10-Q

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

(Mark One)

☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended March 31, 2022

or

☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from to .

Commission file number: 001-37856

Medpace Holdings, Inc.

(Exact name of registrant as specified in its charter)

Delaware	32-0434904
(State or other jurisdiction of incorporation or organization)	(I.R.S. Employer Identification No.)

5375 Medpace Way, Cincinnati, OH 45227

(Address of principal executive offices) (Zip Code)

(513) 579-9911

(Registrant’s telephone number, including area code)

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

Title of each class	Trading Symbol(s)	Name of each exchange on which registered
Common Stock $0.01 par value	MEDP	NASDAQ Global Select Market

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒ No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer”, “accelerated filer”, “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer	☒	Accelerated filer	☐
Non-accelerated filer	☐	Smaller reporting company	☐
Emerging growth company	☐

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

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒

Indicate the number of shares outstanding of each of the issuer’s classes of Common Stock, as of the latest practicable date.

Class	Number of Shares Outstanding
Common Stock $0.01 par value	33,647,133 shares outstanding as of April  22, 2022

MEDPACE HOLDINGS, INC. AND SUBSIDIARIES

FORM 10-Q

FOR QUARTERLY PERIOD ENDED MARCH 31, 2022

TABLE OF CONTENTS

Item Number		Page
	PART I — FINANCIAL INFORMATION	3
Item 1.	Financial Statements (unaudited)	3
	Condensed Consolidated Balance Sheets as of March 31, 2022 and December 31, 2021	3
	Condensed Consolidated Statements of Operations for the three months ended March 31, 2022 and 2021	4
	Condensed Consolidated Statements of Comprehensive Income for the three months ended March 31, 2022 and 2021	5
	Condensed Consolidated Statements of Shareholders’ Equity for the three months ended March 31, 2022 and 2021	6
	Condensed Consolidated Statements of Cash Flows for the three months ended March 31, 2022 and 2021	7
	Notes to Condensed Consolidated Financial Statements	8
Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	17
Item 3.	Quantitative and Qualitative Disclosures About Market Risk	23
Item 4.	Controls and Procedures	23
	PART II — OTHER INFORMATION	23
Item 1.	Legal Proceedings	23
Item 1A.	Risk Factors	23
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	25
Item 3.	Defaults Upon Senior Securities	26
Item 4.	Mine Safety Disclosures	26
Item 5.	Other Information	26
Item 6.	Exhibits	26
	EXHIBIT INDEX	27
	SIGNATURES	28

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PART I — FINANCIAL INFORMATION

Item 1. Financial Statements

MEDPACE HOLDINGS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED)

(Amounts in thousands, except share amounts)	As Of
	March 31,			December 31,
	2022			2021
ASSETS
Current assets:
Cash and cash equivalents	$	82,843		$	461,304
Accounts receivable and unbilled, net (includes $6.0 million and $2.7 million with related parties at March 31, 2022 and December 31, 2021, respectively)		224,759			186,432
Prepaid expenses and other current assets		48,367			43,176
Total current assets		355,969			690,912
Property and equipment, net		98,529			93,153
Operating lease right-of-use assets		141,638			129,558
Goodwill		662,396			662,396
Intangible assets, net		40,522			41,360
Deferred income taxes		25,809			25,134
Other assets		19,483			17,422
Total assets	$	1,344,346		$	1,659,935
LIABILITIES AND SHAREHOLDERS’ EQUITY
Current liabilities:
Accounts payable (includes $0.7 million and $0.3 million with related parties at March 31, 2022 and December 31, 2021, respectively)	$	25,434		$	25,678
Accrued expenses		155,018			159,286
Advanced billings (includes $11.4 million and $8.3 million with related parties at March 31, 2022 and December 31, 2021, respectively)		367,221			344,641
Other current liabilities		31,755			27,612
Total current liabilities		579,428			557,217
Operating lease liabilities		141,624			130,965
Deferred income tax liability		1,055			1,080
Other long-term liabilities		17,223			17,745
Total liabilities		739,330			707,007
Commitments and contingencies (see Note 11)
Shareholders’ equity:
Preferred stock - $0.01 par-value; 5,000,000 shares authorized; no shares issued and outstanding at March 31, 2022 and December 31, 2021, respectively		-			-
Common stock - $0.01 par-value; 250,000,000 shares authorized at March 31, 2022 and December 31, 2021, respectively; 33,651,360 and 36,006,778 shares issued and outstanding at March 31, 2022 and December 31, 2021, respectively		336			360
Treasury stock - 81,573 and 180,000 shares at March 31, 2022 and December 31, 2021, respectively		(14,243	)		(5,427	)
Additional paid-in capital		746,123			727,857
(Accumulated deficit) Retained earnings		(120,812	)		234,984
Accumulated other comprehensive loss		(6,388	)		(4,846	)
Total shareholders’ equity		605,016			952,928
Total liabilities and shareholders’ equity	$	1,344,346		$	1,659,935

See notes to condensed consolidated financial statements.

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MEDPACE HOLDINGS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED)

(Amounts in thousands, except per share amounts)	Three Months Ended
	March 31,
	2022		2021
Revenue, net (includes $13.3 million and $5.3 million with related parties for the three months ended March 31, 2022 and 2021, respectively)	$	330,947	$	259,965
Operating expenses:
Direct service costs, excluding depreciation and amortization		125,434		101,387
Reimbursed out-of-pocket expenses		106,836		80,151
Total direct costs		232,270		181,538
Selling, general and administrative		29,366		25,738
Depreciation		4,270		3,812
Amortization		838		1,278
Total operating expenses		266,744		212,366
Income from operations		64,203		47,599
Other income, net:
Miscellaneous income, net		1,067		924
Interest income (expense), net		54		(14	)
Total other income, net		1,121		910
Income before income taxes		65,324		48,509
Income tax provision		4,013		5,203
Net income	$	61,311	$	43,306
Net income per share attributable to common shareholders:
Basic	$	1.75	$	1.21
Diluted	$	1.69	$	1.14
Weighted average common shares outstanding:
Basic		34,918		35,753
Diluted		36,364		37,749

See notes to condensed consolidated financial statements.

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MEDPACE HOLDINGS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (UNAUDITED)

(Amounts in thousands)	Three Months Ended
	March 31,
	2022			2021
Net income	$	61,311		$	43,306
Other comprehensive income
Foreign currency translation adjustments, net of taxes		(1,542	)		(2,135	)
Comprehensive income	$	59,769		$	41,171

See notes to condensed consolidated financial statements.

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MEDPACE HOLDINGS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (UNAUDITED)
(Amounts in thousands)												Accumulated
							Additional					Other
	Common			Treasury			Paid-In		Retained			Comprehensive
	Stock			Stock			Capital		Earnings			Loss			Total
BALANCE — December 31, 2020	$	355		$	(5,578	)	$	695,904	$	115,229		$	(131	)	$	805,779
Net income										43,306						43,306
Foreign currency translation													(2,135	)		(2,135	)
Stock-based compensation expense								2,871								2,871
Stock options exercised		4						9,102								9,106
BALANCE — March 31, 2021	$	359		$	(5,578	)	$	707,877	$	158,535		$	(2,266	)	$	858,927
									(Accumulated			Accumulated
							Additional		Deficit)			Other
	Common			Treasury			Paid-In		Retained			Comprehensive
	Stock			Stock			Capital		Earnings			Loss			Total
BALANCE — December 31, 2021	$	360		$	(5,427	)	$	727,857	$	234,984		$	(4,846	)	$	952,928
Net income										61,311						61,311
Foreign currency translation													(1,542	)		(1,542	)
Stock-based compensation expense								4,372								4,372
Stock options exercised		3						13,894								13,897
Repurchases of common stock		(27	)		(14,243	)				(411,680	)					(425,950	)
Retirement of treasury stock					5,427					(5,427	)					-
BALANCE — March 31, 2022	$	336		$	(14,243	)	$	746,123	$	(120,812	)	$	(6,388	)	$	605,016
See notes to condensed consolidated financial statements.

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MEDPACE HOLDINGS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED)

(Amounts in thousands)	Three Months Ended
	March 31,
	2022			2021
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$	61,311		$	43,306
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation		4,270			3,812
Amortization		838			1,278
Stock-based compensation expense		4,372			2,871
Noncash lease expense		4,537			3,903
Deferred income tax (benefit) provision		(713	)		1,289
Amortization and adjustment of deferred credit		(155	)		(167	)
Other		(265	)		124
Changes in assets and liabilities:
Accounts receivable and unbilled, net		(38,224	)		1,089
Prepaid expenses and other current assets		(5,547	)		(6,073	)
Accounts payable		(1,041	)		(2,638	)
Accrued expenses		(3,651	)		(10,043	)
Advanced billings		22,580			22,143
Lease liabilities		(3,542	)		(3,155	)
Other assets and liabilities, net		1,486			(420	)
Net cash provided by operating activities		46,256			57,319
CASH FLOWS FROM INVESTING ACTIVITIES:
Property and equipment expenditures		(9,257	)		(6,507	)
Other		(1,951	)		(3,144	)
Net cash used in investing activities		(11,208	)		(9,651	)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from stock option exercises		13,867			9,102
Repurchases of common stock		(425,950	)		-
Proceeds from revolving loan		49,500			-
Payments on revolving loan		(49,500	)		-
Net cash (used in) provided by financing activities		(412,083	)		9,102
EFFECT OF EXCHANGE RATES ON CASH, CASH EQUIVALENTS, AND RESTRICTED CASH		(1,426	)		(1,659	)
(DECREASE) INCREASE IN CASH, CASH EQUIVALENTS, AND RESTRICTED CASH		(378,461	)		55,111
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — Beginning of period		461,304			277,766
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — End of period	$	82,843		$	332,877
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION —
Acquistion of property and equipment—non-cash	$	7,375		$	6,531

See notes to condensed consolidated financial statements.

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MEDPACE HOLDINGS, INC. AND SUBSIDIARIES

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited)

March 31, 2022

(1) 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, project management, regulatory affairs, clinical monitoring, data management and analysis, pharmacovigilance new drug application submissions, post-marketing clinical support, 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.

Unaudited Interim Financial Information

The interim condensed consolidated financial statements include the accounts of the Company, are prepared in conformity with U.S. generally accepted accounting principles (“GAAP”), and are unaudited. In the opinion of the Company’s management, all adjustments of a normal recurring nature necessary for a fair presentation have been reflected. Certain financial information that is normally included in annual financial statements prepared in accordance with GAAP, but that is not required for interim reporting purposes, has been omitted. The preparation of the interim condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the interim condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results and outcomes could differ from management’s estimates and assumptions. As such, the information included in this quarterly report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021.

Share Repurchases

In the second quarter of 2021, the Board approved an increase of $150.0 million to the stock repurchase program bringing the total repurchase authorization up to $300.0 million. In the first quarter of 2022, the Board approved increases totaling $500.0 million to the Company's stock repurchase program. During the three months ended March 31, 2022, the Company repurchased 2,745,865 shares for $425.9 million. As of March 31, 2022, the Company has remaining authorization of $264.6 million under the repurchase program.

Repurchases under the share repurchase program are executed in the open market or negotiated transactions under trading plans put in place pursuant to Rule 10b5-1. The Company constructively retired the repurchased shares associated with these approved share repurchases, except for a small portion which were retained as Treasury Shares on the condensed 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 condensed consolidated balance sheets. The repurchase program may be suspended or discontinued at any time without notice.

Recently Issued 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 is currently evaluating the effect this standard will have on its condensed consolidated financial statements and related disclosures.

(2) 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

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undistributed earnings. The Company’s Restricted Stock Awards (“RSA”) 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 Restricted Stock Units (“RSU”) 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 three months ended March 31, 2022 and 2021 (in thousands, except for earnings per share):

	Three Months Ended
	March 31,
	2022			2021
Weighted-average shares:
Common shares outstanding		34,918			35,753
RSAs		21			116
Total weighted-average shares		34,939			35,869
Earnings per common share—Basic
Net income	$	61,311		$	43,306
Less: Undistributed earnings allocated to RSAs		(36	)		(140	)
Net income available to common shareholders—Basic	$	61,275		$	43,166
Net income per common share—Basic	$	1.75		$	1.21
Basic weighted-average common shares outstanding		34,918			35,753
Effect of diluted shares		1,446			1,996
Diluted weighted-average shares outstanding		36,364			37,749
Net income per common share—Diluted	$	1.69		$	1.14

During the three months ended March 31, 2022, the Company had (in thousands) 264 stock options that were excluded due to the exercise price exceeding the average fair value of the Company’s common stock during the period.

(3) 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 recurring fair value measurements as of March 31, 2022. There were no transfers between Level 1, Level 2 or Level 3 during the three months ended March 31, 2022 or March 31, 2021.

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(4) Contract Assets and Contract Liabilities

Contract assets and liabilities are reflected in the Company’s condensed consolidated balance sheets within the accounts reflected below.

Contract Assets

Accounts receivable represent amounts due from the Company’s customers who are concentrated primarily in the pharmaceutical, biotechnology, and medical device industries. Unbilled represents revenue recognized to date that has not been billed or is not yet contractually billable to the customer. In general, amounts become billable upon the achievement of negotiated contractual events, in accordance with predetermined payment schedules or when a reimbursable expense has been incurred. Amounts classified to unbilled are those billable to customers within one year from the respective balance sheet date.

