# EDGAR Filing Document

**Accession Number:** 0001910851
**File Stem:** 0001628280-23-003817
**Filing Date:** 2023-2
**Character Count:** 51026
**Document Hash:** 2e6ce3f0efb3a9f96e6843687263c5ab
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001628280-23-003817.hdr.sgml**: 20230216

**ACCESSION NUMBER**: 0001628280-23-003817

**CONFORMED SUBMISSION TYPE**: 8-K

**PUBLIC DOCUMENT COUNT**: 25

**CONFORMED PERIOD OF REPORT**: 20230216

**ITEM INFORMATION**: Results of Operations and Financial Condition

**ITEM INFORMATION**: Regulation FD Disclosure

**ITEM INFORMATION**: Financial Statements and Exhibits

**FILED AS OF DATE**: 20230216

**DATE AS OF CHANGE**: 20230216

**FILER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** R1 RCM Inc. /DE
- **CENTRAL INDEX KEY:** 0001910851
- **STANDARD INDUSTRIAL CLASSIFICATION:** SERVICES-MANAGEMENT SERVICES [8741]
- **IRS NUMBER:** 874340782
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 8-K
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41428
- **FILM NUMBER:** 23637106

**BUSINESS ADDRESS:**
- **STREET 1:** 434 W. ASCENSION WAY, 6TH FLOOR
- **CITY:** MURRAY
- **STATE:** UT
- **ZIP:** 84123
- **BUSINESS PHONE:** (312) 324-7820

**MAIL ADDRESS:**
- **STREET 1:** 434 W. ASCENSION WAY, 6TH FLOOR
- **CITY:** MURRAY
- **STATE:** UT
- **ZIP:** 84123

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** PROJECT ROADRUNNER PARENT INC.
- **DATE OF NAME CHANGE:** 20220211

?xml version="1.0" ? achi-20230216

**UNITED STATES** 

**SECURITIES AND EXCHANGE COMMISSION** 

**WASHINGTON, D.C. 20549** 

**________________________**

**FORM 8-K** 

**________________________**

**CURRENT REPORT** 

**Pursuant to Section 13 or 15(d) of the**

&nbsp;&nbsp;&nbsp;&nbsp;**Securities Exchange Act of 1934** 

**Date of Report (Date of earliest event reported): February 16, 2023** 

**____________**

**R1 RCM Inc.** 

 **(Exact Name of Registrant as Specified in Charter)** 

**____________**

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| | | |
|:---|:---|:---|
| **Delaware** | **001-41428** | **87-4340782** |
| **(State or Other Jurisdiction<br>of Incorporation)** | **(Commission<br>File Number)** | **(IRS Employer<br>Identification No.)** |

---

---

| | |
|:---|:---|
| **434 W. Ascension Way** | **84123** |
| **6th Floor** | **84123** |
| **Murray** | **84123** |
| **Utah** | **84123** |
| **(Address of Principal Executive Offices)** | **(Zip Code)** |

---

**Registrant's telephone number, including area code: (312) 324-7820** 

**(Former Name or Former Address, if Changed Since Last Report)**

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

☐&nbsp;&nbsp;&nbsp;&nbsp;Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

☐&nbsp;&nbsp;&nbsp;&nbsp;Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

☐&nbsp;&nbsp;&nbsp;&nbsp;Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

☐&nbsp;&nbsp;&nbsp;&nbsp;Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)) &nbsp;&nbsp;&nbsp;&nbsp;

Securities registered pursuant to Section 12(b) of the Act:

---

| | | |
|:---|:---|:---|
| **Title of each class** | **Trading Symbol(s)** | **Name of each exchange on which registered** |
| Common stock, par value $0.01 per share | RCM | NASDAQ |

---

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (17 CFR §230.405) or Rule 12b-2 of the Securities Exchange Act of 1934 (17 CFR §240.12b-2).

Emerging growth company ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;

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**Item 2.02&nbsp;&nbsp;&nbsp;&nbsp;Results of Operations and Financial Condition**

On February 16, 2023, R1 RCM Inc. (the "Company") announced its financial results for the three months and fiscal year ended December 31, 2022. The full text of the press release issued in connection with the announcement is furnished as Exhibit 99.1 to this Current Report on Form 8-K.

**Item 7.01&nbsp;&nbsp;&nbsp;&nbsp;Regulation FD Disclosure**

The Company is hosting an investor conference call on February 16, 2023 regarding its financial results for the three months and fiscal year ended December 31, 2022. The slide presentation to be used in conjunction with the investor conference call is furnished as Exhibit 99.2 to this Current Report on Form 8-K and will be posted on the Company's website.

The information in this Form 8-K (including Exhibits 99.1 and 99.2) shall not be deemed "filed" for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), or otherwise subject to the liabilities of that section, nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as expressly set forth by specific reference in such a filing.

**Item 9.01&nbsp;&nbsp;&nbsp;&nbsp;Financial Statements and Exhibits**

---

| | | |
|:---|:---|:---|
| (d) | <u>Exhibit Number</u> | <u>Description</u> |
| | <u>[99.1](a2022pressrelease.htm)</u> | <u>[Press Release dated](a2022pressrelease.htm)[February 16, 2023](a2022pressrelease.htm)</u> |
| | <u>[99.2](a4qfy22_earningscalldeck.htm)</u> | <u>[Presentation dated](a4qfy22_earningscalldeck.htm)[February 16, 2023](a4qfy22_earningscalldeck.htm)</u> |
| | 104 | Cover Page Interactive Data File - the cover page iXBRL tags are embedded within the Inline XBRL document |

---

------

**SIGNATURES** 

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

---

| | |
|:---|:---|
| | **R1 RCM INC.** |
| Date: February 16, 2023 |  |
|  | By:&nbsp;&nbsp;&nbsp;&nbsp; <u>/s/ Jennifer Williams&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</u>  |
|  | Name: Jennifer Williams |
|  | Title:&nbsp;&nbsp;&nbsp;&nbsp;Chief Financial Officer |

---

## Exhibit 99.1

**Exhibit 99.1**

![r1logoa09a.jpg](r1logoa09a.jpg)

**R1 RCM Reports Fourth Quarter and Full Year 2022 Results**

**Murray, Utah - February 16, 2023 -** R1 RCM Inc. (NASDAQ: RCM), a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers, today announced results for the three months and year ended December 31, 2022.

