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Waystar Holding Corp.: Q1 FY2026 earnings call

What management said about Q1 FY2026, from the documents filed with the SEC on 29 April 2026: press release. Guidance figures: 4 kept. The quarter’s numbers.

Key takeaways

  • Revenue rose 22% year-over-year: Revenue was $313.9 million, up 22% from $256.4 million a year earlier. Source
  • Net income and GAAP EPS increased: Net income was $43.3 million, up from $29.3 million; diluted GAAP EPS was $0.22, against $0.16. Source
  • Subscription revenue grew fastest: Subscription revenue was $172.2 million, up 38% year-over-year. Source
  • Net revenue retention eased to 111%: Net revenue retention was 111%, down from 112% in the prior release. Source
  • Adjusted EBITDA margin widened: Adjusted EBITDA was $135.4 million, a 43.1% margin against 42.0% a year earlier; net income margin was 13.8%. Source
  • Operating cash flow and FCF rose: Cash flow from operations was $84.9 million, against $64.2 million; unlevered free cash flow was $90.3 million, against $78.8 million. Source
  • Iodine integration advanced: Management said the Iodine integration advanced during the quarter. Source
  • Bookings ahead of internal expectations: Management said bookings came in ahead of its internal expectations. Source

“Waystar delivered a solid first quarter, driven by strong execution and continued expansion across our platform,”

Matt Hawkins, Chief Executive Officer of Waystar

Guidance

AreaPeriodFigureAgainst last quarter
Total revenue SourceFiscal year 2026$1.274 billion to $1.294 billionKept
Adjusted EBITDA SourceFiscal year 2026$530 million to $540 millionKept
Non-GAAP net income SourceFiscal year 2026$317 million to $335 millionKept
Diluted non-GAAP net income per share SourceFiscal year 2026$1.59 to $1.68Kept

What changed from last quarter

  • Guidance kept: The fiscal 2026 guidance ranges are the same as those given on February 17, 2026.
  • New: The company launched an AI-powered recoupment solution during the quarter. Source

Results and growth drivers

  • Revenue rose 22% year-over-year: Revenue was $313.9 million, up 22% from $256.4 million a year earlier. Source
  • Net income and GAAP EPS increased: Net income was $43.3 million, up from $29.3 million; diluted GAAP EPS was $0.22, against $0.16. Source
  • Non-GAAP earnings rose: Non-GAAP net income was $81.2 million and non-GAAP diluted EPS $0.42, against $58.7 million and $0.32 a year earlier. Source

Products and customers

  • Subscription revenue grew fastest: Subscription revenue was $172.2 million, up 38% year-over-year. Source
  • Volume-based revenue grew more slowly: Volume-based revenue was $139.5 million, up 7% year-over-year. Source
  • Net revenue retention eased to 111%: Net revenue retention was 111%, down from 112% in the prior release. Source

“We advanced the Iodine integration, launched new innovations such as our AI-powered recoupment solution, and saw bookings come in ahead of our internal expectations, reinforcing our confidence as providers increasingly standardize on Waystar.”

Matt Hawkins, Chief Executive Officer of Waystar

Costs and margins

  • Adjusted EBITDA margin widened: Adjusted EBITDA was $135.4 million, a 43.1% margin against 42.0% a year earlier; net income margin was 13.8%. Source
  • Cost of revenue and R&D increased: Cost of revenue rose to $97.0 million from $83.3 million; research and development rose to $18.4 million from $11.1 million. Source
  • Stock-based compensation rose: Stock-based compensation was $11.4 million, against $6.7 million; acquisition and integration costs were $1.8 million, against $0.2 million. Source
  • Amortization made up most of D&A: Depreciation and amortization was $41.5 million, of which intangible amortization was $34.5 million. Source

Cash, debt and capital

  • Operating cash flow and FCF rose: Cash flow from operations was $84.9 million, against $64.2 million; unlevered free cash flow was $90.3 million, against $78.8 million. Source
  • Capital spending increased: Purchases of property, equipment and capitalized software were $15.3 million, against $5.4 million. Source
  • Cash fell as securities were bought: Cash and cash equivalents fell to $34.3 million from $61.4 million at December 31, 2025, while investment securities rose to $124.6 million from $24.9 million. Source
  • Leverage ratio lower than year-end: Net debt was $1,318.8 million and the adjusted net leverage ratio 2.7x, against 2.5x a year earlier and 3.0x at December 31, 2025. Source
  • Diluted share count rose: Diluted weighted-average shares were 195.2 million, against 180.7 million a year earlier. Source

Strategy and integration

  • Iodine integration advanced: Management said the Iodine integration advanced during the quarter. Source
  • AI recoupment solution launched: The company launched an AI-powered recoupment solution, one of several new innovations. Source
  • Large platform processing volume: The platform processes over 7.5 billion healthcare payment transactions a year, including over $2.4 trillion in annual gross claims. Source

Demand and bookings

  • Bookings ahead of internal expectations: Management said bookings came in ahead of its internal expectations. Source
  • Providers standardizing on Waystar: Management linked its confidence to providers increasingly standardizing on Waystar. Source
  • Growth in larger clients: 1,433 clients contributed over $100,000 in LTM revenue, up 15% from a year earlier. Source

Figures management reported

FigureReported
Clients with over $100,000 in LTM revenue Source1,433, up 15% year-over-year
Net revenue retention rate Source111%
Subscription revenue Source$172.2 million, up 38% year-over-year

Risks management discussed

  • Financial: Management flagged variability and low visibility in certain costs, mainly incentive compensation, transaction-related expenses and fair value measurements, which could affect future GAAP results. Source

Earlier plans management reported on

  • Ahead: Management said bookings came in ahead of its internal expectations in the quarter. 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.