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Alignment Healthcare Llc
Alignment Healthcare Reports Fourth Quarter and Full-Year 2025 Results; Beats High-End of Guidance Across All Key Metrics
Business
Feb 26 2026
17 min read

Alignment Healthcare Reports Fourth Quarter and Full-Year 2025 Results; Beats High-End of Guidance Across All Key Metrics

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  • Delivers full-year revenue of $3.95 billion, representing 46.1% growth year-over-year 

  • Exceeds high-end of fourth quarter and full-year guidance across all key metrics: membership, revenue, adjusted gross profit and adjusted EBITDA

  • Raises health plan membership guidance by 2,000 at the midpoint and introduces 2026 revenue guidance of $5.14 billion to $5.19 billion, representing 30%-31% growth year-over-year, and adjusted EBITDA of $133 million to $163 million

  • Earns recognition on the 2026 Fortune World’s Most Admired Companies™ list, underscoring the company’s innovative approach to senior health care

ORANGE, Calif., Feb. 26, 2026 (GLOBE NEWSWIRE) -- Alignment Healthcare, Inc. (NASDAQ: ALHC), today reported financial results for its fourth quarter and full year ended Dec. 31, 2025.

“Our fourth quarter and full-year 2025 results show what Medicare Advantage done right looks like,” said John Kao, founder and CEO. “We once again exceeded industry expectations and delivered continued momentum on revenue growth while taking a positive step forward in profitability and margin expansion, including producing free cash flow on a full-year basis. By leading with our care model, we are putting our seniors first and lowering costs by delivering more care, not less. Being named to the 2026 Fortune World's Most Admired Companies™ list affirms the reputation we’ve built since going public. As we move through 2026, we remain focused on disciplined growth, the scalability of our operations and creating long-term value for the members we serve.”

Fourth Quarter 2025 Financial Highlights
All comparisons, unless otherwise noted, are to the three months ended Dec. 31, 2024.

  • Health plan membership at the end of the quarter was approximately 236,300, up 25.0% year-over-year

  • Total revenue was $1,012.8 million, up 44.4% year-over-year

  • Adjusted gross profit* was $124.9 million and loss from operations was $10.3 million

    • Adjusted gross profit excludes depreciation and amortization of $7.8 million and selling, general, and administrative expenses of $125.8 million (which includes $11.5 million of equity-based compensation). Adjusted gross profit also excludes an additional $1.6 million of equity-based compensation recorded within medical expenses

    • Medical benefits ratio based on adjusted gross profit was 87.7%

  • Adjusted EBITDA* was $11.4 million and net loss was $11.0 million

Full Year 2025 Financial Highlights
All comparisons, unless otherwise noted, are to the twelve months ended Dec. 31, 2024.

  • Total revenue was $3,948.7 million, up 46.1% year over year.

  • Adjusted gross profit was $494.8 million and income from operations was $14.8 million

    • Adjusted gross profit excludes depreciation and amortization of $30.4 million and selling, general, and administrative expenses of $443.4 million (which includes $55.9 million of equity-based compensation). Adjusted gross profit also excludes $0.1 of depreciation expense and an additional $6.1 million of equity-based compensation recorded within medical expenses

    • Medical benefits ratio based on adjusted gross profit was 87.5%

  • Adjusted EBITDA was $109.9 million and net loss was $1.0 million

* Please see "Fourth Quarter 2025 Non-GAAP Reconciliation Tables" below for more information on the non-GAAP financial measures reported here as supplemental information.

Outlook for First Quarter and Fiscal Year 2026

 

Three Months Ending March 31, 2026

Twelve Months Ending December 31, 2026

$ Millions

Low

High

Low

High

Health Plan Membership

281,000

285,000

292,000

298,000

Revenue

$1,205

$1,225

$5,135

$5,190

Adjusted Gross Profit(1)

$138

$148

$615

$650

Adjusted EBITDA(1)

$26

$36

$133

$163

_______________________

(1)

Adjusted gross profit and adjusted EBITDA are non-GAAP financial measures presented as supplemental disclosure. We cannot provide estimated ranges for the most directly comparable GAAP measures without unreasonable efforts because of the uncertainty around certain items that may impact such GAAP measures, including equity-based compensation expense and depreciation and amortization, that are not within our control or cannot be reasonably predicted. See “Fourth Quarter 2025 Non-GAAP Reconciliation Tables” for additional information.

