Alignment Healthcare Inc
Q4 2025 Earnings
Market Reaction
S&P 500 over the same 30 days: −5.20%.
Did ALHC Beat Earnings? Q4 2025 Results
Alignment Healthcare closed out fiscal 2025 on a high note, delivering a fourth quarter that beat expectations on both the top and bottom lines and signaled a meaningful profitability inflection for the Medicare Advantage-focused insurer. The company posted Q4 earnings per share of -$0.05, well ahead of the -$0.16 consensus estimate by 68.75%, while revenue of $1.01 billion edged past the $1.00 billion forecast and grew 44.4% year-over-year. The results were underpinned by health plan membership surging 25.0% to roughly 236,300 members, as the company's care delivery model continued to drive both growth and cost discipline. Full-year adjusted EBITDA expanded dramatically to $109.94 million from just $1.34 million in the prior year, and the company generated positive free cash flow for the first time. Looking ahead, management raised its 2026 membership guidance by 2,000 at the midpoint and introduced full-year revenue guidance of $5.14 billion to $5.19 billion, representing 30-31% growth, with adjusted EBITDA guided between $133.00 million and $163.00 million.
- Health plan membership growth of 25.0% year-over-year to approximately 236,300
- Revenue growth of 44.4% year-over-year in Q4 and 46.1% for the full year
- Adjusted EBITDA expanded to $11.4 million in Q4 from $1.4 million a year ago
- Full-year adjusted EBITDA grew to $109.9 million from $1.3 million in the prior year
- Medical benefits ratio of 87.7% in Q4 and 87.5% for the full year
- Generated positive free cash flow on a full-year basis for the first time
“Our fourth quarter and full-year 2025 results show what Medicare Advantage done right looks like. We once again exceeded industry expectations and delivered continued momentum on revenue growth while taking a positive step forward in profitability and margin expansion, including producing free cash flow on a full-year basis.”
Alignment Healthcare CEO, on the earnings call
Forward Guidance & Outlook
For Q1 2026, Alignment Healthcare guides health plan membership of 281,000-285,000, revenue of $1,205-$1,225 million, adjusted gross profit of $138-$148 million, and adjusted EBITDA of $26-$36 million. For full-year 2026, the company guides health plan membership of 292,000-298,000 (raised by 2,000 at the midpoint), revenue of $5,135-$5,190 million (representing 30-31% year-over-year growth), adjusted gross profit of $615-$650 million, and adjusted EBITDA of $133-$163 million.
ALHC YoY Financials
ALHC Revenue by Segment
Figures from SEC filings and company reports. Not investment advice.