-- Delivers full-year revenue of $3.95 billion, representing 46.1% growth
year-over-year
-- Exceeds high-end of fourth quarter and full-year guidance across all key
metrics: membership, revenue, adjusted gross profit and adjusted EBITDA
-- Raises health plan membership guidance by 2,000 at the midpoint and
introduces 2026 revenue guidance of $5.14 billion to $5.19 billion,
representing 30%-31% growth year-over-year, and adjusted EBITDA of $133
million to $163 million
-- Earns recognition on the 2026 Fortune World's Most Admired Companies$(TM)$
list, underscoring the company's innovative approach to senior health
care
ORANGE, Calif., Feb. 26, 2026 (GLOBE NEWSWIRE) -- Alignment Healthcare, Inc. (NASDAQ: ALHC), today reported financial results for its fourth quarter and full year ended Dec. 31, 2025.
"Our fourth quarter and full-year 2025 results show what Medicare Advantage done right looks like," said John Kao, founder and CEO. "We once again exceeded industry expectations and delivered continued momentum on revenue growth while taking a positive step forward in profitability and margin expansion, including producing free cash flow on a full-year basis. By leading with our care model, we are putting our seniors first and lowering costs by delivering more care, not less. Being named to the 2026 Fortune World's Most Admired Companies(TM) list affirms the reputation we've built since going public. As we move through 2026, we remain focused on disciplined growth, the scalability of our operations and creating long-term value for the members we serve."
Fourth Quarter 2025 Financial Highlights
All comparisons, unless otherwise noted, are to the three months ended Dec. 31, 2024.
-- Health plan membership at the end of the quarter was approximately
236,300, up 25.0% year-over-year
-- Total revenue was $1,012.8 million, up 44.4% year-over-year
-- Adjusted gross profit* was $124.9 million and loss from operations was
$10.3 million
-- Adjusted gross profit excludes depreciation and amortization of
$7.8 million and selling, general, and administrative expenses of
$125.8 million (which includes $11.5 million of equity-based
compensation). Adjusted gross profit also excludes an additional
$1.6 million of equity-based compensation recorded within medical
expenses
-- Medical benefits ratio based on adjusted gross profit was 87.7%
-- Adjusted EBITDA* was $11.4 million and net loss was $11.0 million
Full Year 2025 Financial Highlights
All comparisons, unless otherwise noted, are to the twelve months ended Dec. 31, 2024.
-- Total revenue was $3,948.7 million, up 46.1% year over year.
-- Adjusted gross profit was $494.8 million and income from operations was
$14.8 million
-- Adjusted gross profit excludes depreciation and amortization of
$30.4 million and selling, general, and administrative expenses of
$443.4 million (which includes $55.9 million of equity-based
compensation). Adjusted gross profit also excludes $0.1 of
depreciation expense and an additional $6.1 million of
equity-based compensation recorded within medical expenses
-- Medical benefits ratio based on adjusted gross profit was 87.5%
-- Adjusted EBITDA was $109.9 million and net loss was $1.0 million
(* Please see "Fourth Quarter 2025 Non-GAAP Reconciliation Tables" below for more information on the non-GAAP financial measures reported here as supplemental information.)
Outlook for First Quarter and Fiscal Year 2026
Three Months Ending March 31, Twelve Months Ending December
2026 31, 2026
$ Millions Low High Low High
--------------
Health Plan
Membership 281,000 285,000 292,000 298,000
Revenue $1,205 $1,225 $5,135 $5,190
Adjusted Gross
Profit(1) $138 $148 $615 $650
Adjusted
EBITDA(1) $26 $36 $133 $163
_______________________
(1) (Adjusted gross profit and adjusted EBITDA are non-GAAP
financial measures presented as supplemental disclosure.
We cannot provide estimated ranges for the most directly
comparable GAAP measures without unreasonable efforts
because of the uncertainty around certain items that
may impact such GAAP measures, including equity-based
compensation expense and depreciation and amortization,
that are not within our control or cannot be reasonably
predicted. See "Fourth Quarter 2025 Non-GAAP Reconciliation
Tables" for additional information.)
