Healthstream (HSTM)
NASDAQ:HSTM
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HealthStream
(NASDAQ:HSTM)
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Rating:69Neutral
Price Target:
$22.00
▲(3.53% Upside)
Action:DowngradedDate:03/14/26
The score is anchored by strong financial quality (cash generation and a very conservative balance sheet) and constructive 2026 guidance with high recurring revenue visibility. These positives are tempered by a weak technical setup (below key moving averages with negative momentum) and a rich valuation (high P/E and low yield), which reduces near-term attractiveness despite solid fundamentals.
Positive Factors
High Recurring Revenue & Contract Visibility
A 96% subscription mix and $691M of remaining performance obligations provide multi-year revenue visibility and predictability. This recurring base supports steady cash flows, simplifies planning for product investment and M&A, and reduces revenue volatility versus transactional models over the next 2–6 months.
Negative Factors
Gross Margin Pressure from Hosting/Licensing
Rising cloud hosting and third-party licensing costs compress gross margins, challenging the sustainability of mid-60% gross margins unless offset by pricing, scale efficiencies, or product mix shifts. Persistent cost inflation could erode operating leverage and long-term margin expansion.
Read all positive and negative factors
Positive Factors
Negative Factors
High Recurring Revenue & Contract Visibility
A 96% subscription mix and $691M of remaining performance obligations provide multi-year revenue visibility and predictability. This recurring base supports steady cash flows, simplifies planning for product investment and M&A, and reduces revenue volatility versus transactional models over the next 2–6 months.
Read all positive factors
HealthStream (HSTM) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$623.82M
Dividend Yield0.52%
Average Volume (3M)215.55K
Price to Earnings (P/E)37.8
Beta (1Y)0.58
Revenue Growth3.68%
EPS Growth5.62%
CountryUS
Employees1,083
SectorHealthcare
Sector Strength45
IndustryMedical - Healthcare Information Services
Share Statistics
EPS (TTM)0.09
Shares Outstanding29,356,350
10 Day Avg. Volume287,357
30 Day Avg. Volume215,553
Financial Highlights & Ratios
PEG Ratio-4.98
Price to Book (P/B)1.96
Price to Sales (P/S)2.28
P/FCF Ratio11.61
Enterprise Value/Market Cap0.98
Enterprise Value/Revenue2.00
Enterprise Value/Gross Profit3.09
Enterprise Value/Ebitda9.39
Forecast
1Y Price Target
$30.50Price Target Upside43.53% Upside
Rating ConsensusModerate Buy
Number of Analyst Covering4
EPS Forecast (FY)0.74
Revenue Forecast (FY)$326.29M
HealthStream Business Overview & Revenue Model
Company Description
HealthStream, Inc. provides workforce and provider solutions for healthcare organizations in the United States. It operates through two segments, Workforce Solutions and Provider Solutions. The company offers workforce solutions, including softwar...
How the Company Makes Money
HealthStream primarily makes money by selling subscription-based access to its cloud software applications and content to healthcare organizations. A significant portion of revenue is generated from recurring SaaS fees tied to specific modules (e....
HealthStream Key Performance Indicators (KPIs)
HealthStream Earnings Call Summary
Earnings Call Date:Feb 23, 2026
(Q4-2025)
| % Change Since: |
Next Earnings Date:Apr 27, 2026
Earnings Call Sentiment Positive
The call presented a predominantly positive operational and strategic picture: solid revenue and adjusted EBITDA growth, strong product-level expansion (CredentialStream, ShiftWizard, Competency Suite), expanding remaining performance obligations, growing career networks and an articulated platform/AI strategy. Near-term GAAP results were weakened by a one-time, non-cash CEO stock grant and higher hosting/licensing costs that compressed gross margin and reduced reported net income and operating income for the quarter; cash balances also declined due to acquisitions and elevated CapEx. Guidance for 2026 shows continued growth and profitable adjusted EBITDA, and many of the negative items appear strategic or one-time in nature, while underlying subscription and product trends are strong.Positive Updates
Revenue and Adjusted EBITDA Growth
Full year 2025 revenue of $304.1M, up 4.3% year-over-year; Q4 revenue $79.7M, up 7.4% YoY. Full year adjusted EBITDA $71.8M (up 7.5% YoY); Q4 adjusted EBITDA $18.8M, up 16.4% YoY with an adjusted EBITDA margin of 23.6% vs. 21.8% prior-year quarter.
Negative Updates
Q4 GAAP Net Income and Operating Income Decline
Q4 operating income $2.4M, down 48.8% YoY; Q4 net income $2.5M, down 48.1% YoY; GAAP EPS $0.09 vs $0.16 prior year. Decline substantially impacted by a $3.5M non-cash compensation expense related to the CEO stock contribution/grant recorded in Q4.
Read all updates
Q4-2025 Updates
Positive
Negative
Revenue and Adjusted EBITDA Growth
Full year 2025 revenue of $304.1M, up 4.3% year-over-year; Q4 revenue $79.7M, up 7.4% YoY. Full year adjusted EBITDA $71.8M (up 7.5% YoY); Q4 adjusted EBITDA $18.8M, up 16.4% YoY with an adjusted EBITDA margin of 23.6% vs. 21.8% prior-year quarter.