Accounts receivable and unbilled, net consisted of the following (in thousands):

	As of
	March 31,			December 31,
	2022			2021
Accounts receivable	$	185,309		$	150,496
Unbilled receivables		39,620			36,107
Less: allowance for doubtful accounts		(170	)		(171	)
Total accounts receivable and unbilled, net	$	224,759		$	186,432

Contract Liabilities

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

Advanced billings consisted of the following (in thousands):

	As of
	March 31,		December 31,
	2022		2021
Advanced billings	$	367,221	$	344,641

As of March 31, 2022, we had approximately $2.4 billion of performance obligations remaining to be performed for active projects.

(5) Intangible Assets, Net

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

	As of
	March 31,			December 31,
	2022			2021
Intangible assets:
Finite-lived intangible assets:
Carrying amount:
Customer relationships		145,051			145,051
Accumulated amortization:
Customer relationships		(136,175	)		(135,337	)
Total finite-lived intangible assets, net		8,876			9,714
Trade name (indefinite-lived)		31,646			31,646
Total intangible assets, net	$	40,522		$	41,360

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As of March 31, 2022, estimated amortization expense of the Company’s intangible assets for each of the next five years and thereafter is as follows (in thousands):

	Amortization
Remainder of 2022	$	2,515
2023		2,199
2024		1,443
2025		946
2026		620
Later years		1,153
	$	8,876

(6) Accrued Expenses

Accrued expenses consisted of the following (in thousands):

	As of
	March 31,		December 31,
	2022		2021
Employee compensation and benefits	$	44,661	$	57,846
Project related reimbursable expenses		101,085		91,839
Other		9,272		9,601
Total accrued expenses	$	155,018	$	159,286

(7) Debt

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 (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 30, 2020, the Company amended the Credit Facility to extend its expiration date to March 31, 2021 and add provisions for alternative interest rates when certain interbank market offered rates are not available. On March 29, 2021 the Company amended the Credit Facility expiration date to March 31, 2022. On December 27, 2021, the Company entered into Amendment No. 3 to the Credit Facility, which extends the expiration date of the revolving credit note to March 31, 2023 and adds provisions for alternative rates of interest as a result of global reference rate initiatives and removes the ability to obtain advances in any currency other than U.S. Dollars. After the LIBOR cessation date of December 31, 2021, the Credit Facility bears interest at a rate of the sum of The Secured Overnight Financing Rate (SOFR) and the benchmark replacement adjustment plus 100 basis points (1.00%). On March 15, 2022, the Company entered into Amendment No. 4 to the Credit Facility, which increases the aggregate principal amount that may be borrowed under the facility’s line of credit to up to $250.0 million.

As of March 31, 2022, there were no outstanding borrowings under the Credit Facility and $0.2 million in letters of credit outstanding related to certain operating lease obligations, which are secured by the Credit Facility.

(8) 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 18 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):

	Three Months Ended March 31,
	2022		2021
Operating lease cost	$	6,500	$	5,730
Variable lease cost		2,016		1,704

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

	Three Months Ended March 31,
	2022		2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	3,806	$	3,422
Right-of-use assets obtained in exchange for lease obligations:
Operating leases		17,745		2,672

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

	As of
	March 31,			December 31,
	2022			2021
Operating lease right-of-use assets	$	141,638		$	129,558
Other current liabilities	$	18,460		$	16,276
Operating lease liabilities		141,624			130,965
Total operating lease liabilities	$	160,084		$	147,241
Weighted Average Remaining Lease Term (years)
Operating leases	11.4				12.0
Weighted Average Discount Rate
Operating leases		5.3	%		5.5	%

Lease payments due related to lease liabilities as of March 31, 2022 were as follows (in thousands):

	Related Party			Non-Related Parties			Total
	Operating Leases			Operating Leases			Operating Leases
Remainder of 2022	$	8,186		$	10,731		$	18,917
2023		11,025			14,284			25,309
2024		11,154			11,269			22,423
2025		11,286			8,910			20,196
2026		11,422			7,506			18,928
Later years		106,988			10,612			117,600
Total lease payments		160,061			63,312			223,373
Less: imputed interest		(57,504	)		(5,785	)		(63,289	)
Total	$	102,557		$	57,527		$	160,084

As of March 31, 2022, we have several additional leases with contractual obligations, which have not yet commenced, with future payments of $0.1 million.

(9) Shareholder’s Equity and Stock-Based Compensation

The Company granted 364,286 awards to employees under the 2016 Incentive Award Plan during the three months ended March 31, 2022, consisting of 124,043 RSU and 113,009 stock option awards vesting after four years and 127,234 stock option awards vesting after two years.

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Award Activity

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

	Three Months Ended March 31, 2022
				Weighted Average
	Stock Options			Exercise Price
Outstanding - beginning of period		1,992,915		$	68.39
Granted		240,243		$	139.63
Exercised		(308,447	)	$	45.05
Cancelled/Forfeited		(15,550	)	$	79.70
Expired		(6,397	)	$	16.20
Outstanding - end of period		1,902,764		$	81.25
Exercisable - end of period		1,266,283		$	53.82

The following table sets forth the Company’s RSA/RSU activity:

	Three Months Ended
	March 31, 2022
	Shares/Units
Outstanding and unvested - beginning of period		602,187
Granted		124,043
Vested		(82,000	)
Forfeited		(17,165	)
Outstanding and unvested - end of period		627,065
Cumulative vested shares - end of period		2,114,916

Stock-based compensation expense recognized in the condensed consolidated statements of operations related to all outstanding stock based compensation awards is summarized below (in thousands):

	Three Months Ended March 31,
	2022		2021
Total direct costs	$	2,440	$	2,047
Selling, general and administrative		1,932		824
Total stock-based compensation expense	$	4,372	$	2,871

(10) Income Taxes

The Company’s effective income tax rate was 6.1% and 10.7% for the three months ended March 31, 2022 and 2021, respectively. The Company’s effective income tax rate for the three months ended March 31, 2022 varied from the U.S. statutory rate of 21% primarily due to the impact of state taxes, which was favorably offset by excess tax benefits recognized from share-based compensation and benefits from uncertain tax positions.

(11) Commitments and Contingencies

Legal Proceedings

The Company is involved in legal proceedings from time to time in the ordinary course of its business, including employment claims and claims related to other business transactions. The Company cannot predict with certainty the outcome of such proceedings, but it believes that adequate reserves have been recorded and losses already recognized with respect to such proceedings, which were immaterial as of March 31, 2022 and December 31, 2021. There is a reasonable possibility that a loss exceeding amounts already recognized may be incurred related to these actions; however, the Company believes that such potential losses were immaterial as of March 31, 2022.

Purchase Commitments

The Company has several minimum purchase commitments for project related supplies totaling $11.9 million as of March 31, 2022. In return for the commitment, Medpace receives preferential pricing. The commitments expire at various times through 2027.

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(12) 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 $0.2 million existed at March 31, 2022 and December 31, 2021, respectively, and are included in the Prepaid expenses and other current assets and Other assets line items of the condensed consolidated balance sheets, respectively, depending on the contractual repayment date.

Service Agreement

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. 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 $7.4 million and $0.5 million during the three months ended March 31, 2022 and 2021, respectively, in the Company’s condensed consolidated statements of operations. As of March 31, 2022 and December 31, 2021, respectively, the Company had Advanced billings from LIB of $2.9 million in the condensed consolidated balance sheets. In addition, as of March 31, 2022 and December 31, 2021, respectively, the Company had Accounts receivable and unbilled, net from LIB of $3.2 million and $0.5 million in the condensed consolidated balance sheets.

CinRX Pharma and subsidiaries (“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. The Company recognized total revenue from CinRx of $5.8 million and $4.8 million during the three months ended March 31, 2022 and 2021, respectively, in the Company’s condensed consolidated statements of operations. As of March 31, 2022 and December 31, 2021, respectively, the Company had Advanced billings from CinRx of $8.5 million and $5.4 million in the condensed consolidated balance sheets. As of March 31, 2022 and December 31, 2021 the Company had Accounts receivable and unbilled, net from CinRx of $2.8 million and $2.1 million, respectively, in the condensed consolidated balance sheets.

The Summit Hotel (“The Summit”)

The Summit Hotel, located on the Medpace campus, is owned by the chief executive officer, and managed by an unrelated hospitality management entity. Medpace incurs travel lodging and meeting expenses at The Summit. During the three months ended March 31, 2022 and 2021, Medpace incurred expenses of less than $0.1 million and $0.1 million at The Summit, respectively.

Leased Real Estate

Headquarters Lease

The Company entered into an operating lease for its corporate headquarters 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 lease. The lease for headquarters is for an initial term of twelve years through November 2022 with a renewal option for one 10-year term at prevailing market rates. In Q3 2021, the Company accounted for the renewal option, as it became reasonably certain it would be exercised per the agreement, by extending the lease term through November 2032. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for its corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. Operating lease cost recognized for the three months ended March 31, 2022 and 2021 was $0.6 million and $0.5 million, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at March 31, 2022 and December 31, 2021 were $19.3 million and $19.7 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at March 31, 2022 were $1.5 million and $17.9 million, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2021 were $1.5 million and $18.3 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets.

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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 three months ended March 31, 2022 and 2021 was $1.4 million, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at March 31, 2022 and December 31, 2021 were $54.7 million and $55.1 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at March 31, 2022 were $1.0 million and $65.7 million, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2021 were $0.9 million and $65.9 million, respectively and were recognized in Other current liabilities and Operating lease liabilities in the condensed 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 three months ended March 31, 2022 and 2021 was $0.9 million, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at March 31, 2022 and December 31, 2021 were $16.6 million and $17.2 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at March 31, 2022 were $2.6 million and $13.9 million, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2021 were $2.6 million and $14.6 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed 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 $0.4 million and $0.1 million during the three months ended March 31, 2022 and 2021, respectively, related to these travel services. These travel expenses are recorded in Selling, general and administrative in the Company’s condensed consolidated statements of operations. As of March 31, 2022 and December 31, 2021, the Company had Accounts payable to the Aircraft Management Company of $0.6 million and $0.2 million, respectively, in the condensed consolidated balance sheets.

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(13) Entity Wide Disclosures

Revenue by Category

The following table disaggregates our revenue by major source (in thousands):

	Three months Ended
	March 31,
	2022		2021
Therapeutic Area
Oncology	$	105,213	$	79,138
Other		70,417		68,938
Metabolic		48,116		32,495
Central Nervous System		38,487		24,812
Cardiology		37,396		23,762
AVAI		31,318		30,820
Total revenue	$	330,947	$	259,965

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

You should read the following discussion and analysis of our financial condition and results of operations in conjunction with our condensed consolidated financial statements and the notes thereto included elsewhere in this Quarterly Report on Form 10-Q, with our audited consolidated financial statements and the notes thereto included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2021 and with the information under the heading “Management Discussion and Analysis of Financial Condition and Results of Operations” in our Annual Report on Form 10-K for the fiscal year ended December 31, 2021. This item and the related discussion contain forward-looking statements reflecting current expectations that involve risks and uncertainties. Actual results and the timing of events may differ materially from those indicated in such forward-looking statements. Important factors that may cause such differences include, but are not limited to, those discussed under the “Forward-Looking Statements” below and “Risk Factors” in “Item 1A Risk Factors” of Part I of our Annual Report on Form 10-K for the fiscal year ended December 31, 2021.

Forward-Looking Statements

This Quarterly Report on Form 10-Q contains forward-looking statements. We intend such forward-looking statements to be covered by the safe harbor provisions for forward-looking statements contained in Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. All statements other than statements of historical facts contained herein, including statements regarding our results of operations; financial position and performance; the anticipated impact of the coronavirus COVID-19 pandemic and the conflict involving Russia, Ukraine and surrounding countries, respectively, on our business; liquidity and our ability to fund our business operations and initiatives; capital expenditure and debt service obligations; business strategies, plans and goals, including those related to operations, marketing, acquisitions and expansion of our business; product approvals and plans; industry trends; general economic conditions, including inflation; expectations regarding consumer behaviors and trends; our culture and operating philosophy; human resource management; arrangements with and delivery of our services to the customers; conversion of backlog; dividend policy; legal proceedings; and our objectives for future operations, are forward-looking statements. The words “expect,” “anticipate,” “intend,” “plan,” “believe,” “seek,” “see,” “will,” “would,” “target,” “likely,” and similar expressions are intended to identify forward-looking statements. Forward-looking statements are based largely on our current expectations and projections about future events and financial trends that we believe may affect our financial condition, results of operations, business strategy, short-term and long-term business operations and objectives, and financial needs. These forward-looking statements are subject to inherent uncertainties, risks, changes in circumstances and other important factors that are difficult to predict. Moreover, we operate in a very competitive and rapidly changing environment in which new risks emerge from time to time. It is not possible for our management to predict all risks, nor can we assess the impact of all important factors on our business or the extent to which any factor, or combination of such factors, may cause actual results to differ materially from those contained in any forward-looking statements we may make. In light of these risks, uncertainties and assumptions, the forward-looking events and circumstances discussed may not occur and our financial condition and actual results could differ materially and adversely from those anticipated or implied in the forward-looking statements. We caution you therefore against relying on these forward-looking statements.