<u>Fourth Quarter 2022 Results:</u>

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Revenue of $532.8 million, up $133.9 million or 33.6% compared to the same period last year

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• GAAP net loss of $37.1 million, compared to net income of $36.0 million in the same period last year

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Adjusted EBITDA of $125.0 million, up $29.9 million or 31.4% compared to the same period last year

<u>Full Year 2022 Results:</u>

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Revenue of $1,806.4 million, up $331.8 million or 22.5% compared to 2021

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• GAAP net loss of $57.6 million, compared to net income of $97.2 million in 2021

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Adjusted EBITDA of $425.5 million, up $81.9 million or 23.8% compared to 2021

"We are pleased to report strong fourth quarter results. Our operating performance in the quarter sets the stage for continued momentum in 2023," said Lee Rivas, chief executive officer of R1. "Our technology-driven value proposition positions us to address some of the most complex problems facing healthcare providers. We continue to see increased demand for our solutions and remain very optimistic about our long-term growth trajectory."

"Our 2022 results demonstrate our commitment to customer delivery and execution by our teams. We are pleased to have generated double-digit revenue and adjusted EBITDA growth, driven by new customers as well as the Cloudmed acquisition," added Jennifer Williams, chief financial officer. "In 2023, we are focused on strong execution while continuing to invest in technology and operations to serve our growing customer base."

------

**2023 Outlook**

For 2023, R1 expects to generate:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Revenue of between $2,280 million and $2,330 million

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• GAAP operating income of $115 million to $140 million

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Adjusted EBITDA of $595 million to $630 million

**Conference Call and Webcast Details**

R1's management team will host a conference call today at 8:00 a.m. Eastern Time to discuss its financial results and business outlook. To participate, please dial 888-330-2022 (646-960-0690 outside the U.S. and Canada) using conference code number 5681952. A live webcast and replay of the call will be available at the Investor Relations section of the Company's web site at ir.r1rcm.com.

**Non-GAAP Financial Measures**

In order to provide a more comprehensive understanding of the information used by R1's management team in financial and operational decision making, the Company supplements its GAAP consolidated financial statements with certain non-GAAP financial measures, including adjusted EBITDA, non-GAAP cost of services, non-GAAP selling, general and administrative expenses, and net debt. Adjusted EBITDA is defined as GAAP net income before net interest income/expense, income tax provision/benefit, depreciation and amortization expense, share-based compensation expense, CoyCo 2, L.P. ("CoyCo 2") share-based compensation expense, and certain other items, including business acquisition costs, integration costs, strategic initiatives, and the global business services center expansion project in the Philippines. Non-GAAP cost of services is defined as GAAP cost of services less share-based compensation expense, CoyCo 2 share-based compensation expense, and depreciation and amortization expense attributed to cost of services. Non-GAAP selling, general and administrative expenses is defined as GAAP selling, general and administrative expenses less share-based compensation expense, CoyCo 2 share-based compensation expense, and depreciation and amortization expense attributed to selling, general and administrative expenses. Net debt is defined as debt less cash and cash equivalents, inclusive of restricted cash. Adjusted EBITDA guidance is reconciled to operating income guidance, the most closely comparable available GAAP measure.

------

Our board of directors and management team use adjusted EBITDA as (i) one of the primary methods for planning and forecasting overall expectations and for evaluating actual results against such expectations and (ii) a performance evaluation metric in determining achievement of certain executive incentive compensation programs, as well as for incentive compensation programs for employees. Non-GAAP cost of services and non-GAAP selling, general and administrative expenses are used to calculate adjusted EBITDA. Net debt is used as a supplemental measure of our liquidity.

Tables 4 through 9 present a reconciliation of GAAP financial measures to non-GAAP financial measures. Non-GAAP measures should be considered in addition to, but not as a substitute for, the information prepared in accordance with GAAP.

**Forward Looking Statements**

This press release contains "forward-looking statements" made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, as amended and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements generally relate to future events and relationships, plans, future growth, and future performance. These statements are often identified by the use of words such as "anticipate," "believe," "contemplate," "designed," "estimate," "expect," "forecast," "goal," "intend," "designed," "may," "outlook," "plan," "predict," "project," "see," "seek," "target," "would," and similar expressions or variations or negatives of these words, although not all forward-looking statements contain these identifying words. These statements are based on various assumptions, whether or not identified in this press release, and on the current expectations of the Company's management and are not predictions of actual performance. These forward-looking statements are provided for illustrative purposes only and are not intended to serve as, and must not be relied on by any investor as, a guarantee, assurance, prediction or definitive statement of fact or probability. Actual outcomes and results may differ materially from those contemplated by these forward-looking statements as a result of uncertainties, risks, and changes in circumstances, including but not limited to risk and uncertainties related to: (i) geopolitical, economic, and market conditions, including heightened inflation, slower growth or recession, changes to fiscal and monetary policy, higher interest rates, currency fluctuations, and challenges in the supply chain; (ii) the Company's ability to timely and successfully achieve the anticipated benefits and potential synergies of the acquisition of Cloudmed; (iii) the Company's ability to retain existing customers or acquire new customers; (iv) the development of markets for the Company's revenue cycle management offering; (v) variability in the