Fourth Quarter 2025 Non-GAAP Reconciliation Tables
Adjusted Gross Profit(1) is reconciled as follows:
Three Months Ended Year Ended December
December 31, 31,
-------------------- ----------------------
2025 2024 2025 2024
------- ------- -------- --------
(dollars in thousands)
Income (loss) from
operations $(10,284) $(22,545) $ 14,752 $(101,555)
Add back:
Equity-based
compensation
(medical
expenses) $ 1,613 $ 1,546 6,134 4,930
Depreciation
(medical
expenses) $ 4 $ 46 78 190
Restructuring costs
(medical expenses)
(2) $ -- $ -- -- 796
Depreciation and
amortization (3) $ 7,830 $ 6,762 30,404 26,872
Selling, general,
and administrative
expenses $125,764 $102,128 443,407 371,374
------- ------- ------- --------
Total add back 135,211 110,482 480,023 404,162
------- ------- ------- --------
Adjusted gross profit $124,927 $ 87,937 $494,775 $ 302,607
======= ======= ======= ========
(1) Adjusted gross profit is a non-GAAP financial measure
that is presented as supplemental disclosure, that
we define as income (loss) from operations before
depreciation and amortization, medical equity-based
compensation expense, clinical restructuring costs
and selling, general, and administrative expenses.
(2) (Represents severance and related costs incurred as
part of a corporate restructuring designed to streamline
our organizational structure and drive operational
efficiencies.)
(3) (Amortization expense for the year ended Dec. 31,
2025 includes $0.6 million in impairment expense related
to the remeasurement of goodwill associated with one
of our subsidiaries. Amortization expense for the
year ended Dec. 31, 2024 includes $0.6 million in
impairment expense related to intangible assets that
were written off during the year.)
Adjusted EBITDA(1) is reconciled as follows:
Three Months Ended
December 31, Year Ended December 31,
-------------------- -----------------------
2025 2024 2025 2024
------- --------
(dollars in thousands)
Net loss $(11,006) $(31,064) $ (978) $(128,071)
Less: Net income (loss)
attributable to
noncontrolling
interest -- (27) (254) (36)
Adjustments:
Interest expense 3,949 5,492 15,799 23,547
Depreciation and
amortization(2) 7,834 6,808 30,482 27,062
Income tax
expense (3,227) 7 20 21
Equity-based
compensation(3) 13,115 16,236 62,082 71,132
Acquisition
expenses(4) -- -- -- 26
Litigation costs
(5) 749 892 2,357 2,069
Loss on ROU
assets(6) -- -- -- 143
Gain on sale of
property and
equipment -- (1) (72) (9)
Restructuring
costs(7) -- -- -- 2,363
Loss on
extinguishment
of debt -- 3,020 -- 3,020
------- ------- ------- --------
Adjusted EBITDA $ 11,414 $ 1,363 $109,944 $ 1,339
======= ======= ======= ========
(1) Adjusted EBITDA is a non-GAAP financial measure that
is presented as supplemental disclosure, that we define
as net income (loss) before interest expense, income
taxes, depreciation and amortization expense, acquisition
expenses, certain litigation costs, gains or losses
on right of use ("ROU") assets, gains or losses on
sale of property and equipment, restructuring costs,
equity-based compensation expense, and loss on extinguishment
of debt.
(2) (Amortization expense for the year ended Dec. 31,
2025 includes $0.6 million in impairment expense related
to the remeasurement of goodwill associated with one
of our subsidiaries. Amortization expense for the
year ended Dec. 31, 2024 includes $0.6 million in
impairment expense related to intangible assets that
were written off during the year.)
(3) (Represents equity-based compensation related to grants
made in the applicable year.)
(4) (Represents acquisition-related fees, such as legal
and advisory fees, that are non-capitalizable.)
(5) Represents litigation costs considered outside of
the ordinary course of business based on the following
considerations which we assess regularly: (i) the
frequency of similar cases that have been brought
to date, or are expected to be brought within two
years, (ii) complexity of the case, (iii) nature of
the remedies sought, (iv) litigation posture of the
Company, (v) counterparty involved, and (vi) the Company's
overall litigation strategy
(6) (Represents gains or losses related to ROU assets
that were terminated or subleased in the respective
period.)
