and technology platforms of Axia and other acquired businesses or technologies into 

our business;

•  our  ability  to  develop  new  products  and  deliver  outcomes  on  those  products,  including  those  anticipated  from  our 

strategic relationship with Medco, Inc.;

•  our ability to effectively integrate new technologies and approaches, such as those encompassed in our Health and Care 

Support initiatives or otherwise licensed or acquired by us, into our Health and Care Support platform;

•  our ability to renew and/or maintain contracts with our customers under existing terms or restructure these contracts on 

terms that would not have a material negative impact on our results of operations;

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management’s Discussion and analysis of Financial condition and results of Operation

•  our ability to implement our Health and Care Support strategy within expected cost estimates;
•  our ability to obtain adequate financing to provide the capital that may be necessary to support the growth of our operations 

and to support or guarantee our performance under new contracts;

•  unusual and unforeseen patterns of healthcare utilization by individuals with diabetes, cardiac, respiratory and/or other 

• 

diseases or conditions for which we provide services;
the  ability  of  our  customers  to  maintain  the  number  of  covered  lives  enrolled  in  the  plans  during  the  terms  of  our 
agreements;

•  our ability to attract and/or retain and effectively manage the employees required to operate our business;
• 
• 

the impact of litigation involving us and/or our subsidiaries;
the impact of future state, federal, and international health care and other applicable legislation and regulations on our 
ability to deliver our services and on the financial health of our customers and their willingness to purchase our services;

•  current geopolitical turmoil and the continuing threat of domestic or international terrorism;
•  general worldwide and domestic economic conditions and stock market volatility; and
•  other risks detailed in the Company’s other filings with the Securities and Exchange Commission.

We undertake no obligation to update or revise any such forward-looking statements.

critical accounting policies

We describe our accounting policies in Note 1 of the Notes to the Consolidated Financial Statements. We prepare the consolidated 
financial  statements  in  conformity  with  U.S.  generally  accepted  accounting  principles,  which  require  us  to  make  estimates  and 
judgments that affect the reported amounts of assets and liabilities and related disclosures at the date of the financial statements and 
the reported amounts of revenues and expenses during the reporting period. Actual results may differ from those estimates.

We believe the following accounting policies are the most critical in understanding the estimates and judgments that are involved in 

preparing our financial statements and the uncertainties that could impact our results of operations, financial condition and cash flows.

Revenue Recognition

We generally determine our contract fees by multiplying a contractually negotiated rate per member per month (“PMPM”) by the 
number of members covered by our services during the month. We typically set the PMPM rates during contract negotiations with 
customers based on the value we expect our programs to create and a sharing of that value between the customer and the Company. 
In addition, some of our services are billed on a fee for service basis.

Our contracts with health plans generally range from three to five years with provisions for subsequent renewal; contracts with 
self-insured employers, either directly or through their health plans, typically have one to three-year terms. Some contracts allow the 
customer to terminate early.

Some of our contracts provide that a portion (up to 100%) of our fees may be refundable to the customer (“performance-based”) if 
our programs do not achieve, when compared to a baseline year, a targeted percentage reduction in the customer’s healthcare costs 
and selected clinical and/or other criteria that focus on improving the health of the members. Approximately 4% of revenues recorded 
during  fiscal  2008  were  performance-based  and  were  subject  to  final  reconciliation  as  of  August  31,  2008. We  anticipate  that  this 
percentage will fluctuate due to the level of performance-based fees in new contracts, revenue recognition associated with performance-
based fees, and the timing of data reconciliation, which varies according to contract terms. A limited number of contracts also provide 

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management’s Discussion and analysis of Financial condition and results of Operation

opportunities for us to receive incentive bonuses in excess of the contractual PMPM rate if we exceed contractual performance targets.
We generally bill our customers each month for the entire amount of the fees contractually due for the prior month’s enrollment, 
which typically includes the amount, if any, that is performance-based and may be subject to refund should we not meet performance 
targets. Deferred revenues arise from contracts which permit upfront billing and collection of fees covering the entire contractual service 
period, generally 12 months. Contractually, we cannot bill for any incentive bonus until after contract settlement. Fees for service are 
typically billed in the month after the services are provided.

We recognize revenue as follows: 1) we recognize the fixed portion of PMPM fees and fees for service as revenue during the period 
we perform our services; 2) we recognize the performance-based portion of the monthly fees based on the most recent assessment of 
our performance, which represents the amount that the customer would legally be obligated to pay if the contract were terminated 
as of the latest balance sheet date; and 3) we recognize additional incentive bonuses based on the most recent assessment of our 
performance, to the extent we consider such amounts collectible.

We assess our level of performance for our contracts based on medical claims and other data that the customer is contractually required 
to supply. A minimum of four to six months’ data is typically required for us to measure performance. In assessing our performance, 
we may include estimates such as medical claims incurred but not reported and a medical cost trend compared to a baseline year. In 
addition, we may also provide contractual reserves, when appropriate, for billing adjustments at contract reconciliation.

Substantially  all  of  the  fees  under  the  Medicare  Health  Support  pilots  in  which  we  participated  were  performance-based.    Our 
original  cooperative  agreements  required  that,  by  the  end  of  the  third  year,  we  achieve  a  cumulative  net  savings  (total  savings  for 
the intervention population as compared to the control group less fees received from CMS) of 5.0%.  Under an amendment to our 
agreement for our stand-alone Medicare Health Support pilot in Maryland and the District of Columbia, we began serving a “refresh 
population” of approximately 4,500 beneficiaries on August 1, 2006, which was measured as a separate cohort for two years, by the end 
of which the program was required to achieve a 2.5% cumulative net savings when compared to a new control cohort. In April 2008, we 
signed an amendment to our Medicare Health Support protocol with CMS, which changed the financial performance target for both the 
initial cohort and the refresh population to budget neutrality. Although we receive the medical claims and other data associated with 
the intervention group under these pilots on a monthly basis, we assess our performance against the control group under these pilots 
based on quarterly summary performance reports received from CMS’ independent financial reconciliation contractor. As of August 
31, 2008, we had recognized $7.5 million of performance-based fees under the Medicare Health Support pilots, and contract billings 
in excess of earned revenue totaled $58.6 million. Under the terms of our Cooperative Agreement with CMS, we expect to receive the 
final quarterly summary performance report from CMS’ independent financial reconciliation contractor in the first half of calendar 2009. 
While the Cooperative Agreement allows for a 30-day reconciliation period upon receipt of the final quarterly summary performance 
report, we cannot assure you that we will be able to reach a final settlement within this timeframe.

If data is insufficient or incomplete to measure performance, or interim performance measures indicate that we are not meeting 
performance targets, we do not recognize performance-based fees subject to refund as revenues but instead record them in a current 
liability account entitled “contract billings in excess of earned revenue.” Only in the event we do not meet performance levels by the 
end of the measurement period, typically one year, are we contractually obligated to refund some or all of the performance-based fees. 
We would only reverse revenues that we had already recognized if performance to date in the measurement period, previously above 
targeted levels, subsequently dropped below targeted levels. Historically, any such adjustments have been immaterial to our financial 
condition and results of operations.

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management’s Discussion and analysis of Financial condition and results of Operation

During the settlement process under a contract, which generally occurs six to eight months after the end of a contract year, we 
settle any performance-based fees and reconcile healthcare claims and clinical data. As of August 31, 2008, performance-based fees 
that have not yet been settled with our customers but that have been recognized as revenue in the current and prior years totaled 
approximately $49.2 million. Of this amount, $7.5 million was based on calculations which include estimates such as medical claims 
incurred but not reported and/or the customer’s medical cost trend compared to a baseline year, while $41.7 million was based entirely 
on actual data received from our customers. Data reconciliation differences, for which we provide contractual allowances until we reach 
agreement with respect to identified issues, can arise between the customer and us due to customer data deficiencies, omissions, and/
or data discrepancies.

Performance-related adjustments (including any amounts recorded as revenue that were ultimately refunded), changes in estimates, 
data reconciliation differences, or adjustments to incentive bonuses may cause us to recognize or reverse revenue in a current fiscal year 
that pertains to services provided during a prior fiscal year. During fiscal 2008, we recognized a net increase in revenue of $7.4 million 
that related to services provided prior to fiscal 2008.

Impairment of Intangible Assets and Goodwill

In accordance with SFAS No. 142 “Goodwill and Other Intangible Assets,” we review goodwill for impairment on an annual basis or 

more frequently whenever events or circumstances indicate that the carrying value may not be recoverable.

If we determine that the carrying value of goodwill is impaired based upon an impairment review, we calculate any impairment 
using a fair-value-based goodwill impairment test as required by SFAS No. 142. Fair value is the amount at which the asset could be 
bought or sold in a current transaction between two willing parties. We estimate fair value using a number of techniques, including 
quoted market prices, present value techniques based on estimates of cash flows, or multiples of earnings or revenues performance 
measures.

We amortize other identifiable intangible assets, such as acquired technologies and customer contracts, on the straight-line method 
over their estimated useful lives, except for certain trade names, which have an indefinite life and are not subject to amortization. We 
review intangible assets not subject to amortization on an annual basis or more frequently whenever events or circumstances indicate 
that the assets might be impaired. We assess the potential impairment of intangible assets subject to amortization whenever events or 
changes in circumstances indicate that the carrying values may not be recoverable.

If  we  determine  that  the  carrying  value  of  other  identifiable  intangible  assets  may  not  be  recoverable,  we  calculate  any 
impairment using an estimate of the asset’s fair value based on the projected net cash flows expected to result from that asset, 
including eventual disposition.

Future  events  could  cause  us  to  conclude  that  impairment  indicators  exist  and  that  goodwill  and/or  other  intangible  assets 
associated  with  our  acquired  businesses  are  impaired.  Any  resulting  impairment  loss  could  have  a  material  adverse  impact  on  our 
financial condition and results of operations.

Income Taxes

SFAS No. 109, “Accounting for Income Taxes,” establishes financial accounting and reporting standards for the effect of income taxes. The 
objectives of accounting for income taxes are to recognize the amount of taxes payable or refundable for the current year and deferred tax 
liabilities and assets for the future tax consequences of events that have been recognized in an entity’s financial statements or tax returns. 
SFAS No. 109 requires significant judgment in determining income tax provisions, including determination of deferred tax assets, deferred 
tax liabilities, and any valuation allowances that might be required against deferred tax assets, and in evaluating tax positions.

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management’s Discussion and analysis of Financial condition and results of Operation

Accruals for uncertain tax positions are provided for in accordance with the requirements of Financial Accounting Standards Board 
(“FASB”) Interpretation (“FIN”) No. 48, “Accounting for Uncertainty in Income Taxes - an interpretation of FASB Statement No. 109”. Under 
FIN No. 48, we may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will 
be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in 
the financial statements from such a position should be measured based on the largest benefit that has a greater than 50% likelihood 
of being realized upon ultimate settlement. FIN No. 48 also provides guidance on derecognition of income tax assets and liabilities, 
classification of current and deferred income tax assets and liabilities, accounting for interest and penalties associated with tax positions, 
and income tax disclosures. Judgment is required in assessing the future tax consequences of events that have been recognized in our 
financial  statements  or  tax  returns. Variations  in  the  actual  outcome  of  these  future  tax  consequences  could  materially  impact  our 
financial position, results of operations, or cash flows.

Share-Based Compensation

In accordance with SFAS No. 123(R), “Share-Based Payment,” we measure and recognize compensation expense for all share-based 
payment awards based on estimated fair values at the date of grant. Determining the fair value of share-based awards at the grant 
date requires judgment in developing assumptions, which involve a number of variables. These variables include, but are not limited 
to, the expected stock price volatility over the term of the awards and expected stock option exercise behavior. In addition, we also use 
judgment in estimating the number of share-based awards that are expected to be forfeited.

Business Strategy

Our primary strategy is to optimize the health of entire populations, as well as the quality and affordability of healthcare, through 
our  Health  and  Care  Support  solutions  both  domestically  and  internationally,  thereby  creating  value  for  individuals,  health  plans, 
governments, and employers. We plan to continue using our scalable state-of-the-art call centers, medical information content, behavior 
change processes and techniques, strategic relationships, health provider networks and proprietary technologies to gain a competitive 
advantage in delivering our Health and Care Support services.

We continue to see increasing demand for integrated Health and Care Support solutions from self-insured employers. As a result, 
we expect to continue adding and enhancing solutions to extend our reach and effectiveness for entire populations. The flexibility of 
our programs allows customers to enter the Health and Care Support market at the level of services that they deem appropriate for 
their organization. Customers may select from a single Health or Care Support program to a total-population approach, in which all 
members of the customer’s population are eligible to receive the benefit of our programs.

We deliver programs that engage consumers in their health. We believe that we can achieve health improvements and generate 
significant  cost  savings  and  productivity  improvements  by  addressing  consumer  and  customer  needs  for  effective  programs  that 
support the individual throughout his or her lifetime.

We anticipate that we will continue to enhance, expand and further integrate our Health and Care Support capabilities, pursue 
opportunities  in  domestic  government  and  international  markets,  and  enhance  our  information  technology  support. We  may  add 
some of these new capabilities and technologies through internal development, strategic alliances with other entities and/or through 
selective acquisitions or investments.

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management’s Discussion and analysis of Financial condition and results of Operation

results of Operations

The following table shows the components of the statements of operations for the fiscal years ended August 31, 2008, 2007, and 

2006 expressed as a percentage of revenues.