------

lead time of prospective customers; (vi) competition within the market; (vii) breaches or failures of the Company's information security measures or unauthorized access to a customer's data; (viii) delayed or unsuccessful implementation of the Company's technologies or services, or unexpected implementation costs; (ix) disruptions in or damages to the Company's global business services centers and third-party operated data centers; (x) the volatility of our stock price; (xi) our substantial indebtedness, and (xii) the ongoing impact of the COVID-19 pandemic on the Company's business, operating results, and financial condition. Additional risks and uncertainties that could cause actual outcomes and results to differ materially from those contemplated by the forward-looking statements are included under the heading "Risk Factors" in the Company's annual report on Form 10-K for the year ended December 31, 2021, and any other periodic reports that the Company may file with the United States Securities and Exchange Commission. The foregoing list of factors is not exhaustive. All forward-looking statements included herein are expressly qualified in their entirety by these cautionary statements as of the date hereof and involve many risks and uncertainties that could cause the Company's actual results to differ materially from those expressed or implied in the Company's forward-looking statements. Subsequent events and developments, including actual results or changes in the Company's assumptions, may cause the Company's views to change. The Company assumes no obligation and does not intend to update these forward-looking statements, except as required by law. You are cautioned not to place undue reliance on such forward-looking statements.

**About R1 RCM**

R1 is a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. R1's proven and scalable operating models seamlessly complement a healthcare organization's infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience. To learn more, visit: r1rcm.com.

------

**Contact:**

R1 RCM Inc.

Investor Relations:

Atif Rahim

312-324-5476

investorrelations@r1rcm.com

Media Relations:

Allison+Partners

Amanda Critelli

R1PR@allisonpr.com

------

---

| | | |
|:---|:---|:---|
| **Table 1** | **Table 1** | **Table 1** |
| **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** |
| **Consolidated Balance Sheets** | **Consolidated Balance Sheets** | **Consolidated Balance Sheets** |
| **(In millions)** | **(In millions)** | **(In millions)** |
| | **(Unaudited)** | |
| | **December 31,** | **December 31,** |
|  | **2022** | **2021** |
| **Assets** |  |  |
| Current assets: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Cash and cash equivalents | $110.1 | $130.1 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts receivable, net of $15.1 million and $2.4 million allowance as of December 31, 2022 and 2021, respectively | 235.2 | 131.3 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts receivable, net of $0.1 million and $0.1 million allowance - related party as of December 31, 2022 and 2021, respectively | 25.0 | 26.1 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Current portion of contract assets, net | 83.9 |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Prepaid expenses and other current assets | 110.3 | 77.2 |
| Total current assets | 564.5 | 364.7 |
| Property, equipment and software, net | 164.8 | 94.7 |
| Operating lease right-of-use assets | 80.5 | 48.9 |
| Non-current portion of contract assets, net | 32.0 |  |
| Non-current portion of deferred contract costs | 26.7 | 23.4 |
| Intangible assets, net | 1514.5 | 265.4 |
| Goodwill | 2658.2 | 554.7 |
| Non-current deferred tax assets | 10.4 | 51.8 |
| Other assets | 88.2 | 45.7 |
| Total assets | $5139.8 | $1449.3 |
| **Liabilities** |  |  |
| Current liabilities: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts payable | $33.4 | $17.7 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Current portion of customer liabilities | 57.5 | 41.5 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Current portion of customer liabilities - related party | 7.4 | 7.9 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accrued compensation and benefits | 109.0 | 97.0 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Current portion of operating lease liabilities | 18.0 | 13.5 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Current portion of long-term debt | 53.9 | 17.5 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accrued expenses and other current liabilities | 70.6 | 59.1 |
| Total current liabilities | 349.8 | 254.2 |
| Non-current portion of customer liabilities | 5.0 | 3.3 |
| Non-current portion of customer liabilities - related party | 13.7 | 15.4 |
| Non-current portion of operating lease liabilities | 94.4 | 53.4 |
| Long-term debt | 1732.6 | 754.9 |
| Non-current deferred tax liabilities | 200.7 | 4.2 |
| Other non-current liabilities | 23.1 | 17.2 |
| Total liabilities | 2419.3 | 1102.6 |
| **Stockholders' equity:** |  |  |
| Common stock | 4.4 | 3.0 |
| Additional paid-in capital | 3123.2 | 628.5 |
| Accumulated deficit | (121.9) | (64.3) |
| Accumulated other comprehensive loss | (3.4) | (5.3) |
| Treasury stock | (281.8) | (215.2) |
| Total stockholders' equity | 2720.5 | 346.7 |
| Total liabilities and stockholders' equity | $5139.8 | $1449.3 |

