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SHAREHOLDERS’ EQUITY - Schedule of Aggregate Intrinsic Value of Stock Options Exercised, Fair Values of Awards Vested, and Share Based Liabilities Settled (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total intrinsic value of stock options exercised	$ 56,548	$ 77,527	$ 104,695
Total grant-date fair value of stock options vested	3,591	5,228	5,185
Restricted Shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total grant-date fair value of restricted shares vested	9,306	9,248	3,796
Total settlement date fair value of restricted shares vested	$ 31,842	$ 32,802	$ 22,321

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Schedule of Reconciliation of Denominators and Additional Shares that are Excluded from the Calculation of EPS

The following table sets forth the computation of basic and diluted earnings per share for the years ended December 31, 2023, 2022 and 2021 (in thousands, except for earnings per share):


	Year Ended December 31,
	2023		2022		2021
Weighted-average shares:
Common shares outstanding	30,722		32,388		35,862
RSAs	21		21		90
Total weighted-average shares	30,743		32,409		35,952
Earnings per common share—Basic
Net income	$	282,810	$	245,368	$	181,848
Less: Undistributed earnings allocated to RSAs	(191)		(157)		(458)
Net income available to common shareholders—Basic	$	282,619	$	245,211	$	181,390

Net income per common share—Basic	$	9.20	$	7.57	$	5.06

Basic weighted-average common shares outstanding	30,722		32,388		35,862
Effect of diluted shares	1,119		1,283		1,835
Diluted weighted-average shares outstanding	31,841		33,671		37,697

Net income per common share—Diluted	$	8.88	$	7.28	$	4.81

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Principles of Consolidation and Presentation

The accompanying consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“US GAAP”) and include the accounts and operations of the Company and its subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation.

Use of Estimates

The preparation of financial statements in conformity with US GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from these estimates.

Significant items that are subject to management estimates and assumptions include revenue, net, allowances for doubtful accounts, acquisition purchase price allocations, long-lived asset impairment and useful lives, exit liabilities, stock-based compensation, uncertain income tax positions and contingencies.

Reportable Segments

The Company emphasizes its full service outsourcing model, providing services focused on the development, management and execution of clinical trials. As part of this full service approach, the Company utilizes centralized systems, customer interface technology, support functions and processes that cross service offerings and align resources to deliver efficient clinical trial services. Given the full service approach, the chief executive officer, who is the chief operating decision maker (“CODM”) assesses the allocation of resources based on key metrics including revenue, backlog, and net awards by service offering and consolidated profitability and consolidated cash flows. Based on the Company’s full service model, internal management and reporting structure, and key metrics used by the CODM to make resource allocation decisions, management has determined that the Company’s operations consist of a single operating segment. Therefore, results of operations are presented as a single reportable segment.

Foreign Currencies

Assets and liabilities recorded in foreign currencies on foreign subsidiary financial statements are translated at the exchange rate on the balance sheet date, while equity accounts are translated at historical exchange rates. Revenue and expenses are recorded at average rates of exchange during the year. Translation adjustments are recorded to Accumulated other comprehensive loss in the consolidated statements of shareholders’ equity and consolidated statements of comprehensive income.

Separately, net realized gains and losses on foreign currency transactions are included in Miscellaneous income, net, on the consolidated statements of operations. Foreign currency transactions resulted in a net (loss)/gain of $(1.9) million, $3.9 million, and $2.8 million during the years ended December 31, 2023, 2022, and 2021, respectively.

Revenue Recognition

The Company generally enters into contracts with customers to provide services ranging in duration from a few months to several years. The contract terms generally provide for payments based on a fixed fee or unit-of-service arrangement. The Company accounts for revenue in accordance with ASC 606, Revenue from Contracts with Customers. Revenue on contracts is recognized when or as the Company satisfies the contract performance obligations, at the amount that reflects the Company’s cumulative progress toward delivery of the performance obligation. This progress assessment is applied to the amount of consideration to which the Company expects to be paid for delivery of the performance obligation. The Company’s performance obligations are generally satisfied over time and related revenue is recognized as services are provided to meet these obligations.

Contract Assumptions

An arrangement is accounted for as a contract within the scope of ASC 606 when the Company and its customers approve the contract, are committed to perform their respective obligations, each party can identify its rights regarding the goods or services to be transferred, commercial substance is present, and it is probable that the Company will collect substantially all of the consideration to which it will be entitled in exchange for the goods or services that will be transferred to the customer.

For the Company’s services to meet this criteria, contracts generally need to be written, pending regulatory hurdles required to commence work must be cleared, the study protocol must be completed, the customer must have adequate funding or reasonable path to funding to execute the contracted portion of the study, and the study must be actively moving forward. Once these criteria have been met, it is deemed that the Company and its customers are committed to perform their respective obligations. Depending on the timing of when these criteria are met, revenue recognition may vary significantly on a period over period basis.

Accounting for contracts performed over a period of time involves the use of various assumptions to estimate total contract revenue and costs. The Company estimates expected costs to complete a contract and recognizes contracted revenue over the life of the contract as those costs are incurred.

Cost estimates are based on a detailed project budget and are developed based on many variables, including, but not limited to, the scope of the work, the complexity of the study, the participating geographic locations and the Company’s historical experience. To assist with the estimation of costs expected at completion over the life of a project, regular contract reviews are performed in which performance to date is compared to the most current estimate to complete assumptions. The reviews include an assessment of costs incurred to date compared to expectations based on budget assumptions and other

circumstances specific to the project. The total estimated costs necessary to complete is updated and any revisions to the existing cost estimate results in cumulative adjustments to the amount of revenue recognized in the period in which the revisions are identified. In the case of cost estimates related to activities legally contracted as reimbursable in nature, including but not limited to investigator fee activity, these estimates also influence the Company’s assumed contract value and assumed remaining performance obligations. Because of the uncertainties inherent in estimating the costs necessary to fulfill contractual obligations, it is possible that estimates may change in the near term, resulting in a material change in revenue reported.

Contracts generally provide for pricing modifications upon scope of work changes. The Company recognizes revenue, at an amount to which it expects to be entitled, related to work performed in connection with scope changes when the underlying services are performed and a binding contractual commitment has been established with the customer. If the Company’s customers do not agree to contract changes upon changes in the Company’s scope of work, the Company could be exposed to cost overruns and reduced contract profitability. Costs are not deferred in anticipation of contracts being awarded or amendments being finalized, but are expensed as incurred.

Most contracts are terminable by the customer, either immediately or according to advance notice terms specified within the contracts. These contracts require payment of fees for services rendered through the date of termination and may require payment for subsequent services necessary to conclude the study or close out the contract. Final settlement amounts are agreed to with the customer based on remaining work to be performed. These amounts are included in revenue when the Company believes the amount can be estimated reliably and its realization is probable. In evaluating the probability of recognition, the Company considers the contractual basis for the settlement amount and the objective evidence available to support the amount.

Certain contracts contain volume rebate arrangements with our customers that provide for rebates if certain specified spending thresholds are met. These obligations are considered as a reduction in revenue when it appears probable that the arrangement thresholds will be met, which can be at contract inception. Total revenue is presented net of rebates of $12.1 million, $7.9 million and $7.2 million in the consolidated statements of operations during the years ended December 31, 2023, 2022 and 2021, respectively.

The Company occasionally enters into incentive fee arrangements with customers that provide for additional compensation if certain defined contractual milestones or performance thresholds are met. These additional fees are included in the estimated transaction price when there is a basis to reasonably estimate the amount of the fee and when achievement of the incentive milestone is deemed probable. These estimates are based on anticipated performance, the Company’s best judgment at the time or ultimately, upon achievement of the threshold or milestone.

The Company records revenue net of any tax assessments by governmental authorities that are imposed and concurrent with specific revenue generating transactions.

Performance Obligations

Substantially all of the Company’s contracts consist of a single performance obligation, as the promise to transfer the individual services described in the contracts are not separately identifiable from other promises in the contracts, and therefore not distinct. Revenue recognition is determined by assessing the progress of performance completed or delivered to date compared to total services to be delivered under the terms of the arrangement. The measures utilized to assess progress on the satisfaction of performance are specific to the performance obligation identified in the contract.

For the majority of the Company’s contract performance obligations, it utilizes the input method of cost to cost to measure progress, as the Company has determined that it is the most consistent measure of progress among contract tasks and represents the most faithful depiction of the transfer of services over the contract life. Under this method, the Company determines cost incurred to date for the services it provides compared to the total estimated costs at completion.

For certain other contractual performance obligations, the Company has determined that an output method is the best measure of progress. These relate to certain unitized contracts, and the Company recognizes revenue in the period in which the unit is delivered compared to total contracted units.

As of December 31, 2023 and 2022, the Company had approximately $2.9 billion and $2.7 billion of performance obligations remaining to be performed for active projects.

Concentration of Credit Risk

Financial instruments that subject the Company to credit risk primarily consist of cash and cash equivalents and accounts receivable. The cash and cash equivalent balances are held and maintained with financial institutions with reputable credit ratings and, consequently, the Company believes that such funds are subject to minimal credit risk.

The Company generally does not require collateral or other securities to support customer receivables. In the years ended December 31, 2023, 2022 and 2021, credit losses have been immaterial and within management’s expectations. At December 31, 2023 and 2022, there were no customers accounting for more than 10% of the Company’s accounts receivable.

