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Filed Pursuant to Rule 424(b)(1)
Registration No. 333-06769
PROSPECTUS
460,000 SHARES
HEALTH MANAGEMENT SYSTEMS, INC.
COMMON STOCK
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All of the shares of Common Stock, $.01 par value ("Common Stock"), of
Health Management Systems, Inc., a New York corporation ("HMS" or the
"Company"), offered hereby are being sold by certain shareholders (the "Selling
Shareholders") of the Company. See "The Selling Shareholders." Such shares may
be offered and sold, from time to time, on the over-the-counter market or such
national securities exchange upon which the Common Stock is traded at the time
of such sales, at prices prevailing at the time of such sales, or in negotiated
transactions. The Company will not receive any of the proceeds from such sales.
See "Plan of Distribution."
The Common Stock is included on the Nasdaq National Market System under
the symbol "HMSY". On June 19, 1996, the last reported sale price of the
Common Stock was $34.25 per share.
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See "Investment Considerations" for a discussion of
certain factors that should be considered by
prospective investors.
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THESE SECURITIES HAVE NOT BEEN APPROVED OR DISAPPROVED
BY THE SECURITIES AND EXCHANGE COMMISSION OR ANY STATE SECURITIES
COMMISSION NOR HAS THE COMMISSION OR ANY STATE
SECURITIES COMMISSION PASSED UPON THE ACCURACY OR ADEQUACY OF
THIS PROSPECTUS. ANY REPRESENTATION TO THE CONTRARY
IS A CRIMINAL OFFENSE.
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The date of this Prospectus is July 9, 1996.
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TABLE OF CONTENTS
Available Information........................................................1
Incorporation of Certain Documents by Reference..............................1
Investment Considerations....................................................3
The Company..................................................................5
The Selling Shareholders.....................................................6
Plan of Distribution.........................................................9
Validity of the Shares.......................................................9
Experts......................................................................9
Other Matters...............................................................11
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AVAILABLE INFORMATION
The Company has filed with the Securities and Exchange Commission (the
"Commission") a Registration Statement on Form S- 3 (such Registration
Statement, together with all amendments and exhibits thereto, being hereinafter
referred to as the "Registration Statement") under the Securities Act of 1933,
as amended (the "Securities Act"), for the registration under the Securities Act
of the shares of Common Stock offered hereby. This Prospectus does not contain
all the information set forth in the Registration Statement, certain parts of
which are omitted in accordance with the rules and regulations of the
Commission. Reference is hereby made to the Registration Statement for further
information with respect to the Company and the Common Stock offered hereby.
Statements herein concerning the provisions of documents filed as exhibits to
the Registration Statement are necessarily summaries of such documents, and each
such statement is qualified in its entirety by reference to the copy of the
applicable document filed with the Commission.
The Company is subject to the informational requirements of the
Securities Exchange Act of 1934, as amended (the "Exchange Act"), and in
accordance therewith files reports and other information with the Commission.
Reports, proxy statements and other information filed by the Company can be
inspected and copied at public reference facilities maintained by the Commission
at 450 Fifth Street, N.W., in Washington, D.C. 20549, and at the Commission's
Regional Offices located at 75 Park Place, 14th floor, New York, New York 10007,
and Northwestern Atrium Center, 500 West Madison Street, Suite 1400, Chicago,
Illinois 60661. Copies of such material can be obtained by mail from the Public
Reference Section of the Commission, at 450 Fifth Street, N.W., Washington, D.C.
20549 at prescribed rates.
INCORPORATION OF CERTAIN DOCUMENTS BY REFERENCE
There are incorporated in this Prospectus by reference the following
documents which have been filed with the Commission:
(a) the Company's Annual Report on Form 10-K for its fiscal year ended
October 31, 1995, filed with the Commission on January 25, 1996;
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(b) the Company's Quarterly Report on Form 10-Q for the quarter ended
January 31, 1996, filed with the Commission on March 13, 1996;
(c) the Company's Current Report on Form 8-K, dated April 29, 1996,
filed with the Commission on May 14, 1996;
(d) the Company's Quarterly Report on Form 10-Q for the quarter ended
April 30, 1996, filed with the Commission on June 13, 1996; and
(e) the description of the Company's Common Stock contained in the
Company's Form 8-A filed with the Commission on December 9, 1992.