---

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| | | | | |
|:---|:---|:---|:---|:---|
| **Table 2** | **Table 2** | **Table 2** | **Table 2** | **Table 2** |
| **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** |
| **Consolidated Statements of Operations** | **Consolidated Statements of Operations** | **Consolidated Statements of Operations** | **Consolidated Statements of Operations** | **Consolidated Statements of Operations** |
| **(In millions, except share and per share data)** | **(In millions, except share and per share data)** | **(In millions, except share and per share data)** | **(In millions, except share and per share data)** | **(In millions, except share and per share data)** |
| | **(Unaudited)** | **(Unaudited)** | **(Unaudited)** | |
| | **Three Months Ended December 31,** | **Three Months Ended December 31,** | **Year Ended December 31,** | **Year Ended December 31,** |
|  | **2022** | **2021** | **2022** | **2021** |
| Net operating fees | $344.4 | $332.0 | $1309.7 | $1211.8 |
| Incentive fees | 25.9 | 35.8 | 106.8 | 143.8 |
| Modular and other | 162.5 | 31.1 | 389.9 | 119.0 |
| Net services revenue | 532.8 | 398.9 | 1806.4 | 1474.6 |
| Operating expenses: |  |  |  |  |
| Cost of services | 435.4 | 304.6 | 1445.1 | 1162.8 |
| Selling, general and administrative | 54.2 | 32.2 | 174.8 | 120.0 |
| Other expenses | 47.4 | 11.9 | 183.5 | 46.1 |
| Total operating expenses | 537.0 | 348.7 | 1803.4 | 1328.9 |
| Income (loss) from operations | (4.2) | 50.2 | 3.0 | 145.7 |
| Net interest expense | (28.7) | (5.1) | (64.0) | (18.9) |
| Income (loss) before income tax provision (benefit) | (32.9) | 45.1 | (61.0) | 126.8 |
| Income tax provision (benefit) | 4.2 | 9.1 | (3.4) | 29.6 |
| Net income (loss) | $(37.1) | $36.0 | $(57.6) | $97.2 |
| Net income (loss) per common share: |  |  |  |  |
| Basic | $(0.09) | $0.13 | $(0.16) | $(1.86) |
| Diluted | $(0.09) | $0.11 | $(0.16) | $(1.86) |
| Weighted average shares used in calculating net income (loss) per common share: |  |  |  |  |
| Basic | 416680429 | 277974898 | 352337767 | 266183565 |
| Diluted | 416680429 | 321412307 | 352337767 | 266183565 |

---

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| | | | | |
|:---|:---|:---|:---|:---|
| Basic: |  |  |  |  |
| Net income (loss) | $(37.1) | $36.0 | $(57.6) | $97.2 |
| Less dividends on preferred shares |  |  |  | (592.3) |
| Net income (loss) available/allocated to common shareholders - basic | $(37.1) | $36.0 | $(57.6) | $(495.1) |
| Diluted: |  |  |  |  |
| Net income (loss) | $(37.1) | $36.0 | $(57.6) | $97.2 |
| Less dividends on preferred shares |  |  |  | (592.3) |
| Net income (loss) available/allocated to common shareholders - diluted | $(37.1) | $36.0 | $(57.6) | $(495.1) |

---

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| | | |
|:---|:---|:---|
| **Table 3** | **Table 3** | **Table 3** |
| **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** |
| **Consolidated Statements of Cash Flows** | **Consolidated Statements of Cash Flows** | **Consolidated Statements of Cash Flows** |
| **(In millions)** | **(In millions)** | **(In millions)** |
| | **(Unaudited)** | |
| | **Year Ended December 31,** | **Year Ended December 31,** |
|  | **2022** | **2021** |
| **Operating activities** |  |  |
| Net income (loss) | $(57.6) | $97.2 |
| Adjustments to reconcile net income (loss) to net cash (used in) provided by operations: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | 172.0 | 77.5 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Amortization of debt issuance costs | 3.6 | 1.2 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Share-based compensation | 62.0 | 74.3 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;CoyCo 2 share-based compensation | 5.1 |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss/(gain) on disposal and right-of-use asset write-downs | 21.1 | (0.4) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Provision for credit losses | 11.8 | 0.7 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Deferred income taxes | (6.8) | 23.0 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Non-cash lease expense | 14.0 | 9.7 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other | 6.5 | (1.9) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Changes in operating assets and liabilities: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts receivable and related party accounts receivable | (51.8) | (33.2) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Contract assets | (24.1) |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Prepaid expenses and other assets | (39.4) | (18.0) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts payable | (16.0) | 0.1 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accrued compensation and benefits | (77.7) | 42.0 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Lease liabilities | (18.9) | (12.7) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other liabilities | (1.5) | (13.3) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Customer liabilities and customer liabilities - related party | (12.2) | 18.6 |
| Net cash (used in) provided by operating activities | (9.9) | 264.8 |
| **Investing activities** |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Purchases of property, equipment, and software | (93.5) | (51.7) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Payment for business acquisitions, net of cash acquired | (847.7) | (294.7) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other | (8.3) | 6.0 |
| Net cash used in investing activities | (949.5) | (340.4) |
| **Financing activities** |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Issuance of senior secured debt, net of discount and issuance costs | 1016.6 | 698.6 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Borrowings on revolver | 50.0 | 120.0 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Payment of debt issuance costs | (1.0) | (1.9) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Repayment of senior secured debt | (25.5) | (488.9) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Repayments on revolver | (30.0) | (110.0) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Payment of contingent consideration liability |  | (4.8) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Deferred payment related to acquisition of RevWorks |  | (12.5) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Inducement of preferred stock conversion |  | (105.0) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Payment of equity issuance costs | (2.0) |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Exercise of vested stock options | 4.6 | 8.9 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Purchase of treasury stock | (39.3) | (56.5) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Shares withheld for taxes | (30.2) | (16.3) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other | (0.2) | (0.2) |
| Net cash provided by financing activities | 943.0 | 31.4 |
| Effect of exchange rate changes in cash | (3.6) | (0.5) |
| Net (decrease) increase in cash, cash equivalents, and restricted cash | (20.0) | (44.7) |
| Cash, cash equivalents, and restricted cash at beginning of period | 130.1 | 174.8 |
| Cash, cash equivalents, and restricted cash at end of period | $110.1 | $130.1 |

