HealthStream (HSTM) Q4 2025 earnings summary

Executive summary

• Achieved record quarterly and full-year 2025 revenues of $304.1 million, with Q4 revenue up 7.4% year-over-year and Adjusted EBITDA up 16.4%; full-year Adjusted EBITDA grew 7.5% to $71.8 million.

• Completed acquisitions of Virsys12 and MissionCare Collective in Q4, expanding product offerings and career networks.

• CEO contributed $3.8 million in stock for employee equity grants, resulting in a $3.5 million non-cash expense but no dilution to shareholders except the CEO.

• Maintains leadership as the #1 workforce platform in U.S. healthcare, serving a rapidly growing and highly regulated industry.

• Expanded product ecosystem and user base, including launch of new AI-driven applications.

Financial highlights

• Q4 2025 revenues reached $79.7 million; full-year revenues were $304.1 million.

• Q4 Adjusted EBITDA was $18.8 million, up 16.4%; full-year Adjusted EBITDA was $71.8 million.

• Q4 net income was $2.5 million, down 48.1% due to a CEO stock grant; non-GAAP net income was $5.4 million, up 9.5%.

• Cash and cash equivalents at year-end 2025 totaled $57 million, with no debt and a $50 million unused credit facility.

• Free cash flow for the year was $31.1 million, up 5.5% year-over-year.

Outlook and guidance

• 2026 revenue guidance: $323–$330 million (6.2%–8.5% growth); net income: $20.4–$22.8 million; Adjusted EBITDA: $73–$77 million.

• Capital expenditures expected between $31–$34 million; effective tax rate projected at 22%.

• Inorganic revenue from acquisitions expected to be ~$13 million in 2026.

• Guidance excludes impact from future acquisitions, dispositions, or asset impairments.