Waystar Holding Stock Earnings Reports

Waystar reported a strong start to 2026 with Q1 revenue of $314M, up 22% year-over-year, and adjusted EBITDA of $135M (43% margin). Organic revenue grew 11% and subscription revenue reached $172M (up 38% YoY, 55% of total). Net revenue retention was ~111%. Bookings exceeded internal expectations, including a rise in $1M+ deals and the largest qualified pipeline in company history. AI is a major growth driver: management said ~40% of new bookings in Q1 were driven by AI capabilities and ~40% of revenue is already from AI-embedded workflows. The Iodine acquisition is integrating ahead of plan, extending Waystar into mid-cycle clinical intelligence. Short-term headwinds: patient-payment volume was pressured by an accelerated shift from print to digital statements, weather effects and coverage changes, impacting ~25% of revenue tied to patient payments; management views the print-to-digital shift as structural and margin-neutral over time. Cash was $159M with $1.5B gross debt and net leverage of 2.7x (target <=3x). Full-year guidance was reaffirmed: revenue $1.274B–$1.294B (midpoint +17% YoY) and adjusted EBITDA $530M–$540M. Priorities: continue embedding AI into workflows, cross-sell across the installed base, execute implementations (backlog elevated), and maintain disciplined investment in innovation and cybersecurity. Investor takeaways: strong growth and margin profile, accelerating AI monetization and TAM expansion, solid bookings/pipeline, minor near-term volume headwinds in patient payments but guidance unchanged.