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Evolent Health, Inc.: Q1 FY2026 earnings call

What management said about Q1 FY2026, from the documents filed with the SEC on 7 May 2026: press release. Guidance figures: 1 narrowed, 1 new, 2 kept. The quarter’s numbers.

Key takeaways

  • Revenue rose, net loss narrowed: Revenue was $496.2 million against $483.6 million a year earlier. Net loss attributable to common shareholders was $26.6 million, or $(0.24) per share, against $72.3 million, or $(0.63). Source
  • Adjusted EBITDA declined year over year: Adjusted EBITDA was $22.1 million, a 4.4% margin, against $36.9 million and a 7.6% margin a year earlier. Adjusted loss attributable to common shareholders was $(2.3) million, or $(0.02) per share. Source
  • Medical expense ratio increased: Medical expense ratio was 93.3%, against 68.0% a year earlier. On the basis excluding Evolent Care Partners, the prior-year ratio was 84.0%. Source
  • Demand tied to rising medical costs: Management said rising medical costs at health plans continue to drive demand for Evolent's complex specialty care solutions. Source
  • Oncology and Cardiology expansion signed: A national payer client is expanding its existing Oncology and Cardiology solution into new markets, covering Commercial and Medicare lines of business. Source
  • Cash balance lower in quarter: Cash and cash equivalents were $142.0 million at March 31, 2026, against $151.9 million at December 31, 2025. Restricted cash was $24.0 million current and $2.7 million noncurrent. Source
  • Oncology leadership is the stated focus: Management said it remains focused on extending its market leadership in oncology for 2027 and beyond, alongside work on AI. Source

“We are on track with our plan and have had successful, on-time oncology launches at both Highmark and Aetna.”

Seth Blackley, Co-Founder and Chief Executive Officer

Guidance

AreaPeriodFigureAgainst last quarter
Revenue SourceFull year 2026$2.4 billion to $2.6 billionKept
Adjusted EBITDA SourceFull year 2026approximately $110 million to $140 millionKept
Capitalized software development cash SourceFull year 2026approximately $25 million to $30 millionNarrowed, top end cut from approximately $25 million to $35 million
Annual revenue from Oncology and Cardiology expansion SourceAnnual, after the expansion goes liveover $200 million of annual revenueNew

What changed from last quarter

  • Guidance lowered: Capitalized software development cash range narrowed; the top end moved to $30 million from $35 million, and the bottom stayed at $25 million. Source
  • New: Advanced imaging contract signed by an existing Performance Suite client, covering about 4.5 million lives across Commercial, Medicaid and Medicare. Source
  • New: A national payer client is expanding its existing Oncology and Cardiology solution into new markets across the Commercial and Medicare lines of business. Source
  • Ended: Evolent Care Partners revenue was nil in the quarter, against $57.8 million a year earlier, after the sale was completed in December 2025. Source

Results and year-over-year change

  • Revenue rose, net loss narrowed: Revenue was $496.2 million against $483.6 million a year earlier. Net loss attributable to common shareholders was $26.6 million, or $(0.24) per share, against $72.3 million, or $(0.63). Source
  • Adjusted EBITDA declined year over year: Adjusted EBITDA was $22.1 million, a 4.4% margin, against $36.9 million and a 7.6% margin a year earlier. Adjusted loss attributable to common shareholders was $(2.3) million, or $(0.02) per share. Source
  • Prior-year one-off charges did not recur: The prior-year quarter carried a $52.3 million loss on option exercise and $7.6 million of Series A preferred dividends and accretion, and neither appears this quarter. Interest expense was $16.9 million against $10.4 million. Source
  • Depreciation and taxes both lower: Depreciation and amortization was $21.6 million against $24.1 million. The income tax provision was $0.9 million against $1.5 million. Source

