We discuss the year-1 performance of Altera, CSI's largest acquisition to day, and share our learnings from 6+ hours of interviews with Former Altera / Allscripts executives and CSI M&A execs who worked on the deal. We explore:

Why Altera's customer churn could be higher than expected

Challenges meeting meaningful use regulations and new product development on Altera's R&D budget

Impact on CSI's potential levered and unlevered IRR

Comparison with Acceo, CSI's first LBO in 2018