Costs and Expenses

The Company incurs costs associated with service delivery including direct labor and related employee benefits, laboratory supplies, and other expenses. These costs are recorded in Direct service costs, excluding depreciation and amortization as a component of Total direct costs in the accompanying consolidated statements of operations. In addition, the Company incurs expenses on behalf of its customers for various project expenditures including, but not limited to, investigator site payments, travel, meetings, printing, and shipping and handling fees that are reimbursed by its customers at cost. These costs are included in Reimbursable out-of-pocket expenses as a component of Total direct costs in the accompanying consolidated statements of operations. Total direct costs are expensed as incurred and are not deferred in anticipation of contracts being awarded or finalization of changes in scope. Selling, general and administrative includes administrative payroll and related employee benefits, sales and marketing expenses, administrative travel, and other expenses not directly related to service delivery. Rent, utilities, supplies, and software license expenses are allocated between Total direct costs, and Selling, general and administrative based on the estimated contribution among service delivery and support function efforts on a percentage basis. Depreciation and amortization is reported separately in the accompanying consolidated statements of operations. Costs of sales and marketing activities not subject to recovery pursuant to customer contracts, such as feasibility assessments and negotiation of contracts, are expensed as incurred and recorded as a component of Selling, general and administrative in the accompanying consolidated statements of operations.

Advertising expenses are recorded as a component of Selling, general and administrative expenses in the accompanying consolidated statements of operations. Total advertising expenses of $1.5 million, $1.3 million and $1.2 million were incurred during the years ended December 31, 2023, 2022 and 2021, respectively.

Income Taxes

The Company’s consolidated US federal income tax return is comprised of its US subsidiaries, its foreign branches and certain foreign subsidiaries.

The Company provides for income taxes on all transactions that have been recognized in the consolidated financial statements in accordance with accounting guidance governing income tax accounting. Accordingly, the impact of changes in income tax laws on deferred tax assets and deferred tax liabilities are recognized in net earnings in the period during which such changes are enacted.

The Company records deferred tax assets and liabilities based on temporary differences between the financial statement bases and tax bases of assets and liabilities. Deferred tax assets are recorded for tax benefit carryforwards using tax rates anticipated to be in effect in the year in which the temporary differences are expected to reverse. If it does not appear more likely than not that the full value of a deferred tax asset will be realized, the Company records a valuation allowance against the deferred tax asset, with an offsetting charge to the Company’s income tax provision or benefit. The value of the Company’s deferred tax assets is estimated based on, among other things, the Company’s ability to generate a sufficient level of future taxable income. In estimating future taxable income, the Company has considered both positive and negative evidence, such as historical and forecasted results of operations, and has considered the implementation of prudent and feasible tax planning strategies.

The Company’s accounting position is that unremitted foreign earnings are indefinitely reinvested. Therefore, the Company has not recorded deferred foreign withholding taxes on the unremitted foreign earnings. Refer to Note 11 for further information regarding this assertion.

The Company follows accounting guidance related to accounting for uncertainty in income taxes which requires significant judgment in determining what constitutes an individual tax position as well as assessing the possible outcome of each tax

position. Changes in judgments as to recognition or measurement of tax positions can materially affect the estimate of the effective tax rate, and, consequently, the Company’s consolidated financial results. The Company considers many factors when evaluating and estimating tax positions and tax benefits, which may require periodic adjustments and which may not accurately anticipate actual outcomes. In addition, the calculation of tax liabilities involves dealing with uncertainties in the application of complex tax regulations in a multitude of jurisdictions. The Company determines its liability for uncertain tax positions globally. If the payment of these amounts ultimately proves to be unnecessary, the reversal of liabilities would result in tax benefits being recognized in the period when it is determined the liabilities are no longer necessary. If the calculation of the liability related to uncertain tax positions proves to be more or less than the ultimate assessment, a tax expense or tax benefit would result. Interest and penalties associated with uncertain tax positions are recognized as components of the Company’s Income tax provision.

Stock-Based Compensation

The Company has stock-based employee compensation plans for which it incurs compensation expense.

Equity Awards

In connection with the Company's initial public offering (IPO), the Board approved the formation of the 2016 Incentive Award Plan (the “2016 Plan”). The 2016 Plan provides for long-term equity incentive compensation for key employees, officers and non-employee directors. A variety of discretionary awards (collectively, the “Awards”) for employees and non-employee directors are authorized under the 2016 Plan, including vested common shares, stock options, stock appreciation rights (SARs), restricted stock awards (RSAs), restricted stock units (RSUs), or other cash based or stock dividend equivalent awards. The vesting of such awards may be conditioned upon either a specified period of time or the attainment of specific performance goals as determined by the administrator of the 2016 Plan. The option price and term are also subject to determination by the administrator with respect to each grant. Option prices are generally expected to be set at the market price of our common stock at the date of grant and option terms are not expected to exceed ten years. All outstanding Awards under the 2016 Plan are equity classified awards.

Stock-based compensation expense for the 2016 Plan is calculated using the fair value method on the grant date. The Company expenses stock-based compensation over the term of the award based on the vesting described in the award agreement. Stock-based compensation expense is allocated between Total direct costs, and Selling, general and administrative in the consolidated statements of operations based on the underlying classification and scope of work for the employees receiving the Awards.

Net Income Per Share

Basic and diluted earnings or loss per share (EPS) are computed using the two-class method, which is an earnings allocation that determines EPS for each class of common stock and participating securities according to dividends declared and participation rights in undistributed earnings. The Company’s RSAs are considered participating securities because they are legally issued at the date of grant and holders are entitled to receive non-forfeitable dividends during the vesting term.

The computation of diluted EPS includes additional common shares, such as unvested RSUs and stock options with exercise prices less than the average market price of the Company’s common stock during the period (“in-the-money options”), which would be considered outstanding. This assumes that additional shares would have to be issued in cases where the exercise price of stock options is less than the value of the common stock being acquired because the cash proceeds received from the stock option holder would not be sufficient to acquire that same number of shares. The Company does not compute diluted EPS in cases where the inclusion of such additional shares would be anti-dilutive in effect.

The following table sets forth the computation of basic and diluted earnings per share for the years ended December 31, 2023, 2022 and 2021 (in thousands, except for earnings per share):


	Year Ended December 31,
	2023		2022		2021
Weighted-average shares:
Common shares outstanding	30,722		32,388		35,862
RSAs	21		21		90
Total weighted-average shares	30,743		32,409		35,952
Earnings per common share—Basic
Net income	$	282,810	$	245,368	$	181,848
Less: Undistributed earnings allocated to RSAs	(191)		(157)		(458)
Net income available to common shareholders—Basic	$	282,619	$	245,211	$	181,390

Net income per common share—Basic	$	9.20	$	7.57	$	5.06

Basic weighted-average common shares outstanding	30,722		32,388		35,862
Effect of diluted shares	1,119		1,283		1,835
Diluted weighted-average shares outstanding	31,841		33,671		37,697

Net income per common share—Diluted	$	8.88	$	7.28	$	4.81

For the years ended December 31, 2023, 2022 and 2021, the computation of diluted EPS excludes the effect of (in thousands) 0, 9 and 9 stock options, respectively, due to each respective period’s average fair value of the Company’s common stock not exceeding the exercise prices.

Fair Value Measurements

The Company follows accounting guidance related to fair value measurements that defines fair value, establishes a framework for measuring fair value, and establishes a hierarchy for inputs used in measuring fair value. This hierarchy maximizes the use of “observable” inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. The hierarchy specifies three levels based on the inputs, as follows:

Level 1: Valuations based on quoted prices in active markets for identical assets or liabilities.

Level 2: Valuations based on directly observable inputs or unobservable inputs corroborated by market data.

Level 3: Valuations based on unobservable inputs supported by little or no market activity representing management’s determination of assumptions of how market participants would price the assets or liabilities.

The fair value of financial instruments such as cash and cash equivalents, accounts receivable and unbilled, net, accounts payable, accrued expenses, and advanced billings approximate their carrying amounts due to their short term maturities.

The Company does not have any material recurring fair value measurements as of December 31, 2023 and 2022. There were no material transfers between Level 1, Level 2, or Level 3 during the years ended December 31, 2023, 2022 and 2021.

Cash and Cash Equivalents, including Restricted Cash

Cash and cash equivalents, including restricted cash, are invested in demand deposits and money market funds, all of which have an original maturity of three months or less. Restricted cash consists of customer funds received in advance and subject to specific restrictions, as well as amounts placed in escrow for contingent payments resulting from acquisitions or other contractual arrangements.

Accounts Receivable and Unbilled, Net

Accounts receivable represent amounts due from the Company’s customers who are concentrated primarily in the pharmaceutical, biotechnology, and medical device industries. Unbilled services represent revenue recognized to date that is currently not billable to the customer pursuant to contractual terms. In general, amounts become billable upon the achievement of negotiated contractual events or in accordance with predetermined payment schedules. Amounts classified to unbilled services are those billable to customers within one year from the respective balance sheet date.

The Company grants credit terms to its customers prior to signing a service contract and monitors the creditworthiness of its customers on an ongoing basis. The Company maintains an allowance for doubtful accounts based on specific identification of accounts receivable that are at risk of not being collected. Uncollectible accounts receivable are written off only after all reasonable collection efforts have been exhausted. Moreover, in some cases the Company requires advance payment from its customers for a portion of the study contract price upon the signing of a service contract. These advance payments are deferred and recognized as revenue as services are performed.

Inventory

Inventory, which consists primarily of laboratory supplies, is valued at the lower of cost or market. Inventory is stated at purchased cost using the first-in, first out (FIFO) cost method. The inventory balance is included in Prepaid expenses and other current assets in the consolidated balance sheets.

