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In a season in which so many companies are producing disappointing results, gems like athenahealth still exist. athenahealth (NASDAQ:ATHN) is a leading provider for the healthcare industry’s billing and practice management solutions. athenahealth just completed its first year as a public company. I recently spoke with Jonathan Bush, athenahealth’s CEO. You can read the interview here.

athenahealth uses a combination of web-based practice management and electronic medical records (EMR) software, real-time payer knowledge, and offers business services that range from eligibility verification to claims submission to insurance collection – an excellent illustration of SaaS-enabled BPO.. Their workflow management solution has also been talked about for its ability to transform the healthcare sector as they make its various processes more efficient.

In their recently announced Q4 results, athenahealth achieved revenues of $41.4 million, exceeding the market’s expectations of $39.9 million and growing 47% over the year. The quarter was the 36th consecutive quarter of organically driven revenue growth. EPS of $0.11 was two cents lower than the market’s expectations of $0.13 and recorded an 83% increase over the year.

The company ended FY 2008 with $139.6 million in revenues, growing 28% over the year. EPS of $0.35 also grew significantly over the $0.17 earned a year ago.

In some key metrics, athenahealth added over 600 physicians in the quarter, nearly 34% over the year, taking their strength to nearly 12,590. In terms of both providers and non-physician providers, they added about 1,490 providers and grew over 55% to 18,785.

The company crossed the $1 billion threshold in client collection and processed $1.1 billion of clients’ money in Q4 2008, up from $759.1 million processed in Q4 the previous year. For 2008, they posted client collections of $3.7 billion compared to $2.7 billion in 2007. Collections per physician also grew 5% to $85,296 and athenahealth’s business services revenue per physician grew 12% to $3,155.

One key metric for automation is athenahealth’s electronic remittance advice (ERA) rate, which measures the degree to which they have automated the processing of information about payments. The ERA rate increased significantly to 56.3% in Q4 compared to 52.3% in the previous quarter and 42.6% in Q4 2007. This improvement was a result of expanding ERA coverage and improving ERA yield.

In the coming year, athenahealth is looking at increasing investments in the business to enhance their client services organization. They are also looking at furthering their R&D and sales and marketing-related initiatives in the coming years.

In the Obama administration’s recently released 2010 healthcare budget, the US government is looking at immediately investing in computerization of all US medical records to have records digitized within five years while protecting individuals’ privacy. As it continues to build a track record, athenahealth is definitely one company that could benefit from the government’s strategy. Jonathan Bush, athenahealth’s CEO, however, would like pure capitalistic market forces driving his business up, since he strongly believes that his company’s value proposition is solid, important, and convincing in its own right. My kind of guy! [An aside: Read my Capitalism 2.0 series for more on this topic.]

The stock, meanwhile had quite a turbulent first year. It slipped 25% to $25.50 on the announcement of its results and is currently trading at $24.60 with a market capitalization of $822 million. Notwithstanding, this is an excellent company, and in the next decade, holds the promise of growing to a billion dollar enterprise.