Press Release: Alignment Healthcare Delivers Strong First Quarter 2026 Results, Demonstrating Disciplined Growth and Margin Expansion

Dow Jones05-01
   -- Delivers $1.24 billion in total revenue, representing 33.3% growth 
      year-over-year 
 
   -- Grows Medicare Advantage membership 30.9% year-over-year to approximately 
      284,800 members 
 
   -- Raises the midpoint of all guidance metrics: membership, revenue, 
      adjusted gross profit and adjusted EBITDA 

ORANGE, Calif., April 30, 2026 (GLOBE NEWSWIRE) -- Alignment Healthcare, Inc. (NASDAQ: ALHC), today reported financial results for its first quarter ended March 31, 2026.

"Our first-quarter performance demonstrates that Alignment continues to grow with discipline," said John Kao, founder and CEO. "We expanded our profitability by executing across sales, clinical operations and cost management, even as the Medicare Advantage environment continues to change. We delivered strength within our results even while we are investing in our people, processes and technologies. The improvements we are making across each of these areas will position us to scale the business and achieve our embedded earnings potential."

First Quarter 2026 Financial Highlights

All comparisons, unless otherwise noted, are to the three months ended March 31, 2025.

   -- Health plan membership at the end of the quarter was approximately 
      284,800, up 30.9% year-over-year 
 
   -- Total revenue was $1,235.2 million, up 33.3% year-over-year 
 
   -- Adjusted gross profit* was $145.9 million, up 36.1% year-over-year, and 
      income from operations was $15.5 million 
 
          -- Adjusted gross profit excludes depreciation and amortization of 
             $7.8 million and selling, general, and administrative expenses of 
             $121.1 million (which includes $12.6 million of equity-based 
             compensation). Adjusted gross profit also excludes $0.02 million 
             of depreciation expense and an additional $1.4 million of 
             equity-based compensation recorded within medical expenses 
 
          -- Medical benefits ratio based on adjusted gross profit was 88.2%, 
             an improvement of 25 basis points year-over-year 
 
   -- Adjusted EBITDA* of $37.9 million represented an adjusted EBITDA margin 
      of 3.1% and grew 87.6% year-over-year, while net income was $11.4 million, 
      compared to $9.4 million net loss the year prior 

(* Please see "First Quarter 2026 Non-GAAP Reconciliation Tables" below for more information on the non-GAAP financial measures reported here as supplemental information.)

Outlook for Second Quarter and Fiscal Year 2026

 
                 Three Months Ending June 30,   Twelve Months Ending December 
                             2026                          31, 2026 
$ Millions           Low             High            Low             High 
-------------- 
Health Plan 
 Membership            288,000         290,000         294,000         299,000 
Revenue                 $1,295          $1,315          $5,160          $5,205 
Adjusted Gross 
 Profit(1)                $167            $177            $620            $650 
Adjusted 
 EBITDA(1)                 $50             $60            $138            $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 "First Quarter 2026 Non-GAAP Reconciliation 
        Tables" for additional information.) 
 
 

First Quarter 2026 Non-GAAP Reconciliation Tables

Adjusted Gross Profit(1) is reconciled as follows:

 
                                          Three Months Ended March 31, 
                                      ------------------------------------ 
                                            2026               2025 
                                      ----------------  ------------------ 
(dollars in thousands) 
Income (loss) from operations          $        15,503   $       (5,393) 
Add back: 
      Equity-based compensation 
       (medical expenses)                        1,411            1,152 
      Depreciation (medical 
       expenses)                                    23               33 
      Depreciation and amortization 
       (2)                                       7,839            7,594 
      Selling, general, and 
       administrative expenses                 121,138          103,831 
                                          ------------      ----------- 
      Total add back                           130,411          112,610 
                                          ------------      ----------- 
Adjusted gross profit                  $       145,914   $      107,217 
                                          ============      =========== 
 
 
(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, and selling, general, and administrative 
      expenses. 
(2)  (Amortization expense for the year ended March 31, 
      2025, includes $0.6 million in impairment expense 
      related to the remeasurement of goodwill associated 
      with one of our subsidiaries.) 
 
