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    WAY
    Earnings call· Jun 2026(Q2 FY26)

    Waystar Holding Q2 FY26 earnings call WAY

    Jul 29, 2026 Source

    Executive summary

    Waystar Q2 FY26 — Strong Bookings and Raised Full-Year Guidance Driven by Platform Adoption and AI Solutions

    Waystar delivered a solid Q2 FY26, marked by strong financial performance and robust bookings, driven by increasing client adoption of its integrated platform and AI-powered solutions. The company is advancing its vision for an autonomous revenue cycle, with significant investments in AI and successful cross-selling of Iodine capabilities. Management raised full-year revenue and adjusted EBITDA guidance, reflecting confidence in its strategy and market position, while also announcing a CFO transition.

    Highlights

    7

    • Revenue reached $320 million, representing 18% year-over-year growth.

    • Adjusted EBITDA was $137 million, resulting in a 43% adjusted EBITDA margin, exceeding consensus expectations.

    • Achieved a double-digit number of $1 million-plus ACV bookings, reinforcing demand for connected platform solutions.

    • Clients generating more than $100,000 of trailing 12-month revenue grew to 1,453, up 15% year-over-year.

    • Net revenue retention was 108%, within the historical range of 108% to 110%.

    • Raised the low end of full-year revenue guidance by $2 million to a range of $1.276 billion to $1.294 billion.

    • Raised full-year adjusted EBITDA guidance to a range of $535 million to $545 million, an increase of $5 million at the midpoint.

    Concerns

    2

    • Volume-based revenue grew 3% year-over-year (8% normalized organic), impacted by previously discussed comparability items and tough prior-year comps.

    • Capital expenditures, including capitalized software development, increased year-over-year, impacting unlevered free cash flow conversion.

    Guidance & targets

    3
    CategoryTargetConfidence
    Full-year Revenue
    $1.276 billion to $1.294 billion
    high materiality
    High
    Full-year Adjusted EBITDA
    $535 million to $545 million
    high materiality
    High
    Full-year Adjusted EBITDA Margin
    42%
    medium materiality
    High

    Segment performance

    2
    SegmentRevenueYoYQoQMargin
    Subscription Revenue
    Subscription revenue grew 12% organically year-over-year and represented 55% of total revenue, reinforcing the health of the core business.
    		$176M34%2%—
    Volume-based Revenue
    Volume-based revenue increased 3% year-over-year; on a normalized organic basis, it grew approximately 8% year-over-year, aligning with expectations despite comparability items.
    		$142M3%2%—

    Operational metrics

    18
    Organic Revenue Growth
    7%YoY
    Q2 FY26

    Normalized organic growth excludes previously discussed items affecting comparability.

    Adjusted EBITDA Margin
    43%consistent with prior quarter
    Q2 FY26

    Indicative of scalable platform model, disciplined cost management, and favorable margin profile of solutions driving growth.

    Cash, Equivalents, and Short-term Investments
    $192M
    Q2 FY26

    Reflects a strong capital position with healthy cash flows.

    Gross Debt
    $1.5B
    Q2 FY26

    Part of the company's capital structure.

    Net Leverage Ratio
    2.5xvs 2.7x at end of last quarter
    Q2 FY26

    Well below the goal of running the business at or below a 3x leverage ratio, aligning with historical delevering cadence.

    Stock Repurchase
    $13M
    Q2 FY26

    Repurchased under the Board-authorized stock repurchase plan.

    Capital Expenditures (including capitalized software development)
    increasedYoY
    Q2 FY26

    Continued investment in AI platform capabilities to support future growth, drive automation, and advance the autonomous revenue cycle vision.

    Transactions Processed
    7.5 billion
    annually

    The scale of the network creates unique connectivity, data, workflow, and payment intelligence.

    Incremental Revenue Recovered (Anomaly Detection)
    approximately $3M
    per 10,000 admissions

    Achieved by early adopters of the next-generation anomaly detection solution through automated revenue leakage detection.