We qualify all of our forward-looking statements by these cautionary statements. Except as required by applicable law, we do not plan to publicly update or revise any forward-looking statements contained herein, whether as a result of any new information, future events, changed circumstances or otherwise. For a further discussion of the risks relating to our business, see “Item 1A Risk Factors” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2021 and “Part II – Other Information, Item 1A Risk Factors” herein.

Business Overview

We are one of the world’s leading clinical contract research organizations, or CROs, by revenue, solely focused on providing scientifically-driven outsourced clinical development services to the biotechnology, pharmaceutical and medical device industries. Our mission is to accelerate the global development of safe and effective medical therapeutics. We differentiate ourselves from our competitors by our disciplined operating model centered on providing full-service Phase I-IV clinical development services and our therapeutic expertise. We believe this combination results in timely and cost-effective delivery of clinical development services for our customers. We believe that we are a partner of choice for small- and mid-sized biopharmaceutical companies based on our ability to consistently utilize our full-service, disciplined operating model to deliver timely and high-quality results for our customers.

We focus on conducting clinical trials across all major therapeutic areas, with particular strength in Oncology, Metabolic Disease, Cardiology, Antiviral and Anti-infective, or AVAI, and Central Nervous System, or CNS. Our global platform includes approximately 4,700 employees across 41 countries as of March 31, 2022, providing our customers with broad access to diverse markets and patient populations as well as local regulatory expertise and market knowledge.

How We Generate Revenue

We earn fees through the performance of services detailed in our customer contracts. Contract scope and pricing is typically based on either a fixed-fee or unit-of-service model, with consideration of activities performed by third parties, as well as ancillary costs necessary to deliver on the contract scope that are reimbursable by our customers. Our contracts can range in duration from a few months to several years. These contracts are individually priced and negotiated based on the anticipated project scope, including the

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complexity of the project and the performance risks inherent in the project. The majority of our contracts are structured with an upfront fee that is collected at the time of contract signing, and the balance of the fee is collected over the duration of the contract either through an arranged billing schedule or upon completion of certain performance targets or defined milestones.

Revenue, which is distinct from billing and cash receipt, is recognized based on the satisfaction of the individual performance obligations identified in each contract. Substantially all of our customer contracts consist of a single performance obligation, as the promise to transfer the individual services defined in the contracts are not separately identifiable from other promises in the contract, and therefore not distinct. Our performance obligations are generally satisfied over time and recognized as services are performed. The progression of our contract performance obligations are measured primarily utilizing the input method of cost to cost. Cancellation provisions in our contracts allow our customers to terminate a contract either immediately or according to advance notice terms specified within the applicable contract, which is typically 30 days. Contract cancellation may occur for various reasons, including, but not limited to, adverse patient reactions, lack of efficacy, or inadequate patient enrollment. Upon cancellation, we are entitled to fees for services rendered through the date of termination, including payment for subsequent services necessary to conclude the study or close out the contract. These fees are typically discussed and agreed upon with the customer and are realized as revenue when we believe the amount can be estimated reliably and its realization is probable. Changes in revenue from period to period are driven primarily by new business volume and task order execution activity, project cancellations, and the mix of active studies during a given period that can vary based on therapeutic area and or study life cycle stage.

Costs and Expenses

Our costs and expenses are comprised primarily of our total direct costs, selling, general and administrative costs, depreciation and amortization and income taxes.

Total Direct Costs

Total direct costs are primarily driven by labor and related employee benefits, but also include contracted third party service related expenses, fees paid to site investigators, reimbursed out of pocket expenses, laboratory supplies and other expenses contributing to service delivery. The other costs of service delivery can include office rent, utilities, supplies and software licenses which are allocated between Total direct costs and selling, general and administrative expenses based on the estimated contribution among service delivery and support function efforts on a percentage basis. Total direct costs are expensed as incurred and are not deferred in anticipation of contracts being awarded or finalization of changes in scope. Total direct costs, as a percentage of net revenue, can vary from period to period due to project labor efficiencies, changes in workforce, compensation/bonus programs and service mix.

Selling, General and Administrative

Selling, general and administrative expenses are primarily driven by compensation and related employee benefits, as well as rent, utilities, supplies, software licenses, professional fees (e.g., legal and accounting expenses), bad debt expense, travel, marketing and other operating expenses.

Depreciation

Depreciation is provided on our property and equipment 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. Leasehold improvements are amortized on a straight-line basis over the shorter of the estimated useful life of the improvement or the associated remaining lease term.

Amortization

Amortization relates to finite-lived intangible assets recognized as expense using the straight-line method or using an accelerated method over their estimated useful lives of 15 years.

Income Tax Provision

Income tax provision consists of federal, state and local taxes on income in multiple jurisdictions. Our income tax is impacted by the pre-tax earnings in jurisdictions with varying tax rates and any related tax credits that may be available to us. Our current and future provision for income taxes will vary from statutory rates due to the impact of valuation allowances in certain countries, income tax incentives, certain non-deductible expenses, and other discrete items.

Key Performance Metrics

To evaluate the performance of our business, we utilize a variety of financial and performance metrics. These key measures include new business awards, cancellations and backlog.

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New Business Awards, Cancellations and Backlog

New business awards represent the value of anticipated future net revenue that has been awarded during the period that is recognized in backlog. This value is recognized upon the signing of a contract or receipt of a written pre-contract confirmation from a customer that confirms an agreement in principle on budget and scope. New business awards also include contract amendments, or changes in scope, where the customer has provided written authorization for changes in budget and scope or has approved us to perform additional work as of the measurement date. Awards may not be recognized as backlog after consideration of a number of factors, including whether (i) the relevant net revenue is expected only after a pending regulatory hurdle, which might result in cancellation of the study, (ii) the customer funding needed for commencement of the study is not believed to have been secured or (iii) study timelines are uncertain or not well defined. In addition, study amounts that extend beyond a three-year timeline are not included in backlog. The number and amount of new business awards can vary significantly from period to period, and an award’s contractual duration can range from several months to several years based on customer and project specifications.

Cancellations arise in the normal course of business and are reflected when we receive written confirmation from the customer to cease work on a contractual agreement. The majority of our customers can terminate our contracts without cause upon 30 days’ notice. Similar to new business awards, the number and amount of cancellations can vary significantly period over period due to timing of customer correspondence and study-specific circumstances.

Net new business awards represent gross new business awards received in a period offset by total cancellations in that period. Net new business awards were $423.0 million and $356.2 million for the three months ended March 31, 2022 and 2021, respectively.

Backlog represents anticipated future net revenue from net new business awards that have not commenced or are currently in process but not complete. Reported backlog will fluctuate based on new business awards, changes in the scope of existing contracts, cancellations, revenue recognition on existing contracts and foreign exchange adjustments from non-U.S. dollar denominated backlog. As of March 31, 2022, our backlog increased by $456.2 million, or 28.0%, to $2,088.0 million compared to $1,631.8 million as of March 31, 2021. Included within backlog as of March 31, 2022 was approximately $1,060 million to $1,080 million that we expect to convert to net revenue over the next twelve months, with the remainder expected to convert to net revenue thereafter.

The effect of foreign currency adjustments on backlog was as follows: favorable foreign currency adjustments of $1.2 million for the three months ended March 31, 2022 and unfavorable foreign currency adjustments of $3.7 million for the three months ended March 31, 2021.

Backlog and net new business award metrics may not be reliable indicators of our future period revenue as they are subject to a variety of factors that may cause material fluctuations from period to period. These factors include, but are not limited to, changes in the scope of projects, cancellations, and duration and timing of services provided.

Coronavirus (COVID-19)

The COVID-19 pandemic increased travel restrictions and caused the shutdown of many businesses in countries in which we operate. While we continue to operate globally, the pandemic continues to impact our business and the level of activity at each of our locations varies depending on the local governmental requirements and guidelines which continue to evolve and change.

Our office staff are either working remotely or in the office, and our labs are fully operational with modifications made to ensure the safety of our employees. The diversion of resources to treat COVID-19 patients continues to impact the operations at most of the investigative sites where patients in our clinical trials are recruited and treated.

Depending on the duration of the disruption, ongoing studies may be cancelled and some of our clients may lack the funding to complete trials which are extended due to slowed recruitment of patients. We work with many smaller clients with limited financial resources and market disruptions may make raising additional funds difficult for them.

Travel restrictions and business closures continue to impact study participants and clinical sites which affects our ability to efficiently provide clinical trial services. We continue to work with our customers to develop solutions to limit disruption to clinical trials while following required regulatory guidelines and maintaining quality to ensure the health and well-being of study participants. We are continuing along with the rest of the industry with a blend of on-site monitoring and remote based monitoring and we are using technology tools like e-PRO for patient reported outcomes, e-COA, for clinical outcome assessment, remote data capture and remote data review. We are also leveraging internal service capabilities like patient concierge service to help facilitate patient travel to sites and master service agreements in place with strategic vendors for other patient services like home health.

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While certain governments eased restrictions during 2021 and into the three months ended March 31, 2022, the pandemic remains disruptive to our business operations. As we look ahead, we continue to expect impacts to our business to be temporary and primarily relate to limitations on our ability to physically access investigative sites, delays in patient enrollment and trial start-up activities.

The COVID-19 outbreak had a significant adverse effect on our results of operations and we believe that the outbreak may have a continued adverse impact on our results of operations in the future. As we cannot predict the duration or scope of the pandemic, the future financial impact on our results of operations and financial condition cannot be reasonably estimated.

Exchange Rate Fluctuations

The majority of our contracts and operational transactions are U.S. dollar denominated. The Euro represents the largest foreign currency denomination of our contractual and operational exposure. As a result, a portion of our revenue and expenses are subject to exchange rate fluctuations. We have translated the Euro into U.S. dollars using the following average exchange rates based on data obtained from www.xe.com:

	Three Months Ended March 31,
	2022		2021
U.S. Dollars per Euro:		1.12		1.21

Results of Operations

Three Months Ended March 31, 2022 compared to Three Months Ended March 31, 2021

	Three Months Ended
	March 31,
(Amounts in thousands, except percentages)	2022		2021			Change			% Change
Revenue, net	$	330,947	$	259,965		$	70,982			27.3	%
Direct service costs, excluding depreciation and amortization		125,434		101,387			24,047			23.7	%
Reimbursed out-of-pocket expenses		106,836		80,151			26,685			33.3	%
Total direct costs		232,270		181,538			50,732			27.9	%
Selling, general and administrative		29,366		25,738			3,628			14.1	%
Depreciation		4,270		3,812			458			12.0	%
Amortization		838		1,278			(440	)		(34.4	)%
Total operating expenses		266,744		212,366			54,378			25.6	%
Income from operations		64,203		47,599			16,604
Miscellaneous income, net		1,067		924			143
Interest income (expense), net		54		(14	)		68
Income before income taxes		65,324		48,509			16,815
Income tax provision		4,013		5,203			(1,190	)
Net income	$	61,311	$	43,306		$	18,005

Total revenue

Total revenue increased by $71.0 million to $330.9 million for the three months ended March 31, 2022, from $260.0 million for the three months ended March 31, 2021. The increase for the three months ended March 31, 2022 was primarily driven by growth within the Oncology, Metabolic, Central Nervous System and Cardiology therapeutic areas, compared to the same period in the prior year.

Total direct costs

Total direct costs increased by $50.7 million, to $232.3 million for the three months ended March 31, 2022 from $181.5 million for the three months ended March 31, 2021. The increase was primarily attributed to higher reimbursed out-of-pocket expenses and higher personnel costs to support the growth in service activities. Reimbursed out-of-pocket expenses, which can fluctuate significantly from period to period based on the timing of program initiation and closeout, increased $26.7 million for the three months ended March 31, 2022, compared to the same period in the prior year. The higher personnel costs portion increased by $21.4 million for the three months ended March 31, 2022, compared to the same periods in the prior year.

Selling, general and administrative

Selling, general and administrative expenses increased by $3.6 million, to $29.4 million for the three months ended March 31, 2022 from $25.7 million for the three months ended March 31, 2021. The increase was primarily attributed to higher personnel costs to

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support the growth in service activities. The higher personnel costs portion increased by $4.1 million for the three months ended March 31, 2022, compared to the same periods in the prior year.

Depreciation and Amortization

Depreciation and amortization expense of $5.1 million for the three months ended March 31, 2022 remained consistent with $5.1 million for the three months ended March 31, 2021.

Income tax provision

Income tax provision decreased by $1.2 million, to $4.0 million for the three months ended March 31, 2022 from $5.2 million for the three months ended March 31, 2021. The overall effective tax rate for the three months ended March 31, 2022 was 6.1%, compared to an overall effective tax rate of 10.7% for the three months ended March 31, 2021. The decrease in the income tax provision and overall effective tax rate for the three months ended March 31, 2022 was primarily attributable to an increase in excess tax benefits recognized from share based compensation and an increase in the benefit of uncertain tax positions compared to the same period in the prior year.