Year ended August 31,

2008

2007

2006

Revenues
Cost of services (exclusive of depreciation
and amortization included below)
Selling, general and administrative expenses
Depreciation and amortization
Operating income (1)

Interest expense

Income before income taxes 
Income tax expense

Net income (1)

(1) Figures may not add due to rounding.

revenues

100.0%

100.0%

100.0 %

68.4%
9.7%
6.4%
15.4%

2.8%

12.6%
5.1%

7.4%

67.9%
10.9%
6.0%
15.2%

3.0%

12.2%
4.9%

7.3%

68.2 %
10.8 %
5.9 %
15.1 %

0.3 %

14.8 %
5.8 %

9.0 %

Revenues for fiscal 2008 increased $120.7 million, or 19.6%, over fiscal 2007 primarily due to the acquisition of Axia on December 1, 

2006. The remainder of the increase is primarily due to the following:

•	 $35.8  million  due  to  the  addition  of  new  customers,  new  programs  with  existing  customers,  or  the  expansion  of  existing 

programs into additional populations with existing customers since the beginning of fiscal 2007; and

•	 $23.0 million due to increased membership in customers’ existing programs.

These increases were partially offset by decreases in revenues of $26.5 million related to contract terminations and restructurings with 
certain customers.

Revenues for fiscal 2007 increased 49.3% over fiscal 2006 primarily due to the following:
•		 revenues of $   136.5 million attributable to the acquisition of Axia on December 1, 2006;
•		 an increase in the number of self-insured employer billed lives for Care Support programs on behalf of our health plan customers 

from 954,000 at August 31, 2006 to 1,633,000 at August 31, 2007;

•		 the addition of new Care Support programs or expansion of existing programs into additional populations with eight existing 

customers since the beginning of fiscal 2006; and

•		 the commencement of ten new Care Support contracts since the beginning of fiscal 2006.

These increases were slightly offset by decreases in fiscal 2007 revenues compared to fiscal 2006 due to the following:

•		 contract terminations with certain customers, the largest of which we began providing services to again on October 1, 2007; and
•	 decreased revenues associated with the Medicare Health Support pilots. Due primarily to an increasing cumulative net savings 

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management’s Discussion and analysis of Financial condition and results of Operation

target over the term of the pilots, during fiscal 2007 cumulative savings fell below the cumulative net savings target, resulting in 
a reversal of $4.4 million in performance-based revenues.

We anticipate that revenues for fiscal 2009 will not increase significantly, and could decrease, over fiscal 2008 revenues primarily due 
to contract restructurings and terminations with certain customers that may more than offset revenue increases from new or existing 
customers.

cost of Services

Cost of services (excluding depreciation and amortization) as a percentage of revenues for fiscal 2008 increased to 68.4% compared 

to 67.9% for fiscal 2007, primarily due to the following:

•		 an increased portion of our revenue growth generated by fitness center programs, which typically have a higher cost of services 

as a percentage of revenue than our other programs; and

•	 an increase in the level of employee bonus provision during fiscal 2008 compared to fiscal 2007 based on the Company’s financial 

performance against established internal targets during these periods.

These  increases  were  partially  offset  by  a  decrease  in  cost  of  services  as  a  percentage  of  revenues  due  to  decreased  costs  during 
fiscal 2008 related to the two Medicare Health Support pilots in which we participated, which ended in January 2008 and July 2008, 
respectively.

Cost of services (excluding depreciation and amortization) as a percentage of revenues for the three months ended August 31, 2008 
was 66.0% compared to an average of 69.4% for the first three quarters of fiscal 2008, primarily due to a decrease in salaries and benefits 
during the fourth quarter of fiscal 2008 related to capacity consolidation in May 2008 through August 2008.

Cost of services (excluding depreciation and amortization) as a percentage of revenues decreased to 67.9% for fiscal 2007 compared 

to 68.2% for fiscal 2006. The decrease is primarily due to the following:

•  a decrease in the level of employee bonus provision due to the Company’s financial performance not meeting its established 

internal targets; and

•  a decrease in professional consulting fees related to information technology initiatives.

These decreases were partially offset by increases in cost of services as a percentage of revenues for fiscal 2007 compared to fiscal 2006 
related to the following:

• 

•	

increased costs related to the Medicare Health Support pilots, primarily due to 1) additional costs related to the timing of the pilot 
in Georgia in collaboration with CIGNA, which we began serving during the first quarter of fiscal 2006; 2) enhanced interventions 
to  focus  on  the  special  needs  of  this  population;  and  3)  additional  costs  related  to  the  refresh  population,  which  we  began 
serving on August 1, 2006;
the acquisition of Axia, which has somewhat higher cost of services as a percentage of revenues due to the nature of Health 
Support services, as well as the related integration costs; and

•	 an increase in salary and benefit expense, primarily related to organizational design changes in our field support and operations 

structure.

While we believe cost of services as a percentage of revenues will remain generally consistent in the long term with historical 
percentages,  we  anticipate  that  cost  of  services  as  a  percentage  of  revenues  will  increase  during  the  four-month  transition 
period primarily due to costs associated with the aforementioned streamlining of our management structure and other related 
restructuring initiatives.

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management’s Discussion and analysis of Financial condition and results of Operation

Selling, general and administrative expenses

Selling, general and administrative expenses as a percentage of revenues decreased to 9.7% for fiscal 2008 compared to 10.9% for 

fiscal 2007, primarily due to the following:

•	 efficiencies from the integration of the Axia acquisition; and
•	 our ability to more effectively leverage our selling, general and administrative expenses as a result of growth in our operations.
These decreases were somewhat offset by an increase in selling, general and administrative expenses as a percentage of revenues for 
fiscal 2008 compared to fiscal 2007 related to relocating to and operating our new corporate headquarters during fiscal 2008.

Selling, general and administrative expenses as a percentage of revenues increased to 10.9% for fiscal 2007 compared to 10.8% for 

fiscal 2006, primarily due to the following:

•	 an increase in salaries and benefits related to changes in our infrastructure to support anticipated future growth;
•	 an increase in professional consulting fees related to certain strategic initiatives; and
•	

integration costs related to the acquisition of Axia.

These increases were somewhat offset by a decrease in selling, general and administrative expenses as a percentage of revenues for 
fiscal 2007 compared to fiscal 2006 related to the following:

•	 a decrease in the level of employee bonus provision due to the Company not meeting its internal incentive targets; and
•	

the acquisition of Axia, which had somewhat lower selling, general and administrative expenses as a percentage of revenues 
due to the nature of Health Support services.

While we believe selling, general and administrative expenses as a percentage of revenues will remain generally consistent in the 
long  term  with  historical  percentages,  we  anticipate  that  selling,  general  and  administrative  expenses  as  a  percentage  of  revenues 
will increase during the four-month transition period primarily due to costs associated with the aforementioned streamlining of our 
management structure and other related restructuring initiatives.

Depreciation and amortization

Depreciation and amortization expense increased 28.2% for fiscal 2008 compared to fiscal 2007, primarily due to the following:
•	

increased depreciation expense resulting from capital expenditures on computer software development, which we made to  
enhance our information technology capabilities;

•	 depreciation and amortization expense associated with the depreciable assets and identifiable intangible assets recorded in 

connection with the Axia acquisition on December 1, 2006; and 
increased amortization expense associated with patents which were acquired in August 2007.

•	
Depreciation and amortization expense for fiscal 2007 increased 51.1% compared to fiscal 2006, primarily due to the following:
•	 depreciation and amortization expense associated with the depreciable assets and preliminary identifiable intangible assets 

•	

recorded in connection with the Axia acquisition on December 1, 2006; and
increased depreciation expense associated with capital expenditures to enhance our information technology capabilities, to 
relocate our Phoenix call center, and expand our calling capacity at existing call centers.

We  anticipate  that  depreciation  and  amortization  expense  for  fiscal  2009  will  increase  over  fiscal  2008  primarily  as  a  result  of 
additional capital expenditures made during fiscal 2008 associated with our new corporate headquarters, the opening of four new call 
centers, and growth and improvement in our information technology capabilities.

2008

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22

 
 
 
 
 
management’s Discussion and analysis of Financial condition and results of Operation

Interest expense

Interest expense for fiscal 2008 increased $2.7 million compared to fiscal 2007, primarily related to increased interest expense during 
the three months ended November 30, 2007 compared to the three months ended November 30, 2006 due to borrowings under the 
Third  Amended  Credit  Agreement  related  to  the  acquisition  of  Axia  on  December  1,  2006. This  increase  was  somewhat  offset  by  a 
decrease in interest expense from lower average interest rates during fiscal 2008 compared to fiscal 2007.

Interest  expense  for  fiscal  2007  increased  $17.1  million  compared  to  fiscal  2006,  primarily  due  to  borrowings  under  the  Third 
Amended and Restated Revolving Credit and Term Loan Agreement (the “Third Amended Credit Agreement”) related to the acquisition 
of Axia on December 1, 2006.

As discussed in “Liquidity and Capital Resources” below, a significant portion of our long-term debt is subject to fixed interest rate 
swap agreements; however, due to current economic conditions that have created uncertainty and credit constraints in the markets, we 
cannot predict the impact that potential changes in interest rates will have on our variable rate debt.

Income tax expense

Our effective tax rate increased to 40.8% for fiscal 2008 compared to 40.1% for fiscal 2007, primarily due to the impact of interest 
accruals related to unrecognized tax benefits included in our income tax provision for fiscal 2008. The differences between the statutory 
federal income tax rate of 35.0% and our effective tax rate are due primarily to the impact of state income taxes, the lack of tax benefit 
on certain expenses incurred in international initiatives, the tax interest accruals described above, and certain non-deductible expenses 
for income tax purposes.

Our effective tax rate increased to 40.1% for fiscal 2007 compared to 39.3% for fiscal 2006, primarily due to the lack of tax benefit 
on certain expenses incurred in international initiatives, somewhat offset by a reduction in our average state income tax rate, which is 
impacted by our geographic mix of earnings. The differences between the statutory federal income tax rate of 35.0% and our effective 
tax  rate  are  due  primarily  to  the  impact  of  state  income  taxes,  the  lack  of  tax  benefit  on  certain  expenses  incurred  in  international 
initiatives, and certain non-deductible expenses for income tax purposes.

We anticipate that our effective tax rate for fiscal 2009 will not change significantly from fiscal 2008; however, we continue to evaluate 

the impact on our effective tax rate of both international operations and any future adjustments related to uncertain tax positions.

liquidity and capital resources

Cash  and  cash  equivalents  decreased  $12.4  million  during  fiscal  2008  to  $35.2  million  at  August  31,  2008  from  $47.7  million  at 
August 31, 2007. Operating activities for fiscal 2008 generated cash of $105.3 million compared to $107.3 million for fiscal 2007. The 
decrease in operating cash flow resulted primarily from the following:

•	 an increase in days’ sales outstanding in accounts receivable to 55 days at August 31, 2008 from 43 days at August 31, 2007 

primarily due to timing of cash receipts from several large customers; and

•	 a  decrease  in  cash  collections  recorded  to  contract  billings  in  excess  of  earned  revenue,  primarily  related  to  the  Medicare 
  Health Support pilots.

These decreases were somewhat offset by increases in operating cash flow primarily related to the following:

•	 a lower employee bonus payment during fiscal 2008 compared to fiscal 2007;
•	 an increase in interest payments during fiscal 2008 compared to fiscal 2007, primarily due to a full year of borrowings under 

the Third Amended Credit Agreement related to the acquisition of Axia on December 1, 2006; and
lease incentives received during fiscal 2008, primarily related to our new corporate headquarters.

•	

2008

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management’s Discussion and analysis of Financial condition and results of Operation

Investing activities during fiscal 2008 used $86.7 million in cash and consisted primarily of purchases of property and equipment.
Financing activities during fiscal 2008 used $31.1 million in cash primarily for repurchases of our common stock and repayments 
on borrowings under the Third Amended Credit Agreement. These uses were somewhat offset by additional borrowings under the 
Third Amended Credit Agreement.

On December 1, 2006, we entered into the Third Amended Credit Agreement. The Third Amended Credit Agreement provides us 
with a $400.0 million revolving credit facility, including a swingline sub facility of $10.0 million and a $75.0 million sub facility for letters 
of credit, a $200.0 million term loan facility, and an uncommitted incremental accordion facility of $200.0 million. As of August 31, 2008, 
availability under our revolving credit facility totaled $247.9 million.

Revolving advances under the Third Amended Credit Agreement generally bear interest, at our option, at 1) LIBOR plus a spread of 
0.875% to 1.750% or 2) the greater of the federal funds rate plus 0.5%, or the prime rate, plus a spread of 0.000% to 0.250%. Term loan 
borrowings bear interest, at our option, at 1) LIBOR plus 1.50% or 2) the greater of the federal funds rate plus 0.5%, or the prime rate. 
The Third Amended Credit Agreement also provides for a fee ranging between 0.150% and 0.300% of unused commitments. The Third 
Amended Credit Agreement is secured by guarantees from most of the Company’s domestic subsidiaries and by security interests in 
substantially all of the Company’s and such subsidiaries’ assets.

We are required to repay outstanding revolving loans on the revolving commitment termination date, which is December 1, 2011. 
We are required to repay term loans in quarterly principal installments aggregating $0.5 million each, which commenced on March 31, 
2007, and the entire unpaid principal balance of the term loans is due and payable at maturity on December 1, 2013.

