Phreesia Inc
Q4 2026 Earnings
Market Reaction
S&P 500 over the same 30 days: +10.81%.
Did PHR Beat Earnings? Q4 2026 Results
Phreesia delivered a mixed fiscal fourth quarter, posting revenue of $127.07 million, up 15.8% year-over-year and edging past the $126.63 million consensus by 0.35%, while earnings per share of $0.02 fell sharply short of the $0.32 consensus estimate, a miss of 93.73%. The headline revenue growth was powered in large part by the November 2025 acquisition of AccessOne, which drove payment solutions revenue up 45% year-over-year, alongside organic gains across subscription and network solutions. The company also swung to GAAP net income of $1.29 million from a net loss of $6.39 million a year ago, while adjusted EBITDA reached $29.42 million in the quarter. The brighter near-term picture, however, was clouded by a meaningful guidance cut; Phreesia lowered its fiscal 2027 revenue outlook to $510 million to $520 million from a prior range of $545 million to $559 million, citing reduced pharmaceutical manufacturer spending commitments in its network solutions segment. Wells Fargo maintained an Overweight rating on the stock but cut its price target to $15 from $25, reflecting the deceleration. Management kept its adjusted EBITDA outlook at $125 million to $135 million, expecting AI-driven efficiencies to absorb much of the revenue shortfall.
- AccessOne acquisition contributed 39% of the 45% payment solutions revenue growth
- Average Healthcare Services Clients (AHSCs) grew 7% year-over-year to 4,658
- Total revenue per AHSC increased 8% year-over-year to $27,279
- Payment solutions expense as a percentage of payment solutions revenue declined to 60% from 69% year-over-year due to AccessOne's higher-margin financing fees
- Sales and marketing expense decreased $4.2 million year-over-year
- Patient payment volume of $1.128 billion in Q4, up from $1.080 billion year-over-year
“We achieved several critical financial milestones ahead of our internal targets, including achieving positive GAAP net income ($2.3 million) and crossing $100 million of Adjusted EBITDA and $50 million of free cash flow ($78.8 million net cash from operating activities) for fiscal year 2026.”
Phreesia CEO, on the earnings call
Forward Guidance & Outlook
Phreesia lowered its fiscal 2027 revenue outlook to $510 million–$520 million from a previous range of $545 million–$559 million, citing reduced visibility into spending commitments by certain pharmaceutical manufacturers for the second half of fiscal 2027. Network solutions clients are committing lower spend levels due to brand-specific dynamics and regulatory policy impacts, though management does not believe this signals a structural shift in demand. The revenue range assumes approximately $37 million of contribution from AccessOne. The company maintained its Adjusted EBITDA outlook at $125 million–$135 million, expecting to absorb much of the revenue reduction through AI-driven operational efficiencies and continued operating leverage. AHSC growth is expected in the mid-single-digit percentage range, while total revenue per AHSC growth was lowered to the low-single-digit percentage range from low double-digit growth previously. Capital allocation priorities include debt paydown, growth investment, and potential share repurchases.
PHR YoY Financials
PHR Revenue by Segment
Figures from SEC filings and company reports. Not investment advice.