Second Quarter 2026
Filed Jul 30, 2026Alignment Healthcare Reports Second Quarter 2026 Results, Surpassing High End of Guidance Across All Key Metrics
Total revenue grew 31.6% year-over-year, health plan membership grew 31.5%, adjusted gross profit grew 35.3%, adjusted EBITDA grew 48.4%, and the company raised the midpoint of all full-year guidance metrics.
Key metrics
as reported| Metric | Value | q/q | y/y |
|---|---|---|---|
| Health plan membership at the end of the quarterother | approximately 294,100 members | – | 31.5% |
| Total revenuesGAAP | $ 1,335,633 (in thousands) | – | 31.6% |
| Earned premiumsGAAP | $ 1,326,625 (in thousands) | – | – |
| Other revenueGAAP | $ 9,008 (in thousands) | – | – |
| Medical expensesGAAP | $ 1,154,676 (in thousands) | – | – |
| Income from operationsGAAP | $ 42,100 (in thousands) | – | – |
| Net incomeGAAP | $ 36,560 (in thousands) | – | – |
| Adjusted gross profitnon-GAAP | $ 182,853 (in thousands) | – | 35.3% |
| Medical benefits ratio based on adjusted gross profitnon-GAAP | 86.3% | – | an improvement of approximately 40 basis points |
| Adjusted EBITDAnon-GAAP | $ 68,145 (in thousands) | – | 48.4% |
| Adjusted EBITDA marginnon-GAAP | 5.1% | – | – |
| Depreciation and amortizationGAAP | $ 7,857 (in thousands) | – | – |
| Interest expenseGAAP | $ 4,275 (in thousands) | – | – |
| Income tax expenseGAAP | $ 1,266 (in thousands) | – | – |
| Equity-based compensationGAAP | $ 18,174 (in thousands) | – | – |
| Litigation costsGAAP | $ 14 (in thousands) | – | – |
| Gain on sale of property and equipmentGAAP | $ (1) (in thousands) | – | – |
| Six-month total revenuesGAAP | $ 2,570,830 (in thousands) | – | – |
| Six-month earned premiumsGAAP | $ 2,553,191 (in thousands) | – | – |
| Six-month other revenueGAAP | $ 17,639 (in thousands) | – | – |
| Six-month medical expensesGAAP | $ 2,245,393 (in thousands) | – | – |
| Six-month income from operationsGAAP | $ 57,603 (in thousands) | – | – |
| Six-month net incomeGAAP | $ 47,976 (in thousands) | – | – |
| Six-month adjusted gross profitnon-GAAP | $ 328,767 (in thousands) | – | – |
| Six-month adjusted EBITDAnon-GAAP | $ 105,996 (in thousands) | – | – |
Three Months Ending September 30, 2026 and Twelve Months Ending December 31, 2026 outlook
- Revenue$1,300 to $1,320; $5,195 to $5,225
- NoteHealth Plan Membership: 295,500 to 297,500; 298,000 to 301,000
- NoteAdjusted Gross Profit: $148 to $158; $630 to $650
- NoteAdjusted EBITDA: $20 to $30; $145 to $163
What drove it
- Health plan membership at the end of the quarter was approximately 294,100, up 31.5% year-over-year.
- Total revenue was $1,335.6 million, up 31.6% year-over-year.
- Adjusted gross profit was $182.9 million, up 35.3% year-over-year.
- Medical benefits ratio based on adjusted gross profit was 86.3%, an improvement of approximately 40 basis points year-over-year.
- The company cited investments across its clinical model, AI-enabled capabilities and operational infrastructure.
Concerns
- The company identified potential federal reductions in MA funding, changes in applicable laws and regulations, and risks related to indebtedness among risks that could cause results to differ materially from its outlook.
- Other disclosed risks include the ability to attract new members and enter new markets, maintain plan ratings, maintain provider relationships, manage labor costs, and address litigation or a security incident.
- Third-quarter adjusted gross profit guidance of $148 to $158 and adjusted EBITDA guidance of $20 to $30 are below the second-quarter reported amounts of $182.9 million and $68.1 million, respectively.
What to watch
- Health plan membership against third-quarter guidance of 295,500 to 297,500 and full-year guidance of 298,000 to 301,000.
- Revenue against third-quarter guidance of $1,300 to $1,320 and full-year guidance of $5,195 to $5,225.
- Adjusted gross profit against third-quarter guidance of $148 to $158 and full-year guidance of $630 to $650.
- Adjusted EBITDA against third-quarter guidance of $20 to $30 and full-year guidance of $145 to $163.
- Medical benefits ratio based on adjusted gross profit following the reported approximately 40 basis point year-over-year improvement.
