Alignment Healthcare Raises 2026 Guidance After 33% Q1 Revenue Gain
Alignment Healthcare posted Q1 revenue of $1.2 billion, up 33% year-over-year, with 284,800 members (31% growth) and adjusted EBITDA of $38 million (88% increase). Full-year revenue guidance was raised to about $5.2 billion and adjusted EBITDA outlook to $138 million–$163 million.
1. Q1 Revenue and Membership Growth
Alignment Healthcare generated $1.2 billion in Q1 revenue, marking a 33% year-over-year increase. Health plan membership rose to 284,800, a 31% gain driven by enrollment in higher-acuity Medicare Advantage plans.
2. Profitability and Efficiency Gains
Adjusted gross profit reached $146 million with a medical benefit ratio of 88.2%, improving by 20 basis points. Adjusted SG&A expense fell to 8.7% of revenue, while adjusted EBITDA climbed 88% to $38 million, yielding a 3.1% margin.
3. Raised Full-Year Guidance
The company lifted full-year revenue guidance to approximately $5.2 billion (31% growth) and increased adjusted EBITDA outlook to $138 million–$163 million. Operating cash remains robust with $726 million in cash and short-term investments, and funded leverage improved to 2.6× EBITDA.
4. Operational and Regulatory Challenges
A CMS rule change temporarily increased inpatient admissions per thousand to the high 150s, affecting medical costs until the observation workflow was corrected by February. Caution on risk adjustment for new members may delay recognition until updated paid files are received.