- Delivers $1.24 billion in total revenue, representing 33.3% growth year-over-year
- Grows Medicare Advantage membership 30.9% year-over-year to approximately 284,800 members
- Raises the midpoint of all guidance metrics: membership, revenue, adjusted gross profit and adjusted EBITDA
ORANGE, Calif., April 30, 2026 (GLOBE NEWSWIRE) -- Alignment Healthcare, Inc. (NASDAQ: ALHC), today reported financial results for its first quarter ended March 31, 2026.
“Our first-quarter performance demonstrates that Alignment continues to grow with discipline,” said John Kao, founder and CEO. "We expanded our profitability by executing across sales, clinical operations and cost management, even as the Medicare Advantage environment continues to change. We delivered strength within our results even while we are investing in our people, processes and technologies. The improvements we are making across each of these areas will position us to scale the business and achieve our embedded earnings potential.”
First Quarter 2026 Financial Highlights
All comparisons, unless otherwise noted, are to the three months ended March 31, 2025.
- Health plan membership at the end of the quarter was approximately 284,800, up 30.9% year-over-year
- Total revenue was $1,235.2 million, up 33.3% year-over-year
- Adjusted gross profit* was $145.9 million, up 36.1% year-over-year, and income from operations was $15.5 million
- Adjusted gross profit excludes depreciation and amortization of $7.8 million and selling, general, and administrative expenses of $121.1 million (which includes $12.6 million of equity-based compensation). Adjusted gross profit also excludes $0.02 million of depreciation expense and an additional $1.4 million of equity-based compensation recorded within medical expenses
- Medical benefits ratio based on adjusted gross profit was 88.2%, an improvement of 25 basis points year-over-year
- Adjusted EBITDA* of $37.9 million represented an adjusted EBITDA margin of 3.1% and grew 87.6% year-over-year, while net income was $11.4 million, compared to $9.4 million net loss the year prior
* Please see "First Quarter 2026 Non-GAAP Reconciliation Tables" below for more information on the non-GAAP financial measures reported here as supplemental information.
Outlook for Second Quarter and Fiscal Year 2026
Three Months Ending June 30, 2026Twelve Months Ending December 31, 2026
$ MillionsLow
High
Low
High
Health Plan Membership288,000290,000294,000299,000Revenue$1,295$1,315$5,160$5,205Adjusted Gross Profit(1)$167$177$620$650Adjusted EBITDA(1)$50$60$138$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 “First Quarter 2026 Non-GAAP Reconciliation Tables” for additional information.First Quarter 2026 Non-GAAP Reconciliation Tables
Adjusted Gross Profit(1) is reconciled as follows:
Three Months Ended March 31, 20262025
(dollars in thousands) Income (loss) from operations$15,503 $(5,393)Add back: Equity-based compensation (medical expenses) 1,411 1,152 Depreciation (medical expenses) 23 33 Depreciation and amortization (2) 7,839 7,594 Selling, general, and administrative expenses 121,138 103,831 Total add back 130,411 112,610 Adjusted gross profit$145,914 $107,217
Adjusted EBITDA(1) is reconciled as follows:
Three Months Ended March 31, 20262025
(dollars in thousands) Net income (loss)$11,416 $(9,354)Less: Net loss attributable to noncontrolling interest — 240 Adjustments: Interest expense 4,062 3,950 Depreciation and amortization(2) 7,862 7,627 Income tax expense 25 21 Equity-based compensation(3) 14,019 17,187 Litigation costs (4) 467 507 Adjusted EBITDA$37,851 $20,178
Conference Call Details
The company will host a conference call at 5 p.m. EDT 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/53zw9jkh. 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.
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 June 30, 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.
