Waystar (WAY) Q1 2026 earnings summary

Executive summary

• Q1 2026 revenue reached $313.9 million, up 22% year-over-year, with net income of $43.3 million and adjusted EBITDA of $135.4 million, driven by strong subscription growth, AI innovation, and successful integration of Iodine.

• Over 99% of revenue is recurring, with net revenue retention at 111% and client count with over $100,000 in trailing twelve-month revenue rising to 1,433, up 15% year-over-year.

• AI-powered solutions now account for 40% of new bookings and nearly 40% of revenue, accelerating platform adoption and expanding the addressable market.

• Integration of Iodine is ahead of plan, enhancing clinical and financial data convergence, cross-sell opportunities, and AI capabilities.

• Launched new AI-powered recoupment solution and Prebill Anomaly Detection, delivering strong early ROI for providers.

Financial highlights

• Q1 2026 revenue was $313.9 million, up 22% year-over-year; subscription revenue grew 38% to $172.2 million (55% of total), and volume-based revenue increased 7% to $139.5 million.

• Adjusted EBITDA was $135.4 million, up 26% year-over-year, with a 43% margin, slightly above expectations due to favorable revenue mix.

• Net income for Q1 2026 was $43.3 million, up 47.9% year-over-year, with a net income margin of 14%.

• Unlevered free cash flow was $90.3 million, converting 67% of adjusted EBITDA.

• Ended Q1 with $159 million in cash equivalents and $1.5 billion in gross debt; net debt stood at $1.32 billion.

Outlook and guidance

• FY 2026 revenue guidance is $1.274–$1.294 billion (midpoint $1.284 billion, 17% year-over-year growth), with adjusted EBITDA of $530–$540 million and a margin expected to remain at 42–43%.

• Non-GAAP net income projected at $317–$335 million and diluted non-GAAP EPS expected between $1.59 and $1.68.

• Full-year guidance assumes normalized organic revenue growth of ~10% and less seasonality in patient payments.

• Q2 sequential growth expected to be flat to 1%, with Q3 at 1–3%.

• Sufficient liquidity is anticipated for at least the next 12 months, with ongoing investments in growth and technology.