- Delivers full-year revenue of
$3.95 billion , representing 46.1% growth year-over-year - Exceeds high-end of fourth quarter and full-year guidance across all key metrics: membership, revenue, adjusted gross profit and adjusted EBITDA
- Raises health plan membership guidance by 2,000 at the midpoint and introduces 2026 revenue guidance of
$5.14 billion to$5.19 billion , representing 30%-31% growth year-over-year, and adjusted EBITDA of$133 million to$163 million - Earns recognition on the 2026 Fortune World’s Most Admired Companies™ list, underscoring the company’s innovative approach to senior health care
“Our fourth quarter and full-year 2025 results show what Medicare Advantage done right looks like,” said
Fourth Quarter 2025 Financial Highlights
All comparisons, unless otherwise noted, are to the three months ended
- Health plan membership at the end of the quarter was approximately 236,300, up 25.0% year-over-year
- Total revenue was
$1,012.8 million , up 44.4% year-over-year - Adjusted gross profit* was
$124.9 million and loss from operations was$10.3 million - Adjusted gross profit excludes depreciation and amortization of
$7.8 million and selling, general, and administrative expenses of$125.8 million (which includes$11.5 million of equity-based compensation). Adjusted gross profit also excludes an additional$1 .6 million of equity-based compensation recorded within medical expenses - Medical benefits ratio based on adjusted gross profit was 87.7%
- Adjusted gross profit excludes depreciation and amortization of
- Adjusted EBITDA* was
$11.4 million and net loss was$11.0 million
Full Year 2025 Financial Highlights
All comparisons, unless otherwise noted, are to the twelve months ended
- Total revenue was
$3,948.7 million , up 46.1% year over year. - Adjusted gross profit was
$494.8 million and income from operations was$14.8 million - Adjusted gross profit excludes depreciation and amortization of
$30.4 million and selling, general, and administrative expenses of$443.4 million (which includes$55.9 million of equity-based compensation). Adjusted gross profit also excludes$0.1 of depreciation expense and an additional$6.1 million of equity-based compensation recorded within medical expenses - Medical benefits ratio based on adjusted gross profit was 87.5%
- Adjusted gross profit excludes depreciation and amortization of
- Adjusted EBITDA was
$109.9 million and net loss was$1.0 million
* Please see "Fourth Quarter 2025 Non-GAAP Reconciliation Tables" below for more information on the non-GAAP financial measures reported here as supplemental information.
Outlook for First Quarter and Fiscal Year 2026
| Three Months Ending | Twelve Months Ending | |||
| $ Millions | Low | High | Low | High |
| Health Plan Membership | 281,000 | 285,000 | 292,000 | 298,000 |
| Revenue | ||||
| Adjusted Gross Profit(1) | ||||
| Adjusted EBITDA(1) | ||||
_______________________
| (1) | Adjusted gross profit and adjusted EBITDA are non-GAAP financial measures presented as supplemental disclosure. We cannot provide estimated ranges for the most directly comparable GAAP measures without unreasonable efforts because of the uncertainty around certain items that may impact such GAAP measures, including equity-based compensation expense and depreciation and amortization, that are not within our control or cannot be reasonably predicted. See “Fourth Quarter 2025 Non-GAAP Reconciliation Tables” for additional information. |
Fourth Quarter 2025 Non-GAAP Reconciliation Tables
Adjusted Gross Profit(1) is reconciled as follows:
| Three Months Ended | Year Ended | |||||||||||||
| 2025 | 2024 | 2025 | 2024 | |||||||||||
| (dollars in thousands) | ||||||||||||||
| Income (loss) from operations | $ | (10,284 | ) | $ | (22,545 | ) | $ | 14,752 | $ | (101,555 | ) | |||
| Add back: | ||||||||||||||
| Equity-based compensation (medical expenses) | $ | 1,613 | $ | 1,546 | 6,134 | 4,930 | ||||||||
| Depreciation (medical expenses) | $ | 4 | $ | 46 | 78 | 190 | ||||||||
| Restructuring costs (medical expenses) (2) | $ | — | $ | — | — | 796 | ||||||||
| Depreciation and amortization (3) | $ | 7,830 | $ | 6,762 | 30,404 | 26,872 | ||||||||
| Selling, general, and administrative expenses | $ | 125,764 | $ | 102,128 | 443,407 | 371,374 | ||||||||
| Total add back | 135,211 | 110,482 | 480,023 | 404,162 | ||||||||||