    Autonomous Match Rate (Payer Takebacks)
    88%
    Q2 FY26

    Achieved by U.S. Renal Care using Waystar Altitude AI-powered solution for payer takebacks.

    Time Spent Managing Recoupments (Payer Takebacks)
    approximately 80%reduced by
    Q2 FY26

    Reduction achieved by U.S. Renal Care using Waystar Altitude AI-powered solution for payer takebacks.

    Incremental Annual Revenue (Large Client Expansion)
    more than $1M
    annual

    Expected from an expanded partnership across eligibility verification and insurance coverage detection.

    Incremental Annual Investment (Academic Health System)
    7 figures
    annual

    Resulting from the go-live of additional Waystar Altitude AI capabilities to prevent denials.

    Bookings from Existing Clients Purchasing Iodine Capabilities
    More than $6M
    Q2 FY26

    Early proof point of expanding cross-sell opportunity with Iodine solutions.

    Previously Unidentified Billing Opportunities
    nearly $10M
    Q2 FY26

    Uncovered by ProMedica leveraging Waystar's patient insurance coverage solution.

    Incremental Reimbursement (Clinical Documentation)
    $2.17M
    per 10,000 discharges

    Generated from integrated clinical documentation workflows, representing a 3x greater financial impact.

    Rebuild Dollars Caught (Revenue Leakage Protection)
    90%YoY increase
    Q2 FY26

    Increase in rebuild dollars caught by Waystar's revenue leakage protection capabilities.

    AI-enabled Solutions Bookings
    approximately 40%
    Q2 FY26

    Percentage of total bookings for AI-enabled solutions, consistent with prior quarter.

    Industry KPIs

    7
    MetricValueDetails
    Free cash flow$64MUSD
    Adjusted EBITDA$137MUSD
    Net revenue retention108%%
    Healthcare client count1,453clients
    Bookings billings growthstrong bookings
    Revenue adjusted EBITDA guidanceRevenue: $1.276B-$1.294B; Adjusted EBITDA: $535M-$545MUSD
    Subscription recurring revenue growth$176MUSD

    Product announcements

    2
    ProductTypeDetails
    Next-generation anomaly detection solutionlaunch
    Waystar Altitude AI-powered solutionlaunch

    Deals & partnerships

    4
    IodineAcquisition to combine clinical and financial intelligence

    Strategic acquisition to unite front-end, middle, and back-end revenue cycle capabilities, using Iodine as an AI engine to prevent denials and create accurate claims.

    Nonprofit health system (Central New Jersey and Southeastern Pennsylvania)Platform consolidation, replacing multiple vendors>$1M ACV

    Selected Waystar to replace three separate vendors across claims management, patient financial care, clinical documentation integrity, and revenue capture, reinforcing the value of Waystar's platform.

    Largest nonprofit health system in the countryExpanded partnership for eligibility verification and insurance coverage detection

    Already a 7-figure Waystar client, this expansion reinforces the advantage of a single connected platform over point solutions.

    Multibillion-dollar academic health systemImplementation of additional Waystar Altitude AI capabilities

    Went live with AI capabilities designed to prevent denials as part of a strategy to centralize revenue cycle operations, helping lower cost to collect and reduce manual follow-up.

    Risks & headwinds

    4
    Regulatory uncertainty impacting uninsured populationsongoing

    Decrease in Medicaid lives covered, creating uninsurance

    Mitigation: Waystar solutions help providers identify available coverage, optimize payment yield, and address self-pay populations.

    Longer implementation times for large, multi-solution dealsnear to medium term

    6 to 18 months for larger deals

    Mitigation: Robust growth team, proven track record in account discovery, ability to sell full platform or specific solutions based on client needs; continuously working to compress timelines.

    Increased capital expenditures impacting free cash flow conversionongoing

    Capitalized software spend roughly doubled in H1 FY26 vs H1 FY25

    Mitigation: Disciplined investment in AI platform capabilities for future growth; strong P&L and EBITDA performance provide optionality; conscious of unlevered free cash flow conversion rate.