 

 

Fourth Quarter 2025 Non-GAAP Reconciliation Tables

Adjusted Gross Profit(1) is reconciled as follows:

 

Three Months Ended December 31,

 

Year Ended December 31,

 

 

2025

 

 

 

2024

 

 

2025

 

 

2024

 

(dollars in thousands)

 

 

 

 

 

 

 

Income (loss) from operations

$

(10,284

)

 

$

(22,545

)

 

$

14,752

 

$

(101,555

)

Add back:

 

 

 

 

 

 

 

Equity-based compensation (medical expenses)

$

1,613

 

 

$

1,546

 

 

 

6,134

 

 

4,930

 

Depreciation (medical expenses)

$

4

 

 

$

46

 

 

 

78

 

 

190

 

Restructuring costs (medical expenses) (2)

$

 

 

$

 

 

 

 

 

796

 

Depreciation and amortization (3)

$

7,830

 

 

$

6,762

 

 

 

30,404

 

 

26,872

 

Selling, general, and administrative expenses

$

125,764

 

 

$

102,128

 

 

 

443,407

 

 

371,374

 

Total add back

 

135,211

 

 

 

110,482

 

 

 

480,023

 

 

404,162

 

Adjusted gross profit

$

124,927

 

 

$

87,937

 

 

$

494,775

 

$

302,607

 


(1)

Adjusted gross profit is a non-GAAP financial measure that is presented as supplemental disclosure, that we define as income (loss) from operations before depreciation and amortization, medical equity-based compensation expense, clinical restructuring costs and selling, general, and administrative expenses.

(2)

Represents severance and related costs incurred as part of a corporate restructuring designed to streamline our organizational structure and drive operational efficiencies.

(3)

Amortization expense for the year ended Dec. 31, 2025 includes $0.6 million in impairment expense related to the remeasurement of goodwill associated with one of our subsidiaries. Amortization expense for the year ended Dec. 31, 2024 includes $0.6 million in impairment expense related to intangible assets that were written off during the year.

 

 

Adjusted EBITDA(1) is reconciled as follows:

 

Three Months Ended December 31,

 

Year Ended December 31,

 

 

2025

 

 

 

2024

 

 

 

2025

 

 

 

2024

 

(dollars in thousands)

 

 

 

 

 

 

 

Net loss

$

(11,006

)

 

$

(31,064

)

 

$

(978

)

 

$

(128,071

)

Less: Net income (loss) attributable to noncontrolling interest

 

 

 

 

(27

)

 

 

(254

)

 

 

(36

)

Adjustments:

 

 

 

 

 

 

 

Interest expense

 

3,949

 

 

 

5,492

 

 

 

15,799

 

 

 

23,547

 

Depreciation and amortization(2)

 

7,834

 

 

 

6,808

 

 

 

30,482

 

 

 

27,062

 

Income tax expense

 

(3,227

)

 

 

7

 

 

 

20

 

 

 

21

 

Equity-based compensation(3)

 

13,115

 

 

 

16,236

 

 

 

62,082

 

 

 

71,132

 

Acquisition expenses(4)

 

 

 

 

 

 

 

 

 

 

26

 

Litigation costs (5)

 

749

 

 

 

892

 

 

 

2,357

 

 

 

2,069

 

Loss on ROU assets(6)

 

 

 

 

 

 

 

 

 

 

143

 

Gain on sale of property and equipment

 

 

 

 

(1

)

 

 

(72

)

 

 

(9

)

Restructuring costs(7)

 

 

 

 

 

 

 

 

 

 

2,363

 

Loss on extinguishment of debt

 

 

 

 

3,020

 

 

 

 

 

 

3,020

 

Adjusted EBITDA

$

11,414

 

 

$

1,363

 

 

$

109,944

 

 

$

1,339

 


(1)

Adjusted EBITDA is a non-GAAP financial measure that is presented as supplemental disclosure, that we define as net income (loss) before interest expense, income taxes, depreciation and amortization expense, acquisition expenses, certain litigation costs, gains or losses on right of use ("ROU") assets, gains or losses on sale of property and equipment, restructuring costs, equity-based compensation expense, and loss on extinguishment of debt.