Property and Equipment

Property and equipment is recorded at cost. Depreciation is provided on the straight-line method at rates adequate to allocate the cost of the applicable assets over their estimated useful lives, which is three to five years for computer hardware, software, phone, and medical imaging equipment, five to seven years for furniture and fixtures and other equipment, and thirty to forty years for buildings. The Company capitalizes costs of computer software developed for internal use and amortizes these costs on a straight-line basis over the estimated useful life, not to exceed three years. Leasehold improvements are capitalized and amortized on a straight-line basis over the shorter of the estimated useful life of the improvement or the associated remaining lease term. Repairs and maintenance are expensed as incurred.

Leases

The Company enters into contracts to lease facilities and equipment to be used in its operations. At contract inception, the Company determines whether a contract contains a lease within the scope of Accounting Standard Codification Topic 842, Leases (ASC 842), and determines the appropriate classification of the lease as either operating or finance.

Contracts containing operating leases are recorded on the consolidated balance sheets within Operating lease right-of-use (ROU) assets, Other current liabilities, and Operating lease liabilities. Operating lease ROU assets and operating lease liabilities are recognized based on the present value of the future lease payments over the lease term as of the lease commencement date. In addition, operating ROU assets also include lease payments made and exclude lease incentives and initial direct costs incurred. Operating lease expense for lease payments is recognized on a straight-line basis over the lease term within Total direct costs and Selling, general, and administrative expenses. Variable lease costs are primarily related to adjustments for inflation, common area maintenance and property tax and are recognized within Total direct costs and Selling, general and administrative expenses.

Contracts containing finance leases are recognized initially in the same manner as Operating lease ROU assets and liabilities; however, they are recorded on the consolidated balance sheets within Property and equipment, net, Other current liabilities, and Other long-term liabilities. Finance lease assets are subsequently amortized on a straight line basis over the lease term within Depreciation expense, while the lease liability is accreted within Interest expense, net utilizing the discount rate determined at lease commencement and reduced by periodic lease payments over the lease term. Currently, the Company does not have any finance leases.

The discount rate utilized in determining the present value of future payments for both operating and finance leases, unless implicit in the lease contract, is determined based on the Company’s collateralized incremental borrowing rate based on the information available at lease commencement.

Lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option as determined at lease commencement.

Many of our lease agreements have both lease and non-lease components, which the Company has elected to treat as a single lease component for recognition purposes.

The Company may enter into short-term leases (leases with a lease term of less than one year), which it has elected not to capitalize as assets and liabilities on the consolidated balance sheets, but instead recognizes lease payments within Total direct costs and Selling, general, and administrative expenses on a straight line basis over the lease term.

Goodwill and Intangible Assets

Goodwill

Goodwill represents the excess of purchase price over the fair value of net assets acquired in business combinations. The carrying value of goodwill is reviewed at least annually for impairment, or as indicators of potential impairment are identified, at the reporting unit level. The reporting units are Phase I-IV clinical research services and Laboratories as of December 31, 2023.

The Company performs its annual impairment tests during the fourth quarter each year, comparing the fair value of each of our reporting units with its carrying amount, inclusive of goodwill. A goodwill impairment charge would be recognized for the amount by which the carrying amount exceeds the reporting unit’s fair value. Fair value is estimated using a combination of the income approach, a discounted cash flow analysis, and the market approach, utilizing the guideline company method. There was no indication of impairment related to goodwill based on the fourth quarter 2023 assessment.

Intangible Assets

The Company has an indefinite lived intangible asset related to its trade name. The carrying value of the trade name asset is reviewed at least annually for impairment, or as indicators of potential impairment are identified. The Company performs its annual impairment test in the fourth quarter each year in conjunction with its annual assessment of goodwill. The assessment consists of comparing the carrying value of the indefinite lived intangible asset to its estimated fair value, utilizing the relief from royalty method, an income approach valuation. There was no indication of impairment related to the trade name asset based on the fourth quarter 2023 assessment.

Finite-lived intangible assets consist mainly of the value assigned to customer relationships and developed technologies. Finite-lived intangible assets are amortized straight-line or using an accelerated method over their estimated useful lives of fifteen years.

Impairment of Long-Lived Assets

Long-lived assets, primarily property and equipment and finite-lived intangible assets, are reviewed for impairment and the reasonableness of the estimated useful lives whenever events or changes in circumstances indicate that the carrying amounts of the assets may not be recoverable or that a change in useful life may be appropriate. Recoverability for long-lived assets is determined by comparing the forecasted undiscounted cash flows of the operation to which the assets relate to the carrying amount of the assets. If the undiscounted cash flows are less than the carrying amount of the assets, then the Company reduces the carrying value of the assets to estimated fair values, which are primarily based upon forecasted discounted cash flows. Fair value of long-lived assets is determined based on a combination of discounted cash flows and market multiples. There was no indication of impairment related to long-lived assets based on the fourth quarter 2023 assessment.

Advanced Billings

Advanced billings represents cash received from customers, or billed amounts per an agreed upon payment schedule, in advance of services being performed or revenue being recognized.

Government Assistance

The Company receives government incentives from domestic and foreign governments. The incentives come in various arrangements, but consist primarily in the form of tax credits, economic development grants and property tax abatement credits.

Tax credits are available to the Company, in certain jurisdictions, for qualifying research and development spend as well as for certain employment related milestone agreements. These tax credits are recorded on a jurisdiction-by-jurisdiction basis upon the first instance of the credit being monetized. Upon achieving a history of monetization in a jurisdiction, income is typically estimated as the activities or contractual requirements defined in the applicable agreements occur. Depending on the jurisdiction laws and regulations, credits can be monetized immediately or up to 3 years after the credits have been submitted to the relevant taxing agencies.

The Company receives grants from certain jurisdictions for economic development projects, based on job growth, employee retention and capital investment commitments. These grant funds are reimbursed to the Company upon achieving certain milestones and recognized as eligible costs are incurred.

Property tax abatement credits are available to the Company in certain jurisdictions that reduce the cost of renting or owning real and business personal property. These credits are monetized through reductions to the real estate tax liability at the time payments are due and recognized as real estate taxes are incurred.

Government incentives are recorded in accordance with their purpose, net of fees incurred to monetize the benefit, as a reduction of expense within Direct service costs, excluding depreciation and amortization and Selling, general and administrative in the consolidated statements of operations. The Company recognized government assistance income, net of $15.5 million and $15.4 million during the years ended December 31, 2023 and 2022, respectively. Government assistance receivables are recorded in the consolidated balance sheets based on the expected timing of monetizing the benefit. Government assistance receivables recorded on the December 31, 2023 consolidated balance sheets are expected to be recovered through 2027. The Company recorded receivables related to government assistance programs at December 31, 2023 of $9.5 million in Prepaid expenses and other current assets and $12.2 million in Other assets, respectively. The Company recorded receivables related to government assistance programs at December 31, 2022 of $11.3 million in Prepaid expenses and other current assets and $7.1 million in Other assets, respectively.

Recently Adopted Accounting Standards

In November 2021, the FASB issued ASU 2021-10, "Government Assistance (Topic 832): Disclosures by Business Entities about Government Assistance" which requires entities to provide disclosures on material government assistance transactions for annual reporting periods. The disclosures include information around the nature of the assistance, the related accounting policies used to account for government assistance, the effect of government assistance on the entity's financial statements, and any significant terms and conditions of the agreements, including commitments and contingencies. The guidance is effective for annual periods beginning after December 15, 2021, with early adoption permitted. The Company adopted this standard on a prospective basis in the fourth quarter of 2022.

Recently Issued Accounting Pronouncements

In November 2023, the FASB issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures" which requires entities to enhance disclosures around segment reporting. The guidance is effective for annual periods beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures.

In December 2023, the FASB issued ASU 2023-09, "Income Taxes (Topic 740): Improvements to Income Tax Disclosures" which requires entities to enhance disclosures around income taxes. The guidance is effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures.

SHAREHOLDERS’ EQUITY -Schedule of Weighted-Average Assumptions Used in BSM Model to Calculate Fair Value of Options (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected holding period - years	4 years 1 month 6 days	4 years 8 months 12 days	5 years
Expected volatility	45.40%	36.50%	34.30%
Risk-free interest rate	3.80%	1.90%	0.90%
Expected dividend yield	0.00%	0.00%	0.00%

Cover Page - USD ($) $ in Billions	12 Months Ended
Cover Page - USD ($) $ in Billions	Dec. 31, 2023	Feb. 09, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-37856
Entity Registrant Name	Medpace Holdings, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	32-0434904
Entity Address, Address Line One	5375 Medpace Way
Entity Address, City or Town	Cincinnati
Entity Address, State or Province	OH
Entity Address, Postal Zip Code	45227
City Area Code	513
Local Phone Number	579-9911
Title of 12(b) Security	Common Stock $0.01 par value
Trading Symbol	MEDP
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction	false
Entity Shell Company	false
Entity Public Float			$ 5.6
Entity Common Stock, Shares Outstanding		30,759,281
Documents Incorporated by Reference	DOCUMENTS INCORPORATED BY REFERENCE Portions of the registrant's definitive proxy statement to be filed with the Securities and Exchange Commission relating to the 2024 Annual Meeting of Stockholders are incorporated herein by reference into Part III of this Annual Report on Form 10-K to the extent stated herein.
Entity Central Index Key	0001668397
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Amendment Flag	false