All reports subsequently filed by the Company pursuant to Sections 13,
14 or 15(d) of the Exchange Act prior to the termination of the offering shall
be deemed to be incorporated by reference in this Prospectus and to be a part
hereof from the date of filing of such documents. Any statement contained herein
or in a document incorporated or deemed to be incorporated by reference herein
shall be deemed to be modified or superseded for purposes of this Prospectus to
the extent that a statement contained herein or in any other subsequently filed
document which also is or is deemed to be incorporated by reference herein
modifies or supersedes such statement. Any statement so modified or superseded
shall not be deemed, except as so modified or superseded, to constitute a part
of this Prospectus.
The Company will promptly furnish, without charge, to each person to
whom this Prospectus is delivered, upon written or oral request of such person,
a copy of any and all of the documents which are incorporated by reference
herein (other than exhibits to such documents, unless such exhibits are
specifically incorporated by reference into such documents). Such requests
should be directed to the Office of Investor Relations, Health Management
Systems, Inc., 401 Park Avenue South, New York, New York 10016, telephone:
212-685-4545.
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INVESTMENT CONSIDERATIONS
This document contains forward-looking statements. Such statements by
their nature entail various risks, reflecting the dynamic, complex, and rapidly
changing nature of the healthcare industry. Results actually achieved may
differ materially from those currently anticipated. The various ricks include
but are not necessarily limited to: (i) the continued ability of HMS to grow
internally or by acquisition, (ii) the success experienced in integrating
acquired businesses into the HMS group of companies, (iii) changing conditions
in the healthcare industry which could simplify the reimbursement process
and/or data management requirements associated with the healthcare transfer
payment process and adversely affect HMS's business, (iv) government regulatory
and political pressures which could reduce the rate of growth of healthcare
expenditures, (v) competitive actions by other companies, and (vi) other risks,
as noted in HMS's registration statements and periodic reports filed with the
Commission.
In addition to other information contained herein, prospective
investors should consider the following factors in connection with a decision
to purchase the shares offered hereby.
DEPENDENCE UPON KEY MANAGEMENT AND TECHNICAL PERSONNEL. The Company's
success depends upon the continued contributions of its senior management. The
Company has confidentiality and non- solicitation agreements with all executive
officers and many other employees. In general, these agreements contain certain
covenants on the part of the employee concerning the protection of confidential
and proprietary information of the Company and preclude the employee from
soliciting employees of the Company or competing with the Company for periods of
up to three years following termination of employment. The Company does not have
employment agreements with most of its executive officers. The loss of services
of certain of the Company's executive officers could have an adverse effect on
the Company's business.
PROPRIETARY TECHNOLOGY. The Company's success is dependent to a
significant extent on its ability to maintain the proprietary and confidential
aspects of its data processing and computer software technology. The fields of
data processing and related computer software have undergone, and are expected
to continue to undergo, rapid and significant technological change. The Company
expects that the technology associated with its data processing services will
continue to develop rapidly, and the Company's success will depend, in large
part, on its ability to maintain a competitive position with respect to such
technology.
The Company relies on a combination of trade secrets, copyright and
contractual protections to establish and protect its proprietary rights. There
can be no assurance, however, that the legal protections and precautions taken
by the Company will be adequate to prevent misappropriation of the Company's
technology. In addition, these protections do not prevent independent third
party development of competitive technologies or services.
HEALTH CARE PAYMENT COMPLEXITY. Historically, the complexity of the
health care payment process has been a contributing factor to the success of
the Company's service
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offerings. This process includes multiple payors, the unsophisticated
coordination of benefits, frequent reimbursement rate changes, requirements for
pre-admission certification and utilization review, and other administrative
procedures instituted by third-party payors in an effort to control costs. As
the health care field evolves to managed care and a more simplified payment
process, there could be a resulting adverse effect on the Company's core
business offerings.