(7) (Represents severance and related costs incurred as
part of a corporate restructuring designed to streamline
our organizational structure and drive operational
efficiencies.)
Conference Call Details
The company will host a conference call at 5 p.m. EST today to discuss these results and management's outlook for future financial and operational performance. A live audio webcast will be available online at https://ir.alignmenthealth.com/. At the start of the conference call, participants may access the webcast at the following link: https://edge.media-server.com/mmc/p/kd529mia. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web links, and will remain available for approximately 12 months.
About Alignment Health
Alignment Health is championing a new path in senior care that empowers members to age well and live their most vibrant lives. A consumer brand name of Alignment Healthcare (NASDAQ: ALHC), Alignment Health's mission-focused team makes high-quality, low-cost care a reality for its Medicare Advantage members every day. Based in California, the company partners with nationally recognized and trusted local providers to deliver coordinated care, powered by its customized care model, 24/7 concierge care team and purpose-built technology, AVA$(R)$ . As it expands its offerings and grows its national footprint, Alignment upholds its core values of leading with a serving heart and putting the senior first. For more information, visit www.alignmenthealth.com.
From Fortune, (c)2026 Fortune Media IP Limited. All rights reserved. Used under license. Fortune(R) is a registered trademark and Fortune World's Most Admired Companies(TM) is a trademark of Fortune Media IP Limited and is used under license. Fortune and Fortune Media IP Limited are not affiliated with, and does not endorse the products or services of, Alignment Healthcare.
Forward-Looking Statements
This release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, and the Private Securities Litigation Reform Act of 1995, as amended. These forward-looking statements include statements regarding our future growth and our financial outlook for the quarter ending March 31, 2026, and year ending Dec. 31, 2026. Forward-looking statements are subject to risks and uncertainties and are based on assumptions that may prove to be inaccurate, which could cause actual results to differ materially from those expected or implied by the forward-looking statements. Actual results may differ materially from the results predicted, and reported results should not be considered as an indication of future performance. Important risks and uncertainties that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following: our ability to attract new members and enter new markets, including the need for certain governmental approvals; our ability to maintain a high rating for our plans on the Five Star Quality Rating System; our ability to develop and maintain satisfactory relationships with care providers that service our members; risks associated with being a government contractor, including potential federal reductions in MA funding; changes in laws and regulations applicable to our business model; risks related to our indebtedness; changes in market or industry conditions and receptivity to our technology and services; results of litigation or a security incident; and the impact of shortages of qualified personnel and related increases in our labor costs. For a detailed discussion of the risk factors that could affect our actual results, please refer to the risk factors identified in our Annual Report on Form 10-K for the year ended Dec. 31, 2025, and the other periodic reports we file with the SEC. All information provided in this release and in the attachments is as of the date hereof, and we undertake no duty to update or revise this information unless required by law.
Consolidated Balance Sheets
(in thousands, except par value and share amounts)
December 31, December 31,
2025 2024
------------ --------------
Assets
Current Assets:
Cash and cash equivalents $ 575,817 $ 432,859
Accounts receivable (less allowance
for credit losses of $833 at
December 31, 2025 and $0 at December
31, 2024) 253,207 153,904
Investments - current 28,413 37,791
Prepaid expenses and other current
assets 94,140 37,084
---------- ----------
Total current assets 951,577 661,638
Property and equipment, net 64,251 67,139
Right of use asset, net 7,019 7,818
Goodwill 32,060 34,826
Intangible assets, net 4,550 4,550
Other assets 6,329 6,092
---------- ----------
Total assets $ 1,065,786 $ 782,063
========== ==========
Liabilities and Stockholders' Equity
Current Liabilities:
Medical expenses payable $ 474,569 $ 289,788
Accounts payable and accrued expenses 33,284 22,126
Accrued compensation 49,013 39,931
---------- ----------
Total current liabilities 556,866 351,845
Long-term debt, net of debt issuance
costs 323,176 321,428
Long-term portion of lease
liabilities 6,467 7,835
---------- ----------
Total liabilities 886,509 681,108
Stockholders' Equity:
Preferred stock, $.001 par value;
100,000,000 shares authorized as of
December 31, 2025 and 2024,
respectively; no shares issued and
outstanding as of December 31, 2025
and 2024 -- --
Common stock, $.001 par value;
1,000,000,000 shares authorized as of
December 31, 2025 and December 31,
2024; 204,153,619 and 191,778,639
shares issued and outstanding as of
December 31, 2025 and December 31,
2024, respectively 205 192
Additional paid-in capital 1,188,089 1,107,952
Accumulated deficit (1,009,017) (1,008,293)
---------- ----------
Total Alignment Healthcare, Inc.
