Robust Provider Growth
Implemented providers reached 5,380 at year-end 2025, an increase of 591 providers or 12.3% year-over-year; sequential implemented provider growth was +130 from Q3 to Q4. Guidance midpoint for 2026 expects implemented providers to increase ~10.6% year-over-year.
Significant Expansion in Value-Based Lives
Value-based attributed lives totaled 1,540,000 at year-end 2025, up 22.7% year-over-year. Commercial attributed lives rose to ~910,000 (+>16% YoY); Medicare program lives increased 52%; Medicare Advantage +15%; Medicaid +23%. 2026 midpoint attributed lives guidance is ~1,580,000.
Strong Practice Collections Growth
Full-year practice collections were $3.47 billion, up 16.9% year-over-year. Q4 practice collections were $868.7 million, up 9.6% versus Q4 last year. 2026 midpoint guidance projects practice collections growth of ~6.6%.
Adjusted EBITDA and Margin Expansion
Adjusted EBITDA for 2025 was $125.5 million, up 38.8% year-over-year. Q4 adjusted EBITDA was $31.5 million, up 26.4% YoY. EBITDA margin as a percentage of care margin expanded ~480 basis points to ~27.2% for the year (Q4 reported ~27%).
Exceptional Free Cash Flow Conversion and Strong Cash Position
Conversion from EBITDA to free cash flow was 130% in 2025 (reflecting strong collections and timing benefits). Year-end cash balance was ~$480 million after deploying $180 million for transactions. Management expects to end 2026 with ~ $600 million in cash assuming no new BD deployment and guides to ~80% EBITDA-to-free-cash-flow conversion at the 2026 midpoint.
Strategic M&A and Geographic Expansion
Closed acquisition of Evolent Health’s ACO business on December 5, 2025, adding over 120,000 attributed lives and expanding presence; Privia’s national footprint now covers 24 states + DC. Entered Arizona with anchor partner IMS (implemented on platform end of Q3) and reports strong sales momentum in that state.
High Provider Retention and Patient Experience
Gross provider retention remained very high at 98%. Patient Net Promoter Score (NPS) was 87 across the footprint, indicating strong patient satisfaction and engagement.
Operational Leverage and Cost Discipline
Company demonstrated operating leverage with reductions in cost of platform and G&A; practice collections and platform contribution came in at the high end of 2025 guidance. Management expects continued G&A leverage in 2026 and margin improvement opportunities with technology/AI investments.