GOVERNMENT REGULATION. Government regulation can adversely affect the
Company's business by, among other things, reducing the amount of reimbursement
the Company's hospital clients are entitled to receive for providing health care
services. During the past decade, federal and state governments have implemented
legislation designed to contain the increase in health care costs, and it is
anticipated that such legislative initiatives will continue. Proposals to reduce
the rate of growth in Medicare and Medicaid expenditures are currently being
actively considered by the executive and legislative branches of government.
Future legislative initiatives, such as a nationalized health insurance system,
could, if implemented, simplify the health care reimbursement process and
adversely affect the demand for the Company's services. The Company is unable to
predict the effect, if any, that future legislation would have on its business.
The Company's operations are not subject to laws and regulations dealing with
collection agency activities because the Company's services do not deal with the
collection of delinquent accounts receivable and do not involve any contact with
patients, but are directed exclusively towards the transfer of medical payments
between providers and payors of health care. A substantial portion of the
Company's revenue is derived from contingent fees based on a percentage of net
collections of health care receivables. The Company's activities are subject to
laws and regulations of the federal and state agencies that administer the
Medicare and Medicaid programs.
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THE COMPANY
Health Management Systems, Inc. (the "Company") furnishes proprietary
information management and data processing services and software to hospitals
and other health care providers, government health services agencies and other
payors for or purchasers of health care, and other companies serving the health
care industry. The Company's offerings constitute an outsourcing of various
aspects of the information processing functions associated with the health care
transfer payment process, affording the Company's clients the benefits of
enhanced revenue (achieved through improved reimbursability/profitability and
collectability), accelerated cash flow, and reduced operating and administrative
costs.
Hospitals receive payment for services from patients,
third-party payors, or a combination thereof. Third-party payors include
commercial insurance companies, governments or their intermediaries, health
maintenance organizations, preferred provider organizations, third-party
administrators for self-insured companies, and managed care companies. Although
patients generally retain primary responsibility for payment for all health care
services, hospitals usually process claims for which third-party payors bear
responsibility. Obtaining reimbursement from third-party payors has become
increasingly difficult because of frequent changes in reimbursement formulae,
requirements for pre-admission certification and utilization review, and
administrative procedures instituted by third-party payors in an effort to
control costs. In order to obtain reimbursement from third-party payors,
hospitals and other providers of care must have the regulatory knowledge and
technical skills to manage complex data collection, integration, and analysis
functions through the accounts receivable liquidation life-cycle. To ensure that
program costs are no greater than required, third-party payors require knowledge
and skills analogous to those required by providers.
Among the Company's diversified services are those designed to minimize
the degree of error that results from the enormous transaction processing and
information management requirements associated with the health care transfer
payment process. Since its founding in 1974, the Company has concentrated on
applying its expertise in health care reimbursement process and
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information systems technology to the liquidation of health care accounts
receivable. More recently, the Company has expanded its product suite from its
historic focus on (i) maximizing liquidations of accounts receivable at
pre-determined reimbursement rates, to include (ii) decision support software
products which enable health care providers to assemble, analyze, and evaluate
mission-critical cost and quality information, facilitating efforts by the
provider to consider the proposed patient care in terms of its benefit, cost,
reimbursability, and profitability. The Company believes that its development of
proprietary computer software, systems, and databases dedicated exclusively to
the analysis, management, and liquidation of health care accounts receivable by
providers and payors and the concentration of its clients among the nation's
largest urban health care institutions and large purchasers of health care make
the Company unique among companies providing accounts receivable management and
decision support services to hospitals, government health care agencies, and
other companies serving the health care industry.
The Company was incorporated in New York in 1974. The Company's
executive offices are located at 401 Park Avenue South, New York, New York
10016, and its telephone number is 212-685- 4545.