The Third Amended Credit Agreement contains various financial covenants, which require us to maintain, as defined, ratios or levels 
of  1)  total  funded  debt  to  EBITDA,  2)  fixed  charge  coverage,  and  3)  net  worth. The Third  Amended  Credit  Agreement  also  restricts 
the payment of dividends and limits the amount of repurchases of the Company’s common stock. As of August 31, 2008, we were in 
compliance with all of the covenant requirements of the Third Amended Credit Agreement.

As of August 31, 2008, we are currently a party to the following interest rate swap agreements for which we receive a variable rate of 
interest based on the three-month LIBOR and for which we pay the following fixed rates of interest plus a spread of 0.875% to 1.750% 
on revolving advances and a spread of 1.50% on term loan borrowings:

Swap #

Notional Amount in ($000’s)

Fixed Interest Rate

Termination Date

1
2
3
4
5
6

$

230,000
40,000
40,000
50,000
40,000
30,000

4.995%
3.987%
3.433%
3.688%
3.855%
3.760%

(1)

March 31, 2010
December 31, 2009
December 30, 2011
December 30, 2011 (2)
December 30, 2011 (3)
(4)
March 30, 2011

(1) The principal value of this swap arrangement amortizes over a 39-month period.  The notional value of this swap as of August 31, 2008 was $150 million.
(2) This swap agreement becomes effective April 1, 2009. 
(3) This swap agreement becomes effective October 1, 2009.
(4) This swap agreement becomes effective January 2, 2010.

2008

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24

management’s Discussion and analysis of Financial condition and results of Operation

We currently believe that we meet the hedge accounting criteria under SFAS No. 133 in accounting for these interest rate 

swap agreements.

We believe that cash flows from operating activities, our available cash, and our expected available credit under the Third Amended 
Credit Agreement will continue to enable us to meet our contractual obligations and to fund our current operations for the foreseeable 
future.  However,  if  our  operations  require  significant  additional  financing  resources,  such  as  capital  expenditures  for  technology 
improvements, additional call centers and/or letters of credit or other forms of financial assurance to guarantee our performance under 
the terms of new contracts, or if we are required to refund performance-based fees pursuant to contract terms, we may need to raise 
additional capital by expanding our existing credit facility and/or issuing debt or equity. If we face a limited ability to arrange such 
financing, it may restrict our ability to effectively operate our business. Current economic conditions, including turmoil and uncertainty 
in the financial services industry, have created constraints on liquidity and the ability to obtain credit in the markets. Should the credit 
markets not improve, we cannot assure you that we would be able to secure additional financing if needed and, if such funds were 
available, whether the terms or conditions would be acceptable to us.

If contract development accelerates or acquisition opportunities arise, we may need to issue additional debt or equity to provide 
the  funding  for  these  increased  growth  opportunities. We  may  also  issue  equity  in  connection  with  future  acquisitions  or  strategic 
alliances. We cannot assure you that we would be able to issue additional debt or equity on terms that would be acceptable to us.

In July 2007, our Board of Directors authorized a share repurchase program which allowed for the repurchase of up to $100 million 
of our common stock from time to time in the open market or in privately negotiated transactions through July 5, 2009. As of August 31, 
2008, we had repurchased the full $100 million of our common stock authorized under the share repurchase program.

contractual Obligations 

The following schedule summarizes our contractual cash obligations by the indicated period as of August 31, 2008:

Payments Due By Year Ended August 31, 

2009

2010 - 2011

2012 - 2013

2014 and After

Total

( In $000s )
Capital lease obligations
Deferred compensation plan payments
Long-term debt (1)
Operating lease obligations 
Purchase obligations
Other long-term liabilities (2)
Other contractual cash obligations (3)
Total contractual cash obligations

$

48
2,664
20,702
12,916
2,383
—
8,716
$ 47,429

$

$

— 
1,573
36,182
24,596
—
136
13,751
76,238

$

— 
528
172,755
19,454
—
158
7,386
$ 200,281

$

$

— 
5,837
189,065
59,189
—
—
19,333
273,424

$

48
10,602
418,704
116,155
2,383
294
49,186
$ 597,372

(1) Includes scheduled principal payments, repayment of outstanding revolving loans, and estimated interest payments on outstanding borrowings under the Third 
  Amended Credit Agreement.
(2) We have excluded long-term liabilities and interest payable of $2.4 million and $1.5 million, respectively, related to FIN No. 48. We are unable to reasonably estimate 

the timing of these payments in individual years due to uncertainties in the timing of effective settlement of tax positions.

(3) Other contractual cash obligations primarily represent a perpetual license agreement and 25-year strategic relationship agreement that we entered into during 
the second quarter of fiscal 2008. We have total contractual cash obligations of $45.0 million related to these agreements, $25.0 million of which will occur ratably 
  during the first five years of the agreements, and the remaining $20.0 million of which will occur ratably over the last 20 years of the agreements. The table also 
includes cash payments in connection with our strategic alliance agreements, excluding certain variable costs related to one strategic alliance that are based on 
the number of future eligible members.

2008

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management’s Discussion and analysis of Financial condition and results of Operation

recently Issued accounting Standards
Fair Value Measurement

In  September  2006,  the  FASB  issued  SFAS  No.  157, “Fair Value  Measurement,”  which  provides  guidance  for  using  fair  value  to 
measure assets and liabilities, including a fair value hierarchy that prioritizes the information used to develop fair value assumptions.  
It also requires expanded disclosure about the extent to which companies measure assets and liabilities at fair value, the information 
used to measure fair value, and the effect of fair value measurements on earnings.  The standard applies whenever other standards 
require (or permit) assets or liabilities to be measured at fair value and does not expand the use of fair value in any new circumstances.  
SFAS No. 157 is effective for financial statements issued for fiscal years beginning after November 15, 2007, and interim periods within 
those fiscal years.

In  February  2008,  the  FASB  issued  FSP  FAS  No.  157-2, “Effective  Date  of  FASB  Statement  No.  157”,  which  defers  by  one  year  the 
effective date of the provisions of SFAS No. 157 for non-recurring, nonfinancial assets and nonfinancial liabilities to fiscal years beginning 
after November 15, 2008. We do not expect the adoption of SFAS No. 157 to have a material impact on our financial position or results 
of operations.

Fair Value Option for Financial Assets and Financial Liabilities

In February 2007, the FASB issued SFAS No. 159, “The Fair Value Option for Financial Assets and Financial Liabilities—Including an 
amendment of FASB Statement No. 115.”  SFAS No. 159 provides entities with the one-time option to measure financial instruments and 
certain other items at fair value, with changes in fair value recognized in earnings as they occur.  The fair value option may be applied 
instrument by instrument (with a few exceptions), is irrevocable, and must be applied to entire instruments and not to portions of an 
instrument. SFAS No. 159 is effective for financial statements issued for fiscal years beginning after November 15, 2007.  We do not 
expect the adoption of SFAS No. 159 to have a material impact on our financial position or results of operations.

Business Combinations

In December 2007, the FASB issued SFAS No. 141(R), “Business Combinations”. This statement expands the definition of a business 
and a business combination and generally requires the acquiring entity to recognize all of the assets and liabilities of the acquired 
business, regardless of the percentage ownership acquired, at their fair values. It also requires that contingent consideration and certain 
acquired contingencies be recorded at fair value on the acquisition date and that acquisition costs generally be expensed as incurred.

SFAS No. 141(R) is effective for fiscal years beginning after December 15, 2008. The adoption of SFAS No. 141(R) is not expected to 
materially impact our financial position or results of operations when it becomes effective on January 1, 2009; however, we do not yet 
know the impact that it will have on our financial position or results of operations for business combinations entered into on or after 
January 1, 2009.
Accounting for Uncertainty in Income Taxes

On September 1, 2007, we adopted the provisions of FIN No. 48, “Accounting for Uncertainty in Income Taxes - an interpretation of 
FASB Statement No. 109.”  FIN No. 48 creates a single model to address uncertainty in income tax positions by prescribing the minimum 
recognition threshold a tax position is required to meet before being recognized in the financial statements.  It also provides guidance 
on derecognition of income tax assets and liabilities, classification of current and deferred income tax assets and liabilities, accounting 
for interest and penalties associated with tax positions, and income tax disclosures. As a result of the adoption of FIN No. 48, we recorded 
a $0.7 million decrease to the beginning balance of retained earnings as a cumulative effect of a change in accounting principle.

2008

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management’s Discussion and analysis of Financial condition and results of Operation

Quantitative and Qualitative Disclosures about market risk

We are subject to market risk related to interest rate changes, primarily as a result of the Third Amended Credit Agreement, which 
bears interest based on floating rates. Revolving advances under the Third Amended Credit Agreement generally bear interest, at our 
option, at 1) LIBOR plus a spread of 0.875% to 1.750% or 2) the greater of the federal funds rate plus 0.5%, or the prime rate, plus a 
spread of 0.000% to 0.250%. Term loan borrowings bear interest, at our option, at 1) LIBOR plus 1.50% or 2) the greater of the federal 
funds rate plus 0.5%, or the prime rate.

In order to manage our interest rate exposure under the Third Amended Credit Agreement, we have entered into six interest rate 

swap agreements effectively converting our floating rate debt to fixed obligations with interest rates ranging from 3.433% to 4.995%.
A one-point interest rate change would have resulted in interest expense fluctuating approximately $1.0 million for fiscal 2008.
As a result of our investment in international initiatives, as of August 31, 2008 we are also exposed to foreign currency exchange rate 
risks. Because a significant portion of these risks is economically hedged with currency options and forwards contracts and because our 
international initiatives are not yet material to our consolidated results of operations, a 10% change in foreign currency exchange rates 
would not have had a material impact on our results of operations or financial position for fiscal 2008. We do not execute transactions or 
hold derivative financial instruments for trading purposes.

2008

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Financial Statements and Supplementary Data

consolidated Balance Sheets
Assets

August 31,

( In thousands )
Current assets:
Cash and cash equivalents
Accounts receivable, net
Prepaid expenses 
Other current assets
Income taxes receivable
Deferred tax asset
 Total current assets

Property and equipment:
Leasehold improvements
Computer equipment and related software
Furniture and office equipment
Capital projects in process

Less accumulated depreciation

Other assets

Customer contracts, net
Other intangible assets, net
Goodwill, net

Total assets

See accompanying notes to the consolidated financial statements.

2008

2007

$

35,242
113,312
8,992
5,275
—
24,948
187,769

37,475
131,296
29,209
12,052
210,032
(98,971)
111,061

16,575

34,521
72,582
484,305

$

47,655
80,201
10,370
4,319
1,741
7,145
151,431

19,268
87,843
20,435
12,336
139,882
(81,160)
58,722

15,609

41,777
77,722
483,584

$

906,813

$

828,845

2008

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28

Financial Statements and Supplementary Data

consolidated Balance Sheets
Liabilities and Stockholders’ Equity

August 31,

( In thousands, except share and per share data )
Current liabilities:
Accounts payable
Accrued salaries and benefits
Accrued liabilities
Deferred revenue
Contract billings in excess of earned revenue
Income taxes payable
Current portion of long-term debt
Current portion of long-term liabilities
Total current liabilities

Long-term debt
Long-term deferred tax liability
Other long-term liabilities

Stockholders’ equity:
Preferred stock
$.001 par value, 5,000,000 shares
authorized, none outstanding

Common stock 
$.001 par value, 120,000,000 and 75,000,000 shares authorized, 
33,603,320 and 35,606,482 shares outstanding
Additional paid-in capital
Retained earnings
Accumulated other comprehensive loss
Total stockholders’ equity

2008

2007

$

18,753
31,612
23,555
6,422
75,454
3,984
2,837
3,876
166,493

345,395
9,364
31,227

$

13,630
18,960
22,146
7,918
72,829
—
2,213
2,943
140,639

297,059
14,009
14,388

 — 

 — 

34
207,918
147,772
(1,390)
354,334

35
188,126
174,641
(52)
362,750

Total liabilities and stockholders’ equity

$ 906,813

$

828,845

See accompanying notes to the consolidated financial statements.

2008

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29

Financial Statements and Supplementary Data

consolidated Statements of Operations

Year ended August 31,

( In thousands, except earnings per share data )

Revenues

Cost of services (exclusive of depreciation and amortization of $34,105, 

$27,677, and $19,948, respectively, included below)

Selling, general and administrative expenses

Depreciation and amortization 

Operating income

Interest expense

Income before income taxes

Income tax expense

Net income

Earnings per share:

Basic

Diluted

Weighted average common shares and equivalents

Basic

Diluted

See accompanying notes to the consolidated financial statements.