(2)

Amortization expense for the year ended Dec. 31, 2025 includes $0.6 million in impairment expense related to the remeasurement of goodwill associated with one of our subsidiaries. Amortization expense for the year ended Dec. 31, 2024 includes $0.6 million in impairment expense related to intangible assets that were written off during the year.

(3)

Represents equity-based compensation related to grants made in the applicable year.

(4)

Represents acquisition-related fees, such as legal and advisory fees, that are non-capitalizable.

(5)

Represents litigation costs considered outside of the ordinary course of business based on the following considerations which we assess regularly: (i) the frequency of similar cases that have been brought to date, or are expected to be brought within two years, (ii) complexity of the case, (iii) nature of the remedies sought, (iv) litigation posture of the Company, (v) counterparty involved, and (vi) the Company's overall litigation strategy

(6)

Represents gains or losses related to ROU assets that were terminated or subleased in the respective period.

(7)

Represents severance and related costs incurred as part of a corporate restructuring designed to streamline our organizational structure and drive operational efficiencies.

 

 

Conference Call Details
The company will host a conference call at 5 p.m. EST today to discuss these results and management’s outlook for future financial and operational performance. A live audio webcast will be available online at https://ir.alignmenthealth.com/. At the start of the conference call, participants may access the webcast at the following link: https://edge.media-server.com/mmc/p/kd529mia. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web links, and will remain available for approximately 12 months.

About Alignment Health
Alignment Health is championing a new path in senior care that empowers members to age well and live their most vibrant lives. A consumer brand name of Alignment Healthcare (NASDAQ: ALHC), Alignment Health’s mission-focused team makes high-quality, low-cost care a reality for its Medicare Advantage members every day. Based in California, the company partners with nationally recognized and trusted local providers to deliver coordinated care, powered by its customized care model, 24/7 concierge care team and purpose-built technology, AVA®. As it expands its offerings and grows its national footprint, Alignment upholds its core values of leading with a serving heart and putting the senior first. For more information, visit www.alignmenthealth.com.

From Fortune, ©2026 Fortune Media IP Limited. All rights reserved. Used under license. Fortune® is a registered trademark and Fortune World’s Most Admired Companies™ is a trademark of Fortune Media IP Limited and is used under license. Fortune and Fortune Media IP Limited are not affiliated with, and does not endorse the products or services of, Alignment Healthcare.

Forward-Looking Statements

This release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, and the Private Securities Litigation Reform Act of 1995, as amended. These forward-looking statements include statements regarding our future growth and our financial outlook for the quarter ending March 31, 2026, and year ending Dec. 31, 2026. Forward-looking statements are subject to risks and uncertainties and are based on assumptions that may prove to be inaccurate, which could cause actual results to differ materially from those expected or implied by the forward-looking statements. Actual results may differ materially from the results predicted, and reported results should not be considered as an indication of future performance. Important risks and uncertainties that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following: our ability to attract new members and enter new markets, including the need for certain governmental approvals; our ability to maintain a high rating for our plans on the Five Star Quality Rating System; our ability to develop and maintain satisfactory relationships with care providers that service our members; risks associated with being a government contractor, including potential federal reductions in MA funding; changes in laws and regulations applicable to our business model; risks related to our indebtedness; changes in market or industry conditions and receptivity to our technology and services; results of litigation or a security incident; and the impact of shortages of qualified personnel and related increases in our labor costs. For a detailed discussion of the risk factors that could affect our actual results, please refer to the risk factors identified in our Annual Report on Form 10-K for the year ended Dec. 31, 2025, and the other periodic reports we file with the SEC. All information provided in this release and in the attachments is as of the date hereof, and we undertake no duty to update or revise this information unless required by law.