---

------

---

| | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| **Table 4** | **Table 4** | **Table 4** | **Table 4** | **Table 4** | **Table 4** | **Table 4** | **Table 4** | **Table 4** |
| **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** |
| **Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA (Unaudited)** | **Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA (Unaudited)** | **Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA (Unaudited)** | **Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA (Unaudited)** | **Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA (Unaudited)** | **Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA (Unaudited)** | **Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA (Unaudited)** | **Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA (Unaudited)** | **Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA (Unaudited)** |
| **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** |
| | **Three Months Ended December 31,** | **Three Months Ended December 31,** | **2022 vs. 2021 Change** | **2022 vs. 2021 Change** | **Year Ended December 31,** | **Year Ended December 31,** | **2022 vs. 2021 Change** | **2022 vs. 2021 Change** |
|  | **2022** | **2021** | **Amount** | **%** | **2022** | **2021** | **Amount** | **%** |
| **Net income (loss)** | $(37.1) | $36.0 | $(73.1) | (203)% | $(57.6) | $97.2 | $(154.8) | (159)% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net interest expense | 28.7 | 5.1 | 23.6 | 463% | 64.0 | 18.9 | 45.1 | 239% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax provision (benefit) | 4.2 | 9.1 | (4.9) | 54% | (3.4) | 29.6 | (33.0) | (111)% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization expense | 64.2 | 20.7 | 43.5 | 210% | 172.0 | 77.5 | 94.5 | 122% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Share-based compensation expense | 15.5 | 12.3 | 3.2 | 26% | 61.9 | 74.3 | (12.4) | (17)% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;CoyCo 2 share-based compensation expense | 2.1 |  | 2.1 | —% | 5.1 |  | 5.1 | —% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other expenses (1) | 47.4 | 11.9 | 35.5 | 298% | 183.5 | 46.1 | 137.4 | 298% |
| **Adjusted EBITDA (non-GAAP)** | $**125.0** | $**95.1** | $**29.9** | **31%** | $**425.5** | $**343.6** | $**81.9** | **24%** |

---

(1) For details see Note 14, Other, to the Consolidated Financial Statements included in the Company's Annual Report on Form 10-K.

---

| | | | | |
|:---|:---|:---|:---|:---|
| **Table 5** | **Table 5** | **Table 5** | **Table 5** | **Table 5** |
| **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** |
| **Reconciliation of GAAP Cost of Services to Non-GAAP Cost of Services (Unaudited)** | **Reconciliation of GAAP Cost of Services to Non-GAAP Cost of Services (Unaudited)** | **Reconciliation of GAAP Cost of Services to Non-GAAP Cost of Services (Unaudited)** | **Reconciliation of GAAP Cost of Services to Non-GAAP Cost of Services (Unaudited)** | **Reconciliation of GAAP Cost of Services to Non-GAAP Cost of Services (Unaudited)** |
| **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** |
| | **Three Months Ended December 31,** | **Three Months Ended December 31,** | **Year Ended December 31,** | **Year Ended December 31,** |
|  | **2022** | **2021** | **2022** | **2021** |
| Cost of services | $435.4 | $304.6 | $1445.1 | $1162.8 |
| Less: |  |  |  |  |
| Share-based compensation expense | 7.4 | 5.4 | 28.1 | 44.2 |
| CoyCo 2 share-based compensation expense | (0.3) |  | 0.7 |  |
| Depreciation and amortization expense | 63.8 | 20.1 | 170.8 | 74.7 |
| **Non-GAAP cost of services** | $**364.5** | $**279.1** | $**1245.5** | $**1043.9** |

---

---

| | | | | |
|:---|:---|:---|:---|:---|
| **Table 6** | **Table 6** | **Table 6** | **Table 6** | **Table 6** |
| **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** |
| **Reconciliation of GAAP Selling, General and Administrative to Non-GAAP Selling, General and Administrative (Unaudited)** | **Reconciliation of GAAP Selling, General and Administrative to Non-GAAP Selling, General and Administrative (Unaudited)** | **Reconciliation of GAAP Selling, General and Administrative to Non-GAAP Selling, General and Administrative (Unaudited)** | **Reconciliation of GAAP Selling, General and Administrative to Non-GAAP Selling, General and Administrative (Unaudited)** | **Reconciliation of GAAP Selling, General and Administrative to Non-GAAP Selling, General and Administrative (Unaudited)** |
| **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** |
| | **Three Months Ended December 31,** | **Three Months Ended December 31,** | **Year Ended December 31,** | **Year Ended December 31,** |
|  | **2022** | **2021** | **2022** | **2021** |
| Selling, general and administrative | $54.2 | $32.2 | $174.8 | $120.0 |
| Less: |  |  |  |  |
| Share-based compensation expense | 8.1 | 6.9 | 33.8 | 30.1 |
| CoyCo 2 share-based compensation expense | 2.4 |  | 4.4 |  |
| Depreciation and amortization expense | 0.4 | 0.6 | 1.2 | 2.8 |
| **Non-GAAP selling, general and administrative** | $**43.3** | $**24.7** | $**135.4** | $**87.1** |