stockholders' equity 179,277 99,851
---------- ----------
Noncontrolling interest -- 1,104
---------- ----------
Total stockholders' equity 179,277 100,955
---------- ----------
Total liabilities and
stockholders' equity $ 1,065,786 $ 782,063
========== ==========
Consolidated Statements of Operations
(in thousands, except per share amounts)
Three Months Ended December
31, Year Ended December 31,
---------------------------- ------------------------------
2025 2024 2025 2024
----------- -----------
Revenues:
Earned premiums $ 1,003,791 $ 691,785 $ 3,911,718 $ 2,671,931
Other 9,013 9,456 37,001 31,630
----------- ----------- ----------- -----------
Total revenues 1,012,804 701,241 3,948,719 2,703,561
----------- ----------- ----------- -----------
Expenses:
Medical expenses 889,494 614,896 3,460,156 2,406,870
Selling, general,
and
administrative
expenses 125,764 102,128 443,407 371,374
Depreciation and
amortization 7,830 6,762 30,404 26,872
----------- ----------- ----------- -----------
Total expenses 1,023,088 723,786 3,933,967 2,805,116
----------- ----------- ----------- -----------
Income (loss) from
operations (10,284) (22,545) 14,752 (101,555)
----------- ----------- ----------- -----------
Other expenses:
Interest expense 3,949 5,492 15,799 23,547
Other income, net -- -- (89) (72)
Loss on
extinguishment
of debt -- 3,020 -- 3,020
----------- ----------- ----------- -----------
Total other
expenses 3,949 8,512 15,710 26,495
----------- ----------- ----------- -----------
Loss before income
taxes (14,233) (31,057) (958) (128,050)
Provision for income
tax expense
(benefit) (3,227) 7 20 21
----------- ----------- ----------- -----------
Net loss $ (11,006) $ (31,064) $ (978) $ (128,071)
Less: Net loss
attributable to
noncontrolling
interest -- 27 (254) (36)
----------- ----------- ----------- -----------
Net loss
attributable to
Alignment
Healthcare, Inc. $ (11,006) $ (31,091) $ (724) $ (128,035)
=========== =========== =========== ===========
Total
weighted-average
common shares
outstanding -
basic and
diluted 200,970,862 191,897,164 198,006,216 190,793,552
Net loss per
share
attributable to
Alignment
Healthcare, Inc.
- basic and
diluted (0.05) (0.16) 0.00 (0.67)
Consolidated Statements of Cash Flows
(in thousands)
Year Ended December 31,
------------------------------------
2025 2024 2023
-------- --------
Operating Activities:
Net loss $ (978) $(128,071) $(148,173)
Adjustments to reconcile
Net loss to net cash
provided by (used in)
operating activities:
Provision for credit
loss 833 123 91
(Gain) loss on right of
use assets -- 143 (289)
Gain on sale of property
and equipment (72) (9) --
Depreciation and
amortization 30,482 27,062 21,668
Amortization-debt
issuance costs 1,761 1,293 1,254
Amortization-investment
discount (1,298) (2,579) (4,917)
Equity-based
compensation 62,082 71,132 66,835
Non-cash lease expense 1,609 1,764 2,318
Loss on extinguishment
of debt -- 3,020 --
Changes in operating
assets and liabilities:
Accounts receivable (100,106) (34,278) (26,950)
Prepaid expenses and
other current assets (57,059) 7,887 (2,863)
Other assets (50) 60 (142)
Medical expenses
payable 184,781 84,389 35,264
Accounts payable and
accrued expenses 10,364 (1,460) (6,347)
Accrued compensation 9,082 5,819 6,574
Lease liabilities (1,504) (1,525) (3,510)
-------- -------- --------
Net cash provided by
(used in) operating
activities 139,927 34,770 (59,187)
-------- -------- --------
Investing Activities:
Purchase of investments (65,633) (82,200) (379,058)
Sale of property and
equipment 75 14 --
Maturities of investments 76,300 162,795 267,790
Sale of business 1,065 -- --
Acquisition of property
and equipment, net (26,781) (41,418) (35,995)
-------- -------- --------
Net cash provided by
(used in) investing
activities (14,974) 39,191 (147,263)
-------- -------- --------
Financing Activities:
Proceeds from long-term
debt -- 380,000 --
Debt issuance costs (26) (8,792) --
Repayment of long-term
debt -- (215,000) --
Payment of employment
taxes related to release
of restricted stock -- (350) --
Proceeds from exercise of
stock options 18,067 155 --
