Ardent reported Q4 revenue of $1.61 billion, essentially flat year-over-year and in line with expectations; excluding a two-quarter prior-year New Mexico DPP benefit, revenue grew about 3%. Adjusted EBITDA reached $134 million, 2% above the implied guidance midpoint, while adjusted admissions rose 2% and surgeries were flat. Contract labor expense fell 26% to $17 million, and salary and wage costs per adjusted admission declined 2%.

For full-year 2025, Ardent achieved record results with revenue up 6% to $6.3 billion and adjusted EBITDA increasing 9% to $545 million, expanding margin by 20 basis points to 8.6%. Admissions grew 5.3% with adjusted admissions up 2.3%, and operating cash flow hit its highest level in company history.

The multi-year IMPACT transformation program, focused on margin improvement and performance agility, is on track to deliver $55 million of annualized savings (raised from $40 million) by early 2026. Ardent cut agency labor FTEs by about 175 in late 2025, improved OR on-time starts by over 10 percentage points, and deployed tech initiatives—including a single Epic instance, AI scribes reducing documentation time by 35%, and medical wearables cutting mortality by 15% and shortening length of stay by one-third of a day.

Ardent issued 2026 guidance for revenue of $6.4 billion to $6.7 billion (3.6% growth midpoint) and adjusted EBITDA of $485 million to $535 million, reflecting core earnings growth of about 4%. Management expects IMPACT to contribute $55 million, offsetting headwinds of roughly $35 million from exchange disruption and $20 million of restored incentive compensation.