2008

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30

2008

2007

2006

$

736,243

$

615,586

$

412,308

503,940

71,342

47,479

113,482

20,927

92,555

37,740

$

54,815

$

$

1.57

1.50

$

$

$

34,977

36,597

417,721

67,352

37,044

93,469

18,185

75,284

30,163

45,121

1.29

1.22

35,049

37,002

281,161

44,417

24,517

62,213

1,053

61,160

24,009

37,151

1.08

1.02

34,348

36,379

$

$

$

Financial Statements and Supplementary Data

consolidated Statement of changes in Stockholders’ equity

Preferred
Stock

Common
Stock

Additional
Paid-in
Capital

Retained
Earnings

Accumulated
Other
Comprehensive
Income (Loss) 

( In thousands )
Balance, august 31, 2005
Comprehensive income:
Net income
Foreign currency translation adjustment
Total comprehensive income
Exercise of stock options and other
Tax benefit of option exercises
Share-based employee compensation expense
Balance, august 31, 2006
Comprehensive income:
Net income
Net change in fair value of interest rate 
swap, net of income tax benefit of $133
Foreign currency translation adjustment 
Total comprehensive income
Sale of unregistered common stock
Repurchases of common stock
Exercise of stock options and other
Tax benefit of option exercises
Share-based employee compensation expense
Balance, august 31, 2007
Cumulative effect of a change in accounting 
 principle – adoption of FIN 48 
Comprehensive income:
Net income
Net change in fair value of interest rate
swaps, net of income tax benefit of $1,064

Foreign currency translation adjustment
Total comprehensive income
Repurchases of common stock
Exercise of stock options 
Tax benefit of option exercises
Share-based employee compensation expense

Balance, august 31, 2008

$— 

 — 
 — 

 — 
 — 
 — 
$— 

 — 

 — 
 — 

 — 
—
 — 
 — 
 — 
$— 

—

—

—
—

—
 — 
 — 
 — 

$— 

See accompanying notes to the consolidated financial statements.

$34

 — 
 — 

 1 
 — 
 — 
$35

 — 

 — 
 — 

 — 
—
 — 
 — 
 — 
$35

—

—

—
—

(2)
1 
 — 
 — 

$109,425

$97,471

 — 
 — 

5,326
11,467
13,982
$140,200

 — 

 — 
 — 

5,000
(552)
11,221
13,421
18,836
$188,126

—

—

—
—

(13,341)
6,710
9,893
16,530

37,151 
—

 — 
 — 
 — 
$134,622

45,121

 — 
—

 — 
(5,102)
 — 
 — 
 — 
$174,641

(687)

54,815

—
—

(80,997)
 — 
 — 
 — 

$—

 — 
16

 — 
 — 
 — 
$16

 — 

(205)
137

 — 
—
 — 
 — 
 — 
 $(52)

—

—

(1,510)
172

—
 — 
 — 
 — 

total

$206,930

37,151
16
37,167
5,327
11,467
13,982
$274,873

45,121

(205)
137
45,053
5,000
(5,654)
11,221 
13,421
18,836
$362,750 

(687)

54,815

(1,510)
172
53,477
(94,340)
6,711 
9,893
16,530

$34

$207,918

$147,772

 $(1,390)

$354,334 

2008

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31

Financial Statements and Supplementary Data

consolidated Statements of cash Flows

Year ended August 31,

2008

2007

2006

( In thousands )
cash flows from operating activities:
Net income
Adjustments to reconcile net income to net cash provided by 

operating activities, net of business acquisitions:
Depreciation and amortization
Amortization of deferred loan costs
Share-based employee compensation expense
Excess tax benefits from share-based payment arrangements
Increase in accounts receivable, net
Decrease (increase) in other current assets
Increase (decrease) in accounts payable
Increase (decrease) in accrued salaries and benefits
Increase in other current liabilities
Deferred income taxes
Other 
(Increase) decrease in other assets
Payments on other long-term liabilities

Net cash flows provided by operating activities

cash flows from investing activities:
Acquisition of property and equipment
Acquisitions, net of cash acquired
Purchase of investment
Other, net

Net cash flows used in investing activities

cash flows from financing activities:
Decrease in restricted cash
Proceeds from issuance of long-term debt
Deferred loan costs
Proceeds from sale of unregistered common stock
Repurchases of common stock
Excess tax benefits from share-based payment arrangements
Exercise of stock options
Payments of long-term debt

Net cash flows (used in) provided by financing activities

Net (decrease) increase in cash and cash equivalents
Cash and cash equivalents, beginning of period
Cash and cash equivalents, end of period
Supplemental disclosure of cash flow information:

Cash paid during the year for interest
Cash paid during the year for income taxes

See accompanying notes to the consolidated financial statements.

2008

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32

$

54,815

$

45,121

$

37,151

47,479
1,168
16,530
(9,480)
(33,131)
3,927
2,516
12,652
11,491
(10,835)
11,761
(1,367)
(2,220)
105,306

(82,521)
(452)
— 
(3,690)
(86,663)

 — 
85,420
—
—
(94,340)
9,480
6,711
(38,327)
(31,056)
(12,413)
47,655
35,242

19,117
41,249

$

$
$

37,044
991
18,836
(12,152)
(2,749)
(3,299)
(1,143)
(21,362)
52,227
(10,866)
5,092
834
(1,247)
107,327

(29,507)
(493,071)
(9,045)
(13)
(531,636)

 — 
350,000
(4,357)
5,000
(5,654)
12,152
11,221
(51,190)
317,172
(107,137)
154,792
47,655

14,042
38,580

$

$
$

24,517
476
13,982
(10,936)
(12,281)
(3,716)
5,599
9,162
46,434
(11,217)
3,621
(1,539)
(1,445)
99,808

(27,356)
(115)
 — 
 — 
(27,471)

3,811
 — 
(924)
 —
 —
10,936
5,328
(163)
18,988
91,325
63,467
154,792

548
16,415

$

$
$

 
 
 
notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

1. Summary of Significant accounting policies

Healthways, Inc. and its wholly-owned subsidiaries provide specialized, comprehensive Health and Care Support solutions to help 
people maintain or improve their health and, as a result, reduce overall healthcare costs. We deliver our programs to customers, which 
include  health  plans,  governments,  employers,  and  hospitals,  in  all  50  states,  the  District  of  Columbia,  and  Puerto  Rico. We  began 
delivering our Health and Care Support programs in Germany and Brazil in January 2008 and June 2008, respectively.

a. Principles of Consolidation - The consolidated financial statements include the accounts of the Company and its subsidiaries, all of 

which are wholly-owned. We have eliminated all intercompany profits, transactions and balances.

b. Cash and Cash Equivalents - Cash and cash equivalents primarily include tax-exempt debt instruments, commercial paper, and 

other short-term investments with original maturities of less than three months.

c. Accounts Receivable, net - Billed receivables primarily represent fees that are contractually due in the ordinary course of providing 
our services, net of contractual adjustments and allowances for doubtful accounts. Unbilled receivables primarily represent fees for 
service  based  on  the  estimated  utilization  of  fitness  facilities  and  are  generally  billed  in  the  following  month.  Historically,  we  have 
experienced minimal instances of customer non-payment and therefore consider our accounts receivable to be collectible, but we may 
provide reserves, when appropriate, for doubtful accounts and for billing adjustments at contract reconciliation.

d. Property and Equipment - Property and equipment is carried at cost and includes expenditures that increase value or extend 
useful  lives.  We  recognize  depreciation  using  the  straight-line  method  over  useful  lives  of  three  years  for  computer  software  and 
hardware and four to seven years for furniture and other office equipment. Leasehold improvements are depreciated over the shorter 
of the estimated life of the asset or the life of the lease, which ranges from one to fifteen years. Depreciation expense for the years 
ended August 31, 2008, 2007, and 2006 was $31.5 million, $25.6 million, and $20.6 million, respectively, including amortization of assets 
recorded under capital leases.

e. Other Assets - Other assets consist primarily of long-term investments and deferred loan costs net of accumulated amortization. We 
account for these long-term investments in accordance with Statement of Financial Accounting Standards (“SFAS”) No. 115, “Accounting 
for Certain Investments in Debt and Equity Securities” and have classified them as available-for-sale. Available-for-sale securities are 
carried at estimated fair value, with unrealized gains and losses reported in other comprehensive income.

f.  Intangible  Assets  -  Intangible  assets  are  carried  at  cost.  Intangible  assets  subject  to  amortization  primarily  include  acquired 
technology,  customer  contracts,  patents,  distributor  and  provider  networks,  and  other  intangible  assets  which  we  amortize  on  a 
straight-line basis over estimated useful lives ranging from three to 25 years. We assess the potential impairment of intangible assets 
subject to amortization whenever events or changes in circumstances indicate that the carrying values may not be recoverable.

Intangible  assets  not  subject  to  amortization  at  August  31,  2008  and  2007  consist  of  trade  names  of  $33.4  million. We  review 
intangible assets not subject to amortization on an annual basis or more frequently whenever events or circumstances indicate that the 
assets might be impaired. See Note 4 for further information on intangible assets.

g. Goodwill - We recognize goodwill for the excess of the purchase price over the fair value of tangible and identifiable intangible 

net assets of businesses that we acquire.

In accordance with SFAS No. 142, “Goodwill and Other Intangible Assets,” we review goodwill at the reporting unit level (operating 
segment or one level below an operating segment) on an annual basis or more frequently whenever events or circumstances indicate 
that the carrying value may not be recoverable. We estimate fair value using a number of techniques, including quoted market prices, 
present value techniques based on estimates of cash flows, or multiples of earnings or revenues performance measures. We allocate 
goodwill to reporting units based on the reporting unit expected to benefit from the combination. We completed our annual impairment 

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

test as required by SFAS No. 142 during our fourth fiscal quarter and concluded that no impairment of goodwill exists.

h. Contract Billings in Excess of Earned Revenue - Contract billings in excess of earned revenue primarily represent performance-
based  fees  subject  to  refund  that  we  have  not  recognized  as  revenues  because  either  1)  data  from  the  customer  is  insufficient  or 
incomplete to measure performance; or 2) interim performance measures indicate that we are not meeting performance targets.

i. Income Taxes - We file a consolidated federal income tax return that includes all of our domestic wholly-owned subsidiaries. We 
compute our income tax provision under SFAS No. 109, “Accounting for Income Taxes.” SFAS No. 109 generally requires that we record 
deferred income taxes for the tax effect of differences between the book and tax bases of our assets and liabilities. We account for 
uncertain tax positions under Financial Accounting Standards Board (“FASB”) Interpretation (“FIN”) No. 48, “Accounting for Uncertainty 
in Income Taxes - an interpretation of FASB Statement No. 109.” Under FIN No. 48, we recognize the tax benefit from an uncertain tax 
position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the 
technical merits of the position. The tax benefits recognized in the financial statements from such a position are measured based on the 
largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement.

j. Revenue Recognition - We generally determine our contract fees by multiplying a contractually negotiated rate per member per 
month (“PMPM”) by the number of members covered by our services during the month. We typically set the PMPM rates during contract 
negotiations with customers based on the value we expect our programs to create and a sharing of that value between the customer 
and the Company. In addition, some of our services are billed on a fee for service basis.

Some of our contracts provide that a portion (up to 100%) of our fees may be refundable to the customer (“performance-based”) if 
our programs do not achieve, when compared to a baseline year, a targeted percentage reduction in the customer’s healthcare costs 
and selected clinical and/or other criteria that focus on improving the health of the members. Approximately 4% of revenues recorded 
during  fiscal  2008  were  performance-based  and  were  subject  to  final  reconciliation  as  of  August  31,  2008. We  anticipate  that  this 
percentage will fluctuate due to the level of performance-based fees in new contracts, revenue recognition associated with performance-
based fees, and the timing of data reconciliation, which varies according to contract terms. A limited number of contracts also provide 
opportunities for us to receive incentive bonuses in excess of the contractual PMPM rate if we exceed contractual performance targets.
We generally bill our customers each month for the entire amount of the fees contractually due for the prior month’s enrollment, 
which typically includes the amount, if any, that is performance-based and may be subject to refund should we not meet performance 
targets. Deferred revenues can arise from contracts which permit upfront billing and collection of fees covering the entire contractual 
service period, generally 12 months. Contractually, we cannot bill for any incentive bonus until after contract settlement. Fees for service 
are typically billed in the month after the services are provided.

We recognize revenue as follows: 1) we recognize the fixed portion of PMPM fees and fees for service as revenue during the period 
we perform our services; 2) we recognize the performance-based portion of the monthly fees based on the most recent assessment of 
our performance, which represents the amount that the customer would legally be obligated to pay if the contract were terminated 
as of the latest balance sheet date; and 3) we recognize additional incentive bonuses based on the most recent assessment of our 
performance, to the extent we consider such amounts collectible.

We assess our level of performance for our contracts based on medical claims and other data that the customer is contractually required 
to supply. A minimum of four to six months’ data is typically required for us to measure performance. In assessing our performance, 
we may include estimates such as medical claims incurred but not reported and a medical cost trend compared to a baseline year. In 
addition, we may also provide contractual reserves, when appropriate, for billing adjustments at contract reconciliation.

Substantially  all  of  the  fees  under  the  Medicare  Health  Support  pilots  in  which  we  participated  were  performance-based.  Our 

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

original  cooperative  agreements  required  that,  by  the  end  of  the  third  year,  we  achieve  a  cumulative  net  savings  (total  savings  for 
the intervention population as compared to the control group less fees received from CMS) of 5.0%.  Under an amendment to our 
agreement for our stand-alone Medicare Health Support pilot in Maryland and the District of Columbia, we began serving a “refresh 
population” of approximately 4,500 beneficiaries on August 1, 2006, which was measured as a separate cohort for two years, by the end 
of which the program was required to achieve a 2.5% cumulative net savings when compared to a new control cohort. In April 2008, we 
signed an amendment to our Medicare Health Support protocol with CMS, which changed the financial performance target for both the 
initial cohort and the refresh population to budget neutrality. Although we receive the medical claims and other data associated with 
the intervention group under these pilots on a monthly basis, we assess our performance against the control group under these pilots 
based on quarterly summary performance reports received from CMS’ independent financial reconciliation contractor. As of August 31, 
2008, contract billings in excess of earned revenue related to the Medicare Health Support pilots totaled $58.6 million.

