Alignment Healthcare (ALHC) Q1 2026 earnings summary

Executive summary

• Health plan membership grew 30.9% year-over-year to 284,800 as of March 31, 2026, driving 33.3% revenue growth to $1.24 billion in Q1 2026, with expansion in existing and new markets across five states.

• Adjusted EBITDA rose 87.6% year-over-year to $37.9 million, with a margin of 3.1%, reflecting improved operating leverage and exceeding guidance.

• Net income reached $11.4 million, reversing a $9.4 million net loss from the prior year.

• Operational improvements, investments in automation, AI, and clinical infrastructure supported margin expansion and scalability.

• The company remains confident in its path toward 1 million members and continued profitable growth.

Financial highlights

• Adjusted gross profit reached $145.9 million, up 36.1% year-over-year, with an adjusted MBR of 88.2%.

• Adjusted SG&A was $108 million, up 24% year-over-year, but improved as a percentage of revenue to 8.7%.

• Cash, cash equivalents, and short-term investments totaled $726.3 million at quarter-end.

• Income from operations was $15.5 million, compared to a $5.4 million loss in Q1 2025.

• Funded leverage ratio improved to 2.6x trailing 12-month EBITDA.

Outlook and guidance

• Full-year 2026 membership expected between 294,000 and 299,000; revenue guidance raised to $5.2 billion midpoint (31% growth year-over-year).

• Adjusted gross profit guidance increased to $620–$650 million; adjusted EBITDA to $138–$163 million.

• Q2 2026 guidance: membership 288,000–290,000, revenue $1.30–$1.32 billion, adjusted EBITDA $50–$60 million.

• About 60% of full-year EBITDA expected in the first half, up from 55% in 2025.

• Management expects continued investment in technology, market expansion, and product innovation to drive long-term growth.