 

Adjusted EBITDA(1) is reconciled as follows:

 
                                          Three Months Ended March 31, 
                                      ------------------------------------ 
                                            2026               2025 
                                      ----------------  ------------------ 
(dollars in thousands) 
Net income (loss)                      $        11,416   $       (9,354) 
Less: Net loss attributable to 
 noncontrolling interest                            --              240 
Adjustments: 
      Interest expense                           4,062            3,950 
      Depreciation and 
       amortization(2)                           7,862            7,627 
      Income tax expense                            25               21 
      Equity-based compensation(3)              14,019           17,187 
      Litigation costs (4)                         467              507 
 
Adjusted EBITDA                        $        37,851   $       20,178 
                                          ============      =========== 
 
 
(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, certain 
      litigation costs, and equity-based compensation expense. 
(2)  (Amortization expense for the year ended March 31, 
      2025, includes $0.6 million in impairment expense 
      related to the remeasurement of goodwill associated 
      with one of our subsidiaries.) 
(3)  (Represents equity-based compensation related to grants 
      made in the applicable year) 
(4)  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 
 
 

Conference Call Details

The company will host a conference call at 5 p.m. EDT 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/53zw9jkh. 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.

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 June 30, 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.

 
 
                Condensed Consolidated Balance Sheets 
          (in thousands, except par value and share amounts) 
                              (Unaudited) 
 
                                            March 31,    December 31, 
                                               2026          2025 
                                           -----------  -------------- 
                 Assets 
Current Assets: 
  Cash and cash equivalents                $  705,584   $   575,817 
  Accounts receivable (less allowance for 
   credit losses of $0 at March 31, 2026 
   and $833 at December 31, 2025)             277,678       253,207 
  Investments - current                        20,707        28,413 
  Prepaid expenses and other current 
   assets                                     141,396        94,140 
                                            ---------    ---------- 
    Total current assets                    1,145,365       951,577 
  Property and equipment, net                  63,867        64,251 
  Right of use asset, net                       7,073         7,019 
  Goodwill                                     32,060        32,060 
  Intangible assets, net                        4,550         4,550 
  Other assets                                  8,693         6,329 
                                            ---------    ---------- 
    Total assets                           $1,261,608   $ 1,065,786 
                                            =========    ========== 
  Liabilities and Stockholders' Equity 
Current Liabilities: 
  Medical expenses payable                 $  655,967   $   474,569 
  Accounts payable and accrued expenses        34,502        33,284 
  Accrued compensation                         34,288        49,013 
                                            ---------    ---------- 
    Total current liabilities                 724,757       556,866 
  Long-term debt, net of debt issuance 
   costs                                      323,616       323,176 
  Long-term portion of lease liabilities        6,350         6,467 
                                            ---------    ---------- 
    Total liabilities                       1,054,723       886,509 
Stockholders' Equity: 
  Preferred stock, $.001 par value; 
  100,000,000 shares authorized as of 
  March 31, 2026 and December 31, 2025, 
  respectively; no shares issued and 
  outstanding as of March 31, 2026 and 
  December 31, 2025                                --            -- 
Common stock, $.001 par value; 
 1,000,000,000 shares authorized as of 
 March 31, 2026 and December 31, 2025; 
 206,671,068 and 204,153,619 shares 
 issued and outstanding as of March 31, 
 2026 and December 31, 2025, 
 respectively                                     207           205 
  Additional paid-in capital                1,204,279     1,188,089 
  Accumulated deficit                        (997,601)   (1,009,017) 
                                            ---------    ---------- 
    Total stockholders' equity                206,885       179,277 
                                            ---------    ---------- 
      Total liabilities and stockholders' 
       equity                              $1,261,608   $ 1,065,786 
                                            =========    ========== 
 
 
 
            Condensed Consolidated Statements of Operations 
                (in thousands, except per share amounts) 
                               (Unaudited) 
 
                                         Three Months Ended March 31, 
                                      ---------------------------------- 
                                            2026              2025 
                                                        ---------------- 
Revenues: 
   Earned premiums                     $     1,226,566  $     918,043 
   Other                                         8,631          8,889 
                                          ------------   ------------ 
      Total revenues                         1,235,197        926,932 
                                          ------------   ------------ 
Expenses: 
   Medical expenses                          1,090,717        820,900 
   Selling, general, and 
    administrative expenses                    121,138        103,831 
   Depreciation and amortization                 7,839          7,594 
                                          ------------   ------------ 
      Total expenses                         1,219,694        932,325 
                                          ------------   ------------ 
Income (loss) from operations                   15,503         (5,393) 
                                          ------------   ------------ 
Other expenses: 
   Interest expense                              4,062          3,950 
   Other expenses (income), net                     --            (10) 
                                          ------------   ------------ 
      Total other expense                        4,062          3,940 
                                          ------------   ------------ 
Income (loss) before income taxes               11,441         (9,333) 
Provision for income taxes                          25             21 
                                          ------------   ------------ 
Net income (loss)                      $        11,416  $      (9,354) 
Less: Net loss attributable to 
 noncontrolling interest                            --            240 
                                          ------------   ------------ 
Net income (loss) attributable to 
 Alignment Healthcare, Inc.            $        11,416  $      (9,114) 
 
