Alignment Healthcare Delivers Strong First Quarter 2026 Results, Demonstrating Disciplined Growth and Margin Expansion
- 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, 2026 | Twelve Months Ending December 31, 2026 | |||
| $ Millions | Low | High | Low | High |
| Health Plan Membership | 288,000 | 290,000 | 294,000 | 299,000 |
| Revenue | $1,295 | $1,315 | $5,160 | $5,205 |
| Adjusted Gross Profit(1) | $167 | $177 | $620 | $650 |
| Adjusted 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, | |||||||
| 2026 | 2025 | ||||||
| (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 | |||
| (1) | Adjusted gross profit is a non-GAAP financial measure that is presented as supplemental disclosure, that we define as income (loss) from operations before depreciation and amortization, medical equity-based compensation expense, and selling, general, and administrative expenses. |
| (2) | Amortization expense for the year ended March 31, 2025, includes $0.6 million in impairment expense related to the remeasurement of goodwill associated with one of our subsidiaries. |
Adjusted EBITDA(1) is reconciled as follows:
| Three Months Ended March 31, | |||||||
| 2026 | 2025 | ||||||
| (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 | |||
| (1) | Adjusted EBITDA is a non-GAAP financial measure that is presented as supplemental disclosure, that we define as net income (loss) before interest expense, income taxes, depreciation and amortization expense, certain litigation costs, and equity-based compensation expense. |
| (2) | Amortization expense for the year ended March 31, 2025, includes $0.6 million in impairment expense related to the remeasurement of goodwill associated with one of our subsidiaries. |
| (3) | Represents equity-based compensation related to grants made in the applicable year |
| (4) | Represents litigation costs considered outside of the ordinary course of business based on the following considerations which we assess regularly: (i) the frequency of similar cases that have been brought to date, or are expected to be brought within two years, (ii) complexity of the case, (iii) nature of the remedies sought, (iv) litigation posture of the Company, (v) counterparty involved, and (vi) the Company's overall litigation strategy |
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, 2025 | ||||||
| Assets | |||||||
| 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 | |||
| Condensed Consolidated Statements of Operations (in thousands, except per share amounts) (Unaudited) | |||||||
| Three Months Ended March 31, | |||||||
| 2026 | 2025 | ||||||
| Revenues: | |||||||
| 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 | |||||
| Condensed Consolidated Statements of Cash Flows (in thousands) (Unaudited) | ||||||||
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Operating 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, 2026 | March 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.
Investor Contact Harrison Zhuo [email protected] Media Contact Jerry Slowey [email protected]