CONTRACT ASSETS AND CONTRACT LIABILITIES - Summary of Accounts Receivable and Unbilled, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Revenue from Contract with Customer [Abstract]
Accounts receivable	$ 275,932	$ 213,169
Unbilled receivables	22,475	40,405
Less: allowance for doubtful accounts	(7)	(170)	$ (171)	$ (346)
Total accounts receivable and unbilled, net	$ 298,400	$ 253,404

SHAREHOLDERS’ EQUITY - Narrative (Details) $ in Millions	12 Months Ended
SHAREHOLDERS’ EQUITY - Narrative (Details) $ in Millions	Dec. 31, 2023 USD ($) installment shares	Dec. 31, 2022 USD ($) installment shares	Dec. 31, 2021 USD ($) shares	Aug. 11, 2016 shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Options granted (in shares)	12,437	252,490	282,588
Expected dividend yield	0.00%	0.00%	0.00%
Actual tax benefits recognized related to stock-based compensation \| $	$ 18.9	$ 23.2	$ 20.9
2016 Incentive Award Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares registered and available for grant (in shares)				6,000,000
Shares available for future stock compensation grants (in shares)	2,300,000	2,300,000
2016 Incentive Award Plan \| Granted to Employees
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Awards granted to employees (in shares)	47,238
2016 Incentive Award Plan \| Employee
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Awards granted to employees (in shares)		405,550	374,235
2016 Incentive Award Plan \| Non Employee Directors \| Restricted Stock Units (RSU)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares granted (in shares)	848	1,117
Award vesting installments \| installment	4	4
2016 Incentive Award Plan \| Non Employee Directors \| Stock options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Options granted (in shares)	11,187	11,418	10,932
2016 Incentive Award Plan \| Vesting After Four Years \| Restricted Stock Units (RSU)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Award vesting period	4 years	4 years	4 years
Shares granted (in shares)	45,988	164,478	27,854
2016 Incentive Award Plan \| Vesting After Four Years \| Stock options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Options granted (in shares)	1,250	113,838	9,000
Award vesting period	4 years	4 years	4 years
2016 Incentive Award Plan \| Vesting After Two Years \| Stock options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Options granted (in shares)		127,234	57,570
Award vesting period		2 years	2 years
2016 Incentive Award Plan \| Vesting After Four Years and Six Months \| Restricted Stock Units (RSU)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Award vesting period			4 years 6 months
Shares granted (in shares)			74,725
2016 Incentive Award Plan \| Vesting After Four Years and Six Months \| Stock options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Options granted (in shares)			205,086
Award vesting period			4 years 6 months
2016 Incentive Award Plan \| Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation option terms	10 years

EMPLOYEE BENEFIT PLANS - (Details) - USD ($) $ in Millions	12 Months Ended
EMPLOYEE BENEFIT PLANS - (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Defined Contribution Plan Disclosure [Line Items]
Maximum annual contribution by employee, percentage of pre-tax earnings	50.00%
U.S. Employees
Defined Contribution Plan Disclosure [Line Items]
Minimum period of service required for matching contribution eligibility	1 year
Minimum required period of service for employer contributions to fully vest	3 years
Recognized cost of employee benefit plan	$ 7.4	$ 5.4	$ 4.3
Non-U.S. Employees \| Defined Contribution Arrangements
Defined Contribution Plan Disclosure [Line Items]
Recognized cost of employee benefit plan	$ 3.3	$ 2.5	$ 1.9

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Weighted-average shares:
Weighted average number of shares outstanding, basic (in shares)	30,722	32,388	35,862
Total weighted average shares outstanding, basic (in shares)	30,743	32,409	35,952
Earnings per common share—Basic
Net income	$ 282,810	$ 245,368	$ 181,848
Net income available to common shareholders—Basic	$ 282,619	$ 245,211	$ 181,390
Net income per common share, basic (in dollars per share)	$ 9.20	$ 7.57	$ 5.06
Weighted average number of shares outstanding, basic (in shares)	30,722	32,388	35,862
Effect of diluted shares (in shares)	1,119	1,283	1,835
Weighted-average shares outstanding, diluted (in shares)	31,841	33,671	37,697
Net income per common share, diluted (in dollars per share)	$ 8.88	$ 7.28	$ 4.81
RSAs
Weighted-average shares:
Weighted average number of shares outstanding, basic (in shares)	21	21	90
Earnings per common share—Basic
Less: Undistributed earnings allocated to RSAs	$ (191)	$ (157)	$ (458)
Weighted average number of shares outstanding, basic (in shares)	21	21	90
Common Stock
Weighted-average shares:
Weighted average number of shares outstanding, basic (in shares)	30,722	32,388	35,862
Earnings per common share—Basic
Weighted average number of shares outstanding, basic (in shares)	30,722	32,388	35,862

INCOME TAXES- Schedule of Income Tax Provision (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
U.S. federal, current	$ 64,381	$ 49,991	$ 46,138
U.S. federal, deferred	(24,117)	(19,705)	(32,677)
U.S. federal, total	40,264	30,286	13,461
U.S. state and local, current	8,848	7,160	8,405
U.S. state and local, deferred	(1,869)	(3,297)	(3,622)
U.S. state and local, total	6,979	3,863	4,783
Foreign jurisdictions, current	4,622	3,330	2,580
Foreign jurisdictions, deferred	1,007	13	(820)
Foreign jurisdictions, total	5,629	3,343	1,760
Income tax provision (benefit), current	77,851	60,481	57,123
Income tax provision (benefit), deferred	(24,979)	(22,989)	(37,119)
Income tax provision (benefit), total	$ 52,872	$ 37,492	$ 20,004

PROPERTY AND EQUIPMENT, NET

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

PROPERTY AND EQUIPMENT, NET

Property and equipment, net consisted of the following at December 31, (in thousands):


	2023		2022
Land	$	4,833	$	2,410
Equipment	39,927		31,851
Furniture, fixtures, and leasehold improvements	99,581		87,543
Computer hardware, software, and phone equipment	32,051		26,049
Buildings	16,419		13,594
Construction-in-progress	7,182		10,518
Property and equipment at cost	199,993		171,965
Less: Accumulated depreciation	(79,404)		(62,116)
Property and equipment, net	$	120,589	$	109,849

Depreciation expense was $24.1 million, $19.0 million and $16.0 million for the years ended December 31, 2023, 2022 and 2021, respectively.

COMMITMENTS, CONTINGENCIES, AND GUARANTEES - (Details) $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Minimum purchase commitments for project related supplies	$ 17.2

SHORT-TERM DEBT

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

SHORT-TERM DEBT

Debt consisted of the following at December 31 (in thousands):


	2023		2022
Credit facility	$	—	$	50,000
Short-term debt	$	—	$	50,000

The estimated fair value of the Company’s debt based on Level 2 inputs using the market approach, which is primarily based on rates at which the debt is traded among financial institutions, approximates the carrying value as of December 31, 2022.

On September 30, 2019 (the “Closing Date”), the Company obtained an unsecured credit facility in an aggregate principal amount up to $50.0 million (as amended from time to time, the “Credit Facility”) through its wholly owned subsidiaries, Medpace, Inc., as borrower (the “Borrower”), and Medpace IntermediateCo, Inc., as guarantor (the “Guarantor”).

On the Closing Date, the Borrower and lender entered into a Loan Agreement (as it may be amended from time to time, the “Loan Agreement”) providing for the Credit Facility, and the Guarantor executed a Guaranty Agreement providing for its guarantee of the payment and performance of the obligations under the Loan Agreement. On March 15, 2022, the Company entered into Amendment No. 4 to the Loan Agreement, which increased the aggregate principal amount that may be borrowed under the facility’s line of credit to up to $250.0 million. On March 31, 2023, the Company entered into Amendment No. 5 to the Loan Agreement, which changed the aggregate principal amount that may be borrowed under the facility's line of credit to up to $150.0 million, adjusted the interest rate and fee charged on the credit facility and extended the expiration date of resolving credit note to March 29, 2024. The Credit Facility bears interest at a rate of the sum of The Secured Overnight Financing Rate (SOFR) plus 125 basis points (1.25%) or the highest of the Prime Rate, the sum of the Overnight Bank Funding Rate plus 50 basis points (0.50%) and the sum of Daily Simple SOFR plus 100 basis points (1.00%).

The Loan Agreement contains other customary loan terms, representations and warranties, and affirmative and negative covenants, in each case, subject to customary limitations, exceptions and exclusions. The Loan Agreement contains certain events of default, including, among others, non-payment of principal or interest and breach of the covenants.