Consolidated Balance Sheets
(in thousands, except par value and share amounts)

 

 

 

 

 

December 31,
2025

 

December 31,
2024

Assets

 

 

 

Current Assets:

 

 

 

Cash and cash equivalents

$

575,817

 

 

$

432,859

 

Accounts receivable (less allowance for credit losses of $833 at December 31, 2025 and $0 at December 31, 2024)

 

253,207

 

 

 

153,904

 

Investments - current

 

28,413

 

 

 

37,791

 

Prepaid expenses and other current assets

 

94,140

 

 

 

37,084

 

Total current assets

 

951,577

 

 

 

661,638

 

Property and equipment, net

 

64,251

 

 

 

67,139

 

Right of use asset, net

 

7,019

 

 

 

7,818

 

Goodwill

 

32,060

 

 

 

34,826

 

Intangible assets, net

 

4,550

 

 

 

4,550

 

Other assets

 

6,329

 

 

 

6,092

 

Total assets

$

1,065,786

 

 

$

782,063

 

Liabilities and Stockholders' Equity

 

 

 

Current Liabilities:

 

 

 

Medical expenses payable

$

474,569

 

 

$

289,788

 

Accounts payable and accrued expenses

 

33,284

 

 

 

22,126

 

Accrued compensation

 

49,013

 

 

 

39,931

 

Total current liabilities

 

556,866

 

 

 

351,845

 

Long-term debt, net of debt issuance costs

 

323,176

 

 

 

321,428

 

Long-term portion of lease liabilities

 

6,467

 

 

 

7,835

 

Total liabilities

 

886,509

 

 

 

681,108

 

Stockholders' Equity:

 

 

 

Preferred stock, $.001 par value; 100,000,000 shares authorized as of December 31, 2025 and 2024, respectively; no shares issued and outstanding as of December 31, 2025 and 2024

 

 

 

 

 

Common stock, $.001 par value; 1,000,000,000 shares authorized as of December 31, 2025 and December 31, 2024; 204,153,619 and 191,778,639 shares issued and outstanding as of December 31, 2025 and December 31, 2024, respectively

 

205

 

 

 

192

 

Additional paid-in capital

 

1,188,089

 

 

 

1,107,952

 

Accumulated deficit

 

(1,009,017

)

 

 

(1,008,293

)

Total Alignment Healthcare, Inc. stockholders' equity

 

179,277

 

 

 

99,851

 

Noncontrolling interest

 

 

 

 

1,104

 

Total stockholders' equity

 

179,277

 

 

 

100,955

 

Total liabilities and stockholders' equity

$

1,065,786

 

 

$

782,063

 

 

 

 

 

 

 

 

 


Consolidated Statements of Operations
(in thousands, except per share amounts)

 

 

 

 

 

Three Months Ended December 31,

 

Year Ended December 31,

 

 

2025

 

 

 

2024

 

 

 

2025

 

 

 

2024

 

Revenues:

 

 

 

 

 

 

 

Earned premiums

$

1,003,791

 

 

$

691,785

 

 

$

3,911,718

 

 

$

2,671,931

 

Other

 

9,013

 

 

 

9,456

 

 

 

37,001

 

 

 

31,630

 

Total revenues

 

1,012,804

 

 

 

701,241

 

 

 

3,948,719

 

 

 

2,703,561

 

Expenses:

 

 

 

 

 

 

 

Medical expenses

 

889,494

 

 

 

614,896

 

 

 

3,460,156

 

 

 

2,406,870

 

Selling, general, and administrative expenses

 

125,764

 

 

 

102,128

 

 

 

443,407

 

 

 

371,374

 

Depreciation and amortization

 

7,830

 

 

 

6,762

 

 

 

30,404

 

 

 

26,872

 

Total expenses

 

1,023,088

 

 

 

723,786

 

 

 

3,933,967

 

 

 

2,805,116

 

Income (loss) from operations

 

(10,284

)

 

 

(22,545

)

 

 

14,752

 

 

 

(101,555

)

Other expenses:

 

 

 

 

 

 

 

Interest expense

 

3,949

 

 

 

5,492

 

 

 

15,799

 

 

 

23,547

 

Other income, net

 

 

 

 

 

 

 

(89

)

 

 

(72

)

Loss on extinguishment of debt

 

 

 

 

3,020

 

 

 

 

 

 

3,020

 

Total other expenses

 

3,949

 

 

 

8,512

 

 

 

15,710

 

 

 

26,495

 

Loss before income taxes

 

(14,233

)

 

 

(31,057

)

 

 

(958

)

 

 

(128,050

)

Provision for income tax expense (benefit)

 

(3,227

)

 

 

7

 

 

 

20

 

 

 

21

 

Net loss

$

(11,006

)

 

$

(31,064

)

 

$

(978

)

 

$

(128,071

)

Less: Net loss attributable to noncontrolling interest

 

 

 

 

27

 

 

 

(254

)

 

 

(36

)

Net loss attributable to Alignment Healthcare, Inc.