If data is insufficient or incomplete to measure performance, or interim performance measures indicate that we are not meeting 
performance targets, we do not recognize performance-based fees subject to refund as revenues but instead record them in a current 
liability account entitled “contract billings in excess of earned revenue.” Only in the event we do not meet performance levels by the 
end of the measurement period, typically one year, are we contractually obligated to refund some or all of the performance-based fees. 
We would only reverse revenues that we had already recognized if performance to date in the measurement period, previously above 
targeted levels, subsequently dropped below targeted levels. Historically, any such adjustments have been immaterial to our financial 
condition and results of operations.

During the settlement process under a contract, which generally occurs six to eight months after the end of a contract year, we 
settle any performance-based fees and reconcile healthcare claims and clinical data. As of August 31, 2008, performance-based fees 
that have not yet been settled with our customers but that have been recognized as revenue in the current and prior years totaled 
approximately $49.2 million. Of this amount, $7.5 million was based on calculations which include estimates such as medical claims 
incurred but not reported and/or the customer’s medical cost trend compared to a baseline year, while $41.7 million was based entirely 
on actual data received from our customers. Data reconciliation differences, for which we provide contractual allowances until we reach 
agreement with respect to identified issues, can arise between the customer and us due to customer data deficiencies, omissions, and/
or data discrepancies.

Performance-related adjustments (including any amounts recorded as revenue that were ultimately refunded), changes in estimates, 
data reconciliation differences, or adjustments to incentive bonuses may cause us to recognize or reverse revenue in a current fiscal year 
that pertains to services provided during a prior fiscal year. During fiscal 2008, we recognized a net increase in revenue of approximately 
$7.4 million that related to services provided prior to fiscal 2008.

k.  Earnings  Per  Share  – We  report  earnings  per  share  under  SFAS  No.  128 “Earnings  per  Share.” We  calculate  basic  earnings  per 
share using weighted average common shares outstanding during the period. We calculate diluted earnings per share using weighted 
average common shares outstanding during the period plus the effect of all dilutive potential common shares outstanding during the 
period. See Note 13 for a reconciliation of earnings per share.

l.  Share-Based  Compensation  –  We  account  for  share-based  compensation  in  accordance  with  SFAS  No.  123(R),  “Share-Based 
Payment” which requires that all share-based payments to employees, including grants of employee stock options, be recognized in the 
statement of operations based on their fair values.

See Note 11 for further information on share-based compensation.
m. Derivative Instruments and Hedging Activities – In accordance with SFAS No. 133, “Accounting for Derivative Instruments and 

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

Hedging Activities,” as amended, we recognize derivative instruments at their fair values as either assets or liabilities in the consolidated 
balance  sheet.  Changes  in  the  fair  value  of  derivatives  are  recognized  in  other  comprehensive  income  (for  the  effective  portion  of 
the gain or loss) or earnings (for the ineffective portion of the gain or loss). The effective portion, which is initially recorded to other 
comprehensive income, is reclassified into earnings when the forecasted transaction affects earnings. We currently maintain six interest 
rate swap agreements to reduce our exposure to interest rate fluctuations on our floating rate debt commitments which are subject to 
SFAS No. 133. See Note 6 for further information.

n. Management Estimates – In preparing our consolidated financial statements in conformity with generally accepted accounting 
principles,  management  must  make  estimates  and  assumptions  that  affect:  1)  the  reported  amounts  of  assets  and  liabilities  and 
disclosure of contingent assets and liabilities at the date of the financial statements; and 2) the reported amounts of revenues and 
expenses during the reporting period. Actual results could differ from those estimates.

o. Fiscal Year - In August 2008, our Board of Directors approved a change in our fiscal year-end from August 31 to December 31. 
Accordingly, our next full fiscal year will begin on January 1, 2009 following a four-month transition period ending December 31, 2008.

2. recently Issued accounting Standards

Fair Value Measurement

In  September  2006,  the  FASB  issued  SFAS  No.  157, “Fair Value  Measurement,”  which  provides  guidance  for  using  fair  value  to 
measure assets and liabilities, including a fair value hierarchy that prioritizes the information used to develop fair value assumptions.  
It also requires expanded disclosure about the extent to which companies measure assets and liabilities at fair value, the information 
used to measure fair value, and the effect of fair value measurements on earnings.  The standard applies whenever other standards 
require (or permit) assets or liabilities to be measured at fair value and does not expand the use of fair value in any new circumstances.  
SFAS No. 157 is effective for financial statements issued for fiscal years beginning after November 15, 2007, and interim periods within 
those fiscal years.

In  February  2008,  the  FASB  issued  FSP  FAS  No.  157-2, “Effective  Date  of  FASB  Statement  No.  157”,  which  defers  by  one  year  the 
effective date of the provisions of SFAS No. 157 for non-recurring, nonfinancial assets and nonfinancial liabilities to fiscal years beginning 
after November 15, 2008. We do not expect the adoption of SFAS No. 157 to have a material impact on our financial position or results 
of operations.
Fair Value Option for Financial Assets and Financial Liabilities

In February 2007, the FASB issued SFAS No. 159, “The Fair Value Option for Financial Assets and Financial Liabilities—Including an 
amendment of FASB Statement No. 115.”  SFAS No. 159 provides entities with the one-time option to measure financial instruments and 
certain other items at fair value, with changes in fair value recognized in earnings as they occur.  The fair value option may be applied 
instrument by instrument (with a few exceptions), is irrevocable, and must be applied to entire instruments and not to portions of an 
instrument. SFAS No. 159 is effective for financial statements issued for fiscal years beginning after November 15, 2007.  We do not 
expect the adoption of SFAS No. 159 to have a material impact on our financial position or results of operations.
Business Combinations

In December 2007, the FASB issued SFAS No. 141(R), “Business Combinations”. This statement expands the definition of a business 
and a business combination and generally requires the acquiring entity to recognize all of the assets and liabilities of the acquired 
business, regardless of the percentage ownership acquired, at their fair values. It also requires that contingent consideration and certain 
acquired contingencies be recorded at fair value on the acquisition date and that acquisition costs generally be expensed as incurred.

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

SFAS No. 141(R) is effective for fiscal years beginning after December 15, 2008. The adoption of SFAS No. 141(R) is not expected to 
materially impact our financial position or results of operations when it becomes effective on January 1, 2009; however, we do not yet 
know the impact that it will have on our financial position or results of operations for business combinations entered into on or after 
January 1, 2009.
Accounting for Uncertainty in Income Taxes

On September 1, 2007, we adopted the provisions of FIN No. 48.  FIN No. 48 creates a single model to address uncertainty in income 
tax  positions  by  prescribing  the  minimum  recognition  threshold  a  tax  position  is  required  to  meet  before  being  recognized  in  the 
financial statements.  It also provides guidance on derecognition of income tax assets and liabilities, classification of current and deferred 
income tax assets and liabilities, accounting for interest and penalties associated with tax positions, and income tax disclosures. As a 
result of the adoption of FIN No. 48, we recorded a $0.7 million decrease to the beginning balance of retained earnings as a cumulative 
effect of a change in accounting principle. See Note 5 for further information.

3. goodwill

The change in carrying amount of goodwill during the years ended August 31, 2008 and 2007 is shown below:

( In $000s )

Balance, august 31, 2006

Purchase of Axia

Health IQ purchase price adjustment
Other business acquisitions
Balance, august 31, 2007

Health IQ purchase price adjustment

Axia purchase price adjustment and other

Balance, august 31, 2008

$

96,135

384,753

792
1,904

$ 483,584
475
246

$ 484,305

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

4. Intangible assets

Intangible assets subject to amortization at August 31, 2008 consisted of the following:

( In $000s )
Customer contracts
Acquired technology
Patents
Distributor and provider networks
Other
Total

Gross Carrying
Amount

Accumulated
Amortization

$

$

53,140
22,657
22,840
8,709
5,470
112,816

$

$

18,619
15,115
2,397
2,137
838
39,106

Intangible assets subject to amortization at August 31, 2007 consisted of the following:

( In $000s )
Customer contracts
Acquired technology
Patents
Distributor and provider networks
Other
Total

Gross Carrying
Amount

Accumulated
Amortization

$

$

53,150
22,631
22,595
8,709
2,137
109,222

$

$

11,373
10,252
183
916
392
23,116

Net

34,521
7,542
20,443
6,572
4,632
73,710

Net

41,777
12,379
22,412
7,793
1,745
86,106

$

$

$

$

Intangible  assets  subject  to  amortization  are  being  amortized  over  estimated  useful  lives  ranging  from  three  to  25  years. Total 
amortization expense for the years ended August 31, 2008 and 2007, was $16.0 million and $11.5 million, respectively. The following 
table summarizes the estimated amortization expense for each of the next five years and thereafter:

Year ending August 31, 

( In $000s )
2009
2010
2011
2012
2013
2014 and thereafter
Total

$

$

12,159
11,219
10,814
9,089
8,500
21,929
73,710

Intangible assets not subject to amortization at August 31, 2008 and 2007 consist of trade names of $33.4 million.

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

5. Income taxes

Income tax expense is comprised of the following:

Year ended August 31,

2008

2007

2006

( In $000s )
Current taxes
Federal
State

Deferred taxes
Federal
State
Total

$

$

47,147
9,569 

(15,500) 
(3,476)
37,740  

$

$

34,187
6,465

(8,618)
(1,871)
30,163

$

$

29,247
5,977

(9,312)
(1,903)
24,009

Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for 
financial reporting purposes and the amounts used for income tax purposes. The following table shows the significant components of 
our net deferred tax asset (liability) for the fiscal years ended August 31, 2008 and 2007:

At August 31,

(In $000s)
Deferred tax asset:
Accruals and reserves
Deferred compensation
Share-based payments
Net operating loss carryforwards
Other assets and liabilities
Advance receipts 

Valuation allowance

Deferred tax liability:
Property and equipment
Intangible assets
Other assets and liabilities

Net deferred tax asset (liability)

Net current deferred tax asset
Net long-term deferred tax liability

2008

2007

$

$

9,537
8,270
17,644
7,936
2,341
16,381
62,109
(1,239)
60,870

13,895
31,316
75
45,286
15,584

$

24,948
(9,364)
$ 15,584

$

$

$

$

4,603
7,747
12,118
9,001
133
—
33,602
(841)
32,761

3,199
36,362
64
39,625
(6,864)

7,145
(14,009)
(6,864)

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

The valuation allowance increased by $0.4 million from August 31, 2007 to August 31, 2008 due to an increase in the valuation 
allowance against deferred tax assets in non-U.S. jurisdictions with a recent history of losses. Based on the Company’s historical and 
expected future taxable earnings, and a consideration of available tax planning strategies, management believes it is more likely than 
not that the Company will realize the benefit of the existing deferred tax assets, net of the valuation allowance, at August 31, 2008.

For fiscal 2008 and 2007, the tax benefit of stock option compensation, excluding the tax benefit related to the deferred tax asset for 
share-based payments subject to SFAS No. 123(R), was recorded as additional paid-in capital. For fiscal 2008 and 2007, we recorded a tax 
benefit of $1.1 million and $0.1 million, respectively, related to our interest rate swap agreements (see Note 7) to stockholders’ equity as 
a component of other comprehensive income (loss).

At August 31, 2008, we had foreign net operating loss carryforwards, before valuation allowances, of approximately $4.5 million 
with an indefinite carryforward period and approximately $19.1 million of federal loss carryforwards related to the acquisition of Axia. 
The federal loss carryforwards are subject to an annual limitation under Internal Revenue Code Section 382 and also have expiration 
dates ranging from 2011 until 2020.

The difference between income tax expense computed using the statutory federal income tax rate and the effective rate is 

as follows:

Year ended August 31,

2008

2007

2006

( In $000s )
Statutory federal income tax
State income taxes, less federal income tax benefit
Other
Income tax expense

$

$

32,394
3,910
1,436
37,740  

$

$

26,349
3,133
681
30,163

$

$

21,406
2,495
108
24,009

FIN No. 48

We adopted the provisions of FIN No. 48 on September 1, 2007. Adopting FIN No. 48 had the following impact on our financial 
statements: increased other long-term liabilities by $11.9 million; decreased our income taxes payable by $0.2 million; decreased long-
term deferred tax liabilities by $11.0 million; and decreased our retained earnings by $0.7 million. As of August 31, 2008, we had $0.3 
million of unrecognized tax benefits, all of which, if recognized, would affect our effective tax rate. Our policy is to include interest and 
penalties related to unrecognized tax benefits in income tax expense. As of August 31, 2008 and September 1, 2007, we had accrued 
interest related to uncertain tax positions of $1.5 million and $0.8 million, respectively, on our balance sheet. During fiscal 2008, we 
included approximately $0.5 million of net interest related to uncertain tax positions as a component of income tax expense.

The aggregate changes in the balance of unrecognized tax benefits were as follows:

(In $000s)
Unrecognized tax benefits at September 1, 2007
Decreases based on tax positions related to FY‘08
Lapse of statutes of limitation

Unrecognized tax benefits at August 31, 2008

$

11,050

(8,534)
(140)

$

2,376

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

We file income tax returns in the U.S. Federal jurisdiction and in various state and foreign jurisdictions. Tax years remaining subject 
to examination in these jurisdictions include 2005 to present. We are currently under audit by the Internal Revenue Service for our 2005 
and 2006 tax years.