Liquidity and Capital Resources

We assess our liquidity in terms of our ability to generate cash to fund our operating, investing and financing activities. Our principal sources of liquidity are operating cash flows and funds available for borrowing under our unsecured credit facility consisting of up to a $250.0 million revolving line of credit which we entered into on September 30, 2019 (the “Credit Facility”), and has subsequently been amended. As of March 31, 2022, we had cash and cash equivalents of $82.8 million which decreased from $461.3 million as of December 31, 2021 primarily due to share repurchases during the three months ended March 31, 2022. Approximately $26.7 million of cash and cash equivalents, none of which was restricted, was held by our foreign subsidiaries as of March 31, 2022.

As of March 31, 2022, we had $249.8 million available for borrowing under the Credit Facility. Our expected primary cash needs on both a short and long-term basis are for investment in operational growth, capital expenditures, share repurchases, selective strategic bolt-on acquisitions, other investments, and other general corporate needs. We have historically funded our operations and growth with cash flow from operations and borrowings under our credit facilities. We expect to continue expanding our operations through organic growth and potentially highly selective bolt-on acquisitions and investments. As of March 31, 2022, cash commitments to support operating business needs include lease liabilities discussed in Note 8 of the Condensed Consolidated Financial Statements, purchase commitments discussed in Note 11 of the Condensed Consolidated Financial Statements and capital expenditures primarily related to infrastructure investments in our facilities, equipment and technology. Capital spending as a percentage of revenue increased by 30 basis points to 2.80% in the three months ended March 31, 2022, compared to the same period in the prior year. We expect these activities will be funded from existing cash, cash flow from operations and, if necessary, borrowings under our existing or future credit facilities or other debt. We have deemed that foreign earnings will be indefinitely reinvested and therefore we have not provided taxes on these earnings. While we do not anticipate the need to repatriate these foreign earnings for liquidity purposes given our cash flows from operations and available borrowing under existing and future credit facilities, we would incur taxes on these earnings if the need for repatriation due to liquidity purposes arises.

	Three Months Ended
	March 31,
Cash Flows (Amounts in thousands)	2022			2021
Net cash provided by operating activities	$	46,256		$	57,319
Net cash used in investing activities		(11,208	)		(9,651	)
Net cash used in financing activities		(412,083	)		9,102
Effect of exchange rates on cash, cash equivalents and restricted cash		(1,426	)		(1,659	)
(Decrease) increase in cash, cash equivalents and restricted cash	$	(378,461	)	$	55,111

Cash Flow from Operating Activities

Cash flows from operations are driven mainly by net income, noncash lease expense, depreciation, stock based compensation expense, and net movement in advanced billings, accrued expenses, prepaid expenses and other current assets, and accounts receivable and unbilled, net. Accounts receivable and unbilled, net and advanced billings fluctuate on a regular basis as we perform our services, bill our customers and ultimately collect on those receivables. We attempt to negotiate payment terms in order to provide for payments prior to or soon after the provision of services, but this timing of collection can vary significantly on a period by period comparative basis.

Net cash flows provided by operating activities was $46.3 million for the three months ended March 31, 2022 beginning with net income of $61.3 million. Adjustments to reconcile net income to net cash provided by operating activities were $12.9 million,

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primarily related to noncash lease expense of $4.5 million, stock based compensation expense of $4.4 million and depreciation of $4.3 million. Changes in operating assets and liabilities used $27.9 million in operating cash flows and was primarily driven by increased accounts receivable and unbilled, net of $38.2 million and increased prepaid expenses and other current assets of $5.5 million, offset by increased advanced billings of $22.6 million.

Net cash flows provided by operating activities was $57.3 million for the three months ended March 31, 2021 beginning with net income of $43.3 million. Adjustments to reconcile net income to net cash provided by operating activities were $13.1 million, primarily related to noncash lease expense of $3.9 million, depreciation of $3.8 million, stock based compensation expense of $2.9 million and amortization of intangibles of $1.3 million. Changes in operating assets and liabilities provided $0.9 million in operating cash flows and was primarily driven by increased advanced billings of $22.1 million, offset by decreased accrued expenses of $10.0 million, increased prepaid expenses and other current assets of $6.1 million and decreased lease liabilities of $3.2 million.

Cash Flow from Investing Activities

Net cash used in investing activities was $11.2 million for the three months ended March 31, 2022 primarily consisting of $9.3 million in property and equipment expenditures.

Net cash used in investing activities was $9.7 million for the three months ended March 31, 2021 primarily consisting of $6.5 million in property and equipment expenditures.

Cash Flow from Financing Activities

Net cash used in financing activities was $412.1 million for the three months ended March 31, 2022 primarily related to $426.0 million in repurchases of common stock, partially offset by $13.9 million in proceeds from stock option exercises. Additionally, the Company had $49.5 million in proceeds related to the Credit Facility, offset by $49.5 million in repayments of the Credit Facility.

Net cash provided by financing activities was $9.1 million for the three months ended March 31, 2021 primarily related to proceeds from stock options exercises.

Share Repurchases

In the second quarter of 2021, the Board approved an increase of $150.0 million to the stock repurchase program bringing the total repurchase authorization up to $300.0 million. In the first quarter of 2022, the Board approved increases totaling $500.0 million to the Company's stock repurchase program. During the three months ended March 31, 2022, the Company repurchased 2,745,865 shares for $425.9 million. As of March 31, 2022, the Company has remaining authorization of $264.6 million under the repurchase program.

Repurchases under the share repurchase program are executed in the open market or negotiated transactions under trading plans put in place pursuant to Rule 10b5-1. The Company constructively retired the repurchased shares associated with these approved share repurchases, except for a small portion which were retained as Treasury Shares on the condensed 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 condensed consolidated balance sheets. The repurchase program may be suspended or discontinued at any time without notice.

Indebtedness

As of March 31, 2022, we had no indebtedness and $0.2 million in letters of credit outstanding related to certain operating lease obligations, which are secured by the Credit Facility. Refer to Note 7 of the Notes to Condensed Consolidated Financial Statements for details regarding our Credit Facility.

Critical Accounting Policies and Estimates

The preparation of financial statements in accordance with generally accepted accounting principles in the United States of America, or U.S. GAAP, requires us to make a variety of decisions which affect reported amounts and related disclosures, including the selection of appropriate accounting principles and the assumptions on which to base accounting estimates. In reaching such decisions, we apply judgment based on our understanding and analysis of the relevant circumstances, including our historical experience and other assumptions. Actual results could differ from our estimates. We are committed to incorporating accounting principles, assumptions and estimates that promote the representational faithfulness, verifiability, neutrality and transparency of the accounting information included in the financial statements.

There have been no significant changes in the critical accounting policies and estimates as previously described in our Annual Report on Form 10-K for the fiscal year ended December 31, 2021.

- 22 -

Effect of Recent Accounting Pronouncements

Refer to Note 1 of the Condensed Consolidated Financial Statements for management’s discussion of the effect of recent accounting pronouncements.

Item 3. Quantitative and Qualitative Disclosures About Market Risk

There have been no material changes to our quantitative and qualitative disclosures about market risk as compared to the quantitative and qualitative disclosures about market risk described in our Annual Report on Form 10-K for the fiscal year ended December 31, 2021.

Item 4. Controls and Procedures

Limitations on Effectiveness of Controls and Procedures

In designing and evaluating our disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives. In addition, the design of disclosure controls and procedures must reflect the fact that there are resource constraints and that management is required to apply judgment in evaluating the benefits of possible controls and procedures relative to their costs.

Evaluation of Disclosure Controls and Procedures

The Company’s management, with the participation of the Chief Executive Officer (the Principal Executive Officer) and Chief Financial Officer (the Principal Financial Officer), has evaluated the effectiveness of the Company’s disclosure controls and procedures, as defined in Rules 13(a)-15(e) and 15(d) -15(e) of the Securities Exchange Act of 1934 (Exchange Act), as of the end of the period covered by this report. Based on this evaluation, we concluded that, as of the end of the period covered by this report, our disclosure controls and procedures were effective in providing reasonable assurance that information required to be disclosed by us in the reports we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s forms and rules, and the material information relating to the Company is accumulated and communicated to management, including the President and Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosures.

Control systems, no matter how well designed and operated, can provide only reasonable, not absolute, assurance that control objectives are met. Because of inherent limitations in all control systems, no evaluation of controls can provide assurance that all control issues and instances of fraud, if any, within a company will be detected. Additionally, controls can be circumvented by individuals, by collusion of two or more people or by management override. Over time, controls can become inadequate because of changes in conditions or the degree of compliance may deteriorate. Further, the design of any system of controls is based in part upon assumptions about the likelihood of future events. There can be no assurance that any design will succeed in achieving its stated goals under all future conditions. Because of the inherent limitations in any cost-effective control system, misstatements due to errors or fraud may occur and not be detected.

Changes in Internal Control over Financial Reporting

In the ordinary course of business, we routinely enhance our information systems by either upgrading current systems or implementing new ones. There were no changes in our internal control over financial reporting that occurred during the three months ended March 31, 2022 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

PART II—OTHER INFORMATION

Item 1. Legal Proceedings

We are party to legal proceedings incidental to our business. While the outcome of these matters could differ from management’s expectations, we do not believe that the resolution of these matters is reasonably likely to have a material adverse effect to our financial statements.

Item 1A. Risk Factors

For a discussion of our potential risks and uncertainties, see the information under the heading “Risk Factors” in our Annual Report on Form 10-K for the fiscal year ended December 31, 2021. There have been no significant changes from the risk factors previously disclosed in our Annual Report, except as follows:

- 23 -

Our operating margins could decrease due to increased pricing pressure or other pressures, if we are unable to either achieve efficiencies in our operating expenses or grow revenues at a rate faster than expenses.

Historically, we have been able to generate the operating margins that we do because of our disciplined, full-service operating model. However, we operate in a highly competitive environment, and, if we experience increased levels of competitive pricing pressure, or pricing pressure from the continued rise of inflation, our operating margins may decrease. In addition, we may adapt our operating model to achieve greater levels of growth or in response to investor demands. Such changes could result in lower operating margins.

Our business is subject to international economic, political and other risks that could negatively affect our results of operations and financial condition.

We have significant operations in foreign countries, including, but not limited to, countries in Europe, Latin America, Asia, the Middle East and Africa, that may require complex arrangements to deliver services on global contracts for our customers. As a result, we are subject to heightened risks inherent in conducting business internationally, including the following:

• conducting a single trial across multiple countries is complex, and issues in one country, such as a failure to comply with local regulations or restrictions, may affect the progress of the trial in the other countries, for example, by limiting the amount of data necessary for a trial to proceed, resulting in delays or potential cancellation of contracts, which in turn may result in loss of revenue;

• the United States or other countries could enact legislation or impose regulations or other restrictions, including unfavorable labor regulations or tax policies, which could have an adverse effect on our ability to conduct business in or expatriate profits from those countries;

• tax rates in certain foreign countries may exceed those in the United States and foreign earnings may be subject to withholding requirements or the imposition of tariffs, exchange controls or other restrictions, including restrictions on repatriation;

• certain foreign countries are expanding or may expand their regulatory framework with respect to patient informed consent, protection and compensation in clinical trials, and privacy, which could delay or inhibit our ability to conduct trials in such jurisdictions or which could materially increase the risks associated with performing trials in such jurisdictions;

• certain foreign countries are expanding or may expand their banking regulations that govern international currency transactions, particularly cross-border transfers, which may inhibit our ability to transfer funds into or within a jurisdiction, impeding our ability to pay our principal investigators, vendors and employees, thereby impacting our ability to conduct trials in such jurisdictions;

• the regulatory or judicial authorities of foreign countries may not enforce legal rights and recognize business procedures in a manner to which we are accustomed or would reasonably expect;

• we may have difficulty complying with a variety of laws and regulations in foreign countries, some of which may conflict with laws in the United States;

• potential violations of existing or newly adopted local laws or anti-bribery laws, such as the United States Foreign Corrupt Practices Act (FCPA) and the UK Bribery Act of 2010, may cause a material adverse effect on our business, financial condition, results of operations, cash flows or reputation;

• changes in political and economic conditions, including inflation, may lead to changes in the business environment in which we operate, as well as changes in foreign currency exchange rates;

• foreign governments may enact currency exchange controls that may limit the ability to fund our operations or significantly increase the cost of maintaining operations;

• customers in foreign jurisdictions may have longer payment cycles, and it may be more difficult to collect receivables in foreign jurisdictions;

• natural disasters, pandemics or international conflict, including terrorist acts, could interrupt our services, endanger our personnel or cause project delays or loss of trial materials or results; and

• Russian military action in Europe may impact foreign countries in which we may need to enroll patients in our clinical trials and could cause such clinical trials to be delayed or suspended.

These risks and uncertainties could negatively impact our ability to, among other things, perform large, global projects for our customers. Furthermore, our ability to deal with these issues could be affected by applicable U.S. laws and the need to protect our assets. In addition, we may be more susceptible to these risks as we enter and continue to target growth in emerging countries and regions, including Asia, Eastern Europe and Latin America, which may be subject to a relatively higher risk of political instability, economic volatility, crime, corruption and social and ethnic unrest, all of which are exacerbated in many cases by a lack of an independent and experienced judiciary and uncertainties in how local law is applied and enforced. The materialization of any such risks could have an adverse impact on our financial condition, results of operations, cash flows or reputation.

