Accendra Health (ACH) Q4 2025 earnings summary

Executive summary

• Completed the sale of the Products & Healthcare Services business on December 31, 2025, marking a strategic shift to focus on core home-based care operations and improving margin profile.

• Entered 2026 as a leaner company, emphasizing cost controls, cash flow generation, and balance sheet optimization.

• Strong brand recognition and national footprint position the company as a leader in chronic condition home care.

• Leveraging technology and automation to enhance patient experience, operational efficiency, and revenue cycle management.

• Bullish long-term outlook driven by demographic trends, chronic condition prevalence, and competitive positioning.

Financial highlights

• 2025 net revenue was $2.8 billion, up just over 3% year-over-year; Q4 2025 revenue was $709 million, up from $695 million in Q4 2024.

• Adjusted EBITDA for 2025 was $375 million, slightly up from 2024; Q4 adjusted EBITDA was $90 million.

• Free cash flow for 2025 was $98 million, up from $96.4 million in 2024.

• Operating cash flow from continuing operations was $135 million in Q4 and $154 million for the year.

• GAAP net loss for 2025 was $1.1 billion, including significant losses from discontinued operations.

Outlook and guidance

• 2026 revenue guidance is $2.55–$2.65 billion, reflecting a $300+ million impact from a large commercial payer loss.

• 2026 adjusted EBITDA is expected between $335 million and $355 million.

• 2026 free cash flow guidance is $90–$110 million, with at least $100 million projected and 60% of adjusted EBITDA expected in the second half.

• Adjusted effective tax rate for 2026 is projected at 29.0% to 30.0%.

• Expense reduction and elimination of stranded costs are key 2026 priorities.