6. Derivative Instruments and hedging activities

SFAS No. 133, “Accounting for Derivative Investments and Hedging Activities,” as amended, establishes accounting and reporting 
standards for derivative instruments, including certain derivative instruments embedded in other contracts, and for hedging activities. 
It requires companies to record all derivatives at estimated fair value as either assets or liabilities on the balance sheet and to recognize 
the unrealized gains and losses, the treatment of which depends on whether the derivative is designated as a hedging instrument.

As a result of our international initiatives, we are exposed to foreign currency exchange rate risks. A significant portion of these 
risks is economically hedged with currency options and forward contracts in order to minimize our exposure to fluctuations in foreign 
currency  exchange  rates.  Principal  currencies  hedged  include  the  Euro  and  British  pound.  These  derivative  instruments  serve  as 
economic hedges and do not qualify for hedge accounting treatment under SFAS No. 133. Accordingly, they require current period 
mark-to-market accounting, with any change in fair value being recorded each period in the statement of operations. We record the fair 
market value of our foreign currency derivatives as other current assets or accrued liabilities. We routinely monitor our foreign currency 
exposures to maximize the overall effectiveness of our foreign currency hedge positions.

We currently maintain six interest rate swap agreements to reduce our exposure to interest rate fluctuations on our floating rate 
debt commitments. Under these interest rate swap agreements, the interest rate is fixed with respect to specified amounts of notional 
principal. The  swaps  are  accounted  for  in  accordance  with  SFAS  No.  133  and  were  designated  at  their  inception  as  qualifying  cash 
flow hedges; thus, they are recorded at estimated fair value in the balance sheet, with changes in fair value being reported in other 
comprehensive income. The fair values of the swaps at August 31, 2008 of $0.7 million and ($3.6) million have been reported in other 
assets and other long-term liabilities, respectively, with an offset, net of tax, included in accumulated other comprehensive loss in the 
consolidated balance sheets.

7. long-term Debt

On  December  1,  2006,  we  entered  into  a Third  Amended  and  Restated  Revolving  Credit  and Term  Loan  Agreement  (the “Third 
Amended Credit Agreement”). The Third Amended Credit Agreement provides us with a $400.0 million revolving credit facility, including 
a swingline sub facility of $10.0 million and a $75.0 million sub facility for letters of credit, a $200.0 million term loan facility, and an 
uncommitted  incremental  accordion  facility  of  $200.0  million.  As  of  August  31,  2008,  availability  under  our  revolving  credit  facility 
totaled $247.9 million.

Revolving advances under the Third Amended Credit Agreement generally bear interest, at our option, at 1) LIBOR plus a spread of 
0.875% to 1.750% or 2) the greater of the federal funds rate plus 0.5%, or the prime rate, plus a spread of 0.000% to 0.250%. Term loan 
borrowings bear interest, at our option, at 1) LIBOR plus 1.50% or 2) the greater of the federal funds rate plus 0.5%, or the prime rate. 
The Third Amended Credit Agreement also provides for a fee ranging between 0.150% and 0.300% of unused commitments. The Third 
Amended Credit Agreement is secured by guarantees from most of the Company’s domestic subsidiaries and by security interests in 
substantially all of the Company’s and such subsidiaries’ assets.

We are required to repay outstanding revolving loans on the revolving commitment termination date, which is December 1, 2011. 
We are required to repay term loans in quarterly principal installments aggregating $0.5 million each, which commenced on March 31, 

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

2007, and the entire unpaid principal balance of the term loans is due and payable at maturity on December 1, 2013.

The following table summarizes the minimum annual principal payments and repayments of the revolving advances under the 

Third Amended Credit Agreement for each of the next five years and thereafter:

Year ending August 31, 

( In $000s )
2009
2010
2011
2012
2013
2014 and thereafter
Total

$

$

2,000
2,000
2,000
152,000
2,000
187,000
347,000

The Third Amended Credit Agreement contains various financial covenants, which require us to maintain, as defined, ratios or levels 
of  1)  total  funded  debt  to  EBITDA,  2)  fixed  charge  coverage,  and  3)  net  worth.  It  also  restricts  the  payment  of  dividends  and  limits 
the amount of repurchases of the Company’s common stock. As of August 31, 2008, we were in compliance with all of the covenant 
requirements of the Third Amended Credit Agreement.

As of August 31, 2008, we are currently a party to the following interest rate swap agreements for which we receive a variable rate of 
interest based on the three-month LIBOR and for which we pay the following fixed rates of interest plus a spread of 0.875% to 1.750% 
on revolving advances and a spread of 1.50% on term loan borrowings:

Swap #

Notional Amount in ($000’s)

Fixed Interest Rate

Termination Date

1
2
3
4
5
6

$230,000
40,000
40,000
50,000
40,000
30,000

March 31, 2010 (1)

4.995 %
3.987 % December 31, 2009
3.433 % December 30, 2011
3.688 % December 30, 2011 (2)
3.855 % December 30, 2011 (3)
March 30, 2011 (4)
3.760 %

(1) The principal value of this swap arrangement amortizes over a 39-month period. The notional value of this swap as of August 31, 2008 was $150 million.
(2) This swap agreement becomes effective April 1, 2009.
(3) This swap agreement becomes effective October 1, 2009.
(4) This swap agreement becomes effective January 2, 2010.

We currently believe that we meet the hedge accounting criteria under SFAS No. 133 in accounting for these interest rate 

swap agreements.

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

8. Fair value of Financial Instruments

In accordance with SFAS No. 107, “Disclosures About Fair Value of Financial Instruments,” we used the following methods to estimate 

the fair value of each class of financial instruments:

a. Cash and cash equivalents – The carrying amounts at August 31, 2008 and 2007 approximate fair value because of the short 

maturity of those instruments (less than three months).

b. Long-term investments – Long-term investments at August 31, 2008 and 2007 consist primarily of available-for-sale securities 
accounted for in accordance with SFAS No. 115. Available-for-sale securities are carried at estimated fair value, with unrealized gains 
and losses reported in other comprehensive income.

c. Foreign currency contracts – Foreign currency contracts at August 31, 2008 and 2007 are carried at their estimated fair values in 

accordance with SFAS No. 133. The fair values of foreign currency contracts are estimated by obtaining quotes from brokers.

d. Interest rate swaps – Interest rate swaps at August 31, 2008 and 2007 are carried at their estimated fair values in accordance with 
SFAS No. 133. The fair values of our interest rate swap agreements are the amounts at which they could be settled, based on estimates 
obtained from the counterparties.

e. Long-term debt – The estimated fair value of outstanding borrowings under the Third Amended Credit Agreement is based on 
the average of the prices set by the issuing bank given current market conditions and is not necessarily indicative of the amount we 
could  realize  in  a  current  market  exchange. The  estimated  fair  values  and  carrying  amounts  of  outstanding  borrowings  under  the 
Third Amended Credit Agreement at August 31, 2008 are $338.0 million and $348.2 million, respectively. The estimated fair values and 
carrying amounts of outstanding borrowings at August 31, 2007 were $293.3 million and $299.0 million, respectively.

9. Other long-term liabilities

We have a non-qualified deferred compensation plan under which our officers may defer a portion of their salaries and receive a 
Company matching contribution plus a contribution based on our performance. Company contributions vest at 25% per year. We do 
not fund the plan and carry it as an unsecured obligation. Participants in the plan elect payout dates for their account balances, which 
can be no earlier than four years from the period of the deferral.

As of August 31, 2008 and 2007, other long-term liabilities included vested amounts under the plan of $7.9 million and $7.6 million, 
respectively, net of the current portions of $2.7 million and $1.9 million, respectively. For the next five years ended August 31, we must 
make estimated plan payments of $2.7 million, $1.0 million, $0.6 million, $0.5 million, and $0.1 million, respectively.

10. leases

We maintain operating lease agreements principally for our corporate office space, our call centers, and our operations support 
and training offices. Our corporate office lease covers approximately 264,000 square feet. It commenced in March 2008 and expires in 
February 2023. We also lease office space for our 15 call center locations for an aggregate of approximately 391,000 square feet of space 
with lease terms expiring on various dates from 2009 to 2015. Our operations support and training offices contain approximately 74,000 
square feet in aggregate and have lease terms expiring from 2009 to 2015.

Our corporate office lease agreement contains escalation clauses and provides for two renewal options of five years each at then 
prevailing market rates. The base rent for the initial 15-year term is based on the actual construction costs of the building and will range 
from $4.2 million to $6.3 million per year over the term of the lease. The landlord provided a tenant improvement allowance equal to 

2008

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43

notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

$39.20 per square foot. We record leasehold improvement incentives as deferred rent and amortize them as reductions to rent expense 
over the lease term. We recognize rent expense on a straight-line basis over the lease term.

Most of our operating leases include escalation clauses, some of which are fixed amounts, and some of which reflect changes in 
price indices. Certain operating leases contain renewal options to extend the lease for additional periods. For the years ended August 
31,  2008,  2007,  and  2006,  rent  expense  under  lease  agreements  was  approximately  $16.9  million,  $10.6  million,  and  $7.7  million, 
respectively. Our capital lease obligations are included in long-term debt and the current portion of long-term debt.

The following table summarizes our future minimum lease payments, net of sublease income, under all capital leases and non-

cancelable operating leases for each of the next five years:

Year ending August 31,

( In $000s )
2009
2010
2011
2012
2013
2014 and thereafter
Total minimum lease payments
Less amount representing interest
Present value of net minimum lease payments
Less current portion

Capital
Leases

Operating
Leases

$

$

12,916
12,764
11,832
10,673
8,781
59,189
116,155

$

$

48
—
 — 
 — 
 — 
 — 
48
(1)
47
(47)
 —  

11. Share-Based compensation

We have several shareholder-approved stock incentive plans for employees and directors. We currently have three types of share-
based awards outstanding under these plans: stock options, restricted stock, and restricted stock units. We believe that such awards 
align the interests of our employees and directors with those of our stockholders.

We grant options under these plans at market value on the date of grant. The options generally vest over or at the end of four years 
based on service conditions. Options granted on or after August 24, 2005 generally expire seven years from the date of grant, while 
options granted before August 24, 2005 expire ten years from the date of grant. Restricted share awards generally vest at the end of 
four years. Certain option and restricted share awards generally provide for accelerated vesting upon a change in control or normal or 
early retirement (as defined in the plans). At August 31, 2008, we have reserved approximately 1.2 million shares for future equity grants 
under our stock incentive plans.

For the years ended August 31, 2008, 2007 and 2006, we recognized share-based compensation costs of $16.5 million, $18.8 million 
and $14.0 million, respectively, which consisted of $8.0 million, $8.4 million and $6.6 million in cost of services, respectively, and $8.5 
million, $10.4 million and $7.4 million in selling, general and administrative expenses, respectively. We also recognized a total income 

2008

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

tax benefit in the statement of operations for share-based compensation arrangements of $6.5 million, $7.4 million and $5.5 million for 
the years ended August 31, 2008, 2007 and 2006, respectively. We did not capitalize any share-based compensation costs during fiscal 
2008, 2007, or 2006.

As  of  August  31,  2008,  there  was  $35.6  million  of  total  unrecognized  compensation  cost  related  to  nonvested  share-based 
compensation arrangements granted under the stock incentive plans. That cost is expected to be recognized over a weighted average 
period of 2.6 years.

Stock Options

For the years ended August 31, 2008, 2007 and 2006, we used a lattice-based binomial option valuation model (“lattice binomial 
model”) to estimate the fair values of stock options. During fiscal 2007 and 2006, we based expected volatility on both historical volatility 
and implied volatility from traded options on the Company’s stock. During fiscal 2008, we based expected volatility on historical volatility 
due to the low volume of traded options on our stock. The expected term of options granted was derived from the output of the lattice 
binomial model and represents the period of time that options granted are expected to be outstanding. We used historical data to 
estimate expected option exercise and post-vesting employment termination behavior within the lattice binomial model.

The following table shows the weighted average grant-date fair values of options and the weighted average assumptions we used 

to develop the fair value estimates under each of the option valuation models for the years ended August 31, 2008, 2007, and 2006:

Year Ended August 31,

2008

2007

2006

Weighted average grant-date fair value of options

$ 22.16

$ 22.08

$ 22.61

Assumptions:

Expected volatility
Expected dividends
Expected term (in years)
Risk-free rate

37.8%
—
6.6
4.2%

48.7%
—
5.5
5.1%

47.7%
—
5.3
3.8%

A summary of option activity as of August 31, 2008 and changes during the year then ended is presented below:

Options

Shares (000s)

Weighted 
Average Exercise 
Price

Weighted Average 
Remaining 
Contractual
 Term

Aggregate 
Intrinsic Value 
($000s)

Outstanding at September 1, 2007
Granted
Exercised
Forfeited or expired
Outstanding at August 31, 2008

Exercisable at August 31, 2008

5,245
657
(611)
(175)
5,116

3,265

$

22.46
47.88
11.03
39.17
26.52

16.23

4.8

4.6

$

$

16,608

16,608

2008

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45

 
 
 
notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

The  total  intrinsic  value,  which  represents  the  difference  between  the  underlying  stock’s  market  price  and  the  option’s  exercise 

price, of options exercised during fiscal 2008, 2007 and 2006 was $27.5 million, $35.9 million, and $29.0 million, respectively.

