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Evolent Health, Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 24 February 2026: press release. Guidance figures: 4 new. The quarter’s numbers.

Key takeaways

  • Goodwill impairment in fourth-quarter loss: Fourth-quarter net loss attributable to common shareholders was $429,131 thousand, including a $398,000 thousand goodwill impairment. Full-year net loss was $579,401 thousand. Source
  • Adjusted EBITDA margin rose to 8.1%: Fourth-quarter Adjusted EBITDA was $37,793 thousand, an 8.1% margin, against $22,612 thousand and 3.5% a year earlier. Full-year Adjusted EBITDA was $151,155 thousand, an 8.1% margin. Source
  • Performance Suite PMPM fee declined: Performance Suite average PMPM fee was $13.87 in the quarter, against $14.77 in the third quarter. The full-year average was $14.48. Performance Suite average lives were 6,475 in the quarter. Source
  • Medical expense ratio at 90.2% in quarter: Medical expense ratio was 90.2% for the quarter and 80.5% for the year. Excluding Evolent Care Partners, it was 94.8% for the quarter and 89.0% for the year. Source
  • Customer retention and pipeline continue: Management said the company continues to experience customer retention and late-stage pipeline activity, the same wording used in the third-quarter release. Source
  • Full-year 2026 ranges given: Management gave full-year 2026 revenue and Adjusted EBITDA ranges, incorporating year-to-date performance, and forecast 2026 revenue growth of approximately 30%. Source
  • Year-end margins expected to step up: Management expects year-end 2026 margins to step up as new contract reserving effects ease through the year and the cost reduction plan ramps up. Source

“continued to grow market share, renewed customers at strong rates”

Seth Blackley, Co-Founder and Chief Executive Officer

Guidance

AreaPeriodFigureAgainst last quarter
Revenue SourceFull year 2026approximately $2.4 billion to $2.6 billionNew
Adjusted EBITDA SourceFull year 2026approximately $110 million to $140 millionNew
Total revenue growth Source2026approximately 30%New
Capitalized software development, cash deployed Source2026approximately $25 million to $35 millionNew
New Performance Suite revenue Source2026$900 million

What changed from last quarter

  • New guidance: First full-year 2026 guidance was given. The third-quarter release had cited a preliminary 2026 revenue forecast. Source
  • Ended: The Evolent Care Partners sale is described as consummated, so earlier periods are presented on a basis excluding its revenue. Source
  • New: Mario Ramos was named Chief Financial Officer effective January 1, 2026. The appointment was announced in the third-quarter release.

Fourth quarter and full-year results

  • Full-year revenue below 2024: Full-year 2025 revenue was $1,876,229 thousand, compared with $2,554,741 thousand in 2024. Fourth-quarter revenue was $468,719 thousand, against $646,542 thousand a year earlier. Source
  • Goodwill impairment in fourth-quarter loss: Fourth-quarter net loss attributable to common shareholders was $429,131 thousand, including a $398,000 thousand goodwill impairment. Full-year net loss was $579,401 thousand. Source
  • Adjusted EBITDA margin rose to 8.1%: Fourth-quarter Adjusted EBITDA was $37,793 thousand, an 8.1% margin, against $22,612 thousand and 3.5% a year earlier. Full-year Adjusted EBITDA was $151,155 thousand, an 8.1% margin. Source
  • Loss and adjusted income per share: Fourth-quarter basic and diluted loss per share was $(3.84), against $(0.27). Adjusted income per share on a basic basis was $0.08 for the quarter and $0.09 for the year. Source
  • Year-end cash above third-quarter level: Cash and cash equivalents were $151.9 million at December 31, 2025, against $116.7 million at September 30, 2025, as reported in the third-quarter release. Source

Segments and product lines

  • Performance Suite PMPM fee declined: Performance Suite average PMPM fee was $13.87 in the quarter, against $14.77 in the third quarter. The full-year average was $14.48. Performance Suite average lives were 6,475 in the quarter. Source
  • Specialty Technology lives increased: Specialty Technology and Services Suite average lives were 79,677 in the quarter, against 78,050 in the third quarter. Average PMPM fee was 0.40, the same as in the third quarter. Source
  • Administrative Services lives steady: Administrative Services average lives were 1,218 in the quarter, against 1,222 in the third quarter. Average PMPM fee was $15.27, against $15.77 in the third quarter. Source
  • Cases and revenue per case rose: Cases averaged 14 in the quarter, against 13 in the third quarter. Revenue per case was $3,537, against $3,236. Full-year cases averaged 53, at $3,168 per case. Source
  • Performance Suite is largest revenue line: Performance Suite revenue was $269,463 thousand in the quarter, out of $468,719 thousand total revenue. Full-year Performance Suite revenue was $1,127,336 thousand. Source

“Most importantly, we believe we will continue to see a sizable market”