Balance sheet and cash flow
- Cash and cash equivalents: $ 693,453 (in thousands) as of June 30, 2026; $ 575,817 (in thousands) as of December 31, 2025.
- Investments - current: $ 8,258 (in thousands) as of June 30, 2026; $ 28,413 (in thousands) as of December 31, 2025.
- Total current assets: $ 1,160,449 (in thousands) as of June 30, 2026; $ 951,577 (in thousands) as of December 31, 2025.
- Total assets: $ 1,279,038 (in thousands) as of June 30, 2026; $ 1,065,786 (in thousands) as of December 31, 2025.
- Medical expenses payable: $ 612,748 (in thousands) as of June 30, 2026; $ 474,569 (in thousands) as of December 31, 2025.
- Long-term debt, net of debt issuance costs: $ 324,056 (in thousands) as of June 30, 2026; $ 323,176 (in thousands) as of December 31, 2025.
- Total liabilities: $ 1,013,907 (in thousands) as of June 30, 2026; $ 886,509 (in thousands) as of December 31, 2025.
- Total stockholders' equity: $ 265,131 (in thousands) as of June 30, 2026; $ 179,277 (in thousands) as of December 31, 2025.
Analysis
Alignment Healthcare reported a strong second quarter, led by 31.5% year-over-year health plan membership growth to approximately 294,100 members and 31.6% revenue growth to $1,335.6 million. Earned premiums were $1,326,625 (in thousands), while other revenue was $9,008 (in thousands). The six-month revenue total was $2,570,830 (in thousands), compared with $1,942,220 (in thousands) in the prior-year period.
Profitability improved faster than revenue on the measures highlighted by the company. Adjusted gross profit increased 35.3% year-over-year to $182.9 million, and the medical benefits ratio based on adjusted gross profit was 86.3%, an improvement of approximately 40 basis points year-over-year. Income from operations was $42.1 million, compared with $22.7 million in the prior-year quarter, while net income was $36.6 million, compared with $15.7 million.
Adjusted EBITDA rose 48.4% year-over-year to $68.1 million and represented a 5.1% adjusted EBITDA margin. The adjusted EBITDA reconciliation includes $18.2 million of equity-based compensation, $7.9 million of depreciation and amortization, $4.3 million of interest expense, and $1.3 million of income tax expense. Management attributed the results to its clinical model, AI-enabled capabilities and operational infrastructure.
The balance sheet showed $693.5 million of cash and cash equivalents as of June 30, 2026, compared with $575.8 million as of December 31, 2025. Long-term debt, net of debt issuance costs, was $324.1 million, compared with $323.2 million at year-end. Medical expenses payable were $612.7 million, compared with $474.6 million at December 31, 2025.
Management raised the midpoint of all full-year guidance metrics. The company guided third-quarter revenue to $1,300 to $1,320 and full-year revenue to $5,195 to $5,225. Full-year adjusted gross profit guidance is $630 to $650 and adjusted EBITDA guidance is $145 to $163. The principal reported operating indicators to monitor are membership conversion into the guided range, the medical benefits ratio, and execution against the lower third-quarter adjusted gross profit and adjusted EBITDA ranges relative to second-quarter results.
Management, verbatim
Our second quarter results underscore the strength of our purpose-built Medicare Advantage platform and place us in a strong position to deliver upon our full-year objectives.
John Kao, chairman and CEO
We are continuing to realize the benefits of ongoing investments we have made across our clinical model, AI-enabled capabilities and operational infrastructure.
John Kao, chairman and CEO
These financial results are a reflection of how we are delivering for our seniors and demonstrate that better outcomes, stronger member experiences and sustainable profitable growth can all go hand in hand.
John Kao, chairman and CEO
Not in the filing
stated, not guessed- Prior outlook was not provided; comparison of actual results with prior guidance is unavailable.
- GAAP gross margin was not reported in the provided filing text.
- GAAP and non-GAAP diluted EPS were not available in the provided filing text, which truncates during the statements of operations.
- Operating cash flow and free cash flow were not reported in the provided filing text.
- Share repurchases and dividend information were not reported in the provided filing text.
- Segment revenue disclosures were not reported in the provided filing text.
- Third-quarter and full-year guidance for operating expenses and tax rate were not reported.
- Prior-quarter comparisons for reported quarterly operating metrics were not reported.
- The condensed consolidated statements of operations were truncated after the medical expenses line in the provided filing text; remaining GAAP expense, income, and per-share line items are unavailable.
AlphaAI analysis generated from the company’s SEC earnings filing (Form 8-K Item 2.02, or Form 6-K for a foreign private issuer). Every figure was cross-checked against the filing text; consensus estimates, price targets and share-price reactions are not shown because they are not in the filing. AI-generated research, not investment advice.