Cash received from option exercises under all share-based payment arrangements during fiscal 2008 was $6.7 million. The actual tax 
benefit realized during fiscal 2008 for the tax deductions from option exercises totaled $10.8 million. We issue new shares of common 
stock upon exercise of stock options.

Restricted Stock and Restricted Stock Units

The fair value of restricted stock and restricted stock units (“nonvested shares”) is determined based on the closing bid price of the 
Company’s common stock on the grant date. The weighted average grant-date fair value of nonvested shares granted during the years 
ended August 31, 2008, 2007 and 2006 was $43.17, $43.76 and $47.40, respectively 

The following table shows a summary of our nonvested shares as of August 31, 2008 as well as activity during the year then ended. 

The total fair value of shares vested during fiscal 2008, 2007, and 2006 was $0.8 million, $0.5 million, and $0.4 million, respectively.

Nonvested Shares
Nonvested at September 1, 2007
Granted
Vested
Forfeited
Nonvested at August 31, 2008

12. comprehensive Income

Shares (000s)
364
250
(20)
(41)
553

Weighted 
Average Grant 
Date Fair Value
$ 43.76
42.91
40.85
48.19
43.17

Comprehensive income, net of income taxes, was $53.5 million, $45.1 million, and $37.2 million for the years ended August 31, 2008, 

2007, and 2006, respectively.

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

13. earnings per Share

The following is a reconciliation of the numerator and denominator of basic and diluted earnings per share:

Year Ended August 31,
( In 000s except per share data )
Numerator:

2008

2007

2006

Net income - numerator for basic earnings per share

$

54,815

$

45,121

$

37,151

Denominator:
Shares used for basic earnings per share
Effect of dilutive stock options and restricted stock units outstanding:

Non-qualified stock options
Restricted stock units

Shares used for diluted earnings per share

34,977

1,477
143
36,597

Earnings per share:
Basic
Diluted

$
$

1.57
1.50

$
$

1.29
1.22

$
$

Dilutive securities outstanding not included in the computation
of earnings per share because their effect is antidilutive:

1,658

1,117

35,049

34,348

1,887
66
37,002

2,015
16
36,379

1.08
1.02

749

14. Stockholder rights plan

On June 19, 2000, the Board of Directors adopted a stockholder rights plan under which holders of common stock as of June 30, 2000 
received preferred stock purchase rights as a dividend at the rate of one right per share. As amended in June 2004 and July 2006, each 
right initially entitles its holder to purchase one one-hundredth of a Series A preferred share at $175.00, subject to adjustment. Upon 
becoming exercisable, each right will allow the holder (other than the person or group whose actions have triggered the exercisability of 
the rights), under alternative circumstances, to buy either securities of the Company or securities of the acquiring company (depending 
on the form of the transaction) having a value of twice the then current exercise price of the rights.

With  certain  exceptions,  each  right  will  become  exercisable  only  when  a  person  or  group  acquires,  or  commences  a  tender  or 
exchange offer for, 15% or more of our outstanding common stock. Rights will also become exercisable in the event of certain mergers 
or asset sales involving more than 50% of our assets or earning power. The rights will expire on June 15, 2014. The Board of Directors of 
the Company reviews the plan at least once every three years to determine if the maintenance and continuance of the plan is still in the 
best interests of the Company and its stockholders.

2008

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

15. employee Benefits

We have a 401(k) Retirement Savings Plan (the “Plan”) available to substantially all of our employees. Employees can contribute up 
to a certain percentage of their base compensation as defined in the Plan. The Company matching contributions are subject to vesting 
requirements. Company contributions under the Plan totaled $4.3 million, $3.8 million, and $2.5 million for the years ended August 31, 
2008, 2007, and 2006, respectively.

16. commitments and contingencies

Pursuant to an earn-out agreement executed in connection with the acquisition of certain assets of Health IQ in June 2005, we were 
obligated to pay the former stockholders of Health IQ additional purchase price equal to a percentage of revenues recognized from 
Health IQ’s programs in each of the fiscal quarters during the three-year period ended August 31, 2008.

Former Employee Action
In June 1994, a former employee whom we dismissed in February 1994 filed a “whistle blower” action on behalf of the United States 
government. Subsequent to its review of this case, the federal government determined not to intervene in the litigation. The employee 
sued  Healthways,  Inc.  and  our  wholly-owned  subsidiary,  American  Healthways  Services,  Inc.  (“AHSI”),  as  well  as  certain  named  and 
unnamed medical directors and one named client hospital, West Paces Medical Center (“WPMC”), and other unnamed client hospitals.

Healthways, Inc. has since been dismissed as a defendant; however, the case is still pending against AHSI. In addition, WPMC has 
settled claims filed against it as part of a larger settlement agreement that WPMC’s parent organization, HCA Inc., reached with the 
United States government. The plaintiff has also dismissed its claims against the medical directors with prejudice, and on February 7, 
2007 the court granted the plaintiff’s motion and dismissed all claims against all named medical directors.

The complaint alleges that AHSI, the client hospitals and the medical directors violated the federal False Claims Act by entering 
into certain arrangements that allegedly violated the federal anti-kickback statute and provisions of the Social Security Act prohibiting 
physician self-referrals. Although no specific monetary damage has been claimed, the plaintiff, on behalf of the federal government, 
seeks treble damages plus civil penalties and attorneys’ fees. The plaintiff also has requested an award of 30% of any judgment plus 
expenses.

In the action by the former employee, discovery is complete. On April 28, 2008, AHSI filed a motion for summary judgment seeking 
dismissal of the plaintiff’s claims. On July 21, 2008, the court granted the motion for summary judgment with respect to the plaintiff’s 
claims  alleging  violations  of  provisions  of  the  Social  Security  Act  prohibiting  physician  self-referrals,  and  these  claims  have  been 
dismissed. The court denied the motion for summary judgment with respect to the plaintiff’s claims alleging violations of the federal 
anti-kickback statute and ruled that the plaintiff may go to trial as to those claims. The proceedings before the United States District 
Court for the District of Columbia have concluded, and that court has suggested to the Judicial Panel on Multidistrict Litigation that the 
case be remanded to the United States District Court for the Middle District of Tennessee for trial. No trial date has been set. The parties 
have had initial discussions regarding their respective positions in the case; however, no resolution of this case has been reached or can 
be assured prior to the case proceeding to trial.

In a related matter, in February 2006, WPMC filed an arbitration claim seeking indemnification from us for certain costs and 
expenses incurred by it in connection with the case. In the action by WPMC, initial arbitration proceedings were commenced during 
the third quarter of fiscal 2006. During September 2007, the parties to this matter agreed to place the arbitration on hold for an 
indefinite period.

2008

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

We believe that we have conducted our operations in full compliance with applicable statutory requirements and that we 
have  meritorious  defenses  to  the  claims  made  in  the  case  and  the  related  arbitration  proceeding,  and  intend  to  contest  the 
claims vigorously.

Securities Class Action Litigation
Beginning on June 5, 2008, Healthways and certain of its present and former officers and/or directors were named as defendants 
in two putative securities class actions filed in the U.S. District Court for the Middle District of Tennessee, Nashville Division. On August 
8, 2008, the court ordered the consolidation of the two related cases, appointed lead plaintiff and lead plaintiff’s counsel, and granted 
lead plaintiff leave to file a consolidated amended complaint.  

The amended complaint, filed on September 22, 2008, alleges that the Company and the individual defendants violated Sections 
10(b) of the Securities Exchange Act of 1934 (the “Act”) and that the individual defendants violated Section 20(a) of the Act as “control 
persons” of Healthways.  The amended complaint further alleges that certain of the individual defendants also violated Section 20A of 
the Act based on their stock sales.  Plaintiff purports to bring these claims for unspecified monetary damages on behalf of a class of 
investors who purchased Healthways stock between July 5, 2007 and August 25, 2008.  

In  support  of  these  claims,  plaintiff  alleges  generally  that,  during  the  proposed  class  period,  the  Company  made  misleading 
statements and omitted material information regarding (1) the purported loss or restructuring of certain contracts with customers, (2) 
the Company’s participation in the Medicare Health Support (“MHS”) pilot program for the Centers for Medicare & Medicaid Services, 
and  (3)  the  Company’s  guidance  for  fiscal  year  2008.    Defendants’  motion  to  dismiss  the  amended  complaint  is  due  to  be  filed  on 
November 6, 2008.  Discovery has not yet commenced in the consolidated case, and no trial date has been set.   

Shareholder Derivative Lawsuits 
Also, on June 27, 2008 and July 24, 2008, respectively, two shareholders filed putative derivative actions purportedly on behalf of 
Healthways in the Chancery Court for the State of Tennessee, Twentieth Judicial District, Davidson County, against certain directors 
and officers of the Company.  These actions are based upon substantially the same facts alleged in the securities class action litigation 
described above.  The plaintiffs are seeking to recover damages in an unspecified amount and equitable and/or injunctive relief.  

On August 13, 2008, the Court consolidated these two lawsuits and appointed lead counsel.  On October 3, 2008, the Court ordered 
that the consolidated action be stayed until the motion to dismiss in the securities class action has been resolved by the District Court.  
Discovery has not yet commenced in the consolidated case, and no trial date has been set.

ERISA Lawsuits 
Additionally, on July 31, 2008, a purported class action alleging violations of the Employee Retirement Income Security Act (“ERISA”) 
was filed in the U.S. District Court for the Middle District of Tennessee, Nashville Division against Healthways, Inc. and certain of its 
directors and officers alleging breaches of fiduciary duties to participants in the Company’s 401(k) plan.  The central allegation is that 
Company stock was an imprudent investment option for the 401(k) plan.  

The complaint was amended on September 29, 2008.  The named defendants are: the Company, Board of Directors, certain officers, 
and members of the Investment Committee charged with administering the 401(k) plan.  The amended complaint alleges that the 
defendants violated ERISA by failing to remove the Company stock fund from the 401(k) plan when it allegedly became an imprudent 
investment, by failing to disclose adequately the risks and results of the MHS pilot program to 401(k) plan participants, and by failing to 
seek independent advice as to whether to continue to permit the plan to hold Company stock.  It further alleges that the Company and 
its directors should have been more closely monitoring the Investment Committee and other plan fiduciaries.  The amended complaint 

2008

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notes to consolidated Financial Statements  |  Years Ended August 31, 2008, 2007 and 2006

seeks damages in an undisclosed amount and other equitable relief.  Discovery in this case has not yet commenced; a trial date of April 
27, 2010 has been set.  Defendants filed a motion to dismiss on October 29, 2008.

While management believes it has meritorious defenses to the claims made in the foregoing described legal proceedings, resolution 
of  these  legal  matters  could  have  a  material  adverse  effect  on  our  consolidated  results  of  operations,  although  we  are  not  able  to 
reasonably estimate a range of potential losses.  We believe that we will continue to incur legal expenses associated with the defense 
of these matters which may be material to our consolidated results of operations in a particular financial reporting period.  As these 
matters are subject to inherent uncertainties, management’s view of these matters may change in the future. 

17. Segment Disclosures

SFAS No. 131, “Disclosures About Segments of an Enterprise and Related Information,” establishes disclosure standards for segments 
of a company based on a management approach to defining operating segments. We have aggregated several operating segments into 
one reportable segment, Health and Care Support. Our integrated Health and Care Support product line includes programs for various 
diseases, conditions, and wellness programs. It is impracticable for us to report revenues by program. Further, we report revenues from 
our external customers on a consolidated basis since Health and Care Support is the only service that we provide.

In fiscal 2008, two customers each comprised 10% or more of our revenues. Revenues from each of these customers individually 
totaled approximately 20% and 10%, respectively, of fiscal 2008 revenues. In fiscal 2007, we derived approximately 22% of our revenues 
from one customer, with no other customer comprising 10% or more of our revenues. In fiscal 2006, two customers each comprised 
10% or more of our revenues. Revenues from each of these customers individually totaled approximately 27% and 11%, respectively, of 
fiscal 2006 revenues.

2008

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50

report of Independent registered public accounting Firm

The Board of Directors and Stockholders of Healthways, Inc.
We have audited the accompanying consolidated balance sheets of Healthways, Inc. as of August 31, 2008 and 2007, and the related 
consolidated statements of operations, stockholders’ equity, and cash flows for each of the three years in the period ended August 31, 
2008. These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on 
these financial statements based on our audits.

We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). 
Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements 
are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the 
financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as 
well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the financial statements referred to above present fairly, in all material respects, the consolidated financial position of 
Healthways, Inc. at August 31, 2008 and 2007, and the consolidated results of its operations and its cash flows for each of the three years 
in the period ended August 31, 2008, in conformity with U.S. generally accepted accounting principles.

As discussed in Note 2 and 5 to the consolidated financial statements, the Company adopted FASB Interpretation No. 48, Accounting 

for Uncertainty in Income Taxes-An Interpretation of FASB Statement No. 109, effective September 1, 2007.

We  also  have  audited,  in  accordance  with  the  standards  of  the  Public  Company  Accounting  Oversight  Board  (United  States), 
Healthways,  Inc.’s  and  Subsidiaries’  internal  control  over  financial  reporting  as  of  August  31,  2008,  based  on  criteria  established  in 
Internal Control-Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission and our 
report dated October 27, 2008 expressed an unqualified opinion thereon.