THE SELLING SHAREHOLDERS
This Prospectus covers the sale of an aggregate of 460,000 shares of
Common Stock to be offered by Jeffrey R. Donnelly and Joseph H. Czajkowski (the
"Selling Shareholders"). The Selling Shareholders formerly owned all of the
outstanding capital stock of CDR Associates, Inc., a Maryland corporation
("CDR"). The Selling Shareholders acquired their shares of Common Stock in
connection with an Agreement and Plan of Merger, dated as of April 29, 1996 (the
"Merger Agreement"), among the Company, CDR Acquisition Corp. ("Sub"), which was
a newly formed, wholly-owned subsidiary of the Company, and CDR and all
Shareholders of CDR. Pursuant to the Merger Agreement, CDR merged (the "Merger")
with Sub, with the result that CDR became a wholly-owned subsidiary of the
Company. Each share of CDR capital stock issued and outstanding immediately
prior to the Merger was converted into 460 shares of Common Stock, or an
aggregate of 460,000 shares of Common Stock.
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The Merger Agreement provided that, for a period of two years
commencing on April 29, 1996 (the "Closing Date"), each Selling Shareholder will
not sell or otherwise dispose of in excess of (i) 50% of the shares of Common
Stock received by such Selling Shareholder in the Merger during the first 12
months following the Closing Date and (ii) an additional 20% (or an aggregate of
70%) of the shares of Common Stock originally issued to such Selling Shareholder
in the Merger during the second 12 months following the Closing Date.
The following table sets forth certain information regarding the
beneficial ownership of the Company's Common Stock by the Selling Shareholders
as of June 19, 1996. As of June 19, 1996, there were 17,286,596 shares of Common
Stock outstanding. The number of shares of Common Stock outstanding will not
change as a result of the offering, nor will the number of shares owned or
percentage of ownership of any persons other than the Selling Shareholders
change as a result thereof. There is no assurance that any of the Selling
Shareholders will offer for sale or sell any or all of the Common Stock offered
by them pursuant to this Prospectus.
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<TABLE>
<CAPTION>
Number Number of
of Shares to Percent
Name Shares Percent be Owned of
and Owned of Class Number of after Class
Position Prior Owned Shares Completion Owned
With to Prior to Registered of After
Company Offering Offering Hereby Offering(1) Offering
------- -------- -------- ------ --------- --------
<S> <C> <C> <C> <C> <C>
Joseph H. 230,000 1.3% 230,000 0 0
Czajkowski,
President
of CDR
Jeffrey C. 230,000 1.3% 230,000 0 0
Donnelly,
Executive
Vice
President
of CDR
</TABLE>
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(1) Assumes all shares registered pursuant hereto will be sold.
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PLAN OF DISTRIBUTION
The Selling Shareholders may, from time to time, offer all or part of
the shares acquired by them pursuant to the Merger on the over-the-counter
market or such national securities exchange upon which the Common Stock is
traded at the time of such sales, at prices prevailing at the time of such
sales, or in negotiated transactions. Selling Shareholders may also pledge their
shares to banks, brokers or other financial institutions as security for margin
loans or other financial accommodations that may be extended to such Selling
Shareholders, and any such pledgee institution may similarly offer, sell and
effect transactions in such shares. The Company will pay all expenses in
preparing and reproducing the Registration Statement of which this Prospectus is
a part, but will not receive any part of the proceeds of any sales of such
shares. In addition, any securities covered by this Prospectus which qualify for
sale pursuant to Rule 144 under the Act may be sold under Rule 144 rather than
pursuant to this Prospectus. Each Selling Shareholder (and pledgee) reserves the
sole right to accept and, together with its agents from time to time, to reject,
in whole or in part, any proposed purchase of shares to be made directly or
through agents. The Selling Shareholders will pay the brokerage commissions
charged to sellers in connection with such sales.
The Company and the Selling Shareholders may enter into customary
agreements concerning indemnification and the provision of information in
connection with the sale of their shares of Common Stock.