| Adjusted gross profit | $ | 124,927 | $ | 87,937 | $ | 494,775 | $ | 302,607 | ||||||
| (1) | Adjusted gross profit is a non-GAAP financial measure that is presented as supplemental disclosure, that we define as income (loss) from operations before depreciation and amortization, medical equity-based compensation expense, clinical restructuring costs and selling, general, and administrative expenses. |
| (2) | Represents severance and related costs incurred as part of a corporate restructuring designed to streamline our organizational structure and drive operational efficiencies. |
| (3) | Amortization expense for the year ended |
Adjusted EBITDA(1) is reconciled as follows:
| Three Months Ended | Year Ended | ||||||||||||||
| 2025 | 2024 | 2025 | 2024 | ||||||||||||
| (dollars in thousands) | |||||||||||||||
| Net loss | $ | (11,006 | ) | $ | (31,064 | ) | $ | (978 | ) | $ | (128,071 | ) | |||
| Less: Net income (loss) attributable to noncontrolling interest | — | (27 | ) | (254 | ) | (36 | ) | ||||||||
| Adjustments: | |||||||||||||||
| Interest expense | 3,949 | 5,492 | 15,799 | 23,547 | |||||||||||
| Depreciation and amortization(2) | 7,834 | 6,808 | 30,482 | 27,062 | |||||||||||
| Income tax expense | (3,227 | ) | 7 | 20 | 21 | ||||||||||
| Equity-based compensation(3) | 13,115 | 16,236 | 62,082 | 71,132 | |||||||||||
| Acquisition expenses(4) | — | — | — | 26 | |||||||||||
| Litigation costs (5) | 749 | 892 | 2,357 | 2,069 | |||||||||||
| Loss on ROU assets(6) | — | — | — | 143 | |||||||||||
| Gain on sale of property and equipment | — | (1 | ) | (72 | ) | (9 | ) | ||||||||
| Restructuring costs(7) | — | — | — | 2,363 | |||||||||||
| Loss on extinguishment of debt | — | 3,020 | — | 3,020 | |||||||||||
| Adjusted EBITDA | $ | 11,414 | $ | 1,363 | $ | 109,944 | $ | 1,339 | |||||||
| (1) | Adjusted EBITDA is a non-GAAP financial measure that is presented as supplemental disclosure, that we define as net income (loss) before interest expense, income taxes, depreciation and amortization expense, acquisition expenses, certain litigation costs, gains or losses on right of use ("ROU") assets, gains or losses on sale of property and equipment, restructuring costs, equity-based compensation expense, and loss on extinguishment of debt. |
| (2) | Amortization expense for the year ended |
| (3) | Represents equity-based compensation related to grants made in the applicable year. |
| (4) | Represents acquisition-related fees, such as legal and advisory fees, that are non-capitalizable. |
| (5) | Represents litigation costs considered outside of the ordinary course of business based on the following considerations which we assess regularly: (i) the frequency of similar cases that have been brought to date, or are expected to be brought within two years, (ii) complexity of the case, (iii) nature of the remedies sought, (iv) litigation posture of the Company, (v) counterparty involved, and (vi) the Company's overall litigation strategy |
| (6) | Represents gains or losses related to ROU assets that were terminated or subleased in the respective period. |
| (7) | Represents severance and related costs incurred as part of a corporate restructuring designed to streamline our organizational structure and drive operational efficiencies. |
Conference Call Details
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About
From Fortune, ©2026 Fortune
Forward-Looking Statements
This release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, and the Private Securities Litigation Reform Act of 1995, as amended. These forward-looking statements include statements regarding our future growth and our financial outlook for the quarter ending
| Consolidated Balance Sheets (in thousands, except par value and share amounts) | |||||||
2025 | 2024 | ||||||
| Assets | |||||||
| Current Assets: | |||||||
| Cash and cash equivalents | $ | 575,817 | $ | 432,859 | |||
| Accounts receivable (less allowance for credit losses of | 253,207 | 153,904 | |||||
| Investments - current | 28,413 | 37,791 | |||||
| Prepaid expenses and other current assets | 94,140 | 37,084 | |||||
| Total current assets | 951,577 | 661,638 | |||||
| Property and equipment, net | 64,251 | 67,139 | |||||
| Right of use asset, net | 7,019 | 7,818 | |||||
| 32,060 | 34,826 | ||||||
| Intangible assets, net | 4,550 | 4,550 | |||||
| Other assets | 6,329 | 6,092 | |||||