Seth Blackley, Co-Founder and Chief Executive Officer

Costs, medical expense ratio and margins

  • Medical expense ratio at 90.2% in quarter: Medical expense ratio was 90.2% for the quarter and 80.5% for the year. Excluding Evolent Care Partners, it was 94.8% for the quarter and 89.0% for the year. Source
  • Adjusted SG&A above prior-year quarter: Adjusted SG&A was $59,743 thousand for the quarter, against $54,352 thousand a year earlier and $62,060 thousand in the third quarter. Full-year Adjusted SG&A was $251,959 thousand. Source
  • Severance and transaction costs increased: Severance costs were $6,802 thousand in the quarter, against $17 thousand a year earlier. Transaction-related costs were $3,998 thousand, against $700 thousand. Source
  • Adjusted cost of revenue lower than 2024: Adjusted cost of revenue was $371,183 thousand in the quarter, against $569,578 thousand a year earlier and $378,518 thousand in the third quarter. Source
  • Depreciation and amortization increased: Depreciation and amortization expenses were $45,037 thousand in the quarter, against $29,296 thousand a year earlier and $23,615 thousand in the third quarter. Source

Demand, retention and contract migration

  • Customer retention and pipeline continue: Management said the company continues to experience customer retention and late-stage pipeline activity, the same wording used in the third-quarter release. Source
  • Rising medical costs drive health plan demand: Management attributes demand for specialty care solutions to rising medical costs at health plans, as they manage oncology, cardiology and musculoskeletal conditions. Source
  • Performance Suite clients migrate to new model: Management said the migration of Performance Suite clients to the enhanced contract model continued through 2025. Source

2026 guidance and first-half timing

  • Full-year 2026 ranges given: Management gave full-year 2026 revenue and Adjusted EBITDA ranges, incorporating year-to-date performance, and forecast 2026 revenue growth of approximately 30%. Source
  • First-half Adjusted EBITDA pressure expected: Management said 2026 additions of new Performance Suite revenue and Exchange membership changes create an impact on Adjusted EBITDA in the first half of the year. Source
  • Year-end margins expected to step up: Management expects year-end 2026 margins to step up as new contract reserving effects ease through the year and the cost reduction plan ramps up. Source

Cash, debt and shareholder returns

  • Operating cash flow positive for 2025: Net cash and restricted cash provided by operating activities was $38,843 thousand for 2025, against $18,765 thousand in 2024. Reserve for claims and performance-based arrangements used $126,509 thousand. Source
  • Long-term debt raised and repaid: The company received $408,047 thousand of long-term debt proceeds, net of offering costs, and repaid $342,984 thousand. Long-term debt, net was $970,537 thousand at year-end, against $490,520 thousand. Source
  • Share repurchases and preferred dividends: Common stock repurchases totaled $39,996 thousand in 2025. Payments of preferred dividends were $11,127 thousand. Source
  • Disposal proceeds from non-strategic assets: Net proceeds from disposal of non-strategic assets and divestiture of discontinued operations were $91,312 thousand for 2025. Source

Strategy, investment and divestiture

  • Evolent Care Partners revenue shown separately: Revenue from Evolent Care Partners was $13,030 thousand in the quarter and $107,848 thousand for 2025, shown separately in the medical expense ratio reconciliation. Source
  • Acquisition spending rose: Cash paid for asset acquisitions and business combinations was $57,443 thousand in 2025, against $30,725 thousand in 2024. Source
  • Software and equipment investment rose: Investments in internal-use software and purchases of property and equipment were $34,088 thousand in 2025, against $24,893 thousand in 2024. Source

People and leadership

  • Chief Strategy Officer appointment set: John Johnson was named Chief Strategy Officer, effective January 1, 2026, as stated in the third-quarter release.
  • Chief Operating Officer role changed: Katie DiPerna takes the Chief Operating Officer role, reporting to President Dan McCarthy. Emily Rafferty becomes Executive Vice President, Customer Success.
  • Talent leader named Chief People Officer: Felicia Crawford-Smith, previously Vice President of Talent, becomes Chief People Officer as non-clinical operations staffing structures change.
  • CEO backs new CFO's discipline: CEO Seth Blackley said he is confident CFO Mario Ramos will execute the growth plan with financial discipline.

Coming up, as management said on 24 February 2026

  • Cost reduction plan ramps in 2026: Management expects the operating cost reduction plan to ramp up across 2026, supporting the year-end margin step-up it described. Source

Risks management discussed

  • Financial: Management said new contract reserving effects weigh on margins until they ease through the year. Source
  • Demand: Management cited significant health plan membership decreases in Exchange products as an impact on 2026 results. Source

Earlier plans management reported on

  • Met: Management said the company executed on its 2025 earnings targets. Source
  • Met: The fourth-quarter release refers to the Evolent Care Partners sale as consummated. It does not restate the use of proceeds.

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.