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Waystar Holding Corp.: Q2 FY2026 earnings call

What management said about Q2 FY2026, from the documents filed with the SEC on 29 July 2026: press release. Guidance figures: 4 raised. The quarter’s numbers.

Key takeaways

  • Revenue growth moderated to 18%: Q2 revenue reached $319.7 million, growing 18% year-over-year, compared to 22% growth in Q1. Source
  • Adjusted EBITDA margin stable at 43%: Adjusted EBITDA of $136.7 million maintained 43% margin consistent with Q1, demonstrating operating leverage. Source
  • Free cash flow generation continued: Unlevered free cash flow of $63.9 million in Q2 contributed to $154.2 million for the first half of 2026. Source
  • Subscription revenue accelerated growth: Subscription revenue grew 34% year-over-year to $176.3 million, comprising 55% of total revenue. Source
  • Provider revenue expanded significantly: Provider segment revenue of $231.8 million grew 23% year-over-year, comprising 73% of total revenue. Source
  • High-value customer base expanded: Clients generating over $100,000 in annual revenue increased 15% year-over-year to 1,453. Source
  • Net revenue retention declined: Net revenue retention rate of 108% declined from 111% in Q1, reflecting pricing or volume changes. Source
  • Adjusted EBITDA margin demonstrates consistency: Adjusted EBITDA margin of 43% held steady from Q1, indicating disciplined cost management. Source
  • EBITDA guidance improved substantially: Adjusted EBITDA guidance for 2026 raised from $530-540M to $535-545M, representing $5M increase at both ends. Source
  • EPS guidance raised for full year: Diluted non-GAAP EPS raised from $1.59-$1.68 range to $1.61-$1.70, reflecting improved profitability expectations. Source
  • Provider adoption accelerating broadly: Management cited growing provider adoption across the platform, with bookings performing ahead of internal expectations. Source

Guidance

AreaPeriodFigureAgainst last quarter
Full-year revenue Sourcefiscal 2026$1.276 billion to $1.294 billionRaised from $1.274 billion to $1.294 billion
Adjusted EBITDA Sourcefiscal 2026$535 million to $545 millionRaised from $530 million to $540 million
Non-GAAP net income Sourcefiscal 2026$322 million to $340 millionRaised from $317 million to $335 million
Diluted non-GAAP EPS Sourcefiscal 2026$1.61 to $1.70Raised from $1.59 to $1.68

What changed from last quarter

  • Guidance raised: Revenue guidance low end raised $2 million to $1.276 billion while maintaining $1.294 billion high end. Source
  • Guidance raised: Adjusted EBITDA range expanded with both endpoints raised $5 million to $535-545 million. Source
  • Guidance raised: Non-GAAP net income and diluted EPS guidance raised at both endpoints reflecting confidence in execution. Source
  • New: Management emphasized accelerating impact of AltitudeAI capabilities as platform expansion continues. Source

Quarterly results and revenue

  • Revenue growth moderated to 18%: Q2 revenue reached $319.7 million, growing 18% year-over-year, compared to 22% growth in Q1. Source
  • Net income margin compressed slightly: Net income of $40.9 million represented 13% margin, down from 14% in Q1, with diluted EPS of $0.21. Source
  • Adjusted EBITDA margin stable at 43%: Adjusted EBITDA of $136.7 million maintained 43% margin consistent with Q1, demonstrating operating leverage. Source
  • Operating cash flow declined sequentially: Cash from operations totaled $59.4 million in Q2, down from $84.9 million in Q1. Source
  • Free cash flow generation continued: Unlevered free cash flow of $63.9 million in Q2 contributed to $154.2 million for the first half of 2026. Source

Revenue mix and growth drivers

  • Subscription revenue accelerated growth: Subscription revenue grew 34% year-over-year to $176.3 million, comprising 55% of total revenue. Source
  • Volume-based revenue growth slowed: Volume-based revenue of $142.1 million rose only 3% year-over-year, representing 45% of quarterly revenue. Source
  • Provider revenue expanded significantly: Provider segment revenue of $231.8 million grew 23% year-over-year, comprising 73% of total revenue. Source
  • Patient segment revenue grew moderately: Patient revenue reached $87.9 million with 7% year-over-year growth, accounting for 27% of revenue. Source

Customer metrics and retention

  • High-value customer base expanded: Clients generating over $100,000 in annual revenue increased 15% year-over-year to 1,453. Source
  • Net revenue retention declined: Net revenue retention rate of 108% declined from 111% in Q1, reflecting pricing or volume changes. Source
  • Large customer base and scale: Company serves approximately 30,000 clients representing over 1 million distinct providers. Source

Profitability and operating leverage

  • Gross margin under cost pressure: Cost of revenue grew faster than revenue, with operating expenses increasing proportionally, pressuring margins. Source
  • Non-GAAP earnings reflected core profitability: Non-GAAP net income of $83.3 million with diluted EPS of $0.43 excluded $42.4 million of adjustments. Source
  • Adjusted EBITDA margin demonstrates consistency: Adjusted EBITDA margin of 43% held steady from Q1, indicating disciplined cost management. Source

Cash generation and capital deployment

  • Free cash flow declined from Q1: Unlevered free cash flow of $63.9 million in Q2 decreased from $90.3 million in Q1 primarily from working capital. Source
  • Share repurchase program initiated: Company repurchased $12.7 million of common stock during the first half of 2026. Source

2026 guidance raised across metrics

  • EBITDA guidance improved substantially: Adjusted EBITDA guidance for 2026 raised from $530-540M to $535-545M, representing $5M increase at both ends. Source
  • EPS guidance raised for full year: Diluted non-GAAP EPS raised from $1.59-$1.68 range to $1.61-$1.70, reflecting improved profitability expectations. Source

Product innovation and platform strategy

  • Iodine integration advancement continues: Management previously advanced Iodine integration with ongoing momentum, representing significant M&A execution.
  • Provider adoption accelerating broadly: Management cited growing provider adoption across the platform, with bookings performing ahead of internal expectations. Source

Risks management discussed

  • Operational: Cybersecurity incident resulted in $1.6 million in costs during Q2 2026, indicating platform security challenges. Source

Earlier plans management reported on

  • On track: Management advanced Iodine integration in Q1 and continues integration progress in Q2.
  • Ahead: Bookings in Q1 came ahead of internal expectations, signaling strong customer demand.

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.