- 24 -

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

Share Repurchases

This table provides certain information with respect to our monthly repurchases of the Company’s common stock during the first quarter of fiscal year 2022:

Period	Total Number of Shares Purchased		Average Price Paid per Share		Total Number of Shares Purchased as Part of Publically Announced Plan		Approximate Dollar Value of Shares That May Yet Be Purchased Under the Plan
January 1, 2022, through January 31, 2022		500,998	$	168.91		2,061,876	$	605,860,306
February 1, 2022, through February 28, 2022		1,452,441	$	154.43		3,514,317	$	381,553,487
March 1, 2022, through March 31, 2022		792,426	$	147.55		4,306,743	$	264,627,571
Total		2,745,865	$	155.09		4,306,743

All share repurchases were made using cash resources and executed pursuant to established Rule 10b5-1 trading plans. Our share repurchases may occur through open market purchases or negotiated transactions. The above table excludes shares repurchased to settle employee tax withholding related to the vesting of stock awards.

We returned $425.9 million to shareholders in the form of share repurchases in the first quarter of fiscal year 2022. Refer to Note 1 – Basis of Presentation of the Notes to Condensed Consolidated Financial Statements (Part I, Item 1 of this Form 10-Q) for further discussion regarding share repurchases.

Recent Sales of Unregistered Securities

Date	Equity Plan	Number of Stock Options Exercised		Exercise Price		Approximate Aggregate Purchase Price
January 4, 2022	2014 Equity Incentive Plan		3,703	$	16.20	$	60,000
January 5, 2022	2014 Equity Incentive Plan		1,851		16.20		30,000
January 6, 2022	2014 Equity Incentive Plan		1,222		16.20		19,800
January 10, 2022	2014 Equity Incentive Plan		250		18.23		4,600
January 12, 2022	2014 Equity Incentive Plan		1,111		16.20		18,000
January 18, 2022	2014 Equity Incentive Plan		3,333		16.20		54,000
January 19, 2022	2014 Equity Incentive Plan		853		16.20		13,800
January 19, 2022	2014 Equity Incentive Plan		37,000		18.23		674,500
January 20, 2022	2014 Equity Incentive Plan		1,111		16.20		18,000
January 25, 2022	2014 Equity Incentive Plan		850		16.20		13,800
February 2, 2022	2014 Equity Incentive Plan		11,111		16.20		180,000
February 3, 2022	2014 Equity Incentive Plan		2,962		16.20		48,000
February 15, 2022	2014 Equity Incentive Plan		11,744		16.20		190,300
February 16, 2022	2014 Equity Incentive Plan		5,184		16.20		84,000
February 24, 2022	2014 Equity Incentive Plan		900		16.20		14,600
February 25, 2022	2014 Equity Incentive Plan		3,180		16.20		51,500
March 8, 2022	2014 Equity Incentive Plan		200		16.20		3,200
March 11, 2022	2014 Equity Incentive Plan		5,185		16.20		84,000
March 16, 2022	2014 Equity Incentive Plan		1,851		16.20		30,000
March 18, 2022	2014 Equity Incentive Plan		1,851		16.20		30,000
March 21, 2022	2014 Equity Incentive Plan		1,481		16.20		24,000
March 25, 2022	2014 Equity Incentive Plan		1,851		16.20		30,000
March 28, 2022	2014 Equity Incentive Plan		3,753		16.20		60,800
Total			102,537			$	1,736,900

All of the forgoing transactions involved issuances of securities to employees of the Company and are exempt from registration pursuant to Rule 701 promulgated under the Securities Act of 1933, as amended, as transactions pursuant to benefit plans and contracts relating to compensation.

Use of Proceeds from Registered Securities

Not applicable.

- 25 -

Item 3. Defaults Upon Senior Securities

None.

Item 4. Mine Safety Disclosures

Not applicable.

Item 5. Other Information

None.

Item 6. Exhibits

The exhibits in the accompanying Exhibit Index preceding the signature page are filed or furnished as a part of this report and are incorporated herein by reference.

- 26 -

EXHIBIT INDEX

		Incorporated by Reference
Exhibit Number	Exhibit Description	Form	File No.	Exhibit	Filing Date	Filed/ Furnished Herewith
10.1	Amendment No. 4 dated March 15, 2022 to Loan Documents	8-K	001-37856	10.1	3/16/2022
31.1	Rule 13a-14(a) / 15d-14(a) Certification of Chief Executive Officer					*
31.2	Rule 13a-14(a) / 15d-14(a) Certification of Chief Financial Officer					*
32.1	Section 1350 Certification of Chief Executive Officer					**
32.2	Section 1350 Certification of Chief Financial Officer					**
101.INS	Inline XBRL Instance Document – the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document					*
101.SCH	Inline XBRL Taxonomy Extension Schema Document					*
101.CAL	Inline XBRL Taxonomy Calculation Linkbase Document					*
101.DEF	Inline XBRL Taxonomy Extension Definition Linkbase Document					*
101.LAB	Inline XBRL Taxonomy Extension Label Linkbase Document					*
101.PRE	Inline XBRL Taxonomy Extension Presentation					*
104	Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101)

* Filed herewith.

** Furnished herewith.

- 27 -

SIGNATURES

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

MEDPACE HOLDINGS, INC.

/s/ Kevin M. Brady

Kevin M. Brady

Chief Financial Officer

(Principal Financial Officer)

Date: April 26, 2022

- 28 -

EX-31.1

Exhibit 31.1

I, August J. Troendle, certify that:

1.I have reviewed this Quarterly Report on Form 10-Q of Medpace Holdings, Inc.;

2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

a)Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

b)Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c)Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d)Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5.The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

a)All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

b)Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: April 26, 2022

/s/ August J. Troendle

August J. Troendle

Chief Executive Officer and Chairman of the Board of Directors

(Principal Executive Officer)

EX-31.2

Exhibit 31.2

I, Kevin M. Brady, certify that:

1.I have reviewed this Quarterly Report on Form 10-Q of Medpace Holdings, Inc.;

2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

a)Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

b)Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c)Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d)Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5.The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

a)All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

b)Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: April 26, 2022

/s/ Kevin M. Brady

Kevin M. Brady

Chief Financial Officer

(Principal Financial Officer)

EX-32.1

Exhibit 32.1

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350

AS ADOPTED PURSUANT TO SECTION 906

OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of Medpace Holdings, Inc. (the “Company”) on Form 10-Q for the quarter ended March 31, 2022 filed with the Securities and Exchange Commission on the date hereof (the “Report”), I certify, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

•The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

•The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company for the periods presented therein.

Date: April 26, 2022

By:	/s/ August J. Troendle
	August J. Troendle
	Chief Executive Officer and Chairman of the Board of Directors
	(Principal Executive Officer)

EX-32.2

Exhibit 32.2

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350

AS ADOPTED PURSUANT TO SECTION 906

OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of Medpace Holdings, Inc. (the “Company”) on Form 10-Q for the quarter ended March 31, 2022 filed with the Securities and Exchange Commission on the date hereof (the “Report”), I certify, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

•The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

•The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company for the periods presented therein.

Date: April 26, 2022

By:	/s/ Kevin M. Brady
	Kevin M. Brady
	Chief Financial Officer
	(Principal Financial Officer)

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Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2022	Apr. 22, 2022
Cover [Abstract]
Document Type	10-Q
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Document Period End Date	Mar. 31, 2022
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q1
Trading Symbol	MEDP
Entity Registrant Name	Medpace Holdings, Inc.
Entity Central Index Key	0001668397
Entity Current Reporting Status	Yes
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		33,647,133
Entity File Number	001-37856
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
Security Exchange Name	NASDAQ
Title of 12(b) Security	Common Stock $0.01 par value
Entity Interactive Data Current	Yes
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CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 82,843	$ 461,304
Accounts receivable and unbilled, net (includes $6.0 million and $2.7 million with related parties at March 31, 2022 and December 31, 2021, respectively)	224,759	186,432
Prepaid expenses and other current assets	48,367	43,176
Total current assets	355,969	690,912
Property and equipment, net	98,529	93,153
Operating lease right-of-use assets	141,638	129,558
Goodwill	662,396	662,396
Intangible assets, net	40,522	41,360
Deferred income taxes	25,809	25,134
Other assets	19,483	17,422
Total assets	1,344,346	1,659,935
Current liabilities:
Accounts payable (includes $0.7 million and $0.3 million with related parties at March 31, 2022 and December 31, 2021, respectively)	25,434	25,678
Accrued expenses	155,018	159,286
Advanced billings (includes $11.4 million and $8.3 million with related parties at March 31, 2022 and December 31, 2021, respectively)	367,221	344,641
Other current liabilities	31,755	27,612
Total current liabilities	579,428	557,217
Operating lease liabilities	141,624	130,965
Deferred income tax liability	1,055	1,080
Other long-term liabilities	17,223	17,745
Total liabilities	739,330	707,007
Commitments and contingencies (see Note 11)
Shareholders’ equity:
Preferred stock - $0.01 par-value; 5,000,000 shares authorized; no shares issued and outstanding at March 31, 2022 and December 31, 2021, respectively	0	0
Common stock - $0.01 par-value; 250,000,000 shares authorized at March 31, 2022 and December 31, 2021, respectively; 33,651,360 and 36,006,778 shares issued and outstanding at March 31, 2022 and December 31, 2021, respectively	336	360
Treasury stock - 81,573 and 180,000 shares at March 31, 2022 and December 31, 2021, respectively	(14,243)	(5,427)
Additional paid-in capital	746,123	727,857
(Accumulated deficit) Retained earnings	(120,812)	234,984
Accumulated other comprehensive loss	(6,388)	(4,846)
Total shareholders’ equity	605,016	952,928
Total liabilities and shareholders’ equity	$ 1,344,346	$ 1,659,935

XML

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) (Parenthetical) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Accounts receivable, unbilled services with related parties	$ 6.0	$ 2.7
Accounts payable includes related parties	0.7	0.3
Advanced billings with related parties	$ 11.4	$ 8.3
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock shares authorized	5,000,000	5,000,000
Preferred stock shares issued	0	0
Preferred stock shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock shares authorized	250,000,000	250,000,000
Common stock shares issued	33,651,360	36,006,778
Common stock shares outstanding	33,651,360	36,006,778
Treasury stock shares	81,573	180,000

XML

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenue, net (includes $13.3 million and $5.3 million with related parties for the three months ended March 31, 2022 and 2021, respectively)	$ 330,947	$ 259,965
Operating expenses:
Total direct costs	232,270	181,538
Selling, general and administrative	29,366	25,738
Depreciation	4,270	3,812
Amortization	838	1,278
Total operating expenses	266,744	212,366
Income from operations	64,203	47,599
Other income, net:
Miscellaneous income, net	1,067	924
Interest income (expense), net	54	(14)
Total other income, net	1,121	910
Income before income taxes	65,324	48,509
Income tax provision	4,013	5,203
Net income	$ 61,311	$ 43,306
Net income per share attributable to common shareholders:
Basic	$ 1.75	$ 1.21
Diluted	$ 1.69	$ 1.14
Weighted average common shares outstanding:
Basic	34,918	35,753
Diluted	36,364	37,749
Direct Costs
Operating expenses:
Total direct costs	$ 125,434	$ 101,387
Reimbursable Out of Pocket Costs
Operating expenses:
Total direct costs	$ 106,836	$ 80,151

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CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED) (Parenthetical) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenue Net
Revenue with related parties	$ 13,300	$ 5,300,000

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CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (UNAUDITED) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 61,311	$ 43,306
Other comprehensive income
Foreign currency translation adjustments, net of taxes	(1,542)	(2,135)
Comprehensive income	$ 59,769	$ 41,171

XML

CONDENSED CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (UNAUDITED) - USD ($) $ in Thousands	Total	Common Stock	Treasury Stock	Additional Paid-in Capital	(Accumulated Deficit) Retained Earnings	Accumulated Other Comprehensive Loss
Balance at Dec. 31, 2020	$ 805,779	$ 355	$ (5,578)	$ 695,904	$ 115,229	$ (131)
Net income	43,306				43,306
Foreign currency translation	(2,135)					(2,135)
Stock-based compensation expense	2,871			2,871
Stock options exercised	9,106	4		9,102
Balance at Mar. 31, 2021	858,927	359	(5,578)	707,877	158,535	(2,266)
Balance at Dec. 31, 2021	952,928	360	(5,427)	727,857	234,984	(4,846)
Net income	61,311				61,311
Foreign currency translation	(1,542)					(1,542)
Stock-based compensation expense	4,372			4,372
Stock options exercised	13,897	3		13,894
Repurchases of common stock	(425,950)	27	14,243		411,680
Retirement of treasury stock			(5,427)		5,427
Balance at Mar. 31, 2022	$ 605,016	$ 336	$ (14,243)	$ 746,123	$ (120,812)	$ (6,388)

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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 61,311	$ 43,306
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	4,270	3,812
Amortization	838	1,278
Stock-based compensation expense	4,372	2,871
Noncash lease expense	4,537	3,903
Deferred income tax (benefit) provision	(713)	1,289
Amortization and adjustment of deferred credit	(155)	(167)
Other	(265)	124
Changes in assets and liabilities:
Accounts receivable and unbilled, net	(38,224)	1,089
Prepaid expenses and other current assets	(5,547)	(6,073)
Accounts payable	(1,041)	(2,638)
Accrued expenses	(3,651)	(10,043)
Advanced billings	22,580	22,143
Lease liabilities	(3,542)	(3,155)
Other assets and liabilities, net	1,486	(420)
Net cash provided by operating activities	46,256	57,319
CASH FLOWS FROM INVESTING ACTIVITIES:
Property and equipment expenditures	(9,257)	(6,507)
Other	(1,951)	(3,144)
Net cash used in investing activities	(11,208)	(9,651)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from stock option exercises	13,867	9,102
Repurchases of common stock	(425,950)
Proceeds from revolving loan	49,500
Payments on revolving loan	(49,500)
Net cash (used in) provided by financing activities	(412,083)	9,102
EFFECT OF EXCHANGE RATES ON CASH, CASH EQUIVALENTS, AND RESTRICTED CASH	(1,426)	(1,659)
(DECREASE) INCREASE IN CASH, CASH EQUIVALENTS, AND RESTRICTED CASH	(378,461)	55,111
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — Beginning of period	461,304	277,766
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — End of period	82,843	332,877
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION—
Acquisition of property and equipment—non-cash	$ 7,375	$ 6,531

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Basis of Presentation

3 Months Ended

Mar. 31, 2022

Accounting Policies [Abstract]

Basis of Presentation

(1) 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, project management, regulatory affairs, clinical monitoring, data management and analysis, pharmacovigilance new drug application submissions, post-marketing clinical support, 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.

