Ardent Health (ARDT) Q4 2025 earnings summary

Executive summary

• Achieved record 2025 revenue of $6.32 billion (6% growth) and adjusted EBITDA of $545 million (9.3% growth), with margin expansion of 20bps to 8.6%.

• Q4 2025 revenue was $1.61 billion, nearly flat year-over-year, with adjusted EBITDA at $134 million, down 26.6% due to prior year state payment program benefit.

• Operating cash flow increased 49% to $471 million in 2025, with cash and equivalents rising to $710 million at year-end.

• IMPACT program initiatives delivered significant cost savings, with a $55 million savings target for 2026.

• Technology and AI deployment, including virtual care and AI scribe, are driving efficiency and care transformation.

Financial highlights

• FY25 total revenue: $6.32 billion (6% YoY growth); Q4 revenue: $1.61 billion (flat YoY, up 3% adjusted for prior year DPP benefit).

• FY25 adjusted EBITDA: $545 million (9.3% YoY growth); Q4 adjusted EBITDA: $134 million (-26.6% YoY).

• Operating cash flow for FY25: $471 million (+49% YoY); Q4 operating cash flow: $223 million.

• Margins expanded 20bps to 8.6% (adjusted EBITDA) and 12.7% (pre-NCI adjusted EBITDAR).

• Free cash flow net of non-controlling interest distributions was $170 million in 2025.

Outlook and guidance

• 2026 revenue guidance: $6.4–$6.7 billion; adjusted EBITDA: $485–$535 million; net income: $129–$183 million.

• Diluted EPS guidance: $0.90–$1.27; adjusted admissions growth expected at 1.5–2.5%.

• Capital expenditures projected at $225–$265 million for 2026.

• Guidance reflects headwinds from professional fee pressures, payor denials, and expiration of enhanced Exchange subsidies, offset by IMPACT program savings.

• Anticipates return to adjusted EBITDA growth in 2027 as headwinds are lapped and IMPACT savings build.