$

(11,006

)

 

$

(31,091

)

 

$

(724

)

 

$

(128,035

)

 

 

 

 

 

 

 

 

Total weighted-average common shares outstanding - basic and diluted

 

200,970,862

 

 

 

191,897,164

 

 

 

198,006,216

 

 

 

190,793,552

 

Net loss per share attributable to Alignment Healthcare, Inc. - basic and diluted

 

(0.05

)

 

 

(0.16

)

 

 

0.00

 

 

 

(0.67

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Consolidated Statements of Cash Flows
(in thousands)

 

 

 

Year Ended December 31,

 

 

2025

 

 

 

2024

 

 

 

2023

 

Operating Activities:

 

 

 

 

 

Net loss

$

(978

)

 

$

(128,071

)

 

$

(148,173

)

Adjustments to reconcile Net loss to net cash provided by (used in) operating activities:

 

 

 

 

 

Provision for credit loss

 

833

 

 

 

123

 

 

 

91

 

(Gain) loss on right of use assets

 

 

 

 

143

 

 

 

(289

)

Gain on sale of property and equipment

 

(72

)

 

 

(9

)

 

 

 

Depreciation and amortization

 

30,482

 

 

 

27,062

 

 

 

21,668

 

Amortization-debt issuance costs

 

1,761

 

 

 

1,293

 

 

 

1,254

 

Amortization-investment discount

 

(1,298

)

 

 

(2,579

)

 

 

(4,917

)

Equity-based compensation

 

62,082

 

 

 

71,132

 

 

 

66,835

 

Non-cash lease expense

 

1,609

 

 

 

1,764

 

 

 

2,318

 

Loss on extinguishment of debt

 

 

 

 

3,020

 

 

 

 

Changes in operating assets and liabilities:

 

 

 

 

 

Accounts receivable

 

(100,106

)

 

 

(34,278

)

 

 

(26,950

)

Prepaid expenses and other current assets

 

(57,059

)

 

 

7,887

 

 

 

(2,863

)

Other assets

 

(50

)

 

 

60

 

 

 

(142

)

Medical expenses payable

 

184,781

 

 

 

84,389

 

 

 

35,264

 

Accounts payable and accrued expenses

 

10,364

 

 

 

(1,460

)

 

 

(6,347

)

Accrued compensation

 

9,082

 

 

 

5,819

 

 

 

6,574

 

Lease liabilities

 

(1,504

)

 

 

(1,525

)

 

 

(3,510

)

Net cash provided by (used in) operating activities

 

139,927

 

 

 

34,770

 

 

 

(59,187

)

Investing Activities:

 

 

 

 

 

Purchase of investments

 

(65,633

)

 

 

(82,200

)

 

 

(379,058

)

Sale of property and equipment

 

75

 

 

 

14

 

 

 

 

Maturities of investments

 

76,300

 

 

 

162,795

 

 

 

267,790

 

Sale of business

 

1,065

 

 

 

 

 

 

 

Acquisition of property and equipment, net

 

(26,781

)

 

 

(41,418

)

 

 

(35,995

)

Net cash provided by (used in) investing activities

 

(14,974

)

 

 

39,191

 

 

 

(147,263

)

Financing Activities:

 

 

 

 

 

Proceeds from long-term debt

 

 

 

 

380,000

 

 

 

 

Debt issuance costs

 

(26

)

 

 

(8,792

)

 

 

 

Repayment of long-term debt

 

 

 

 

(215,000

)

 

 

 

Payment of employment taxes related to release of restricted stock

 

 

 

 

(350

)

 

 

 

Proceeds from exercise of stock options

 

18,067

 

 

 

155

 

 

 

 