Nashville, Tennessee
October 27, 2008

2008

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Quarterly Financial Information (unaudited):

Fiscal 2008

First

Second

third

Fourth

( In thousands, except per share data )
Revenues
Gross margin 
Income before income taxes 
Net income

Basic earnings per share (2)
Diluted earnings per share (2)

Fiscal 2007

Revenues
Gross margin 
Income before income taxes 
Net income

Basic earnings per share (2)
Diluted earnings per share (2)

$ 175,819
43,823
$
18,986
$
11,183
$

$ 178,966
46,134
$
21,165
$
12,454
$

$ 191,439
53,135
$
23,724
$
13,974
$

$ 190,018
55,105
$
28,680
$
17,203
$

$
$

$
$
$
$

$
$

0.31
0.30

$
$

0.35
0.33

First

Second

117,055
33,871
19,809
11,834

$ 160,281
$
$
$

43,803 (1)
18,266
11,024

0.34
0.32

$
$

0.32
0.30

$
$

$
$
$
$

$
$

0.40
0.39

$
$

0.51
0.49

Third

Fourth

167,900

44,873 (1)
17,145
10,792

$ 170,350
47,638
$
20,063
$
11,471
$

0.31
0.29

$
$

0.32
0.31

(1)  Reflects certain reclassifications from selling, general and administrative expenses to cost of services that were made to conform to current classifications.
(2)  We  calculated  earnings  per  share  for  each  of  the  quarters  based  on  the  weighted  average  number  of  shares  and  dilutive  options  outstanding  for  each 
   period. Accordingly, the sum of the quarters may not necessarily be equal to the full year income per share.

reconciliation of non-gaap measures to gaap measures (unaudited)
Reconciliation of EBITDA to Net Income

Year ended August 31,

2004

2005

2006

2007

2008

( In thousands )
EBITDA(1)
Interest expense
Income tax expense
Depreciation and amortization
Net income

$ 65,262
3,509
17,245
18,450
$ 26,058

$ 78,833
1,630
21,711
22,408
$ 33,084

$ 86,730
1,053
24,009
24,517
$ 37,151

$ 130,513
18,185
30,163
37,044
$ 45,121

$ 160,961
20,927
37,740
47,479
$ 54,815

(1)  Earnings  before  interest,  taxes,  depreciation  and  amortization  (“EBITDA”)  is  a  non-GAAP  financial  measure.  The  Company  excludes  interest,  taxes, 
   depreciation  and  amortization  from  this  measure  and  provides  EBITDA  to  enhance  investors’  understanding  of  the  Company’s  operating  performance 
   and  its  capacity  to  fund  capital  expenditures  and  working  capital  requirements. The  Company  believes  it  is  useful  to  investors  to  provide  disclosures  of 
its operating results on the same basis as that used by management.  You should not consider EBITDA in isolation or as a substitute for net income determined 
in accordance with accounting principles generally accepted in the United States.

2008

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52

 
 
 
 
 
 
 
  
  
management’s annual report on Internal control over Financial reporting

Management, including the principal executive officer and principal financial officer, is responsible for establishing and maintaining 
adequate  internal  control  over  financial  reporting.  Internal  control  over  financial  reporting  (as  defined  in  Rule  13a-15(f)  under  the 
Securities Exchange Act of 1934) 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.

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 and procedures may deteriorate.

Management has performed an assessment of the effectiveness of the Company’s internal control over financial reporting as of 
August 31, 2008 based on criteria established by the Committee of Sponsoring Organizations of the Treadway Commission (“COSO”), 
Internal  Controls  -  Integrated  Framework,  and  believes  that  the  COSO  framework  is  a  suitable  framework  for  such  an  evaluation. 
Management has concluded that the Company’s internal control over financial reporting was effective as of August 31, 2008.

Ernst & Young LLP, the independent registered public accounting firm that audited the Company’s consolidated financial statements 
for the year ended August 31, 2008, has issued an attestation report on the Company’s internal control over financial reporting which is 
included in this Annual Report to Stockholders.

We have performed an evaluation as of the end of the period covered by this report of the effectiveness of our “disclosure controls 
and procedures” (as defined in Rule 13a-15(e) promulgated under the Securities Exchange Act of 1934), under the supervision and with 
the participation of our Chief Executive Officer and our Chief Financial Officer. Based upon our evaluation, our Chief Executive Officer 
and Chief Financial Officer concluded that our disclosure controls and procedures were effective as of the end of the period covered by 
this report.

There have been no changes in our internal controls over financial reporting during the quarter ended August 31, 2008 that have 

materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

2008

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53

report of Independent registered public accounting Firm

The Board of Directors and Stockholders of Healthways, Inc.
We  have  audited  Healthways,  Inc.’s  internal  control  over  financial  reporting  as  of  August  31,  2008,  based  on  criteria  established 
in Internal Control—Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (the 
COSO criteria). Healthways, Inc.’s management is responsible for maintaining effective internal control over financial reporting, and for 
its assessment of the effectiveness of internal control over financial reporting included in the accompanying Management’s Annual 
Report on Internal Control over Financial Reporting. Our responsibility is to express an opinion on the company’s internal control over 
financial reporting based on our audit.

We  conducted  our  audit  in  accordance  with  the  standards  of  the  Public  Company  Accounting  Oversight  Board  (United  States). 
Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal control 
over financial reporting was maintained in all material respects. Our audit included obtaining an understanding of internal control over 
financial reporting, assessing the risk that a material weakness exists, testing and evaluating the design and operating effectiveness of 
internal control based on the assessed risk, and performing such other procedures as we considered necessary in the circumstances. We 
believe that our audit provides a reasonable basis for our opinion.

A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability 
of  financial  reporting  and  the  preparation  of  financial  statements  for  external  purposes  in  accordance  with  generally  accepted 
accounting principles. A company’s internal control over financial reporting includes those policies and procedures that (1) pertain to 
the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the 
company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements 
in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only 
in  accordance  with  authorizations  of  management  and  directors  of  the  company;  and  (3)  provide  reasonable  assurance  regarding 
prevention or timely detection of unauthorized acquisition, use or disposition of the company’s assets that could have a material effect 
on the financial statements.

Because  of  its  inherent  limitations,  internal  control  over  financial  reporting  may  not  prevent  or  detect  misstatements.  Also, 
projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of 
changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

In our opinion, Healthways, Inc. maintained, in all material respects, effective internal control over financial reporting as of August 

31, 2008, based on the COSO criteria.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), the 
consolidated balance sheets of Healthways, Inc. as of August 31, 2008 and 2007, and the related consolidated statements of operations, 
stockholders’ equity, and cash flows for each of the three years in the period ended August 31, 2008 of Healthways, Inc. and our report 
dated October 27, 2008 expressed an unqualified opinion thereon.

Nashville, Tennessee
October 27, 2008

2008

HEALTHWAYS

54

Directors, executive Officers and advisory councils

BOarD OF DIrectOrS
John w. Ballantine
Former Executive Vice President and 
Chief Risk Management Officer
First Chicago NBD Corporation
J. cris Bisgard, m.D., m.p.h.
Former Director of Health Services
Delta Air Lines
thomas g. cigarran
Chairman and former Chief
Executive Officer
Healthways, Inc.
mary Jane england, m.D.
President of Regis College
henry D. herr
Former Executive Vice President 
and Chief Financial Officer
Healthways, Inc.
Ben r. leedle, Jr.
Chief Executive Officer
Healthways, Inc.
l. Ben lytle
Former Chairman and Chief
Executive Officer
Axia Health Management, LLC
c. warren neel, ph.D.
Director of the Center for
Corporate Governance
University of Tennessee

william c. O’neil, Jr.
Former Chairman, President and
Chief Executive Officer
ClinTrials Research, Inc.

alison taunton-rigby, ph.D.
Chief Executive Officer
RiboNovix, Inc.

John a. wickens
Former National Health
Plan President
UnitedHealth Group

executIve OFFIcerS

Ben r. leedle, Jr.
Chief Executive Officer

Stefen F. Brueckner
President and
Chief Operating Officer

mary a. chaput
Executive Vice President and 
Chief Financial Officer

matthew e. Kelliher
Executive Vice President,
International Business

alfred lumsdaine
Senior Vice President,
Corporate Controller and
Chief Accounting Officer

anne m. wilkins
Executive Vice President,
Strategy

meDIcal anD ScIentIFIc 
aDvISOry cOuncIl

pamela allweiss, m.D., m.S.p.h.
Lexington, KY

John e. anderson, m.D.
The Frist Clinic
Nashville, TN

charles h. Booras, m.D., F.a.a.F.p.
W. P. Booras, M.D., PA
Jacksonville, FL

Schumarry h. chao, m.D.
Santa Monica, CA

richard S. chung, m.D.
Senior Vice President, Health 
Services Division
Hawaii Medical Service Association
Honolulu, HI

John Dixon, m.D., F.a.c.c., 
F.a.h.a., F.S.c.a.I.
Associate Professor of Medicine
Vanderbilt University Medical Center
Nashville, TN

rich Feifer, m.D., m.p.h., F.a.c.p.
Vice President of Program Development, 
Care Enhancing Solutions
Medco Health Solutions, Inc. 
Franklin Lakes, NJ 

Kenan haver, m.D.
Massachusetts General Hospital
Boston, MA

clarence S. F. Ing, m.D., m.p.h.
Weimar Institute
Weimar, CA

robert c. Karch, ed.D.
American University
Washington, DC

marjorie King, m.D., F.a.c.c.
Director, Cardiac Services
Helen Hayes Hospital
West Haverstraw, NY

allen J. naftilan, m.D, ph.D.
The Vanderbilt Heart Institute
Nashville, TN

Joan Ordman, m.D.
Owings Mills, MD

James powers, m.D.
Vanderbilt University Medical Center
Nashville, TN

Janice m. prochaska, ph.D.
Pro-Change Behavior Systems, Inc 
W. Kingston, RI 

Fred g. toffel, m.D., F.a.c.e.
Desert Springs Hospital
Las Vegas, NV

performance graph 
The following graph compares the total stockholder return of $100 invested on August 29, 2003 in (a) the Company, (b) the CRSP Index for Nasdaq Stock 
Market (U.S. Companies), and (c) the CRSP Index for Nasdaq Health Services Stocks (“Nasdaq Health Services”), assuming the reinvestment of all dividends.

8/29/03
8/29/08
$100.0 $153.9 $249.1 $294.3 $283.9 $108.6
HWAY
  131.8
Nasdaq U.S. Stocks
  100.0
  239.9
Nasdaq Health Services   100.0

  144.1
  230.8

  101.8
  119.1

  119.6
  180.2

  122.0
  199.6

8/31/05

8/31/06

8/31/04

8/31/07

nOteS:  a. The lines represent annual index levels derived from compounded daily returns that 
include all dividends.  B. The indexes are reweighted daily, using the market capitalization on the 
previous trading day.  c. If the monthly interval, based on the fiscal year end, is not a trading day, 
the preceding trading day is used.  D. The index level for all series was set to $100.00 on August 
29, 2003. The stock price performance shown on the graph is not necessarily indicative of future 
price performance.

HWAY

Nasdaq U.S. Stocks

Nasdaq Health Services

$300

$200

$100

8/29/2003

8/31/2004

8/31/2005

8/31/2006

8/31/2007

8/29/2008

2008

HEALTHWAYS

55

corporate Information

Corporate Office
Healthways, Inc.
701 Cool Springs Boulevard
Franklin, Tennessee 37067
(800) 327-3822
www.healthways.com

Registrar and Transfer Agent
National City Bank
Shareholder Services Group
P.O. Box 92301
LOC 01-5352
Cleveland, OH 44101-4301
Tel: (800) 622-7657
E-mail: shareholder.inquiries@nationalcity.com

Form 10-K/Investor Contact

A copy of the Healthways, Inc. Annual Report on Form 10-K for Fiscal 2008 (without exhibits) filed with the Securities and 
Exchange Commission is available on the Company’s website, www.healthways.com.  It is also available from the Company at 
no charge.  These requests and other investor contacts should be directed to Chip Wochomurka, Senior Vice President, Investor 
Relations, at the Company’s corporate office.

Annual Meeting

The annual meeting of stockholders will be held on January 29, 2009, at 9:00 a.m. at the Franklin Marriott Cool Springs, 700 

Cool Springs Boulevard, Franklin, Tennessee.

Common Stock and Dividend Information

The common stock of Healthways, Inc. is traded on The Nasdaq Stock Market under the symbol HWAY.  At October 13, 2008, 
there were approximately 28,000 holders of the common stock, including 179 stockholders of record.  No cash dividends have 
been paid on the common stock.

The  following  table  sets  forth  the  high  and  low  sales  prices  per  share  of  common  stock  as  reported  by  Nasdaq  for  the 

relevant periods.

year ended august 31, 2008 

First Quarter
Second Quarter
Third Quarter
Fourth Quarter

year ended august 31, 2007 

First Quarter
Second Quarter
Third Quarter
Fourth Quarter

high

$ 60.88
71.22
37.79
34.60

high

$ 52.37
49.58
48.76
56.90

low

$ 48.99
28.43
29.68
18.57

low

$ 37.55
42.64
41.58
42.77

2008

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56

2008

HEALTHWAYS

III

701 Cool Springs Blvd. •  Franklin, TN 37067  •  800.327.3822  •  www.Healthways.com

2008

HEALTHWAYS

Iv