Suite revenue and membership

  • Performance Suite revenue rose: Performance Suite revenue was $323.3 million against $303.0 million. Excluding Evolent Care Partners, the prior-year figure was $245.2 million. Source
  • Specialty and administrative revenue fell: Specialty Technology and Services Suite revenue was $80.8 million against $82.8 million. Administrative Services revenue was $49.6 million against $57.2 million, and average lives in both suites were lower than a year earlier. Source
  • Cases revenue rose on fewer cases: Cases revenue was $42.6 million against $40.6 million, with fewer cases and higher revenue per case than in the prior-year quarter. Source

“all while fulfilling our commitments to shareholders, employees and customers”

Seth Blackley, Co-Founder and Chief Executive Officer

Medical expense ratio and claims

  • Medical expense ratio increased: Medical expense ratio was 93.3%, against 68.0% a year earlier. On the basis excluding Evolent Care Partners, the prior-year ratio was 84.0%. Source
  • Specialty care claims increased: Total claims incurred for the specialty care management solution were $301.8 million, against $206.0 million in the prior-year quarter. Source
  • Cost of revenue increased: Cost of revenue was $412.5 million against $381.2 million, and adjusted cost of revenue was $412.0 million against $380.5 million. Source
  • Adjusted SG&A and severance lower: Adjusted selling, general and administrative expenses were $62.2 million against $66.3 million. The prior-year quarter included $1.0 million of severance costs, and transaction-related costs were $0.5 million against $0.7 million. Source

Demand and new revenue agreements

  • Demand tied to rising medical costs: Management said rising medical costs at health plans continue to drive demand for Evolent's complex specialty care solutions. Source
  • Oncology and Cardiology expansion signed: A national payer client is expanding its existing Oncology and Cardiology solution into new markets, covering Commercial and Medicare lines of business. Source
  • Average unique members lower: Average unique members were 38,903, against 40,628 a year earlier, and Performance Suite average lives fell modestly. Source

Cash, debt and balance sheet

  • Cash balance lower in quarter: Cash and cash equivalents were $142.0 million at March 31, 2026, against $151.9 million at December 31, 2025. Restricted cash was $24.0 million current and $2.7 million noncurrent. Source
  • Operating cash flow turned negative: Net cash used in operating activities was $1.0 million, against $4.6 million provided a year earlier. The reserve for claims and performance-based arrangements rose to $232.0 million from $192.2 million at December 31, 2025. Source
  • Software and equipment spend lower: Investments in internal-use software and property were $6.4 million, against $8.6 million a year earlier. Long-term debt, net, was $973.5 million, against $970.5 million at year-end. Source

Strategy, software and shareholder payments

  • Oncology leadership is the stated focus: Management said it remains focused on extending its market leadership in oncology for 2027 and beyond, alongside work on AI. Source
  • Software development spend planned: Capitalized software development cash for 2026 is planned in the range stated in the guidance list, with the top end below the prior release. Source
  • No repurchases or preferred dividends: The cash flow statement shows no preferred dividend payments in the quarter, against $4.6 million a year earlier, and no debt repayment. Source

Coming up, as management said on 7 May 2026

  • Advanced imaging go-live in third quarter: The advanced imaging solution is expected to go live in the third quarter, subject to state regulatory approvals in certain states. Source
  • Oncology expansion go-live in third quarter: The Oncology and Cardiology expansion is scheduled to go live in the third quarter, subject to regulatory approvals in certain states. Source

Figures management reported

FigureReported
Performance Suite average lives on platform Source6,078 vs 6,486
Specialty Technology and Services Suite average lives Source76,101 vs 77,079
Administrative Services average lives Source1,118 vs 1,213
Cases Source11 vs 14
Average unique members Source38,903 vs 40,628
Performance Suite average PMPM fee Source$17.73 vs $15.57
Revenue per case Source3,772 vs 2,947

Risks management discussed

  • Regulatory: Both go-lives depend on regulatory approvals, including state approvals in certain states. Source
  • Financial: Management said the exact amount of non-GAAP adjustments to future results is not currently determinable and may be significant. Source

Earlier plans management reported on

  • On track: Management said the company is on track with its plan. Source
  • Met: Management said the oncology launches at both Highmark and Aetna were on time. Source

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.