Read all positive updates
Company Guidance
HealthStream guided 2026 revenues of $323.0M to $330.0M (growth of ~6.2%–8.5%), with net income of $20.4M to $22.8M and adjusted EBITDA of $73M to $77M (inorganic revenue contribution of about $13M expected); they estimate Q1 revenue growth of ~8% and expect sequentially higher revenue growth in H1 than H2 (attributed to acquisition timing). Management forecast capital expenditures of $31M–$34M and an effective tax rate of ~22%; guidance excludes the impact of any future acquisitions/dispositions, changes in fair value of nonmarketable equity or contingent consideration, or impairments. As context, they enter 2026 with $57M of cash and investments, no long‑term debt, $691M of remaining performance obligations (≈39% convertable to revenue in 12 months and ≈67% in 24 months), and noted continued focus on M&A, share repurchases and dividends.HealthStream Financial Statement Overview
Summary
Income Statement
74
Positive
Balance Sheet
90
Very Positive
Cash Flow
78
Positive
| Breakdown | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|
Income Statement | |||||
| Total Revenue | 304.06M | 291.65M | 279.06M | 266.83M | 256.71M |
| Gross Profit | 196.85M | 193.71M | 184.04M | 175.68M | 165.68M |
| EBITDA | 66.70M | 62.53M | 57.09M | 50.39M | 44.87M |
| Net Income | 18.34M | 20.01M | 15.21M | 12.09M | 5.84M |
Balance Sheet | |||||
| Total Assets | 520.37M | 510.77M | 499.94M | 497.74M | 486.75M |
| Cash, Cash Equivalents and Short-Term Investments | 57.00M | 97.22M | 71.13M | 53.91M | 51.95M |
| Total Debt | 14.68M | 20.17M | 20.25M | 23.32M | 29.11M |
| Total Liabilities | 166.35M | 151.41M | 159.19M | 163.68M | 147.73M |
| Stockholders Equity | 354.02M | 359.36M | 340.75M | 334.06M | 339.02M |
Cash Flow | |||||
| Free Cash Flow | 59.63M | 29.52M | 61.77M | 49.42M | 38.97M |
| Operating Cash Flow | 63.32M | 57.66M | 63.97M | 51.19M | 42.38M |
| Investing Cash Flow | -50.35M | -33.97M | -56.60M | -28.39M | -25.72M |
| Financing Cash Flow | -36.27M | -4.52M | -13.04M | -23.70M | -6.21M |
HealthStream Technical Analysis
Neutral
21.25
Price Trends
21.08
Positive
22.62
Negative
24.88
Negative
Market Momentum
-0.07
Negative
52.10
Neutral
62.35
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For HSTM, the sentiment is Neutral. The current price of 21.25 is above the 20-day moving average (MA) of 21.17, above the 50-day MA of 21.08, and below the 200-day MA of 24.88, indicating a neutral trend. The MACD of -0.07 indicates Negative momentum. The RSI at 52.10 is Neutral, neither overbought nor oversold. The STOCH value of 62.35 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral sentiment for HSTM.
HealthStream Risk Analysis
HealthStream disclosed 38 risk factors in its most recent earnings report. HealthStream reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
HealthStream Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
69 Neutral | $623.82M | 37.76 | 5.87% | 0.52% | 3.68% | 5.62% | |
67 Neutral | $776.64M | -72.16 | -7.10% | ― | 50.51% | 50.92% | |
64 Neutral | $661.02M | 15.58 | 23.80% | ― | 236.03% | ― | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
48 Neutral | $155.66M | -2.20 | -47.69% | ― | -5.30% | 46.01% | |
45 Neutral | $265.70M | -0.85 | -69.22% | ― | -16.65% | -71.92% | |
45 Neutral | $80.94M | -0.94 | -30.28% | ― | 4.64% | -17.17% |
* Healthcare Sector Average
HSTM
HealthStream
21.25
-10.68
-33.44%
EVH
Evolent Health
2.38
-7.25
-75.29%
HCAT
Health Catalyst
1.10
-3.50
-76.09%
NUTX
Clinigence Holdings
94.86
39.22
70.49%
DH
Definitive Healthcare Corp
1.09
-1.87
-63.18%
OMDA
Omada Health, Inc.
13.18
-9.42
-41.68%
HealthStream Corporate Events
Business Operations and StrategyStock BuybackPrivate Placements and Financing
HealthStream Expands Capital Flexibility, Launches New Share Buyback
Positive
Mar 13, 2026
On March 13, 2026, HealthStream, Inc., a healthcare technology platform company focused on clinical workforce solutions, amended its revolving credit agreement with Truist Bank to loosen restrictions on certain payments to shareholders. The amendm...
Business Operations and StrategyStock BuybackDividendsFinancial Disclosures
HealthStream Reports Record Q4 Revenue and Raises Dividend
Positive
Feb 23, 2026
HealthStream reported on February 23, 2026 that fourth-quarter 2025 revenue rose 7.4% year over year to a record $79.7 million, driven by higher subscription sales and supported by acquisitions of Virsys12 and MissionCare Collective, though GAAP o...
M&A Transactions
HealthStream Acquires MissionCare Collective LLC
Positive
Dec 15, 2025
On December 15, 2025, HealthStream announced the acquisition of MissionCare Collective LLC, a healthcare workforce company known for its extensive caregiver network and flagship product, myCNAjobs.com. This acquisition marks the addition of Health...
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.