| Total assets | $ | 1,065,786 | $ | 782,063 | |||
| Liabilities and Stockholders' Equity | |||||||
| Current Liabilities: | |||||||
| Medical expenses payable | $ | 474,569 | $ | 289,788 | |||
| Accounts payable and accrued expenses | 33,284 | 22,126 | |||||
| Accrued compensation | 49,013 | 39,931 | |||||
| Total current liabilities | 556,866 | 351,845 | |||||
| Long-term debt, net of debt issuance costs | 323,176 | 321,428 | |||||
| Long-term portion of lease liabilities | 6,467 | 7,835 | |||||
| Total liabilities | 886,509 | 681,108 | |||||
| Stockholders' Equity: | |||||||
| Preferred stock, | — | — | |||||
| Common stock, | 205 | 192 | |||||
| Additional paid-in capital | 1,188,089 | 1,107,952 | |||||
| Accumulated deficit | (1,009,017 | ) | (1,008,293 | ) | |||
| 179,277 | 99,851 | ||||||
| Noncontrolling interest | — | 1,104 | |||||
| Total stockholders' equity | 179,277 | 100,955 | |||||
| Total liabilities and stockholders' equity | $ | 1,065,786 | $ | 782,063 | |||
| Consolidated Statements of Operations (in thousands, except per share amounts) | |||||||||||||||
| Three Months Ended | Year Ended | ||||||||||||||
| 2025 | 2024 | 2025 | 2024 | ||||||||||||
| Revenues: | |||||||||||||||
| Earned premiums | $ | 1,003,791 | $ | 691,785 | $ | 3,911,718 | $ | 2,671,931 | |||||||
| Other | 9,013 | 9,456 | 37,001 | 31,630 | |||||||||||
| Total revenues | 1,012,804 | 701,241 | 3,948,719 | 2,703,561 | |||||||||||
| Expenses: | |||||||||||||||
| Medical expenses | 889,494 | 614,896 | 3,460,156 | 2,406,870 | |||||||||||
| Selling, general, and administrative expenses | 125,764 | 102,128 | 443,407 | 371,374 | |||||||||||
| Depreciation and amortization | 7,830 | 6,762 | 30,404 | 26,872 | |||||||||||
| Total expenses | 1,023,088 | 723,786 | 3,933,967 | 2,805,116 | |||||||||||
| Income (loss) from operations | (10,284 | ) | (22,545 | ) | 14,752 | (101,555 | ) | ||||||||
| Other expenses: | |||||||||||||||
| Interest expense | 3,949 | 5,492 | 15,799 | 23,547 | |||||||||||
| Other income, net | — | — | (89 | ) | (72 | ) | |||||||||
| Loss on extinguishment of debt | — | 3,020 | — | 3,020 | |||||||||||
| Total other expenses | 3,949 | 8,512 | 15,710 | 26,495 | |||||||||||
| Loss before income taxes | (14,233 | ) | (31,057 | ) | (958 | ) | (128,050 | ) | |||||||
| Provision for income tax expense (benefit) | (3,227 | ) | 7 | 20 | 21 | ||||||||||
| Net loss | $ | (11,006 | ) | $ | (31,064 | ) | $ | (978 | ) | $ | (128,071 | ) | |||
| Less: Net loss attributable to noncontrolling interest | — | 27 | (254 | ) | (36 | ) | |||||||||
| Net loss attributable to | $ | (11,006 | ) | $ | (31,091 | ) | $ | (724 | ) | $ | (128,035 | ) | |||
| Total weighted-average common shares outstanding - basic and diluted | 200,970,862 | 191,897,164 | 198,006,216 | 190,793,552 | |||||||||||
| Net loss per share attributable to | (0.05 | ) | (0.16 | ) | 0.00 | (0.67 | ) | ||||||||
| Consolidated Statements of Cash Flows (in thousands) | |||||||||||
| Year Ended | |||||||||||
| 2025 | 2024 | 2023 | |||||||||
| Operating Activities: | |||||||||||
| Net loss | $ | (978 | ) | $ | (128,071 | ) | $ | (148,173 | ) | ||
| Adjustments to reconcile Net loss to net cash provided by (used in) operating activities: | |||||||||||
| Provision for credit loss | 833 | 123 | 91 | ||||||||
| (Gain) loss on right of use assets | — | 143 | (289 | ) | |||||||
| Gain on sale of property and equipment | (72 | ) | (9 | ) | — | ||||||
| Depreciation and amortization | 30,482 | 27,062 | 21,668 | ||||||||
| Amortization-debt issuance costs | 1,761 | 1,293 | 1,254 | ||||||||
| Amortization-investment discount | (1,298 | ) | (2,579 | ) | (4,917 | ) | |||||
| Equity-based compensation | 62,082 | 71,132 | 66,835 | ||||||||
| Non-cash lease expense | 1,609 | 1,764 | 2,318 | ||||||||
| Loss on extinguishment of debt | — | 3,020 | — | ||||||||
| Changes in operating assets and liabilities: | |||||||||||
| Accounts receivable | (100,106 | ) | (34,278 | ) | (26,950 | ) | |||||
| Prepaid expenses and other current assets | (57,059 | ) | 7,887 | (2,863 | ) | ||||||
| Other assets | (50 | ) | 60 | (142 | ) | ||||||
| Medical expenses payable | 184,781 | 84,389 | 35,264 | ||||||||
| Accounts payable and accrued expenses | 10,364 | (1,460 | ) | (6,347 | ) | ||||||
| Accrued compensation | 9,082 | 5,819 | 6,574 | ||||||||
| Lease liabilities | (1,504 | ) | (1,525 | ) | (3,510 | ) | |||||
