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Evolent Health, Inc.: Q2 FY2026 earnings call

What management said about Q2 FY2026, from the documents filed with the SEC on 6 August 2026: press release. Guidance figures: 1 raised, 4 new, 1 kept. The quarter’s numbers.

Key takeaways

  • Revenue rose on Performance Suite growth: Revenue was $652.5 million, against $444.3 million a year earlier and $496.2 million in the first quarter. Performance Suite revenue was $484.5 million, against $267.9 million. Source
  • Adjusted EBITDA declined year over year: Adjusted EBITDA margin was 4.3%, against 8.5%. First-quarter Adjusted EBITDA was $22.1 million at a 4.4% margin. Source
  • Performance Suite lives and fees rose: Average PMPM fee was $24.05, against $13.76 a year earlier, and Performance Suite lives rose to 6,715 from 6,490. Source
  • Medical expense ratio rose to 95.3%: Medical expense ratio was 95.3%, against 80.0% a year earlier and 93.3% in the first quarter. Excluding Evolent Care Partners, the ratio was 95.3%, against 84.9%. Source
  • Oncology partnership with imaging client: An existing advanced imaging client is preparing for an Oncology Performance Suite go-live. The partnership covers Medicaid and Medicare populations and includes full enhanced contractual protections. Source
  • Cash fell to $115.7 million: Cash and cash equivalents were $115.7 million at June 30, 2026, against $151.9 million at December 31, 2025. Restricted cash was $23.0 million current and $2.8 million noncurrent. Source

“We believe our results for the second quarter of 2026, our updated 2026 guidance and our 2027 outlook all demonstrate that Evolent is delivering strong growth, profitability and cash flow.”

Seth Blackley, Co-Founder and Chief Executive Officer

Guidance

AreaPeriodFigureAgainst last quarter
Revenue SourceFull year 2026$2.6 to $2.7 billionRaised from $2.4 billion to $2.6 billion
Adjusted EBITDA SourceFull year 2026$120 to $135 million
Capitalized software development cash SourceFull year 2026$25 million to $30 millionKept
Revenue growth Source2027 compared with 2026over 25%New
Adjusted EBITDA Source2027 midpointat or above $150 millionNew
Oncology partnership revenue SourceAnnualized, once launchedapproximately $300 millionNew
Blues plan contract revenue SourceAnnualizedless than $5 millionNew

What changed from last quarter

  • Guidance raised: 2026 revenue guidance range was raised, per the release. Source
  • New guidance: 2027 expectations were given for the first time, covering revenue growth and the Adjusted EBITDA midpoint. Source
  • Guidance kept: The 2026 capitalized software spending range is the same as in the prior release. Source
  • New: An oncology Performance Suite partnership was added with an existing advanced imaging client. Source
  • New: A regional Blues plan client agreed to broaden its use of the Specialty Technology & Services Suite. Source

Results and growth drivers

  • Revenue rose on Performance Suite growth: Revenue was $652.5 million, against $444.3 million a year earlier and $496.2 million in the first quarter. Performance Suite revenue was $484.5 million, against $267.9 million. Source
  • Adjusted EBITDA declined year over year: Adjusted EBITDA margin was 4.3%, against 8.5%. First-quarter Adjusted EBITDA was $22.1 million at a 4.4% margin. Source
  • Net loss narrowed; adjusted income positive: Net loss attributable to common shareholders was $28.4 million, or $0.25 per share, against $51.1 million, or $0.44 per share. Adjusted income was $2.2 million, or $0.02 per share. Source
  • Six-month revenue and EBITDA compared: For the six months, revenue was $1,148.8 million against $928.0 million, Adjusted EBITDA $50.1 million against $74.4 million, and net loss $55.0 million against $123.3 million. Source

Products and unit economics

  • Performance Suite lives and fees rose: Average PMPM fee was $24.05, against $13.76 a year earlier, and Performance Suite lives rose to 6,715 from 6,490. Source
  • Administrative and specialty fees per member fell: Administrative Services fee per member was $13.46, against $15.13, and the Specialty Technology and Services Suite fee was $0.34, against $0.35. Administrative Services lives were 1,189, against 1,231. Source
  • Case revenue rose on higher revenue per case: Cases were 12, against 13, and revenue per case was $3,608, against $2,969. Case revenue was $41.9 million, against $39.1 million a year earlier. Source

“We are confident in our emerging AI-led operational model that we believe allows us to deliver excellent client and clinical outcomes, while being highly disciplined with our cost structure.”