---

------

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| | | | | |
|:---|:---|:---|:---|:---|
| **Table 7** | **Table 7** | **Table 7** | **Table 7** | **Table 7** |
| **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** |
| **Consolidated Non-GAAP Financial Information (Unaudited)** | **Consolidated Non-GAAP Financial Information (Unaudited)** | **Consolidated Non-GAAP Financial Information (Unaudited)** | **Consolidated Non-GAAP Financial Information (Unaudited)** | **Consolidated Non-GAAP Financial Information (Unaudited)** |
| **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** | **(In millions)** |
| | **Three Months Ended December 31,** | **Three Months Ended December 31,** | **Year Ended December 31,** | **Year Ended December 31,** |
|  | **2022** | **2021** | **2022** | **2021** |
| Net operating fees | $344.4 | $332.0 | $1309.7 | $1211.8 |
| Incentive fees | 25.9 | 35.8 | 106.8 | 143.8 |
| Modular and other | 162.5 | 31.1 | 389.9 | 119.0 |
| **Net services revenue** | **532.8** | **398.9** | **1806.4** | **1474.6** |
| Operating expenses: |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Cost of services (non-GAAP) | 364.5 | 279.1 | 1245.5 | 1043.9 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Selling, general and administrative (non-GAAP) | 43.3 | 24.7 | 135.4 | 87.1 |
| **Sub-total (non-GAAP)** | **407.8** | **303.8** | **1380.9** | **1131.0** |
| **Adjusted EBITDA** | $**125.0** | $**95.1** | $**425.5** | $**343.6** |

---

---

| | |
|:---|:---|
| **Table 8** | **Table 8** |
| **R1 RCM Inc.** | **R1 RCM Inc.** |
| **Reconciliation of GAAP Operating Income Guidance to Non-GAAP Adjusted EBITDA Guidance (Unaudited)** | **Reconciliation of GAAP Operating Income Guidance to Non-GAAP Adjusted EBITDA Guidance (Unaudited)** |
| **(In millions)** | **(In millions)** |
|  | **2022** |
| GAAP Operating Income Guidance | $115-140 |
| Plus: |  |
| Depreciation and amortization expense | $260-280 |
| Share-based compensation expense | $75-85 |
| CoyCo 2 share-based compensation expense | $10-15 |
| Strategic initiatives, severance and other costs | $110-135 |
| **Adjusted EBITDA Guidance** | **$595-630** |

---

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| | | |
|:---|:---|:---|
| **Table 9** | **Table 9** | **Table 9** |
| **R1 RCM Inc.** | **R1 RCM Inc.** | **R1 RCM Inc.** |
| **Reconciliation of Total Debt to Net Debt (Unaudited)** | **Reconciliation of Total Debt to Net Debt (Unaudited)** | **Reconciliation of Total Debt to Net Debt (Unaudited)** |
| **(In millions)** | **(In millions)** | **(In millions)** |
| | **December 31,** | **December 31,** |
|  | **2022** | **2021** |
| Senior Revolver | $100.0 | $80.0 |
| Term A Loans | 1211.4 | 695.6 |
| Term B Loan | 498.7 |  |
| Total debt | 1810.1 | 775.6 |
| Less: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Cash and cash equivalents | 110.1 | 130.1 |
| **Net Debt** | $**1700.0** | $**645.5** |

---

## Exhibit 99.2

![](a4qfy22_earningscalldeck001.jpg)

February 16, 2023 Fourth Quarter and Full Year 2022 Earnings Call

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![](a4qfy22_earningscalldeck002.jpg)

22 Forward-Looking Statements This presentation includes information that may constitute "forward-looking statements" made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995 and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements generally relate to future events and relationships, plans, future growth, and future performance, including, but not limited to, statements about future financial and operational performance, the expected effects and benefits of the acquisition of Cloudmed, the strategic direction of the combined company, the Company's other strategic initiatives, capital plans, costs, ability to successfully implement new technologies, and liquidity. These statements are often identified by the use of words such as "anticipate," "believe," "estimate," "expect," "intend," "designed," "may," "plan," "predict," "project," "target," "contemplate," "would," "seek," "see," and similar expressions or variations or negatives of these words, although not all forward-looking statements contain these identifying words. These statements are based on various assumptions, whether or not identified in this presentation, and on the current expectations of the Company's management and are not predictions of actual performance. These forward-looking statements are provided for illustrative purposes only and are not intended to serve as, and must not be relied on by any investor as, a guarantee, assurance, prediction or definitive statement of fact or probability. Actual outcomes and results may differ materially from those contemplated by these forward-looking statements as a result of uncertainties, risks, and changes in circumstances, including but not limited to risk and uncertainties related to: (i) geopolitical, economic, and market conditions, including heightened inflation, slower growth or recession, changes to fiscal and monetary policy, higher interest rates, currency fluctuations, and challenges in the supply chain; (ii) the Company's ability to timely and successfully achieve the anticipated benefits and potential synergies from the acquisition of Cloudmed; (iii) the Company's ability to retain existing customers or acquire new customers; (iv) the development of markets for the Company's revenue cycle management offering; (v) variability in the lead time of prospective customers; (vi) competition within the market; (vii) breaches or failures of the Company's information security measures or unauthorized access to a customer's data; (viii) delayed or unsuccessful implementation of the Company's technologies or services, or unexpected implementation costs; (ix) disruptions in or damages to the Company's global business services centers and third-party operated data centers; (x) the volatility of the Company's stock price; (xi) the Company's substantial indebtedness; and (xii) the ongoing impact of the COVID-19 pandemic on the Company's business, operating results, and financial condition. Additional risks and uncertainties that could cause actual outcomes and results to differ materially from those contemplated by the forward-looking statements are included under the heading "Risk Factors" in the Company's annual report on Form 10-K for the year ended December 31, 2021, quarterly reports on Form 10-Q, the proxy statement relating to the Company's annual meeting and the acquisition of Cloudmed, and any other periodic reports that the Company may file with the United States Securities and Exchange Commission (the "SEC"). The foregoing list of factors is not exhaustive. All forward-looking statements included herein are expressly qualified in their entirety by these cautionary statements as of the date hereof and involve many risks and uncertainties that could cause the Company's actual results to differ materially from those expressed or implied in the Company's forward-looking statements. Subsequent events and developments, including actual results or changes in the Company's assumptions, may cause the Company's views to change. The Company assumes no obligation and does not intend to update these forward-looking statements, except as required by law. You are cautioned not to place undue reliance on such forward-looking statements. Non-GAAP Financial Information Some of the financial information and data contained in this presentation, including Adjusted EBITDA (and related measures), have not been prepared in accordance with U.S. generally accepted accounting principles ("GAAP"). Our non-GAAP measures may be calculated differently from, and therefore may not be comparable to, similarly titled measures used by other companies. These non-GAAP financial measures should not be considered in isolation or as a substitute for analysis of our results of operations as reported under GAAP. Please refer to the Appendix located at the end of this presentation for a reconciliation of non-GAAP financial measures to their most directly comparable GAAP financial measure.