Condensed Consolidated Balance Sheets(in thousands, except par value and share amounts)
(Unaudited)
March 31,
2026 December 31,
2025Assets Current Assets: Cash and cash equivalents$705,584 $575,817 Accounts receivable (less allowance for credit losses of $0 at March 31, 2026 and $833 at December 31, 2025) 277,678 253,207 Investments - current 20,707 28,413 Prepaid expenses and other current assets 141,396 94,140 Total current assets 1,145,365 951,577 Property and equipment, net 63,867 64,251 Right of use asset, net 7,073 7,019 Goodwill 32,060 32,060 Intangible assets, net 4,550 4,550 Other assets 8,693 6,329 Total assets$1,261,608 $1,065,786 Liabilities and Stockholders' Equity Current Liabilities: Medical expenses payable$655,967 $474,569 Accounts payable and accrued expenses 34,502 33,284 Accrued compensation 34,288 49,013 Total current liabilities 724,757 556,866 Long-term debt, net of debt issuance costs 323,616 323,176 Long-term portion of lease liabilities 6,350 6,467 Total liabilities 1,054,723 886,509 Stockholders' Equity: Preferred stock, $.001 par value; 100,000,000 shares authorized as of March 31, 2026 and December 31, 2025, respectively; no shares issued and outstanding as of March 31, 2026 and December 31, 2025 — — Common stock, $.001 par value; 1,000,000,000 shares authorized as of March 31, 2026 and December 31, 2025; 206,671,068 and 204,153,619 shares issued and outstanding as of March 31, 2026 and December 31, 2025, respectively 207 205 Additional paid-in capital 1,204,279 1,188,089 Accumulated deficit (997,601) (1,009,017)Total stockholders' equity 206,885 179,277 Total liabilities and stockholders' equity$1,261,608 $1,065,786
(in thousands, except per share amounts)
(Unaudited)
Three Months Ended March 31, 2026
2025Revenues: Earned premiums$1,226,566 $918,043 Other 8,631 8,889 Total revenues 1,235,197 926,932 Expenses: Medical expenses 1,090,717 820,900 Selling, general, and administrative expenses 121,138 103,831 Depreciation and amortization 7,839 7,594 Total expenses 1,219,694 932,325 Income (loss) from operations 15,503 (5,393)Other expenses: Interest expense 4,062 3,950 Other expenses (income), net — (10)Total other expense 4,062 3,940 Income (loss) before income taxes 11,441 (9,333)Provision for income taxes 25 21 Net income (loss)$11,416 $(9,354)Less: Net loss attributable to noncontrolling interest — 240 Net income (loss) attributable to Alignment Healthcare, Inc.$11,416 $(9,114) Net income (loss) per share attributable to Alignment Healthcare, Inc.: Basic 0.06 (0.05)Diluted 0.05 (0.05)Weighted-average common shares outstanding: Basic 205,356,397 193,606,438 Diluted 213,128,231 193,606,438
(in thousands)
(Unaudited)
Three Months Ended March 31, 2026 2025Operating Activities: Net income (loss)$11,416 $(9,354) Adjustments to reconcile net income (loss) to net cash provided by operating activities: Depreciation and amortization 7,862 7,627 Amortization-investment discount (245) (370) Amortization-debt issuance costs 507 440 Equity-based compensation 14,019 17,187 Non-cash lease expense 450 395 Changes in operating assets and liabilities: Accounts receivable (24,471) (60,155) Prepaid expenses and other current assets (47,256) (43,800) Other assets (16) (23) Medical expenses payable 181,398 106,946 Accounts payable and accrued expenses 287 5,365 Accrued compensation (14,725) (7,577) Lease liabilities (544) (65) Net cash provided by operating activities 128,682 16,616 Investing Activities: Purchase of investments (10,598) (17,905) Maturities of investments 18,540 22,695 Acquisition of property and equipment (7,364) (8,252) Net cash provided by (used in) investing activities 578 (3,462)Financing Activities: Debt issuance costs (1,658) (26) Proceeds from stock option exercises 2,173 207 Net cash provided by financing activities 515 181 Net increase in cash 129,775 13,335 Cash, cash equivalents and restricted cash at beginning of period 577,937 434,942 Cash, cash equivalents and restricted cash at end of period$707,712 $448,277 Supplemental disclosure of cash flow information: Cash paid for interest$— $— Supplemental non-cash investing and financing activities: Acquisition of property in accounts payable$94 $85 Debt issuance costs in accounts payable$719 $—
The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the consolidated balance sheets to the total above:
March 31, 2026March 31, 2025
Cash and cash equivalents$705,584 $446,184 Restricted cash in other assets 2,128 2,093 Total$707,712 $448,277
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, certain litigation costs, and equity-based compensation expense.
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, and medical equity-based compensation, 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, 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.