Evolent Health (EVH) Q4 2025 earnings summary

Executive summary

• Q4 2025 revenue and Adjusted EBITDA exceeded guidance midpoints, reflecting disciplined execution, strong customer retention, and momentum in organic growth and capital allocation.

• Achieved $468.7M in Q4 2025 revenue and $1.88B for the full year, with Adjusted EBITDA of $37.8M for Q4 and $151.2M for the year.

• Closed the divestiture of Evolent Care Partners in December 2025, using proceeds to pay down senior term debt.

• Migrated Performance Suite clients to enhanced contract models, supporting future growth and margin predictability.

• Forecasts approximately 30% revenue growth for 2026, driven by new Performance Suite contracts and oncology expansion.

Financial highlights

• Q4 2025 revenue was $469 million; full-year revenue was $1.88 billion; Adjusted EBITDA was $37.8 million for Q4 and $151.2 million for the year.

• FY 2025 baseline revenue (excluding ACO divestiture) was $1.7 billion; Adjusted EBITDA would have been ~$141 million.

• 2025 Medical Expense Ratio (MER) was 89% (excluding ECP); Adjusted EBITDA margin for 2025 was 8.1%.

• Cash and cash equivalents at year-end were $151.9 million; net debt was $782 million.

• Q4 2025 GAAP net loss attributable to common shareholders was $429.1 million; full year net loss was $579.4 million.

Outlook and guidance

• 2026 revenue guidance is $2.4–$2.6 billion, with Adjusted EBITDA expected between $110–$140 million.

• 2026 Performance Suite launches expected to generate $900 million in revenue, representing 37% of total revenue.

• Adjusted EBITDA is expected to be 70% weighted to the second half of 2026, with Q4 run rate EBITDA projected at $150 million.

• MER for 2026 is guided at 93%, up from 89% in 2025, due to new contract reserving and onboarding.

• Expects $10–$20 million in operating cash flow in 2026 after interest expense; $25–$35 million in capitalized software development and CapEx.