Net income (loss) per share 
attributable to Alignment 
Healthcare, Inc.: 
Basic                                             0.06          (0.05) 
Diluted                                           0.05          (0.05) 
Weighted-average common shares 
outstanding: 
   Basic                                   205,356,397    193,606,438 
   Diluted                                 213,128,231    193,606,438 
 
 
 
              Condensed Consolidated Statements of Cash Flows 
                               (in thousands) 
                                (Unaudited) 
 
                                         Three Months Ended March 31, 
                                    -------------------------------------- 
                                           2026                2025 
                                    -------------------  ----------------- 
Operating Activities: 
 Net income (loss)                   $       11,416       $      (9,354) 
 Adjustments to reconcile net 
 income (loss) to net cash 
 provided by operating 
 activities: 
   Depreciation and amortization              7,862               7,627 
   Amortization-investment 
    discount                                   (245)               (370) 
   Amortization-debt issuance 
    costs                                       507                 440 
   Equity-based compensation                 14,019              17,187 
   Non-cash lease expense                       450                 395 
   Changes in operating assets and 
   liabilities: 
     Accounts receivable                    (24,471)            (60,155) 
     Prepaid expenses and other 
      current assets                        (47,256)            (43,800) 
     Other assets                               (16)                (23) 
     Medical expenses payable               181,398             106,946 
     Accounts payable and accrued 
      expenses                                  287               5,365 
     Accrued compensation                   (14,725)             (7,577) 
     Lease liabilities                         (544)                (65) 
                                        -----------          ---------- 
       Net cash provided by 
        operating activities                128,682              16,616 
                                        -----------          ---------- 
Investing Activities: 
 Purchase of investments                    (10,598)            (17,905) 
 Maturities of investments                   18,540              22,695 
 Acquisition of property and 
  equipment                                  (7,364)             (8,252) 
                                        -----------          ---------- 
       Net cash provided by (used 
        in) investing activities                578              (3,462) 
                                        -----------          ---------- 
Financing Activities: 
 Debt issuance costs                         (1,658)                (26) 
 Proceeds from stock option 
  exercises                                   2,173                 207 
       Net cash provided by 
        financing activities                    515                 181 
                                        -----------          ---------- 
 Net increase in cash                       129,775              13,335 
 Cash, cash equivalents and 
  restricted cash at beginning of 
  period                                    577,937             434,942 
                                        -----------          ---------- 
 Cash, cash equivalents and 
  restricted cash at end of 
  period                             $      707,712       $     448,277 
                                        ===========          ========== 
Supplemental disclosure of cash 
flow information: 
   Cash paid for interest            $           --       $          -- 
Supplemental non-cash investing 
and financing activities: 
   Acquisition of property in 
    accounts payable                 $           94       $          85 
   Debt issuance costs in accounts 
    payable                          $          719       $          -- 
 
 

The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the consolidated balance sheets to the total above:

 
                                   March 31, 2026     March 31, 2025 
                                  ----------------  ------------------ 
Cash and cash equivalents          $       705,584   $       446,184 
Restricted cash in other assets              2,128             2,093 
                                      ------------      ------------ 
Total                              $       707,712   $       448,277 
                                      ============      ============ 
 
 

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, certain litigation costs, and equity-based compensation expense.

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, and medical equity-based compensation, 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, and selling, general, and administrative expenses.

Adjusted gross profit 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 gross profit in lieu of income (loss) from operations, which is the most directly comparable financial measure calculated in accordance with GAAP.

Our use of the term adjusted gross profit 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.

Investor Contact 
Harrison Zhuo 
hzhuo@ahcusa.com 
 
Media Contact 
Jerry Slowey 
publicrelations@ahcusa.com 

(END) Dow Jones Newswires

April 30, 2026 16:01 ET (20:01 GMT)

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