Seth Blackley, Co-Founder and Chief Executive Officer

Medical expense ratio and claims

  • Medical expense ratio rose to 95.3%: Medical expense ratio was 95.3%, against 80.0% a year earlier and 93.3% in the first quarter. Excluding Evolent Care Partners, the ratio was 95.3%, against 84.9%. Source
  • Claims incurred more than doubled: Total claims incurred for the specialty care management solution were $461.5 million, against $214.2 million. For the six months, the medical expense ratio was 94.5%, against 73.6%. Source
  • Evolent Care Partners sale affects comparison: The Evolent Care Partners sale closed in December 2025. Its revenue was $15.5 million in the second quarter of 2025 and nil in 2026, so the ratio is also shown excluding it. Source

Costs and operating expenses

  • Cost of revenue rose year over year: Cost of revenue was $571.7 million, against $343.9 million. Selling, general and administrative expenses were $68.8 million, against $75.2 million. Adjusted cost of revenue was $571.0 million. Source
  • Adjusted SG&A fell year over year: Adjusted selling, general and administrative expenses were $53.5 million, against $63.9 million. Stock-based compensation within selling, general and administrative expenses was $14.5 million, against $10.5 million. Source
  • Interest expense rose to $16.9 million: Interest expense was $16.9 million, against $11.6 million, and interest income was $0.7 million, against $1.1 million. Depreciation and amortization was $21.6 million, against $23.1 million. Source

“based on contracts in place today, upcoming launches scheduled and the strong continuing demand for our oncology solution”

Mario Ramos, Chief Financial Officer

Demand and partnerships

  • Two partnership announcements this quarter: The two announcements covered an oncology partnership and an expansion with a regional Blues plan client, bringing the year-to-date total to four. Source
  • Oncology partnership with imaging client: An existing advanced imaging client is preparing for an Oncology Performance Suite go-live. The partnership covers Medicaid and Medicare populations and includes full enhanced contractual protections. Source
  • Demand from rising medical costs: Management said rising medical costs at health plans continue to drive robust demand for its complex specialty care solutions. Source
  • Blues plan expands specialty technology use: A regional Blues plan client already using the Specialty Technology & Services Suite signed to add new products and extend existing solutions to additional populations. Source

Cash, debt and shareholders

  • Cash fell to $115.7 million: Cash and cash equivalents were $115.7 million at June 30, 2026, against $151.9 million at December 31, 2025. Restricted cash was $23.0 million current and $2.8 million noncurrent. Source
  • Operating cash use was lower: For the six months, net cash and restricted cash used in operating activities was $10.3 million, against $25.8 million a year earlier. Net cash used in investing activities was $13.1 million, against $73.6 million. Source
  • Claims reserve and receivables both rose: Reserve for claims and performance-based arrangements rose to $378.4 million from $192.2 million at year-end. Accounts receivable, net, rose to $449.1 million from $309.9 million. Source
  • Debt and repayments in the period: Long-term debt, net, was $966.5 million, against $970.5 million at December 31, 2025. Debt repayments were $10.0 million in the six months, against $62.5 million in the first half of 2025, when $221.0 million was issued. Source
  • No Series A preferred dividends this year: No Series A Preferred Stock dividends or accretion were recorded in the three or six months ended June 30, 2026. The second quarter of 2025 included $31.2 million. Source
  • Weighted share count fell year over year: Weighted-average basic and diluted shares were 112.5 million for the quarter, against 115.9 million. Shares issued were 118.7 million at June 30, 2026, against 117.6 million at year-end. Source

Investment, financing and operating model

  • Internal software spend lower in six months: Investments in internal-use software and property and equipment were $13.3 million for the six months, against $17.4 million a year earlier. Source
  • AI-led operating model and cost discipline: Management said it is confident in an emerging AI-led operational model that it believes supports client and clinical outcomes while keeping cost discipline. Source
  • Financing outflow compared with inflow: Net cash used in financing activities was $15.0 million for the six months, against $98.9 million provided a year earlier. Changes in working capital for claims processing used $3.1 million. Source

Coming up, as management said on 6 August 2026

  • Oncology partnership go-live: Go-live of the oncology partnership with the advanced imaging client is expected by December 2026, subject to certain regulatory approvals. Source
  • Blues plan implementations in 2026: Implementations for the regional Blues plan client are expected in the third and fourth quarters of 2026. Source
  • Debt reduction initiatives under evaluation: Management said it is currently evaluating targeted debt reduction initiatives. The release gives no timing or amounts for them. Source

Figures management reported

FigureReported
Performance Suite lives on platform (average) Source6,715 against 6,490
Specialty Technology and Services Suite lives on platform (average) Source75,641 against 77,019
Administrative Services lives on platform (average) Source1,189 against 1,231
Cases Source12 against 13
Average unique members Source39,956 against 40,201
Performance Suite average PMPM fee (dollars) Source$24.05 against $13.76

Risks management discussed

  • Demand: Management cited Medicaid and other client-specific membership attrition as significant continuing industry headwinds. Source
  • Operational: The CFO tied the 2027 Adjusted EBITDA expectation to improved Performance Suite care margins and expense reductions. Source
  • Financial: Management linked the capital structure and financial flexibility to improved cash flow conversion and targeted debt reduction under evaluation. Source

Earlier plans management reported on

  • On track: The first-quarter release said the company was on track with its plan.
  • Met: The first-quarter release described the oncology launches at Highmark and Aetna as on time.

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.