Contributions from
noncontrolling interest
holders -- 15 105
-------- -------- --------
Net cash provided by
financing activities 18,041 156,028 105
-------- -------- --------
Net increase (decrease) in
cash 142,994 229,989 (206,345)
Cash, cash equivalents and
restricted cash at beginning
of period 434,943 204,954 411,299
-------- -------- --------
Cash, cash equivalents and
restricted cash at end of
period $ 577,937 $ 434,943 $ 204,954
======== ======== ========
Supplemental disclosure of
cash flow information:
Cash paid for interest $ 13,752 $ 22,157 $ 19,165
Supplemental non-cash
investing and financing
activities:
Acquisition of property
in accounts payable $ 97 $ 70 $ 59
Debt issuance costs in
accounts payable $ -- $ 512 $ --
The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the consolidated balance sheets to the total above:
December 31, 2025 December 31, 2024 December 31, 2023
------------------ ------------------ ------------------
Cash and cash
equivalents $ 575,817 $ 432,859 $ 202,904
Restricted
cash in other
assets 2,120 2,084 2,050
--- ------------- --- ------------- --- -------------
Total $ 577,937 $ 434,943 $ 204,954
=== ============= === ============= === =============
Non-GAAP Financial Measures
Certain of these financial measures are considered "non-GAAP" financial measures within the meaning of Item 10 of Regulation S-K promulgated by the SEC. We believe that non-GAAP financial measures provide an additional way of viewing aspects of our operations that, when viewed with the GAAP results, provide a more complete understanding of our results of operations and the factors and trends affecting our business. These non-GAAP financial measures are also used by our management to evaluate financial results and to plan and forecast future periods. However, non-GAAP financial measures should be considered as a supplement to, and not as a substitute for, or superior to, the corresponding measures calculated in accordance with GAAP. Non-GAAP financial measures used by us may differ from the non-GAAP measures used by other companies, including our competitors. To supplement our consolidated financial statements presented on a GAAP basis, we disclose the following non-GAAP measures: Medical Benefits Ratio, Adjusted EBITDA and Adjusted Gross Profit as these are performance measures that our management uses to assess our operating performance. Because these measures facilitate internal comparisons of our historical operating performance on a more consistent basis, we use these measures for business planning purposes and in evaluating acquisition opportunities.
Adjusted EBITDA
Adjusted EBITDA is a non-GAAP financial measure that we define as net income (loss) before interest expense, income taxes, depreciation and amortization expense, acquisition expenses, certain litigation costs, gains or losses on right of use ("ROU") assets, gains or losses on sale of property and equipment, restructuring costs, equity-based compensation expense, and loss on extinguishment of debt.
Adjusted EBITDA should not be considered in isolation of, or as an alternative to, measures prepared in accordance with GAAP. There are a number of limitations related to the use of Adjusted EBITDA in lieu of net income (loss), which is the most directly comparable financial measure calculated in accordance with GAAP.
Our use of the term Adjusted EBITDA may vary from the use of similar terms by other companies in our industry and accordingly may not be comparable to similarly titled measures used by other companies.
Medical Benefits Ratio (MBR)
We calculate our MBR by dividing total medical expenses, excluding depreciation, equity-based compensation and clinical restructuring costs, by total revenues in a given period.
Adjusted Gross Profit
Adjusted gross profit is a non-GAAP financial measure that we define as income (loss) from operations before depreciation and amortization, medical equity-based compensation expense, clinical restructuring costs and selling, general, and administrative expenses.
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