Unaudited Interim Financial Information

The interim condensed consolidated financial statements include the accounts of the Company, are prepared in conformity with U.S. generally accepted accounting principles (“GAAP”), and are unaudited. In the opinion of the Company’s management, all adjustments of a normal recurring nature necessary for a fair presentation have been reflected. Certain financial information that is normally included in annual financial statements prepared in accordance with GAAP, but that is not required for interim reporting purposes, has been omitted. The preparation of the interim condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the interim condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results and outcomes could differ from management’s estimates and assumptions. As such, the information included in this quarterly report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021.

Share Repurchases

In the second quarter of 2021, the Board approved an increase of $150.0 million to the stock repurchase program bringing the total repurchase authorization up to $300.0 million. In the first quarter of 2022, the Board approved increases totaling $500.0 million to the Company's stock repurchase program. During the three months ended March 31, 2022, the Company repurchased 2,745,865 shares for $425.9 million. As of March 31, 2022, the Company has remaining authorization of $264.6 million under the repurchase program.

Repurchases under the share repurchase program are executed in the open market or negotiated transactions under trading plans put in place pursuant to Rule 10b5-1. The Company constructively retired the repurchased shares associated with these approved share repurchases, except for a small portion which were retained as Treasury Shares on the condensed 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 condensed consolidated balance sheets. The repurchase program may be suspended or discontinued at any time without notice.

Recently Issued 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 is currently evaluating the effect this standard will have on its condensed consolidated financial statements and related disclosures.

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Net Income Per Share

3 Months Ended

Mar. 31, 2022

Earnings Per Share [Abstract]

Net Income Per Share

(2) 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 Restricted Stock Awards (“RSA”) 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 Restricted Stock Units (“RSU”) 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 three months ended March 31, 2022 and 2021 (in thousands, except for earnings per share):

	Three Months Ended
	March 31,
	2022			2021
Weighted-average shares:
Common shares outstanding		34,918			35,753
RSAs		21			116
Total weighted-average shares		34,939			35,869
Earnings per common share—Basic
Net income	$	61,311		$	43,306
Less: Undistributed earnings allocated to RSAs		(36	)		(140	)
Net income available to common shareholders—Basic	$	61,275		$	43,166
Net income per common share—Basic	$	1.75		$	1.21
Basic weighted-average common shares outstanding		34,918			35,753
Effect of diluted shares		1,446			1,996
Diluted weighted-average shares outstanding		36,364			37,749
Net income per common share—Diluted	$	1.69		$	1.14

During the three months ended March 31, 2022, the Company had (in thousands) 264 stock options that were excluded due to the exercise price exceeding the average fair value of the Company’s common stock during the period.

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Fair Value Measurements

3 Months Ended

Mar. 31, 2022

Fair Value Disclosures [Abstract]

Fair Value Measurements

(3) 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 recurring fair value measurements as of March 31, 2022. There were no transfers between Level 1, Level 2 or Level 3 during the three months ended March 31, 2022 or March 31, 2021.

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Contract Assets and Contract Liabilities

3 Months Ended

Mar. 31, 2022

Revenue from Contract with Customer [Abstract]

Contract Assets and Contract Liabilities

(4) Contract Assets and Contract Liabilities

Contract assets and liabilities are reflected in the Company’s condensed consolidated balance sheets within the accounts reflected below.

Contract Assets

Accounts receivable represent amounts due from the Company’s customers who are concentrated primarily in the pharmaceutical, biotechnology, and medical device industries. Unbilled represents revenue recognized to date that has not been billed or is not yet contractually billable to the customer. In general, amounts become billable upon the achievement of negotiated contractual events, in accordance with predetermined payment schedules or when a reimbursable expense has been incurred. Amounts classified to unbilled are those billable to customers within one year from the respective balance sheet date.

Accounts receivable and unbilled, net consisted of the following (in thousands):

	As of
	March 31,			December 31,
	2022			2021
Accounts receivable	$	185,309		$	150,496
Unbilled receivables		39,620			36,107
Less: allowance for doubtful accounts		(170	)		(171	)
Total accounts receivable and unbilled, net	$	224,759		$	186,432

Contract Liabilities

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

Advanced billings consisted of the following (in thousands):

	As of
	March 31,		December 31,
	2022		2021
Advanced billings	$	367,221	$	344,641

As of March 31, 2022, we had approximately $2.4 billion of performance obligations remaining to be performed for active projects.

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Intangible Assets, Net

3 Months Ended

Mar. 31, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

Intangible Assets, Net

(5) Intangible Assets, Net

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

	As of
	March 31,			December 31,
	2022			2021
Intangible assets:
Finite-lived intangible assets:
Carrying amount:
Customer relationships		145,051			145,051
Accumulated amortization:
Customer relationships		(136,175	)		(135,337	)
Total finite-lived intangible assets, net		8,876			9,714
Trade name (indefinite-lived)		31,646			31,646
Total intangible assets, net	$	40,522		$	41,360

As of March 31, 2022, estimated amortization expense of the Company’s intangible assets for each of the next five years and thereafter is as follows (in thousands):

	Amortization
Remainder of 2022	$	2,515
2023		2,199
2024		1,443
2025		946
2026		620
Later years		1,153
	$	8,876

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Accrued Expenses

3 Months Ended

Mar. 31, 2022

Payables and Accruals [Abstract]

Accrued Expenses

(6) Accrued Expenses

Accrued expenses consisted of the following (in thousands):

	As of
	March 31,		December 31,
	2022		2021
Employee compensation and benefits	$	44,661	$	57,846
Project related reimbursable expenses		101,085		91,839
Other		9,272		9,601
Total accrued expenses	$	155,018	$	159,286

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Debt

3 Months Ended

Mar. 31, 2022

Debt Disclosure [Abstract]

Debt

(7) Debt

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 (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 30, 2020, the Company amended the Credit Facility to extend its expiration date to March 31, 2021 and add provisions for alternative interest rates when certain interbank market offered rates are not available. On March 29, 2021 the Company amended the Credit Facility expiration date to March 31, 2022. On December 27, 2021, the Company entered into Amendment No. 3 to the Credit Facility, which extends the expiration date of the revolving credit note to March 31, 2023 and adds provisions for alternative rates of interest as a result of global reference rate initiatives and removes the ability to obtain advances in any currency other than U.S. Dollars. After the LIBOR cessation date of December 31, 2021, the Credit Facility bears interest at a rate of the sum of The Secured Overnight Financing Rate (SOFR) and the benchmark replacement adjustment plus 100 basis points (1.00%). On March 15, 2022, the Company entered into Amendment No. 4 to the Credit Facility, which increases the aggregate principal amount that may be borrowed under the facility’s line of credit to up to $250.0 million.

As of March 31, 2022, there were no outstanding borrowings under the Credit Facility and $0.2 million in letters of credit outstanding related to certain operating lease obligations, which are secured by the Credit Facility.

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Leases

3 Months Ended

Mar. 31, 2022

Leases [Abstract]

Leases

(8) 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 18 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):

	Three Months Ended March 31,
	2022		2021
Operating lease cost	$	6,500	$	5,730
Variable lease cost		2,016		1,704

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

	Three Months Ended March 31,
	2022		2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	3,806	$	3,422
Right-of-use assets obtained in exchange for lease obligations:
Operating leases		17,745		2,672

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

	As of
	March 31,			December 31,
	2022			2021
Operating lease right-of-use assets	$	141,638		$	129,558
Other current liabilities	$	18,460		$	16,276
Operating lease liabilities		141,624			130,965
Total operating lease liabilities	$	160,084		$	147,241
Weighted Average Remaining Lease Term (years)
Operating leases	11.4				12.0
Weighted Average Discount Rate
Operating leases		5.3	%		5.5	%

Lease payments due related to lease liabilities as of March 31, 2022 were as follows (in thousands):

	Related Party			Non-Related Parties			Total
	Operating Leases			Operating Leases			Operating Leases
Remainder of 2022	$	8,186		$	10,731		$	18,917
2023		11,025			14,284			25,309
2024		11,154			11,269			22,423
2025		11,286			8,910			20,196
2026		11,422			7,506			18,928
Later years		106,988			10,612			117,600
Total lease payments		160,061			63,312			223,373
Less: imputed interest		(57,504	)		(5,785	)		(63,289	)
Total	$	102,557		$	57,527		$	160,084

As of March 31, 2022, we have several additional leases with contractual obligations, which have not yet commenced, with future payments of $0.1 million.

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Shareholder's Equity and Stock-Based Compensation

3 Months Ended

Mar. 31, 2022

Equity [Abstract]

Shareholder's Equity and Stock-Based Compensation

(9) Shareholder’s Equity and Stock-Based Compensation

The Company granted 364,286 awards to employees under the 2016 Incentive Award Plan during the three months ended March 31, 2022, consisting of 124,043 RSU and 113,009 stock option awards vesting after four years and 127,234 stock option awards vesting after two years.

Award Activity

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

	Three Months Ended March 31, 2022
				Weighted Average
	Stock Options			Exercise Price
Outstanding - beginning of period		1,992,915		$	68.39
Granted		240,243		$	139.63
Exercised		(308,447	)	$	45.05
Cancelled/Forfeited		(15,550	)	$	79.70
Expired		(6,397	)	$	16.20
Outstanding - end of period		1,902,764		$	81.25
Exercisable - end of period		1,266,283		$	53.82

The following table sets forth the Company’s RSA/RSU activity:

	Three Months Ended
	March 31, 2022
	Shares/Units
Outstanding and unvested - beginning of period		602,187
Granted		124,043
Vested		(82,000	)
Forfeited		(17,165	)
Outstanding and unvested - end of period		627,065
Cumulative vested shares - end of period		2,114,916

Stock-based compensation expense recognized in the condensed consolidated statements of operations related to all outstanding stock based compensation awards is summarized below (in thousands):

	Three Months Ended March 31,
	2022		2021
Total direct costs	$	2,440	$	2,047
Selling, general and administrative		1,932		824
Total stock-based compensation expense	$	4,372	$	2,871

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Income Taxes

3 Months Ended

Mar. 31, 2022

Income Tax Disclosure [Abstract]

Income Taxes

(10) Income Taxes

The Company’s effective income tax rate was 6.1% and 10.7% for the three months ended March 31, 2022 and 2021, respectively. The Company’s effective income tax rate for the three months ended March 31, 2022 varied from the U.S. statutory rate of 21% primarily due to the impact of state taxes, which was favorably offset by excess tax benefits recognized from share-based compensation and benefits from uncertain tax positions.

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Commitments and Contingencies

3 Months Ended

Mar. 31, 2022

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

(11) Commitments and Contingencies

Legal Proceedings

The Company is involved in legal proceedings from time to time in the ordinary course of its business, including employment claims and claims related to other business transactions. The Company cannot predict with certainty the outcome of such proceedings, but it believes that adequate reserves have been recorded and losses already recognized with respect to such proceedings, which were immaterial as of March 31, 2022 and December 31, 2021. There is a reasonable possibility that a loss exceeding amounts already recognized may be incurred related to these actions; however, the Company believes that such potential losses were immaterial as of March 31, 2022.

Purchase Commitments

The Company has several minimum purchase commitments for project related supplies totaling $11.9 million as of March 31, 2022. In return for the commitment, Medpace receives preferential pricing. The commitments expire at various times through 2027.

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Related Party Transactions

3 Months Ended

Mar. 31, 2022

Related Party Transactions [Abstract]

Related Party Transactions

(12) 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 $0.2 million existed at March 31, 2022 and December 31, 2021, respectively, and are included in the Prepaid expenses and other current assets and Other assets line items of the condensed consolidated balance sheets, respectively, depending on the contractual repayment date.