As of December 31, 2023, there were less than $0.1 million in letters of credit outstanding related to certain operating lease obligations, which are secured by the Credit Facility.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
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-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
-Section 50
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+ Details

BASIS OF PRESENTATION	12 Months Ended
BASIS OF PRESENTATION	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BASIS OF PRESENTATION	BASIS OF PRESENTATION Description of Business Medpace Holdings, Inc. together with its subsidiaries, (“Medpace” or the “Company”), a Delaware corporation, is a global provider of clinical research-based drug and medical device development services. The Company partners with pharmaceutical, biotechnology, and medical device companies in the development and execution of clinical trials. The Company’s drug development services focus on full service Phase I-IV clinical development services and include development plan design, coordinated central laboratory, project management, regulatory affairs, clinical monitoring, data management and analysis, pharmacovigilance new drug application submissions, and post-marketing clinical support. The Company also provides bio-analytical laboratory services, clinical human pharmacology, imaging services, and electrocardiography reading support for clinical trials. The Company’s operations are principally based in North America, Europe, and Asia. Share Repurchases In 2018, the Board of Directors approved a stock repurchase program which has been amended several times to increase the aggregate amount of the stock repurchase authorization. For the year ended December 31, 2022, the Company repurchased 5,463,244 shares for $800.5 million under this repurchase program. For the year ended December 31, 2021, the Company repurchased 377,783 shares for $62.1 million. As of June 30, 2022, the Company completed all authorized share repurchases under this repurchase program. In the fourth quarter of 2022, the Board approved a new stock repurchase program of up to $500.0 million. For the year ended December 31, 2023, the Company repurchased 781,068 shares for $144.0 million under the new repurchase program. For the year ended December 31, 2022, the Company repurchased 228,247 shares for $47.2 million under the new repurchase program. As of December 31, 2023, we have remaining authorization of $308.8 million under the new repurchase program. Repurchases under the share repurchase programs are executed in the open market or negotiated transactions under trading plans established pursuant to Rule 10b5-1. The Company constructively retires the repurchased shares associated with these approved share repurchase programs, except for a small portion which were retained as Treasury Shares on the consolidated statements of shareholders' equity. Retired share repurchase amounts paid in excess of par value are reflected within Accumulated deficit/Retained earnings in the Company’s consolidated balance sheets. The repurchase programs may be suspended or discontinued at any time without notice.

RELATED PARTY TRANSACTIONS	12 Months Ended
RELATED PARTY TRANSACTIONS	Dec. 31, 2023
Related Party Transactions [Abstract]
RELATED PARTY TRANSACTIONS	RELATED PARTY TRANSACTIONS Employee Loans The Company periodically extends short term loans or advances to employees, typically upon commencement of employment. Total receivables as a result of these employee advances of $0.3 million existed at December 31, 2023 and 2022, respectively, and are included in the Prepaid expenses and other current assets and Other assets line items of the consolidated balance sheets, respectively, depending on the contractual repayment date. Service Agreements LIB Therapeutics LLC and subsidiaries (“LIB”) Certain executives and employees of the Company, including the chief executive officer, are members of LIB’s board of managers and/or have equity investments in LIB. The Company entered into a MSA dated November 24, 2015 with LIB, a company that engages in research, development, marketing and commercialization of pharmaceutical drugs. Subsequently, the Company and LIB have entered into several task orders for the Company to perform clinical trial related services. The Company recognized total revenue from LIB of $43.7 million, $40.5 million and $11.8 million during the years ended December 31, 2023, 2022 and 2021, respectively, in the Company’s consolidated statement of operations. As of December 31, 2023 and 2022, the Company had, from LIB, Advanced billings of $7.6 million and $7.4 million in the consolidated balance sheets, respectively. In addition, the Company had Accounts receivable and unbilled, net from LIB of $0.5 million and $5.5 million in the consolidated balance sheets at December 31, 2023 and 2022, respectively. The Company had Other current liabilities with LIB of $12.5 million in the consolidated balance sheets at December 31, 2022. CinRX Pharma, subsidiaries and affiliates (“CinRx”) Certain executives and employees of the Company, including the chief executive officer, are members of CinRx’s board of managers and/or have equity investments in CinRx, a biotech company. The Company and CinRx have entered into several task orders for the Company to perform clinical trial related services. During the years ended December 31, 2023, 2022 and 2021, the Company recognized total revenue from CinRx of $15.8 million, $15.0 million and $22.7 million in the Company’s consolidated statements of operations, respectively. As of December 31, 2023 and 2022, the Company had Advanced billings from CinRx of $2.5 million and $1.4 million in the consolidated balance sheets, respectively. As of December 31, 2023 and 2022 the Company had Accounts receivable and unbilled, net from CinRx of $1.9 million and $2.2 million in the consolidated balance sheets, respectively. The Company had Prepaid expenses and other current assets with CinRX of $0.2 million in the consolidated balance sheets at December 31, 2023. Certain affiliates of CinRx included in previous reported quarters are no longer disclosed due to changes in the affiliate relationship. The Summit Hotel (“The Summit”) The Summit Hotel, located on the Medpace campus, is owned by the chief executive officer. Medpace incurs travel lodging and meeting expenses at The Summit. During the years ended December 31, 2023, 2022 and 2021, Medpace incurred expenses of $0.4 million, $0.3 million and $0.3 million at The Summit, respectively. Leased Real Estate Campus Headquarters Leases The Company entered into an operating lease for the occupancy of office space in a building in Cincinnati, Ohio with an entity that is wholly owned by the chief executive officer of the Company. The Company has evaluated its relationship with the related party and concluded that the related party is not a variable interest entity because the Company has no direct ownership interest or relationship other than the leases. The lease was renewed in the first quarter of fiscal year 2023 for a term of ten years through December 2032 with a renewal option for one 10-year term at prevailing market rates. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the properties. Annual base rent for the corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. The Company has determined that the lease is an operating lease. Operating lease cost recognized for the years ended December 31, 2023, 2022 and 2021 was $2.6 million, $2.3 million and 2.1 million, respectively, and was allocated between Total direct costs, and Selling, general and administrative in the consolidated statements of operations. The Operating lease right-of-use assets at December 31, 2023 and 2022 were $19.3 million and $18.2 million in the consolidated balance sheets, respectively. The current and long-term portions of the lease liabilities at December 31, 2023 were $1.5 million and $18.1 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2022 were $1.5 million and $16.7 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the consolidated balance sheets. In 2018, Medpace, Inc. entered into a multi-year lease agreement governing future occupancy of additional office space in Cincinnati, Ohio with an entity that is wholly owned by the Company’s chief executive officer and certain members of his immediate family. The Company began to occupy the premises in the second quarter of fiscal year 2020. The lease expires in 2040 and the Company has two 10-year options to extend the term of the lease. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for the corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. The Company has determined that the lease is an operating lease. Operating lease cost recognized for the years ended December 31, 2023, 2022 and 2021 was $5.7 million, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the consolidated statements of operations. The Operating lease right-of-use assets at December 31, 2023 and 2022 were $51.9 million and $53.5 million in the consolidated balance sheets, respectively. The current and long-term portions of the lease liabilities at December 31, 2023 were $1.3 million and $63.5 million, respectively. The current and long-term portions of the lease liabilities at December 31, 2022 were $1.1 million and $64.8 million, respectively and were recognized in Other current liabilities and Operating lease liabilities in the consolidated balance sheets. The Company entered into two multi-year lease agreements governing the occupancy of space of two buildings in Cincinnati, Ohio with an entity that is wholly owned by the Company’s chief executive officer and certain members of his immediate family. The Company assumed occupancy in 2012 and the leases expire in 2027 with the Company having one 10-year option to extend the lease term. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for the corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. The Company has determined that the leases are operating leases. Operating lease cost recognized for the years ended December 31, 2023, 2022 and 2021 was $3.6 million, respectively. The lease cost was allocated between Total direct costs and Selling, general and administrative in the consolidated statements of operations. The Operating lease right-of-use assets at December 31, 2023 and 2022 were $11.9 million and $14.6 million, respectively, in the consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2023 were $3.0 million and $8.9 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2022 were $2.8 million and $11.9 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the consolidated balance sheets. Travel Services The Company incurs expenses for travel services for company executives provided by private aviation charter companies which is a company controlled by the chief executive officer of the Company (each a “private aviation charter”). The Company may contract directly with the private aviation charter for the use of its aircraft or indirectly through a third party aircraft management and jet charter company (the “Aircraft Management Company”). The travel services provided are primarily for business purposes, with certain personal travel paid for as part of the executives’ compensation arrangements. The Aircraft Management Company also makes the private aviation charter aircraft available to third parties. The Company incurred travel expenses of $2.0 million, $2.3 million and $1.3 million during the years ended December 31, 2023, 2022 and 2021, respectively. These travel expenses are recorded in Selling, general and administrative in the Company’s consolidated statements of operations. As of December 31, 2023 and 2022, the Company had Accounts payable to the Aircraft Management Company of $0.4 million and $0.3 million, respectively, in the consolidated balance sheets.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
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-URI https://asc.fasb.org//1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

LEASES - Summary of Components of Lease Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Operating lease cost	$ 27,919	$ 25,874	$ 23,873
Variable lease cost	$ 9,455	$ 8,569	$ 6,627

BASIS OF PRESENTATION - (Details) - USD ($) $ in Thousands	12 Months Ended
BASIS OF PRESENTATION - (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Basis Of Presentation [Line Items]
Repurchase of shares, value	$ 144,020	$ 847,849	$ 62,096
2018 Share Repurchase Program
Basis Of Presentation [Line Items]
Stock repurchased, including number of shares for re-issuance (in shares)		5,463,244
Repurchase of shares (in shares)			377,783,000
Repurchase of shares, value		$ 800,500	$ 62,100
2022 Share Repurchase Program
Basis Of Presentation [Line Items]
Repurchase of shares (in shares)	781,068	228,247
Repurchase of shares, value	$ 144,000	$ 47,200
2022 Share Repurchase Program \| Maximum
Basis Of Presentation [Line Items]
Stock repurchase program, authorized amount		$ 500,000
Remaining amount of repurchase program	$ 308,800

