AdaptHealth (AHCO) Q1 2026 earnings summary

Executive summary

• Completed the largest patient transition and de novo expansion in home medical equipment history, onboarding over 10 million new members under a new capitated contract and becoming exclusive provider to a strategic partner.

• Q1 2026 net revenue reached $819.8 million, up 5.4% year-over-year, driven by organic growth and new capitated contracts, but net loss widened to $16.0 million from $7.2 million due to higher costs.

• Adjusted EBITDA was $121.2 million (14.8% margin), down from $127.9 million and 16.4% margin in Q1 2025, impacted by elevated labor and startup costs.

• Advanced digital engagement, with registered patient portal/myApp users rising to 412,000.

• Completed $1.1 billion refinancing, reducing near-term debt costs, extending maturities, and enhancing balance sheet strength.

Financial highlights

• Q1 2026 net revenue was $819.8 million, with organic revenue growth of 9.1% and $22 million above guidance midpoint.

• Adjusted EBITDA was $121.2 million (14.8% margin), about $7 million below guidance due to elevated labor costs.

• Free cash flow was negative $27.5 million, reflecting high CapEx for patient equipment; cash flow from operations was $93.7 million.

• Net loss per share was $0.12, compared to $0.05 in Q1 2025.

• Sales revenue was $472.4 million, rental revenue $272.4 million, and capitated revenue $74.9 million.

Outlook and guidance

• Fiscal 2026 net revenue guidance raised by $10 million to $3.45–$3.52 billion.

• Adjusted EBITDA guidance maintained at $680–$730 million; free cash flow guidance at $175–$225 million.

• Q2 2026 guidance: net revenue of $840–$860 million, adjusted EBITDA margin ~19%, with free cash flow expected to be modest due to elevated CapEx.

• Guidance excludes impact of future acquisitions and certain non-recurring items.

• Expect margin improvement as labor costs normalize and full quarter of capitated revenue is realized.