Service Agreement

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. 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 $7.4 million and $0.5 million during the three months ended March 31, 2022 and 2021, respectively, in the Company’s condensed consolidated statements of operations. As of March 31, 2022 and December 31, 2021, respectively, the Company had Advanced billings from LIB of $2.9 million in the condensed consolidated balance sheets. In addition, as of March 31, 2022 and December 31, 2021, respectively, the Company had Accounts receivable and unbilled, net from LIB of $3.2 million and $0.5 million in the condensed consolidated balance sheets.

CinRX Pharma and subsidiaries (“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. The Company recognized total revenue from CinRx of $5.8 million and $4.8 million during the three months ended March 31, 2022 and 2021, respectively, in the Company’s condensed consolidated statements of operations. As of March 31, 2022 and December 31, 2021, respectively, the Company had Advanced billings from CinRx of $8.5 million and $5.4 million in the condensed consolidated balance sheets. As of March 31, 2022 and December 31, 2021 the Company had Accounts receivable and unbilled, net from CinRx of $2.8 million and $2.1 million, respectively, in the condensed consolidated balance sheets.

The Summit Hotel (“The Summit”)

The Summit Hotel, located on the Medpace campus, is owned by the chief executive officer, and managed by an unrelated hospitality management entity. Medpace incurs travel lodging and meeting expenses at The Summit. During the three months ended March 31, 2022 and 2021, Medpace incurred expenses of less than $0.1 million and $0.1 million at The Summit, respectively.

Leased Real Estate

Headquarters Lease

The Company entered into an operating lease for its corporate headquarters 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 lease. The lease for headquarters is for an initial term of twelve years through November 2022 with a renewal option for one 10-year term at prevailing market rates. In Q3 2021, the Company accounted for the renewal option, as it became reasonably certain it would be exercised per the agreement, by extending the lease term through November 2032. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for its corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. Operating lease cost recognized for the three months ended March 31, 2022 and 2021 was $0.6 million and $0.5 million, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at March 31, 2022 and December 31, 2021 were $19.3 million and $19.7 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at March 31, 2022 were $1.5 million and $17.9 million, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2021 were $1.5 million and $18.3 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed 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 three months ended March 31, 2022 and 2021 was $1.4 million, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at March 31, 2022 and December 31, 2021 were $54.7 million and $55.1 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at March 31, 2022 were $1.0 million and $65.7 million, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2021 were $0.9 million and $65.9 million, respectively and were recognized in Other current liabilities and Operating lease liabilities in the condensed 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 three months ended March 31, 2022 and 2021 was $0.9 million, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at March 31, 2022 and December 31, 2021 were $16.6 million and $17.2 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at March 31, 2022 were $2.6 million and $13.9 million, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2021 were $2.6 million and $14.6 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed 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 $0.4 million and $0.1 million during the three months ended March 31, 2022 and 2021, respectively, related to these travel services. These travel expenses are recorded in Selling, general and administrative in the Company’s condensed consolidated statements of operations. As of March 31, 2022 and December 31, 2021, the Company had Accounts payable to the Aircraft Management Company of $0.6 million and $0.2 million, respectively, in the condensed consolidated balance sheets.

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Entity Wide Disclosures

3 Months Ended

Mar. 31, 2022

Entity Wide Disclosures [Abstract]

Entity Wide Disclosures

(13) Entity Wide Disclosures

Revenue by Category

The following table disaggregates our revenue by major source (in thousands):

	Three months Ended
	March 31,
	2022		2021
Therapeutic Area
Oncology	$	105,213	$	79,138
Other		70,417		68,938
Metabolic		48,116		32,495
Central Nervous System		38,487		24,812
Cardiology		37,396		23,762
AVAI		31,318		30,820
Total revenue	$	330,947	$	259,965

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Basis of Presentation (Policies)

3 Months Ended

Mar. 31, 2022

Accounting Policies [Abstract]

Unaudited Interim Financial Information

Unaudited Interim Financial Information

The interim condensed consolidated financial statements include the accounts of the Company, are prepared in conformity with U.S. generally accepted accounting principles (“GAAP”), and are unaudited. In the opinion of the Company’s management, all adjustments of a normal recurring nature necessary for a fair presentation have been reflected. Certain financial information that is normally included in annual financial statements prepared in accordance with GAAP, but that is not required for interim reporting purposes, has been omitted. The preparation of the interim condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the interim condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results and outcomes could differ from management’s estimates and assumptions. As such, the information included in this quarterly report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021.

Share Repurchases

Share Repurchases

In the second quarter of 2021, the Board approved an increase of $150.0 million to the stock repurchase program bringing the total repurchase authorization up to $300.0 million. In the first quarter of 2022, the Board approved increases totaling $500.0 million to the Company's stock repurchase program. During the three months ended March 31, 2022, the Company repurchased 2,745,865 shares for $425.9 million. As of March 31, 2022, the Company has remaining authorization of $264.6 million under the repurchase program.

Repurchases under the share repurchase program are executed in the open market or negotiated transactions under trading plans put in place pursuant to Rule 10b5-1. The Company constructively retired the repurchased shares associated with these approved share repurchases, except for a small portion which were retained as Treasury Shares on the condensed 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 condensed consolidated balance sheets. The repurchase program may be suspended or discontinued at any time without notice.

Recently Adopted Accounting Standards

Recently Issued 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 is currently evaluating the effect this standard will have on its condensed consolidated financial statements and related disclosures.

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Net Income Per Share (Tables)

3 Months Ended

Mar. 31, 2022

Earnings Per Share [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 three months ended March 31, 2022 and 2021 (in thousands, except for earnings per share):

	Three Months Ended
	March 31,
	2022			2021
Weighted-average shares:
Common shares outstanding		34,918			35,753
RSAs		21			116
Total weighted-average shares		34,939			35,869
Earnings per common share—Basic
Net income	$	61,311		$	43,306
Less: Undistributed earnings allocated to RSAs		(36	)		(140	)
Net income available to common shareholders—Basic	$	61,275		$	43,166
Net income per common share—Basic	$	1.75		$	1.21
Basic weighted-average common shares outstanding		34,918			35,753
Effect of diluted shares		1,446			1,996
Diluted weighted-average shares outstanding		36,364			37,749
Net income per common share—Diluted	$	1.69		$	1.14

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Contract Assets and Contract Liabilities (Tables)

3 Months Ended

Mar. 31, 2022

Revenue from Contract with Customer [Abstract]

Summary of Company's Contract Asset and Contract Liability

Accounts receivable and unbilled, net consisted of the following (in thousands):

	As of
	March 31,			December 31,
	2022			2021
Accounts receivable	$	185,309		$	150,496
Unbilled receivables		39,620			36,107
Less: allowance for doubtful accounts		(170	)		(171	)
Total accounts receivable and unbilled, net	$	224,759		$	186,432

Advanced billings consisted of the following (in thousands):

	As of
	March 31,		December 31,
	2022		2021
Advanced billings	$	367,221	$	344,641

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Intangible Assets, Net (Tables)

3 Months Ended

Mar. 31, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Intangible Assets, Net

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

	As of
	March 31,			December 31,
	2022			2021
Intangible assets:
Finite-lived intangible assets:
Carrying amount:
Customer relationships		145,051			145,051
Accumulated amortization:
Customer relationships		(136,175	)		(135,337	)
Total finite-lived intangible assets, net		8,876			9,714
Trade name (indefinite-lived)		31,646			31,646
Total intangible assets, net	$	40,522		$	41,360

Schedule of Estimated Amortization Expense of Intangible Assets

As of March 31, 2022, estimated amortization expense of the Company’s intangible assets for each of the next five years and thereafter is as follows (in thousands):

	Amortization
Remainder of 2022	$	2,515
2023		2,199
2024		1,443
2025		946
2026		620
Later years		1,153
	$	8,876

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Accrued Expenses (Tables)

3 Months Ended

Mar. 31, 2022

Payables and Accruals [Abstract]

Schedule of Accrued Expenses

Accrued expenses consisted of the following (in thousands):

	As of
	March 31,		December 31,
	2022		2021
Employee compensation and benefits	$	44,661	$	57,846
Project related reimbursable expenses		101,085		91,839
Other		9,272		9,601
Total accrued expenses	$	155,018	$	159,286

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Leases (Tables)

3 Months Ended

Mar. 31, 2022

Leases [Abstract]

Summary of Components of Lease Expense

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

	Three Months Ended March 31,
	2022		2021
Operating lease cost	$	6,500	$	5,730
Variable lease cost		2,016		1,704

Summary of Supplemental Cash Flow Information Related to Leases

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

	Three Months Ended March 31,
	2022		2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	3,806	$	3,422
Right-of-use assets obtained in exchange for lease obligations:
Operating leases		17,745		2,672

Summary of Supplemental Balance Sheet Information Related to Leases

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

	As of
	March 31,			December 31,
	2022			2021
Operating lease right-of-use assets	$	141,638		$	129,558
Other current liabilities	$	18,460		$	16,276
Operating lease liabilities		141,624			130,965
Total operating lease liabilities	$	160,084		$	147,241
Weighted Average Remaining Lease Term (years)
Operating leases	11.4				12.0
Weighted Average Discount Rate
Operating leases		5.3	%		5.5	%

Schedule of Lease Payments Due Related To Lease Liabilities

Lease payments due related to lease liabilities as of March 31, 2022 were as follows (in thousands):

	Related Party			Non-Related Parties			Total
	Operating Leases			Operating Leases			Operating Leases
Remainder of 2022	$	8,186		$	10,731		$	18,917
2023		11,025			14,284			25,309
2024		11,154			11,269			22,423
2025		11,286			8,910			20,196
2026		11,422			7,506			18,928
Later years		106,988			10,612			117,600
Total lease payments		160,061			63,312			223,373
Less: imputed interest		(57,504	)		(5,785	)		(63,289	)
Total	$	102,557		$	57,527		$	160,084

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Shareholder's Equity and Stock-Based Compensation (Tables)

3 Months Ended

Mar. 31, 2022

Equity [Abstract]

Schedule of Stock Option Activity

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

	Three Months Ended March 31, 2022
				Weighted Average
	Stock Options			Exercise Price
Outstanding - beginning of period		1,992,915		$	68.39
Granted		240,243		$	139.63
Exercised		(308,447	)	$	45.05
Cancelled/Forfeited		(15,550	)	$	79.70
Expired		(6,397	)	$	16.20
Outstanding - end of period		1,902,764		$	81.25
Exercisable - end of period		1,266,283		$	53.82

Schedule of RSA/RSU Activity

The following table sets forth the Company’s RSA/RSU activity:

	Three Months Ended
	March 31, 2022
	Shares/Units
Outstanding and unvested - beginning of period		602,187
Granted		124,043
Vested		(82,000	)
Forfeited		(17,165	)
Outstanding and unvested - end of period		627,065
Cumulative vested shares - end of period		2,114,916

Summary of Stock-Based Compensation Expense Recognized in Statements of Operations Related to All Outstanding Stock Based Compensation Awards

Stock-based compensation expense recognized in the condensed consolidated statements of operations related to all outstanding stock based compensation awards is summarized below (in thousands):

	Three Months Ended March 31,
	2022		2021
Total direct costs	$	2,440	$	2,047
Selling, general and administrative		1,932		824
Total stock-based compensation expense	$	4,372	$	2,871

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Entity Wide Disclosures (Tables)

3 Months Ended

Mar. 31, 2022

Entity Wide Disclosures [Abstract]

Summary of Revenue by Major Source

The following table disaggregates our revenue by major source (in thousands):

	Three months Ended
	March 31,
	2022		2021
Therapeutic Area
Oncology	$	105,213	$	79,138
Other		70,417		68,938
Metabolic		48,116		32,495
Central Nervous System		38,487		24,812
Cardiology		37,396		23,762
AVAI		31,318		30,820
Total revenue	$	330,947	$	259,965

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Basis of Presentation - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Jun. 30, 2021
Basis Of Presentation [Line Items]
Repurchases of shares, value	$ 425,950
Share Repurchase Program
Basis Of Presentation [Line Items]
Stock repurchase program, additional amount authorized	$ 500,000	$ 150,000
Repurchases of shares	2,745,865
Repurchases of shares, value	$ 425,900
Remaining amount of repurchase program	$ 264,600
Share Repurchase Program | Maximum
Basis Of Presentation [Line Items]
Stock repurchase program, authorized amount		$ 300,000

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Net Income Per Share - Schedule of Reconciliation of Denominators and Additional Shares that are Excluded from the Calculation of EPS (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Weighted-average shares:
Basic weighted-average common shares outstanding	34,918	35,753
Total weighted-average shares	34,939	35,869
Earnings per common share—Basic
Net income	$ 61,311	$ 43,306
Net income available to common shareholders—Basic	$ 61,275	$ 43,166
Net income per common share—Basic	$ 1.75	$ 1.21
Basic weighted-average common shares outstanding	34,918	35,753
Effect of diluted shares	1,446	1,996
Diluted weighted-average shares outstanding	36,364	37,749
Net income per common share—Diluted	$ 1.69	$ 1.14
RSAs
Weighted-average shares:
Basic weighted-average common shares outstanding	21	116
Earnings per common share—Basic
Less: Undistributed earnings allocated to RSAs	$ (36)	$ (140)
Basic weighted-average common shares outstanding	21	116
Common Stock
Weighted-average shares:
Basic weighted-average common shares outstanding	34,918	35,753
Earnings per common share—Basic
Basic weighted-average common shares outstanding	34,918	35,753