| Net cash provided by (used in) operating activities | 139,927 | 34,770 | (59,187 | ) | |||||||
| Investing Activities: | |||||||||||
| Purchase of investments | (65,633 | ) | (82,200 | ) | (379,058 | ) | |||||
| Sale of property and equipment | 75 | 14 | — | ||||||||
| Maturities of investments | 76,300 | 162,795 | 267,790 | ||||||||
| Sale of business | 1,065 | — | — | ||||||||
| Acquisition of property and equipment, net | (26,781 | ) | (41,418 | ) | (35,995 | ) | |||||
| Net cash provided by (used in) investing activities | (14,974 | ) | 39,191 | (147,263 | ) | ||||||
| Financing Activities: | |||||||||||
| Proceeds from long-term debt | — | 380,000 | — | ||||||||
| Debt issuance costs | (26 | ) | (8,792 | ) | — | ||||||
| Repayment of long-term debt | — | (215,000 | ) | — | |||||||
| Payment of employment taxes related to release of restricted stock | — | (350 | ) | — | |||||||
| Proceeds from exercise of stock options | 18,067 | 155 | — | ||||||||
| Contributions from noncontrolling interest holders | — | 15 | 105 | ||||||||
| Net cash provided by financing activities | 18,041 | 156,028 | 105 | ||||||||
| Net increase (decrease) in cash | 142,994 | 229,989 | (206,345 | ) | |||||||
| Cash, cash equivalents and restricted cash at beginning of period | 434,943 | 204,954 | 411,299 | ||||||||
| Cash, cash equivalents and restricted cash at end of period | $ | 577,937 | $ | 434,943 | $ | 204,954 | |||||
| Supplemental disclosure of cash flow information: | |||||||||||
| Cash paid for interest | $ | 13,752 | $ | 22,157 | $ | 19,165 | |||||
| Supplemental non-cash investing and financing activities: | |||||||||||
| Acquisition of property in accounts payable | $ | 97 | $ | 70 | $ | 59 | |||||
| Debt issuance costs in accounts payable | $ | — | $ | 512 | $ | — | |||||
The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the consolidated balance sheets to the total above:
| Cash and cash equivalents | $ | 575,817 | $ | 432,859 | $ | 202,904 | ||
| Restricted cash in other assets | 2,120 | 2,084 | 2,050 | |||||
| Total | $ | 577,937 | $ | 434,943 | $ | 204,954 | ||
Non-GAAP Financial Measures
Certain of these financial measures are considered “non-GAAP” financial measures within the meaning of Item 10 of Regulation S-K promulgated by the
Adjusted EBITDA
Adjusted EBITDA is a non-GAAP financial measure that we define as net income (loss) before interest expense, income taxes, depreciation and amortization expense, acquisition expenses, certain litigation costs, gains or losses on right of use ("ROU") assets, gains or losses on sale of property and equipment, restructuring costs, equity-based compensation expense, and loss on extinguishment of debt.
Adjusted EBITDA should not be considered in isolation of, or as an alternative to, measures prepared in accordance with GAAP. There are a number of limitations related to the use of Adjusted EBITDA in lieu of net income (loss), which is the most directly comparable financial measure calculated in accordance with GAAP.
Our use of the term Adjusted EBITDA may vary from the use of similar terms by other companies in our industry and accordingly may not be comparable to similarly titled measures used by other companies.
Medical Benefits Ratio (MBR)
We calculate our MBR by dividing total medical expenses, excluding depreciation, equity-based compensation and clinical restructuring costs, by total revenues in a given period.
Adjusted Gross Profit
Adjusted gross profit is a non-GAAP financial measure that we define as income (loss) from operations before depreciation and amortization, medical equity-based compensation expense, clinical restructuring costs and selling, general, and administrative expenses.
Adjusted gross profit should not be considered in isolation of, or as an alternative to, measures prepared in accordance with GAAP. There are a number of limitations related to the use of adjusted gross profit in lieu of income (loss) from operations, which is the most directly comparable financial measure calculated in accordance with GAAP.
Our use of the term adjusted gross profit may vary from the use of similar terms by other companies in our industry and accordingly may not be comparable to similarly titled measures used by other companies.
Investor Contact
hzhuo@ahcusa.com
Media Contact
mPR, Inc. for
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