Total Revenue and Sequential Growth
Q1 total revenue of $496 million, representing 9% sequential growth versus Q4 2025 (ex-ECP).
Adjusted EBITDA In Line With Expectations
Adjusted EBITDA of $22 million for Q1, consistent with guidance and the outlook provided in February.
Performance Suite Momentum
Performance Suite revenue of $323 million, up 26% sequentially versus Q4 2025 (ex-ECP); successful new launches with Aetna (Jan 1) and Highmark (May 1) with early clinical intervention and provider engagement metrics tracking above internal targets.
Major New Contracts and Cross-Sell Success
Announced two new Performance Suite deals: an advanced imaging contract covering 4.5 million lives (expected Q3 go-live) and an oncology/cardiology expansion expected to generate >$200 million of annual revenue (expected Q3 go-live), demonstrating cross-sell and platform integration strength.
Medical Expense Ratio Improvement and Full-Year Guidance
Q1 MER of ~93%, improving ~150 basis points versus Q4 2025 (ex-ECP). Reiterated full-year 2026 guidance: revenue $2.4B–$2.6B, adjusted EBITDA $110M–$140M, and estimated MER ~93%.
AI and Automation Progress
Continued AI/automation deployment with goal to auto-improve ~80% of authorization volume; initial imaging AI rollouts drove auto approvals up in the high teens and in some cases up to ~30% with minimal clinical value loss.
Balance Sheet and Liquidity Position
Unrestricted cash of $142 million at quarter end and no debt maturities until 2029, with a stated path to deleveraging.
Operational Efficiency Initiatives
Adjusted cost of revenue (ex-medical claims) plus adjusted SG&A was $173 million for Q1; company expects approx. $675 million for the year and is tracking efficiency initiatives that should moderate elevated exchange-related costs.