    Cost of compute/token expense for AI modelsongoing

    Token expense is a market concern

    Mitigation: Internal AI governance model to manage and govern token expense; constructive partnership with Google (hyperscaler) for co-development and progressive solutions.

    What to watch in Q3 FY26

    5

    Large client implementation timelines

    Next quarter / H2 FY26
    Current6-18 months
    TargetCompression towards 6-9 months

    Why it matters

    Faster implementation of large deals accelerates revenue recognition and platform benefits, impacting future growth.

    But most often, it's a very deliberate, thoughtful process that provider decision-makers go through and it tends to be that 6 to 18 months, especially for the larger deals that -- where we've highlighted some examples.

    Q&A highlights

    8

    What are you seeing in transaction volume/patient pay given market changes (ACA, Medicaid)? How are customers responding to combat these changes?

    Patient utilization is returning to the long-term average of 1-2% growth. Regulatory uncertainty and decreasing Medicaid lives create demand for Waystar solutions, as providers focus on lowering collection costs, optimizing payment yield, and detecting coverage. The platform approach helps combat point solution fatigue.

    “We know that they want to use a platform approach versus a point solution because there's this point solution fatigue where many of them are using well over a dozen point solutions in a patchwork way to try to figure out how they can optimize their collections and address their patient population.”

    asked by Ryan Daniels · answered by Matthew Hawkins

    2 min read5 chapters

    Detailed Narrative

    01

    Platform Consolidation & Client Expansion

    Waystar observed an accelerating trend of providers consolidating from fragmented point solutions to a single connected software platform. This shift is independently validated by KLAS Research's inaugural RCM suites report, which highlighted Waystar clients' strong improvements in collections performance and cost to collect. The company secured a double-digit number of $1 million-plus ACV bookings, including a nonprofit health system replacing three vendors, and expanded partnerships with existing large clients, generating significant incremental annual revenue.

    02

    AI-Powered Solutions & Autonomous Revenue Cycle

    Waystar is actively advancing its vision for an autonomous revenue cycle by orchestrating AI across critical workflows to reduce administrative burden and improve outcomes. The company's AI deployment is embedded and monetized, delivering meaningful results. External recognition included being named to the TIME100 Most Influential Companies list and earning the Time Impact in AI award. Early adopters of the next-generation anomaly detection solution are seeing approximately $3 million in incremental revenue recovered per 10,000 admissions, and a new AI-powered payer takebacks solution achieved an 88% autonomous match rate.

    03

    Iodine Integration & Cross-Sell Success

    The acquisition of Iodine is proving strategically valuable, enabling Waystar to combine clinical and financial intelligence to prevent denials and create more accurate claims. This integration allows Waystar to reach further upstream into clinical workflows. The company reported over $6 million in bookings from existing Waystar clients purchasing Iodine capabilities, demonstrating early success in cross-selling and expanding the platform's value proposition.

    04

    Market Dynamics & Demand Environment

    The evolving healthcare market, characterized by regulatory uncertainty🌐 around uninsured populations and a return to historical patient utilization growth rates of 1-2%, is driving strong demand for Waystar's solutions. Providers are focused on lowering collection costs, optimizing payment yield, and detecting coverage, which aligns directly with Waystar's offerings. The company's mission-critical solutions help providers navigate these changes, contributing to robust bookings momentum and a strong pipeline.

    05

    CFO Transition

    Steven Oreskovich will be transitioning from his role as Chief Financial Officer after eight years with Waystar, during which he played a critical role in scaling the business, building the finance organization, and navigating the IPO. He will remain as an adviser for several months to ensure a smooth transition. Alpana Wegner has been appointed as the new CFO, bringing extensive public company finance and software industry leadership experience.

    AI-generated summary of the company’s earnings call. Not investment advice.