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Net Income Per Share - Additional Information (Details) shares in Thousands	3 Months Ended
	Mar. 31, 2022 shares
Stock Options
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of diluted EPS	264

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Fair Value Measurements - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Fair value measurements transfers between level 1, level 2 or level 3	$ 0	$ 0

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Contract Assets and Contract Liabilities - Summary of Accounts Receivable and Unbilled, Net (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Revenue from Contract with Customer [Abstract]
Accounts receivable	$ 185,309	$ 150,496
Unbilled receivables	39,620	36,107
Less: allowance for doubtful accounts	(170)	(171)
Total accounts receivable and unbilled, net	$ 224,759	$ 186,432

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Contract Assets and Contract Liabilities - Summary of Advanced Billings (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Revenue from Contract with Customer [Abstract]
Advanced billings	$ 367,221	$ 344,641

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Contract Assets and Contract Liabilities - Additional Information (Details) $ in Billions	Mar. 31, 2022 USD ($)
Revenue from Contract with Customer [Abstract]
Performance obligations remaining to be performed	$ 2.4

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Intangible Assets, Net - Schedule of Intangible Assets, Net (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Accumulated amortization:
Total finite-lived intangible assets, net	$ 8,876	$ 9,714
Trade name (indefinite-lived)	31,646	31,646
Total intangible assets, net	40,522	41,360
Customer Relationships
Finite-lived intangible assets:
Total finite-lived intangible assets	145,051	145,051
Accumulated amortization:
Total accumulated amortization	$ (136,175)	$ (135,337)

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Intangible Assets, Net - Schedule of Estimated Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Remainder of 2022	$ 2,515
2023	2,199
2024	1,443
2025	946
2026	620
Later years	1,153
Total finite-lived intangible assets, net	$ 8,876	$ 9,714

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Accrued Expenses - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Accrued Liabilities and Other Liabilities [Abstract]
Employee compensation and benefits	$ 44,661	$ 57,846
Project related reimbursable expenses	101,085	91,839
Other	9,272	9,601
Total accrued expenses	$ 155,018	$ 159,286

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Debt - Additional Information (Details) - USD ($)	Jan. 01, 2022	Dec. 27, 2021	Mar. 29, 2021	Mar. 30, 2020	Mar. 31, 2022	Mar. 15, 2022	Sep. 30, 2019
Debt Instrument [Line Items]
Outstanding letters of credit					$ 200,000
Credit Facility
Debt Instrument [Line Items]
Credit facility, expiration date		Mar. 31, 2023	Mar. 31, 2022	Mar. 31, 2021
Outstanding borrowings					$ 0
Credit Facility | The Secured Overnight Financing Rate
Debt Instrument [Line Items]
Debt instrument, basis points	1.00%
Maximum
Debt Instrument [Line Items]
Aggregate principal amount borrowed under line of credit facility						$ 250,000,000.0
Maximum | Credit Facility
Debt Instrument [Line Items]
Debt instrument, principal amount							$ 50,000,000.0

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Leases - Additional Information (Details) $ in Millions	3 Months Ended
	Mar. 31, 2022 USD ($)
Lessee Lease Description [Line Items]
Lease not yet commenced, future payments	$ 0.1
Real Estate and Equipment
Lessee Lease Description [Line Items]
Description of option to extend the lease	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.
Operating lease, existense of option to extend	true
Description of option to terminate the lease	Many leases also include options to terminate the leases within 1 year or per other contractual terms.
Lessee, operating lease, existence of option to terminate	true
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
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	18 years

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Leases - Summary of Components of Lease Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Lease, Cost [Abstract]
Operating lease cost	$ 6,500	$ 5,730
Variable lease cost	$ 2,016	$ 1,704

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Leases - Summary of Supplemental Cash Flow Information Related to Leases (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 3,806	$ 3,422
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 17,745	$ 2,672

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Leases - Summary of Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Assets and Liabilities, Lessee [Abstract]
Operating lease right-of-use assets	$ 141,638	$ 129,558
Other current liabilities	$ 18,460	$ 16,276
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Other current liabilities	Other current liabilities
Operating lease liabilities	$ 141,624	$ 130,965
Total operating lease liabilities	$ 160,084	$ 147,241
Weighted Average Remaining Lease Term (years)
Operating leases	11 years 4 months 24 days	12 years
Weighted Average Discount Rate
Operating leases	5.30%	5.50%

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Leases - Schedule of Lease Payments Due Related To Lease Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2022	$ 18,917
2023	25,309
2024	22,423
2025	20,196
2026	18,928
Later years	117,600
Total lease payments	223,373
Less: imputed interest	(63,289)
Total	160,084	$ 147,241
Related Party
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2022	8,186
2023	11,025
2024	11,154
2025	11,286
2026	11,422
Later years	106,988
Total lease payments	160,061
Less: imputed interest	(57,504)
Total	102,557
Non-Related Party
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2022	10,731
2023	14,284
2024	11,269
2025	8,910
2026	7,506
Later years	10,612
Total lease payments	63,312
Less: imputed interest	(5,785)
Total	$ 57,527

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Shareholder's Equity and Stock-Based Compensation - Additional Information (Details)	3 Months Ended
	Mar. 31, 2022 shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options granted	240,243
2016 Incentive Award Plan | Granted to Employees
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Awards granted to employees	364,286
2016 Incentive Award Plan | Vesting After Two Years | Stock Options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options granted	127,234
Award vesting period	2 years
2016 Incentive Award Plan | Vesting After Four Years | Stock Options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options granted	113,009
Award vesting period	4 years
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
Shares granted	124,043

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Shareholder's Equity and Stock-Based Compensation - Schedule of Stock Option Activity (Details)	3 Months Ended
	Mar. 31, 2022 $ / shares shares
Equity [Abstract]
Number of Stock Options, Outstanding - beginning of period | shares	1,992,915
Number of Stock Options, Granted | shares	240,243
Number of Stock Options, Exercised | shares	(308,447)
Number of Stock Options, Cancelled/Forfeited | shares	(15,550)
Number of Stock Options, Expired | shares	(6,397)
Number of Stock Options, Outstanding - end of period | shares	1,902,764
Number of Stock Options, Exercisable - end of period | shares	1,266,283
Weighted Average Exercise Price, Outstanding - beginning of period | $ / shares	$ 68.39
Weighted Average Exercise Price, Granted | $ / shares	139.63
Weighted Average Exercise Price, Exercised | $ / shares	45.05
Weighted Average Exercise Price, Cancelled/Forfeited | $ / shares	79.70
Weighted Average Exercise Price, Expired | $ / shares	16.20
Weighted Average Exercise Price, Outstanding - end of period | $ / shares	81.25
Weighted Average Exercise Price, Exercisable - end of period | $ / shares	$ 53.82

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Shareholder's Equity and Stock-Based Compensation - Schedule of RSA/RSU Activity (Details) - RSA/RSU	3 Months Ended
	Mar. 31, 2022 shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Outstanding and unvested - beginning of period	602,187
Granted	124,043
Vested	(82,000)
Forfeited	(17,165)
Outstanding and unvested - end of period	627,065
Cumulative vested shares - end of period	2,114,916

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Shareholder's Equity and Stock-Based Compensation - Summary of Stock-Based Compensation Expense Recognized in Statements of Operations Related to All Outstanding Stock Based Compensation Awards (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 4,372	$ 2,871
Total Direct Costs
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	2,440	2,047
Selling, General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 1,932	$ 824

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Income Taxes - Additional Information (Details)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Effective income tax rate	6.10%	10.70%
U.S. statutory rate	21.00%

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Commitments and Contingencies - Additional Information (Details) $ in Millions	3 Months Ended
	Mar. 31, 2022 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Minimum purchase commitments for project related supplies	$ 11.9
Minimum purchase commitments, description	The Company has several minimum purchase commitments for project related supplies totaling $11.9 million as of March 31, 2022. In return for the commitment, Medpace receives preferential pricing. The commitments expire at various times through 2027.

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Related Party Transactions - Additional Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2022 USD ($) RenewalOption Agreement Building	Mar. 31, 2021 USD ($)	Dec. 31, 2021 USD ($)
Related Party Transaction [Line Items]
Advanced billings	$ 11,400		$ 8,300
Accounts receivable and unbilled, net	6,000		2,700
Operating lease cost recognized	6,500	$ 5,730
Operating lease right-of-use assets	141,638		129,558
Current portion of lease liability	18,460		16,276
Long-term portion of lease liabilities	141,624		130,965
Accounts payable	700		300
Employee Loans | Prepaid Expenses and Other Current Assets and Other Assets
Related Party Transaction [Line Items]
Employee advances receivables	200		200
Service Agreement | LIB
Related Party Transaction [Line Items]
Advanced billings	2,900		2,900
Accounts receivable and unbilled, net	3,200		500
Service Agreement | LIB | Revenue Net
Related Party Transaction [Line Items]
Revenue with related parties	7,400	500
Service Agreement | CinRx Pharma and Subsidiaries
Related Party Transaction [Line Items]
Advanced billings	8,500		5,400
Accounts receivable and unbilled, net	2,800		2,100
Service Agreement | CinRx Pharma and Subsidiaries | Revenue Net
Related Party Transaction [Line Items]
Revenue with related parties	5,800	4,800
Service Agreement | The Summit
Related Party Transaction [Line Items]
Expenses incurred		100
Service Agreement | The Summit | Maximum
Related Party Transaction [Line Items]
Expenses incurred	$ 100
Leased Real Estate | Chief Executive Officer
Related Party Transaction [Line Items]
Term of lease	12 years
Lease expiration period	2022-11
Number of lease renewal, 10-year option | RenewalOption	1
Lease term upon renewal	10 years
Lease term reassessment Description	In Q3 2021, the Company accounted for the renewal option, as it became reasonably certain it would be exercised per the agreement, by extending the lease term through November 2032.
Leased Real Estate | Chief Executive Officer | Direct Costs and Selling, General And Administrative
Related Party Transaction [Line Items]
Operating lease cost recognized	$ 600	500
Leased Real Estate | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Number of lease renewal, 10-year option | RenewalOption	2
Lease term upon renewal	10 years
Lease expiration year	2040
Leased Real Estate | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Number of lease renewal, 10-year option | RenewalOption	1
Lease term upon renewal	10 years
Lease expiration year	2027
Number of lease agreements | Agreement	2
Number of buildings | Building	2
Lease occupancy year	2012
Leased Real Estate | Chief Executive Officer And Immediate Family | Direct Costs and Selling, General And Administrative | Office Space
Related Party Transaction [Line Items]
Operating lease cost recognized	$ 1,400	1,400
Leased Real Estate | Chief Executive Officer And Immediate Family | Direct Costs and Selling, General And Administrative | Building
Related Party Transaction [Line Items]
Operating lease cost recognized	900	900
Leased Real Estate | Operating Lease Right-of-Use Assets | Chief Executive Officer
Related Party Transaction [Line Items]
Operating lease right-of-use assets	19,300		19,700
Leased Real Estate | Operating Lease Right-of-Use Assets | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Operating lease right-of-use assets	54,700		55,100
Leased Real Estate | Operating Lease Right-of-Use Assets | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Operating lease right-of-use assets	16,600		17,200
Leased Real Estate | Other Current Liabilities | Chief Executive Officer
Related Party Transaction [Line Items]
Current portion of lease liability	1,500		1,500
Leased Real Estate | Other Current Liabilities | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Current portion of lease liability	1,000		900
Leased Real Estate | Other Current Liabilities | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Current portion of lease liability	2,600		2,600
Leased Real Estate | Operating Lease Liabilities | Chief Executive Officer
Related Party Transaction [Line Items]
Long-term portion of lease liabilities	17,900		18,300
Leased Real Estate | Operating Lease Liabilities | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Long-term portion of lease liabilities	65,700		65,900
Leased Real Estate | Operating Lease Liabilities | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Long-term portion of lease liabilities	13,900		14,600
Travel Services
Related Party Transaction [Line Items]
Accounts payable	600		$ 200
Travel Services | Chief Executive Officer
Related Party Transaction [Line Items]
Travel expenses with related party	$ 400	$ 100

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Entity Wide Disclosures - Summary of Revenue by Major Source (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Disaggregation Of Revenue [Line Items]
Total revenue	$ 330,947	$ 259,965
Oncology
Disaggregation Of Revenue [Line Items]
Total revenue	105,213	79,138
Other
Disaggregation Of Revenue [Line Items]
Total revenue	70,417	68,938
Metabolic
Disaggregation Of Revenue [Line Items]
Total revenue	48,116	32,495
Central Nervous System
Disaggregation Of Revenue [Line Items]
Total revenue	38,487	24,812
Cardiology
Disaggregation Of Revenue [Line Items]
Total revenue	37,396	23,762
AVAI
Disaggregation Of Revenue [Line Items]
Total revenue	31,318	30,820
Revenue Net
Disaggregation Of Revenue [Line Items]
Total revenue	$ 330,947	$ 259,965