VALIDITY OF THE SHARES
The validity of the shares of Common Stock offered hereby will
be passed upon for the Company by Coleman & Rhine LLP, 1120 Avenue of the
Americas, New York, New York 10036. Partners of Coleman & Rhine LLP own 8,604
shares of Common Stock.
EXPERTS
The supplemental consolidated financial statements and supplemental
financial statement schedule of Health Management Systems, Inc. and subsidiaries
as of October 31, 1995 and 1994, and for each of the years in the three-year
period ended October
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31, 1995, incorporated by reference herein, have been incorporated by reference
herein in reliance upon the reports of KPMG Peat Marwick LLP, Coopers &
Lybrand L.L.P. and Ernst and Young LLP, independent certified public
accountants, incorporated by reference herein, and upon the authority of said
firms as experts in accounting and auditing.
The report of KPMG Peat Marwick LLP covering the supplemental
consolidated financial statements and supplemental financial statement schedule
described in the preceding paragraph contains an explanatory paragraph that
states that the supplemental consolidated financial statements and supplemental
financial statement schedule give retroactive effect to the merger of Health
Management Systems, Inc. and CDR Associates, Inc. on April 29, 1996, which has
been accounted for as a pooling of interests. Generally accepted accounting
principles proscribe giving effect to a consummated business combination
accounted for by the pooling of interests method in financial statements that do
not include the date of consummation. The aforementioned financial statements do
not extend through the date of consummation. However, they will become the
historical consolidated financial statements of Health Management Systems, Inc.
and subsidiaries after financial statements covering the date of consummation of
the business combination are issued.
The consolidated financial statements and financial statement schedule
of Health Management Systems, Inc. and subsidiaries as of October 31, 1995 and
1994, and for each of the years in the three-year period ended October 31, 1995,
incorporated by reference herein, have been incorporated by reference herein in
reliance upon the reports of KPMG Peat Marwick LLP, Coopers & Lybrand L.L.P.
and Ernst and Young LLP, independent certified public accountants, incorporated
by reference herein, and upon the authority of said firms as experts in
accounting and auditing.
The financial statements of CDR Associates, Inc. as of October 31,
1995, and for the year then ended, incorporated by reference herein, have been
incorporated by reference herein in reliance upon the report of KPMG Peat
Marwick LLP, independent certified public accountants, incorporated by reference
herein, and upon the authority of said firm as experts in accounting and
auditing.
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OTHER MATTERS
The Business Corporation Law of the State of New York provides
that, under certain circumstances, directors, officers, employees or agents of a
New York corporation may be indemnified against expenses, payments, fines and
amounts actually and reasonably incurred by them in connection with settling, or
otherwise disposing of, suits or threatened suits, to which they are a party or
threatened to be named a party by reason of acting in any of such capacities, if
such person acted in good faith and in a manner such person reasonably believed
to be in, or not opposed to, the best interests of the corporation. The by-laws
of the Company provide for indemnification of officers and directors under the
circumstances, and to the extent, permitted by law. Insofar as indemnification
for liabilities arising under the Act may be permitted to directors, officers or
persons controlling the Company pursuant to the foregoing provisions and
agreements, the Company has been informed that, in the opinion of the
Commission, such indemnification is against public policy as expressed in such
Act and is therefore unenforceable.
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[Outside Back Cover]
No dealer, salesperson or other person has been authorized to give any
information or make any representation other than is contained in this
Prospectus, and, if given or made, such information or representation must not
be relied upon as having been authorized by the Company or any Selling
Shareholder. This Prospectus does not constitute an offer to sell or a
solicitation of an offer to buy any security offered hereby in any jurisdiction
to any person to whom it is unlawful to make such offer or solicitation in such
jurisdiction. Neither the delivery of this Prospectus nor any sale made
hereunder shall, under any circumstances, create any implication that there has
been no change in the affairs of the Company since the date hereof or that the
information contained herein is correct as of any time subsequent to its date.
