Reported fourth-quarter revenue fell 41.1% to $151.7 million versus $257.6 million a year earlier. Management attributed the decline to a one-time $55 million true-up of 18,950 arbitration claims deemed ineligible and a $69 million prior-year arbitration revenue item, noting adjusted revenue would have been $206.7 million.

For full-year 2025, revenue increased 82% to $875.3 million from $479.9 million in 2024. Net income rose to $70.8 million from $52.1 million, despite a $117 million non-cash stock-based compensation expense tied to earnout obligations that management expects to “decrease drastically” in future periods.

Operating cash flow jumped to $248.1 million for 2025 from $23.2 million a year ago, with Q4 cash from operations at $70.4 million versus $0.1 million. The company submits 50%–60% of claims through IDR, prevails in over 85% of cases and collects an average of 85% on wins, while arbitration costs run about 26% of related revenue.

Year-end cash and equivalents reached $185.6 million, up from $40.6 million, with total bank debt of $43.5 million. Management authorized a new $25 million share repurchase program and outlined priorities: hospital investment, IPA and population health expansion, and real estate development with potential sale-leaseback transactions.