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![](a4qfy22_earningscalldeck003.jpg)

33 Today's Discussion Topics Operational Execution • Exceeded 2022 targets by signing over $13B in end-to-end NPR, 15 large physician groups, and over 600 distinct modular solution bookings • Integrated legacy teams under Kyle Hicok's leadership • Grew pipeline to advance relationships across all solutions Commercial Activity • Continued emphasis on the technology platform • 2023 focuses on three goals: • Automate tasks that are traditionally completed manually • Create optimal workflows • Leverage vast data and analytics to their full potential Technological Advancements • Improved operational metrics in Q4 while continuing to address payer delays and other market headwinds • Expanded global footprint by further scaling India operations and opening a Philippines service center • Recognized as best in KLAS for Ambulatory RCM, Denials Management, and Robotic Process Automation offerings

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![](a4qfy22_earningscalldeck004.jpg)

44 4Q'22/FY'22 Results and 2023 Guidance Fourth Quarter 2022 Results • Revenue of $1,806.4 million, up $331.8 million or 22.5% compared to 2021 • GAAP net loss of $57.6 million, compared to net income of $97.2 million in 2021 • Adjusted EBITDA1 of $425.5 million, up $81.9 million or 23.8% compared to 2021 Full Year 2022 Results • Revenue of $2,280 million to $2,330 million • GAAP operating income of $115 million to $140 million • Adjusted EBITDA1 of $595 million to $630 million 2023 Guidance Note1: Adjusted EBITDA is a non-GAAP measure; refer to the Appendix for reconciliation of non-GAAP financial measures • Revenue of $532.8 million, up $133.9 million or 33.6% compared to the same period last year • GAAP net loss of $37.1 million, compared to net income of $36.0 million in the same period last year • Adjusted EBITDA1 of $125.0 million, up $29.9 million or 31.4% compared to the same period last year

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![](a4qfy22_earningscalldeck005.jpg)

55 4Q'22 GAAP and Non-GAAP Results: Q/Q and Y/Y Comparison ($ in millions) 4Q'22 3Q'22 4Q'21 Key Change Driver(s) Revenue $532.8 $496.0 $398.9 • Q/Q: New customers, modular growth and higher incentive fees due to incremental operational efforts • Y/Y: Contribution from Cloudmed and new customers, partially offset by lower incentive fees and physician revenue Adjusted Cost of Services1 $364.5 $326.9 $279.1 • Q/Q: Upfront costs to onboard new customers and higher costs to attain incentive fees • Y/Y: Cloudmed cost of services, onboarding costs for new customers and higher costs to attain incentive fees Adjusted SG&A Expense1 $43.3 $45.1 $24.7 • Q/Q: Allowance for credit losses in Q3 and higher healthcare and corporate costs in Q4 • Y/Y: Cloudmed SG&A Adjusted EBITDA1 $125.0 $124.0 $95.1 • Q/Q: Cloudmed contribution and higher incentive fees, offset by investments to onboard new customers • Y/Y: Cloudmed contribution and cost savings from automation, offset by costs to onboard new customers and lower incentive fees Note1: Adjusted cost of services, adjusted SG&A expense, and adjusted EBITDA are non-GAAP measures; refer to the Appendix for a reconciliation of non-GAAP financial measures

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![](a4qfy22_earningscalldeck006.jpg)

66 Full Year 2022 GAAP and Non-GAAP Results: Y/Y Comparison ($ in millions) 2022 2021 Y/Y Change Key Change Driver(s) Revenue $1,806.4 $1,474.6 22.5% • Contribution from Cloudmed and new end-to-end customers, partially offset by lower incentive fees Adjusted Cost of Services1 $1,245.5 $1,043.9 19.3% • Cloudmed cost of services, onboarding of new customers and investments to support growth, partially offset by lower costs from automation and other operational efficiencies Adjusted SG&A Expense1 $135.4 $87.1 55.4% • Cloudmed SG&A costs as well as incremental spend to support growth • Increase in allowance for credit losses related to a physician customer Adjusted EBITDA1 $425.5 $343.6 23.8% • Contribution from Cloudmed, cost savings from automation, and net incremental investments to support growth Note1: Adjusted cost of services, adjusted SG&A expense, and adjusted EBITDA are non-GAAP measures; refer to the Appendix for a reconciliation of non-GAAP financial measures

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![](a4qfy22_earningscalldeck007.jpg)

