Evolent Health (EVH) Q1 2026 earnings summary

Executive summary

• Q1 2026 revenue reached $496.2M, up 2.6% year-over-year, driven by new Performance Suite contracts and commercial momentum, partially offset by the Evolent Care Partners (ECP) divestiture and lower Medicare membership.

• Adjusted EBITDA was $22.1M, with a net loss attributable to common shareholders of $26.6M, improved from $72.3M in the prior year.

• Medical Expense Ratio (MER) for Q1 2026 was 93.3%, up from 84.0% year-over-year (excluding ECP), reflecting higher claims costs.

• Successful launches with Aetna and Highmark contributed to Performance Suite growth and expansion in oncology and AI.

• Liquidity remains strong with $142.0M in cash and cash equivalents as of March 31, 2026.

Financial highlights

• Q1 2026 revenue: $496.2M, up from $483.6M in Q1 2025.

• Adjusted EBITDA: $22.1M; net loss: $26.6M; loss per share: $(0.24), improved from $(0.63) year-over-year.

• Adjusted EBITDA margin: 4.4%, down from 7.6% year-over-year.

• Performance Suite revenue: $323.3M; Specialty T&S: $80.8M; Administrative Services: $49.6M; Cases: $42.6M.

• Cash and cash equivalents: $142.0M; net debt: $791.9M at quarter end.

Outlook and guidance

• 2026 full-year revenue guidance reiterated at $2.4B–$2.6B; adjusted EBITDA guidance at $110M–$140M.

• Full-year MER expected to be approximately 93%.

• Cash flow from operations expected at $10M–$20M for the year; $25M–$30M planned for capitalized software development.

• Guidance assumes continued ramp of new launches and a 40% decline in exchange membership.

• Q2 adjusted EBITDA expected in line with Q1, with sequential improvement in Q3 and Q4.