SHAREHOLDERS’ EQUITY - Schedule of Stock Options Expected To Vest, Stock Options Exercisable, and Unvested Restricted Share Awards Expected To Vest (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Options expected to vest, weighted average exercise price (in dollars per share)	$ 100.75
Options exercisable, end of period (in dollars per share)	$ 74.79	$ 60.52	$ 56.43
Stock options expected to vest (in shares)	1,343,287
Shares/units expected to vest (in shares)	390,998
Number of stock options expected to vest, weighted average remaining life	2 years 8 months 12 days
Total stock options exercisable, weighted average remaining life	2 years 1 month 6 days
Stock options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options expected to vest (in shares)	1,343,287
Total stock options exercisable (in shares)	901,865
Unrecognized compensation cost	$ 7,727
Weighted average years over which unrecognized compensation cost will be recognized	1 year 9 months 18 days
RSAs
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Weighted average years over which unrecognized compensation cost will be recognized	2 years 6 months
Shares/units expected to vest (in shares)	390,998
Unrecognized compensation cost	$ 27,058

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenue, net (includes $59.6 million, $55.4 million and $34.5 million with related parties for the years ended December 31, 2023, 2022 and 2021, respectively)	$ 1,885,842	$ 1,459,996	$ 1,142,377
Operating expenses:
Direct operating costs	1,361,337	1,027,558	814,222
Selling, general and administrative	161,352	131,400	108,421
Depreciation	24,129	18,989	16,005
Amortization	2,199	3,352	5,114
Total operating expenses	1,549,017	1,181,299	943,762
Income from operations	336,825	278,697	198,615
Other (expense) income, net:
Miscellaneous (expense) income, net	(655)	7,068	3,342
Interest expense, net	(488)	(2,905)	(105)
Total other (expense) income, net	(1,143)	4,163	3,237
Income before income taxes	335,682	282,860	201,852
Income tax provision	52,872	37,492	20,004
Net income	$ 282,810	$ 245,368	$ 181,848
Net income per share attributable to common shareholders:
Earnings per share, basic (in dollars per share)	$ 9.20	$ 7.57	$ 5.06
Earnings per share, diluted (in dollars per share)	$ 8.88	$ 7.28	$ 4.81
Weighted average common shares outstanding:
Weighted average number of shares outstanding, basic (in shares)	30,722	32,388	35,862
Weighted-average shares outstanding, diluted (in shares)	31,841	33,671	37,697
Direct Costs
Operating expenses:
Direct operating costs	$ 638,249	$ 534,887	$ 441,090
Reimbursed out-of-pocket expenses
Operating expenses:
Direct operating costs	$ 723,088	$ 492,671	$ 373,132

ACCRUED EXPENSES (Tables)

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Schedule of Accrued Expenses

Accrued expenses consisted of the following at December 31 (in thousands):


	2023		2022
Employee compensation and benefits	$	75,822	$	71,197
Project related reimbursable expenses	205,864		128,416
Other	11,275		10,512
Total accrued expenses	$	292,961	$	210,125

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Narrative (Details) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) customer shares	Dec. 31, 2022 USD ($) customer shares	Dec. 31, 2021 USD ($) shares
Summary Of Significant Accounting Policies [Line Items]
Net gain (loss) on foreign currency transaction	$ (1,929)	$ 3,859	$ 2,779
Sales rebates	12,100	7,900	$ 7,200
Performance obligations remaining to be performed	$ 2,900,000	$ 2,700,000
Number of customers accounted for more than 10% of accounts receivable \| customer	0	0
Government assistance, amount	$ 15,500	$ 15,400
Government Assistance, Statement of Income or Comprehensive Income [Extensible Enumeration]	Direct operating costs, Selling, general and administrative
Prepaid Expenses and Other Current Assets
Summary Of Significant Accounting Policies [Line Items]
Government assistance, amount	$ 9,500	11,300
Other Assets
Summary Of Significant Accounting Policies [Line Items]
Government assistance, amount	$ 12,200	$ 7,100
Maximum
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life of finite-lived intangible assets	15 years
Maximum \| 2016 Incentive Award Plan
Summary Of Significant Accounting Policies [Line Items]
Share-based compensation option terms	10 years
Maximum \| Computer Hardware Software Phone and Medical Imaging Equipment
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life of property and equipment	5 years
Maximum \| Furniture and Fixtures and Other Equipment
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life of property and equipment	7 years
Maximum \| Buildings
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life of property and equipment	40 years
Maximum \| Computer Software Developed Costs
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life of property and equipment	3 years
Minimum \| Computer Hardware Software Phone and Medical Imaging Equipment
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life of property and equipment	3 years
Minimum \| Furniture and Fixtures and Other Equipment
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life of property and equipment	5 years
Minimum \| Buildings
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life of property and equipment	30 years
Stock options
Summary Of Significant Accounting Policies [Line Items]
Anti-dilutive securities excluded from computation of diluted EPS (in shares) \| shares	0	9	9
Selling, general, and administrative
Summary Of Significant Accounting Policies [Line Items]
Advertisement expenses	$ 1,500	$ 1,300	$ 1,200

ENTITY WIDE DISCLOSURES - Summary of Property and Equipment, Net by Geographic Region (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Property and equipment, net:
Property and equipment, net	$ 120,589	$ 109,849
United States
Property and equipment, net:
Property and equipment, net	77,850	81,217
Europe, Belgium
Property and equipment, net:
Property and equipment, net	18,190	11,778
Europe, Other
Property and equipment, net:
Property and equipment, net	8,772	9,294
Total Europe
Property and equipment, net:
Property and equipment, net	26,962	21,072
Asia-Pacific
Property and equipment, net:
Property and equipment, net	14,472	6,223
Other
Property and equipment, net:
Property and equipment, net	$ 1,305	$ 1,337

GOODWILL AND INTANGIBLE ASSETS - Narrative (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Goodwill And Intangible Assets [Line Items]
Fair value assets measured on non-recurring basis	$ 1,656,828	$ 1,352,495
Goodwill	662,396	$ 662,396
Indefinite-lived intangible assets	31,600
Accumulated goodwill impairment losses to date	9,300
Fair Value Measurement Non-Recurring \| Level 3
Goodwill And Intangible Assets [Line Items]
Fair value assets measured on non-recurring basis	$ 694,000

- Definition

Sum of the carrying amounts as of the balance sheet date of all assets that are recognized. Assets are probable future economic benefits obtained or controlled by an entity as a result of past transactions or events.

+ References

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+ Details

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

INCOME TAXES - Schedule of Gross Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Beginning Balance	$ 15,947	$ 13,784	$ 10,691
Increases in tax positions for prior years	0	171	1,253
Decreases in tax positions for prior years	(97)	(490)	(223)
Increases in tax positions for current year	5,382	4,871	3,098
Lapse in statute of limitations	(852)	(2,389)	(1,035)
Ending Balance	$ 20,380	$ 15,947	$ 13,784

CONSOLIDATED STATEMENTS OF SHAREHOLDERS’ EQUITY - USD ($) $ in Thousands	Total	Common Stock	Treasury Stock	Additional Paid-In Capital	(Accumulated Deficit) Retained Earnings	Accumulated Other Comprehensive Loss
Balance, beginning of period at Dec. 31, 2020	$ 805,779	$ 355	$ (5,578)	$ 695,904	$ 115,229	$ (131)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	181,848				181,848
Foreign currency translation	(4,715)					(4,715)
Stock-based compensation expense	14,469			14,469
Stock options exercised	17,643	8	151	17,484
Repurchases of common stock	(62,096)	(3)			(62,093)
Balance, end of period at Dec. 31, 2021	952,928	360	(5,427)	727,857	234,984	(4,846)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	245,368				245,368
Foreign currency translation	(7,546)					(7,546)
Stock-based compensation expense	21,412			21,412
Stock options exercised	22,074	6	1,746	21,525	(1,203)
Repurchases of common stock	(847,849)	(57)	(14,243)		(833,549)
Retirement of treasury stock	0		5,427		(5,427)
Balance, end of period at Dec. 31, 2022	386,387	309	(12,497)	770,794	(359,827)	(12,392)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	282,810				282,810
Foreign currency translation	2,320					2,320
Stock-based compensation expense	20,516			20,516
Stock options exercised	11,378	7		11,371
Repurchases of common stock	(144,461)	(8)			(144,453)
Re-issuance of treasury stock	0		175		(175)
Balance, end of period at Dec. 31, 2023	$ 558,950	$ 308	$ (12,322)	$ 802,681	$ (221,645)	$ (10,072)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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- Definition

Amount of equity (deficit) attributable to parent. Excludes temporary equity and equity attributable to noncontrolling interest.

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+ Details

LEASES - Narrative (Details) $ in Millions	12 Months Ended
LEASES - Narrative (Details) $ in Millions	Dec. 31, 2023 USD ($)
Lessee Lease Description [Line Items]
Lease not yet commenced, future payments	$ 2.7
Real Estate \| Minimum
Lessee Lease Description [Line Items]
Remaining lease term, operating lease	1 year
Real Estate \| Maximum
Lessee Lease Description [Line Items]
Remaining lease term, operating lease	17 years
Real Estate and Equipment \| Maximum
Lessee Lease Description [Line Items]
Lease renewal term, operating lease	20 years
Operating lease, options to terminate lease term	1 year

SHAREHOLDERS’ EQUITY

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

SHAREHOLDERS’ EQUITY

Stock-Based Compensation

2016 Incentive Award Plan

On August 11, 2016 in connection with the Company's IPO, the Board approved the 2016 Incentive Award Plan (the “2016 Plan”). The 2016 Plan provides for long-term equity incentive compensation for key employees, officers and non-employee directors. A variety of discretionary awards (collectively, the “Awards”) for employees and non-employee directors are authorized under the 2016 Plan, including vested shares, stock options, stock appreciation rights (SARs), restricted stock awards (RSAs), restricted stock units (RSUs), or other cash based or stock dividend equivalent awards, which are all equity-classified instruments under the 2016 Plan. The number of shares registered and available for grant under the 2016 Plan is 6,000,000. The vesting of such awards may be conditioned upon either a specified period of time or the attainment of specific performance goals as determined by the administrator of the 2016 Plan. The option price and term are also subject to determination by the administrator with respect to each grant. Option prices are generally expected to be set at the market price of the Company’s common stock at the date of grant and option terms are not expected to exceed ten years.