Contributions from noncontrolling interest holders

 

 

 

 

15

 

 

 

105

 

Net cash provided by financing activities

 

18,041

 

 

 

156,028

 

 

 

105

 

Net increase (decrease) in cash

 

142,994

 

 

 

229,989

 

 

 

(206,345

)

Cash, cash equivalents and restricted cash at beginning of period

 

434,943

 

 

 

204,954

 

 

 

411,299

 

Cash, cash equivalents and restricted cash at end of period

$

577,937

 

 

$

434,943

 

 

$

204,954

 

Supplemental disclosure of cash flow information:

 

 

 

 

 

Cash paid for interest

$

13,752

 

 

$

22,157

 

 

$

19,165

 

Supplemental non-cash investing and financing activities:

 

 

 

 

 

Acquisition of property in accounts payable

$

97

 

 

$

70

 

 

$

59

 

Debt issuance costs in accounts payable

$

 

 

$

512

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the consolidated balance sheets to the total above:

 

December 31, 2025

 

December 31, 2024

 

December 31, 2023

Cash and cash equivalents

$

575,817

 

$

432,859

 

$

202,904

Restricted cash in other assets

 

2,120

 

 

2,084

 

 

2,050

Total

$

577,937

 

$

434,943

 

$

204,954

 

 

 

 

 

 

 

 

 

Non-GAAP Financial Measures

Certain of these financial measures are considered “non-GAAP” financial measures within the meaning of Item 10 of Regulation S-K promulgated by the SEC. We believe that non-GAAP financial measures provide an additional way of viewing aspects of our operations that, when viewed with the GAAP results, provide a more complete understanding of our results of operations and the factors and trends affecting our business. These non-GAAP financial measures are also used by our management to evaluate financial results and to plan and forecast future periods. However, non-GAAP financial measures should be considered as a supplement to, and not as a substitute for, or superior to, the corresponding measures calculated in accordance with GAAP. Non-GAAP financial measures used by us may differ from the non-GAAP measures used by other companies, including our competitors. To supplement our consolidated financial statements presented on a GAAP basis, we disclose the following non-GAAP measures: Medical Benefits Ratio, Adjusted EBITDA and Adjusted Gross Profit as these are performance measures that our management uses to assess our operating performance. Because these measures facilitate internal comparisons of our historical operating performance on a more consistent basis, we use these measures for business planning purposes and in evaluating acquisition opportunities.

Adjusted EBITDA

Adjusted EBITDA is a non-GAAP financial measure that we define as net income (loss) before interest expense, income taxes, depreciation and amortization expense, acquisition expenses, certain litigation costs, gains or losses on right of use ("ROU") assets, gains or losses on sale of property and equipment, restructuring costs, equity-based compensation expense, and loss on extinguishment of debt.

Adjusted EBITDA should not be considered in isolation of, or as an alternative to, measures prepared in accordance with GAAP. There are a number of limitations related to the use of Adjusted EBITDA in lieu of net income (loss), which is the most directly comparable financial measure calculated in accordance with GAAP.

Our use of the term Adjusted EBITDA may vary from the use of similar terms by other companies in our industry and accordingly may not be comparable to similarly titled measures used by other companies.

Medical Benefits Ratio (MBR)

We calculate our MBR by dividing total medical expenses, excluding depreciation, equity-based compensation and clinical restructuring costs, by total revenues in a given period.

Adjusted Gross Profit

Adjusted gross profit is a non-GAAP financial measure that we define as income (loss) from operations before depreciation and amortization, medical equity-based compensation expense, clinical restructuring costs and selling, general, and administrative expenses.

Adjusted gross profit should not be considered in isolation of, or as an alternative to, measures prepared in accordance with GAAP. There are a number of limitations related to the use of adjusted gross profit in lieu of income (loss) from operations, which is the most directly comparable financial measure calculated in accordance with GAAP.

Our use of the term adjusted gross profit may vary from the use of similar terms by other companies in our industry and accordingly may not be comparable to similarly titled measures used by other companies.

Investor Contact
Harrison Zhuo
hzhuo@ahcusa.com

Media Contact
Priya Shah
mPR, Inc. for Alignment Health
alignment@mpublicrelations.com