77 Additional Commentary Cash Flow and Balance Sheet Highlights • Expect Q1 2023 adjusted EBITDA1 to grow approximately 5% relative to Q4 2022 Q1'23 Outlook Note1: Net debt and adjusted EBITDA are non-GAAP measures; refer to the Appendix for a reconciliation of non-GAAP financial measures Note2: Includes cash, cash equivalents and availability under our revolver • Cash and cash equivalents of $110.1 million as of 12/31/22 • Cash use in Q4 was driven by Cloudmed integration costs and timing of customer payments • Net debt1 of $1.7 billion as of 12/31/22 • Net debt leverage of 3.0x for credit agreement purposes • $609 million in available liquidity2 at year-end

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![](a4qfy22_earningscalldeck008.jpg)

8 Appendix

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![](a4qfy22_earningscalldeck009.jpg)

99 Use of Non-GAAP Financial Measures Reconciliation of GAAP Operating Income Guidance to Non-GAAP Adjusted EBITDA Guidance $ in millions  In order to provide a more comprehensive understanding of the information used by R1's management team in financial and operational decision making, the Company supplements its GAAP consolidated financial statements with certain non-GAAP financial performance measures, including adjusted EBITDA, non-GAAP cost of services, non- GAAP selling, general and administrative expenses, and net debt. Adjusted EBITDA is defined as GAAP net income before net interest income/expense, income tax provision/benefit, depreciation and amortization expense, share-based compensation expense, CoyCo 2, L.P. ("CoyCo 2") share-based compensation expense, and certain other items, including business acquisition costs, integration costs, strategic initiatives, and the global business services center expansion project in the Philippines. Non-GAAP cost of services is defined as GAAP cost of services less share-based compensation expense, CoyCo 2 share-based compensation expense, and depreciation and amortization expense attributed to cost of services. Non-GAAP selling, general and administrative expenses is defined as GAAP selling, general and administrative expenses less share- based compensation expense, CoyCo 2 share-based compensation expense, and depreciation and amortization expense attributed to selling, general and administrative expenses. Net debt is defined as debt less cash and cash equivalents, inclusive of restricted cash. Adjusted EBITDA guidance for 2023 is reconciled to operating income guidance, the most closely comparable available GAAP measure.  Our board of directors and management team use adjusted EBITDA as (i) one of the primary methods for planning and forecasting overall expectations and for evaluating actual results against such expectations and (ii) a performance evaluation metric in determining achievement of certain executive incentive compensation programs, as well as for incentive compensation programs for employees. Non-GAAP cost of services and non-GAAP selling, general and administrative expenses are used to calculate adjusted EBITDA. Net debt is used as a supplemental measure of our liquidity.  A reconciliation of GAAP operating income guidance to non-GAAP adjusted EBITDA guidance for 2023 is provided below. R1 cannot provide a reconciliation of adjusted EBITDA guidance for Q1 2023 because it is unable to provide a meaningful estimation of certain reconciling items, such as share-based compensation expense, without unreasonable effort. Adjusted EBITDA should be considered in addition to, but not as a substitute for, the information presented in accordance with GAAP. 2023E GAAP Operating Income Guidance $115-140 Plus: Depreciation and amortization expense $260-280 Share-based compensation expense $75-85 CoyCo 2 share-based compensation expense $10-15 Strategic initiatives, severance and other costs1 $110-135 Adjusted EBITDA Guidance $595-630 Note1: Strategic initiatives, severance and other costs are comprised of strategic initiative costs, customer employee transition, restructuring expenses, acquisition and integration costs, various exit activities, transformation initiatives, and certain other costs Reconciliation of Total Debt to Net Debt $ in millions

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![](a4qfy22_earningscalldeck010.jpg)

1010 Reconciliation of Non-GAAP Financial Measures $ in millions Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA Three Months Ended December 31, Year Ended December 31, Three Months Ended September 30, 2022 2021 2022 2021 2022 Net income (loss) $(37.1) $36.0 $(57.6) $97.2 $(29.5) Net interest expense 28.7 5.1 64.0 18.9 23.7 Income tax provision (benefit) 4.2 9.1 (3.4) 29.6 7.8 Depreciation and amortization expense 64.2 20.7 172.0 77.5 64.2 Share-based compensation expense 15.5 12.3 61.9 74.3 24.7 CoyCo 2 share-based compensation expense 2.1 — 5.1 — 3.0 Other expenses 47.4 11.9 183.5 46.1 30.1 Adjusted EBITDA (non-GAAP) $125.0 $95.1 $425.5 $343.6 $124.0 Reconciliation of GAAP Cost of Services to Non-GAAP Cost of Services Three Months Ended December 31, Year Ended December 31, Three Months Ended September 30, 2022 2021 2022 2021 2022 Cost of services $435.4 $304.6 $1,445.1 $1,162.8 $403.1 Less: Share-based compensation expense 7.4 5.4 28.1 44.2 11.3 CoyCo 2 share-based compensation expense (0.3) — 0.7 — 1.0 Depreciation and amortization expense 63.8 20.1 170.8 74.7 63.9 Non-GAAP cost of services $364.5 $279.1 $1,245.5 $1,043.9 $326.9 Reconciliation of GAAP SG&A to Non-GAAP SG&A Three Months Ended December 31, Year Ended December 31, Three Months Ended September 30, 2022 2021 2022 2021 2022 Selling, general and administrative $54.2 $32.2 $174.8 $120.0 $60.8 Less: Share-based compensation expense 8.1 6.9 33.8 30.1 13.4 CoyCo 2 share-based compensation expense 2.4 — 4.4 — 2.0 Depreciation and amortization expense 0.4 0.6 1.2 2.8 0.3 Non-GAAP selling, general and administrative $43.3 $24.7 $135.4 $87.1 $45.1

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