The Company granted 47,238 awards to employees under the 2016 Incentive Award Plan during the year ended December 31, 2023, consisting of 45,988 RSU and 1,250 stock option awards having four year vesting schedules. The Company granted an additional 848 RSU that vest in four approximately equal installments on March 31, 2024, June 30, 2024, September 30, 2024 and December 31, 2024, and 11,187 stock option awards to non-employee directors under the 2016 Incentive Award Plan, during the year ended December 31, 2023. These stock option awards will vest on the earlier of (a) the day immediately preceding the date of the first annual meeting following the date of grant and (b) the first anniversary of the date of grant, subject to the non-employee director continuing in service through the applicable vesting date.

The Company granted 405,550 awards to employees under the 2016 Incentive Award Plan during the year ended December 31, 2022, consisting of 164,478 RSU and 113,838 stock option awards having four year vesting schedules and 127,234 stock option awards having two year vesting schedules. The Company granted an additional 1,117 RSU that vest in four approximately equal installments on March 31, 2023, June 30, 2023, September 30, 2023 and December 31, 2023, and 11,418 stock option awards to non-employee directors under the 2016 Incentive Award Plan, during the year ended December 31, 2022. These stock option awards will vest on the earlier of (a) the day immediately preceding the date of the first annual meeting following the date of grant and (b) the first anniversary of the date of grant, subject to the non-employee director continuing in service through the applicable vesting date.

The Company granted 374,235 awards to employees under the 2016 Incentive Award Plan during the year ended December 31, 2021, consisting of 74,725 RSU and 205,086 stock option awards vesting after 4 years and six months, 27,854 RSU and 9,000 stock option awards vesting after four years, and 57,570 stock option awards vesting after two years. The Company granted an additional 10,932 stock option awards to non-employee directors under the 2016 Incentive Award Plan, during the year ended December 31, 2021. These awards will vest on the earlier of (a) the day immediately preceding the date of the first annual meeting following the date of grant and (b) the first anniversary of the date of grant, subject to the non-employee director continuing in service through the applicable vesting date.

The 2016 Plan expires in 2026, except for awards then outstanding, and is administered by the Board. All Awards granted at the IPO or thereafter were or will be issued under the 2016 Plan.

The Company satisfies stock option exercises and vested stock awards with treasury shares or newly issued shares. Shares available for future stock compensation grants under the 2016 Plan totaled 2.3 million at December 31, 2023 and 2022, respectively.

Equity Awards

Valuation Assumptions

The Company determines the fair value of stock options using the Black-Scholes-Merton option pricing model (the “BSM Model”). The BSM Model is primarily affected by the fair value of the Company’s common stock (see restricted share valuation discussion below), the expected holding period for the option, expected stock price volatility over the term of the awards, the risk-free interest rate, and expected dividends.

The following table sets forth the key weighted-average assumptions used in the BSM Model to calculate the fair value of options:


	Year Ended December 31,
	2023	2022	2021
Expected holding period - years	4.1	4.7	5.0
Expected volatility	45.4%	36.5%	34.3%
Risk-free interest rate	3.8%	1.9%	0.9%
Expected dividend yield	0.0%	0.0%	0.0%

The assumptions used in the table above reflect grant date inputs to arrive at the grant date fair values for stock options subject to equity-classified stock compensation accounting.

The expected holding period represents the period of time the grants are expected to be outstanding. The Company uses the simplified method, as prescribed by accounting guidance governing such awards, to calculate the expected holding period for options granted to employees as we do not have sufficient historical evidence data to provide a reasonable basis upon which to estimate the expected holding period. For options valued by the Company for the years ended December 31, 2023, 2022 and 2021, respectively, the expected holding period is based on an average between the midpoint of the vesting date and the expiration date of the options.

Due to the lack of Company specific historical and implied volatility data, our estimate of expected volatility is based upon a blended approach that utilizes the historical volatility of the Company's common stock for periods in which the Company has sufficient information and the historical volatility of a group of peer companies that are most representative of our company.

The risk-free interest rate is based on the yield on U.S. Treasury obligations with remaining durations equal to the expected holding period of the options. The expected dividend yield is assumed to be zero based on recent and anticipated dividend activity.

The fair value of restricted shares is based upon the market price of the Company’s common stock on the date of grant as listed on the NASDAQ.

The following table summarizes the grant date fair values of stock options and restricted shares issued during the period as well as the allocation of stock-based compensation expense to Total direct costs, and Selling, general and administrative reported in the consolidated statements of operations:


	Year Ended December 31,
	2023		2022		2021
Weighted average, grant date fair value
Stock options	$	85.30	$	47.57	$	52.70
Restricted shares (RSAs and RSUs)	$	225.69	$	149.87	$	174.94

Stock-based compensation expense allocated to:
Total direct costs	$	11,099	$	11,801	$	9,345
Selling, general, and administrative	9,417		9,611		5,124
Total stock-based compensation expense	$	20,516	$	21,412	$	14,469

Award Activity

The following table sets forth the Company’s stock option activity:


	Year Ended December 31,
	2023			2022			2021
	Options	Weighted Average Exercise Price		Options	Weighted Average Exercise Price		Options	Weighted Average Exercise Price
Outstanding - beginning of Period	1,629,148	$	89.71	1,992,915	$	68.39	2,500,727	$	43.26
Granted	12,437	$	211.25	252,490	$	138.91	282,588	$	168.34
Exercised	(287,048)	$	39.64	(579,407)	$	38.10	(745,572)	$	23.67
Cancelled/Forfeited/Expired	(11,250)	$	183.04	(36,850)	$	85.40	(44,828)	$	40.50
Outstanding - end of period	1,343,287	$	100.75	1,629,148	$	89.71	1,992,915	$	68.39

Exercisable - end of period	901,865	$	74.79	1,116,255	$	60.52	1,290,627	$	56.43

The following table sets forth the Company’s Restricted Share activity:


	Year Ended December 31,
	2023	2022	2021
	Shares/Units	Shares/Units	Shares/Units
Outstanding and unvested - beginning of period	523,377	602,187	695,562
Granted	46,836	165,595	102,579
Vested	(154,618)	(197,000)	(119,000)
Forfeited	(24,597)	(47,405)	(76,954)
Outstanding and unvested - end of period	390,998	523,377	602,187

The following table summarizes information about stock options expected to vest, stock options exercisable, and unvested restricted share awards expected to vest at December 31, 2023:


	Weighted Average Exercise Price		Stock Options		Restricted Shares/Units		Weighted Average Remaining Life (Years)
Number of stock options expected to vest	$	100.75	1,343,287		—		2.7
Number of restricted shares/units expected to vest					390,998
Total expected to vest			1,343,287		390,998
Total stock options exercisable	$	74.79	901,865		—		2.1
Unrecognized compensation cost (in thousands)			$	7,727	$	27,058
Weighted average years over which unrecognized compensation cost will be recognized			1.8		2.5

The following table sets forth the aggregate intrinsic value of stock options exercised, the fair values of awards vested, and share based liabilities settled during the respective periods (in thousands):


	Year Ended December 31,
	2023		2022		2021
Total intrinsic value of stock options exercised	$	56,548	$	77,527	$	104,695
Total grant-date fair value of stock options vested	$	3,591	$	5,228	$	5,185
Total grant-date fair value of restricted shares vested	$	9,306	$	9,248	$	3,796
Total settlement date fair value of restricted shares vested	$	31,842	$	32,802	$	22,321

The actual tax benefits recognized related to stock-based compensation totaled $18.9 million, $23.2 million and $20.9 million for the years ended December 31, 2023, 2022 and 2021, respectively.

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Accounts receivable and unbilled, net	$ 298,400	$ 253,404
Prepaid expenses and other current assets	49,979	52,293
Accounts payable	31,869	33,069
Advanced billings	559,860	462,729
Other current liabilities	$ 40,441	$ 47,547
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock authorized (in shares)	5,000,000	5,000,000
Preferred stock issued (in shares)	0	0
Preferred stock outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock authorized (in shares)	250,000,000	250,000,000
Common stock issued (in shares)	30,752,292	31,091,694
Common stock outstanding (in shares)	30,752,292	31,091,694
Treasury stock (in shares)	70,573	71,573
Related Party
Accounts receivable and unbilled, net	$ 2,400	$ 7,700
Prepaid expenses and other current assets	300
Accounts payable	3,100	300
Advanced billings	$ 10,100	8,800
Other current liabilities		$ 12,500

SHAREHOLDERS’ EQUITY (Tables)

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Schedule of Weighted-Average Assumptions Used in BSM Model to Calculate Fair Value of Options

The following table sets forth the key weighted-average assumptions used in the BSM Model to calculate the fair value of options:


	Year Ended December 31,
	2023	2022	2021
Expected holding period - years	4.1	4.7	5.0
Expected volatility	45.4%	36.5%	34.3%
Risk-free interest rate	3.8%	1.9%	0.9%
Expected dividend yield	0.0%	0.0%	0.0%

Schedule of Grant Date Fair Value and Stock-based Compensation Expense Allocated


	Year Ended December 31,
	2023		2022		2021
Weighted average, grant date fair value
Stock options	$	85.30	$	47.57	$	52.70
Restricted shares (RSAs and RSUs)	$	225.69	$	149.87	$	174.94

Stock-based compensation expense allocated to:
Total direct costs	$	11,099	$	11,801	$	9,345
Selling, general, and administrative	9,417		9,611		5,124
Total stock-based compensation expense	$	20,516	$	21,412	$	14,469

Schedule of Stock Option Activity

The following table sets forth the Company’s stock option activity:


	Year Ended December 31,
	2023			2022			2021
	Options	Weighted Average Exercise Price		Options	Weighted Average Exercise Price		Options	Weighted Average Exercise Price
Outstanding - beginning of Period	1,629,148	$	89.71	1,992,915	$	68.39	2,500,727	$	43.26
Granted	12,437	$	211.25	252,490	$	138.91	282,588	$	168.34
Exercised	(287,048)	$	39.64	(579,407)	$	38.10	(745,572)	$	23.67
Cancelled/Forfeited/Expired	(11,250)	$	183.04	(36,850)	$	85.40	(44,828)	$	40.50
Outstanding - end of period	1,343,287	$	100.75	1,629,148	$	89.71	1,992,915	$	68.39

Exercisable - end of period	901,865	$	74.79	1,116,255	$	60.52	1,290,627	$	56.43

Schedule of Restricted Share Activity

The following table sets forth the Company’s Restricted Share activity:


	Year Ended December 31,
	2023	2022	2021
	Shares/Units	Shares/Units	Shares/Units
Outstanding and unvested - beginning of period	523,377	602,187	695,562
Granted	46,836	165,595	102,579
Vested	(154,618)	(197,000)	(119,000)
Forfeited	(24,597)	(47,405)	(76,954)
Outstanding and unvested - end of period	390,998	523,377	602,187

Schedule of Stock Options Expected To Vest, Stock Options Exercisable, and Unvested Restricted Share Awards Expected To Vest

The following table summarizes information about stock options expected to vest, stock options exercisable, and unvested restricted share awards expected to vest at December 31, 2023:


	Weighted Average Exercise Price		Stock Options		Restricted Shares/Units		Weighted Average Remaining Life (Years)
Number of stock options expected to vest	$	100.75	1,343,287		—		2.7
Number of restricted shares/units expected to vest					390,998
Total expected to vest			1,343,287		390,998
Total stock options exercisable	$	74.79	901,865		—		2.1
Unrecognized compensation cost (in thousands)			$	7,727	$	27,058
Weighted average years over which unrecognized compensation cost will be recognized			1.8		2.5

Schedule of Aggregate Intrinsic Value of Stock Options Exercised, Fair Values of Awards Vested, and Share Based Liabilities Settled


	Year Ended December 31,
	2023		2022		2021
Total intrinsic value of stock options exercised	$	56,548	$	77,527	$	104,695
Total grant-date fair value of stock options vested	$	3,591	$	5,228	$	5,185
Total grant-date fair value of restricted shares vested	$	9,306	$	9,248	$	3,796
Total settlement date fair value of restricted shares vested	$	31,842	$	32,802	$	22,321

GOODWILL AND INTANGIBLE ASSETS

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

GOODWILL AND INTANGIBLE ASSETS

Goodwill

Total assets reflected on the balance sheet and not remeasured to fair value on a recurring basis, identified as Level 3 measurements, as of December 31, 2023 are $694.0 million, comprised of $662.4 million of goodwill and $31.6 million of identified indefinite-lived intangible assets. Accumulated goodwill impairment losses to date amounts to $9.3 million, all of which was recognized in the year ended December 31, 2015.

Intangible Assets, Net

Intangible assets, net consisted of the following at December 31 (in thousands):


	2023		2022
Intangible assets:
Finite-lived intangible assets:
Carrying amount:
Customer relationships	145,051		145,051
Accumulated amortization:
Customer relationships	(140,888)		(138,689)
Total finite-lived intangible assets, net	4,163		6,362
Trade name (indefinite-lived)	31,646		31,646
Total intangible assets, net	$	35,809	$	38,008

As of December 31, 2023, estimated amortization expense of the Company’s intangible assets for each of the next five years is as follows (in thousands):


	Amortization
2024	$	1,443
2025	946
2026	620
2027	577
2028	577
	$	4,163

LEASES

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Lessee, Operating Leases

LEASES

The Company enters into leases for real estate and equipment. Real estate leases are for our corporate office space and laboratories around the world. Real estate leases have remaining lease terms of less than 1 year to 17 years.

Many of the Company’s leases include options to extend the leases on a month to month basis or for set periods for up to 20 years. Many leases also include options to terminate the leases within 1 year or per other contractual terms.

The components of lease expense were as follows (in thousands):


	Year Ended December 31,
	2023		2022		2021
Operating lease cost	$	27,919	$	25,874	$	23,873
Variable lease cost	$	9,455	$	8,569	$	6,627

Supplemental cash flow information related to the leases was as follows (in thousands):


	Year Ended December 31,
	2023		2022		2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	19,829	$	17,002	$	16,266

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	23,960		30,882		33,133

Supplemental balance sheet information related to the leases was as follows at December 31 (in thousands):


	2023			2022
Operating lease right-of-use assets - related parties	$	83,065		$	86,356
Operating lease right-of-use assets - non-related parties	61,736			52,712
Operating lease right-of-use assets	$	144,801		$	139,068

Other current liabilities - related parties	5,730			5,409
Other current liabilities - non-related parties	16,635			13,863
Other current liabilities	$	22,365		$	19,272

Operating lease liabilities - related parties	90,568			93,393
Operating lease liabilities - non-related parties	51,554			45,474
Operating lease liabilities	142,122			138,867
Total operating lease liabilities	$	164,487		$	158,139

Weighted Average Remaining Lease Term (years)
Operating leases	10.0			11.1
Weighted Average Discount Rate
Operating leases	5.6		%	5.2		%

Lease payments due related to lease liabilities as of December 31, 2023 were as follows (in thousands):


	Related Party Operating Leases		Non-Related Parties Operating Leases		Total Operating Leases
2024	$	11,412	$	18,671	$	30,083
2025	11,607		17,008		28,615
2026	11,807		14,199		26,006
2027	10,839		10,974		21,813
2028	8,609		6,124		14,733
Later years	91,669		9,548		101,217
Total lease payments	145,943		76,524		222,467
Less: imputed interest	(49,645)		(8,335)		(57,980)
Total	$	96,298	$	68,189	$	164,487

As of December 31, 2023, we have several additional leases with contractual obligations, which have not yet commenced, with future payments of $2.7 million.

PROPERTY AND EQUIPMENT, NET (Tables)

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Summary of Property and Equipment, Net

Property and equipment, net consisted of the following at December 31, (in thousands):


	2023		2022
Land	$	4,833	$	2,410
Equipment	39,927		31,851
Furniture, fixtures, and leasehold improvements	99,581		87,543
Computer hardware, software, and phone equipment	32,051		26,049
Buildings	16,419		13,594
Construction-in-progress	7,182		10,518
Property and equipment at cost	199,993		171,965
Less: Accumulated depreciation	(79,404)		(62,116)
Property and equipment, net	$	120,589	$	109,849

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net income	$ 282,810	$ 245,368	$ 181,848

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

SHORT-TERM DEBT - Schedule of Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Short-Term Debt [Line Items]
Short-term debt	$ 0	$ 50,000
Credit facility
Short-Term Debt [Line Items]
Short-term debt	$ 0	$ 50,000

CONTRACT ASSETS AND CONTRACT LIABILITIES - Narrative (Details) $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($)
Revenue from Contract with Customer [Abstract]
Revenue recognized	$ 396.3

MISCELLANEOUS (EXPENSE) INCOME, NET (Tables)

12 Months Ended

Dec. 31, 2023

Other Income and Expenses [Abstract]

Components of Miscellaneous Income (Expense), Net

Miscellaneous (expense) income, net consisted of the following (in thousands):


	Year Ended December 31,
	2023		2022		2021
Net (loss) gain on foreign-currency transactions	$	(1,929)	$	3,859	$	2,779
Other income	1,274		3,209		563
Miscellaneous (expense) income, net	$	(655)	$	7,068	$	3,342

ACCRUED EXPENSES - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Employee compensation and benefits	$ 75,822	$ 71,197
Project related reimbursable expenses	205,864	128,416
Other	11,275	10,512
Total accrued expenses	$ 292,961	$ 210,125

Insider Trading Arrangements

3 Months Ended

12 Months Ended

Dec. 31, 2023

Trading Arrangements, by Individual

Material Terms of Trading Arrangement

During the three months ended December 31, 2023, no director or officer of the Company adopted or terminated a “Rule 10b5-1 trading arrangement” or “non-Rule 10b5-1 trading arrangement,” as each term is defined in Item 408(a) of Regulation S-K, except as described in the table below:

Action

Date

Trading Arrangement

Total Shares to be Purchased or Sold

Duration/Expiration Date

Rule 10b5-1*

Non-Rule 10b5-1**

Medpace Investors, LLC [1]

Adopt

November 14, 2023 [2]

Up to 25,000 shares to be sold

Good until cancelled

Medpace Investors, LLC [1]

Adopt

November 15, 2023 [3]