Research Reports

Prepared Highlights

Revenue: Q1 2026 revenue of $314 million, up 22% year-over-year (YoY) (prepared). Organic revenue grew 11% YoY (CFO).
Subscription revenue: $172 million, up 38% YoY and 3% sequentially; 55% of total revenue (CFO). Organic subscription revenue grew 14% YoY (CFO).
Volume-based revenue: $139 million, up 7% YoY and 4% sequentially (CFO). Headwinds from patient payment solutions (~25% of revenue) due to accelerated digital conversion, coverage changes, and weather (CFO).
Adjusted EBITDA: $135 million, up 26% YoY; margin of 43%, driven by higher-margin provider solutions (CFO).
Net Revenue Retention (NRR): 111% on a last-12-month basis, slightly above historical 108%-110% range (CFO).
New clients: Added 42 clients with >$100k trailing-12-month revenue in Q1 (CEO). Clients >$100k revenue totaled 1,433, up 15% YoY (CFO).
Bookings: Exceeded internal expectations; double-digit count of $1M+ annual value contracts (CFO). AI-powered capabilities drove ~40% of new bookings (CEO).
Cash & leverage: Cash and equivalents $159 million; gross debt $1.5 billion; net leverage 2.7x (down from 3x at end of 2025) (CFO). Unlevered free cash flow $90 million; conversion of 67% of adjusted EBITDA (CFO).
AI traction: ~50% of solutions leverage AI; ~40% of revenue from AI-embedded workflows (CEO). First-pass acceptance rate ~99% (CEO).
Iodine integration: Running ahead of plan; cross-sell traction exceeding expectations (CEO).
Pipeline: Largest qualified sales pipeline in company history, supporting visibility into 2027 (CEO).

Official Guidance

Full-year 2026 revenue: $1.274 billion to $1.294 billion; midpoint $1.284 billion (17% YoY growth) (CFO).
Full-year 2026 adjusted EBITDA: $530 million to $540 million; midpoint $535 million (CFO).
Sequential growth expectations: Q2 2026 flat to 1%; Q3 2026 1% to 3% (revised from prior 1%-3% with Q3 low end) (CFO).

Mgmt Quotes

"Waystar delivered a solid start to the year reflecting strong execution across the business and our innovation road map." (CEO)
"AI-powered capabilities drove roughly 40% of new bookings in Q1 and our clients leaned into the platform for prevention, automation and visibility rather than downstream rework." (CEO)
"We carry what we believe is the largest qualified sales pipeline in our history, reflecting deep multiyear platform commitments from providers and supporting visibility into 2027." (CEO)
"The growth and revenue composition are in line with our expectations." (CFO)
"We are balancing that expectation with the near-term impact of the previously discussed offset, which we expect adjust the typical first half, second half of the year seasonality curve." (CFO)

Prepared Metrics

Metric	Value	Speaker/Context
Revenue	$314M	Q1 2026, 22% YoY growth (prepared)
Organic revenue growth	11% YoY	Q1 2026 (CFO)
Subscription revenue	$172M	38% YoY, 55% of total (CFO)
Volume-based revenue	$139M	7% YoY (CFO)
Adjusted EBITDA	$135M	43% margin (CFO)
Net Revenue Retention	111%	Last-12-month basis (CFO)
Clients >$100k revenue	1,433	Up 15% YoY (CFO)
New clients >$100k	42	Q1 2026 (CEO)
Cash & equivalents	$159M	End of Q1 (CFO)
Gross debt	$1.5B	End of Q1 (CFO)
Net leverage	2.7x	Down from 3x at end of 2025 (CFO)
Unlevered free cash flow	$90M	Q1 2026 (CFO)
AI-powered bookings share	~40%	Q1 2026 (CEO)
AI-embedded revenue share	~40%	Current (CEO)
First-pass acceptance rate	~99%	Platform-wide (CEO)

Q&A Batch (1-5 of 12)

Q1 — Adam Hotchkiss

Topic: AI 对 TAM 和收入增长的增量影响
Key points:
- 40% 的收入与 AI 相关的工作流有关；AI 能力（如新招聘 SKU、预账单异常检测）替代人工服务，扩大 TAM。
- 近期 McKinsey 报告指出价值池从服务向技术和软件平台转移，扩大可寻址市场机会。
- AI 被视为“顺风”和“我们一生中最大的机会”。
Mgmt stance: 看涨（AI 是扩大 TAM 和收入增长的核心驱动力，管理层明确表示兴奋）。

Q2 — Charles Rhyee

Topic: 患者支付收入增速放缓及从纸质向数字账单转换的影响
Key points:
- 患者支付收入 Q1 同比增长约 4%，此前两季度约 8%；放缓主因是纸质账单向数字账单转换加速。
- 提供者解决方案（占总收入 75%）过去 6 个季度有机增长平均 13%-14%；患者支付（25%）受转换影响，但单位经济上对利润和现金流中性。
- 转换长期带来利润率提升；Q1 还提及天气因素，但未量化。
Mgmt stance: 中性偏乐观（转换是长期利好，与 AI 竞争无关，管理层强调机会而非风险）。

Q3 — Jailendra Singh

Topic: 新签合同（bookings）超预期，AI 驱动及剩余 60% 的构成
Key points:
- 40% 新签合同由 AI 解决方案驱动；剩余 60% 来自新客户和交叉销售/向上销售，所有业务板块均增长。
- 2025 年后两季度百万美元级合同数量是过去 3 年季度均值的 2 倍以上；Q2 开始拥有史上最大合格管道和实施积压。
- 大型合同（多解决方案或平台销售）通常需 6-18 个月才能完全体现在收入中。
Mgmt stance: 看涨（业务每季度改善，管道和积压创历史新高，管理层对势头有信心）。

Q4 — Ryan Daniels

Topic: AI 新 SKU（支付招聘解决方案）的推广时间及市场策略
Key points:
- 新 AI 驱动招聘 SKU 已获早期采用者良好 ROI 反馈；后续将推出预账单异常检测解决方案。
- 定价基于价值；团队通过增长峰会、网络研讨会和 ROI 计算器培训销售和运营团队。
- 部分 SKU 可快速上线，但需培训和教育；平台每季度交付数百项能力，用户需适应 AI 消费。
Mgmt stance: 看涨（新 SKU 代表增量收入机会，早期反馈积极，管理层强调平台优势）。

Q5 — Craig Hettenbach

Topic: 收入周期管理市场从点解决方案向平台加速转变的驱动因素
Key points:
- 客户（如大型系统 CIO）对使用 12 个以上点解决方案感到疲劳，寻求合规、安全、深度集成的平台。
- Waystar 的平台方法推动合同规模扩大和管道质量提升；前向需求指标显示平台吸引力“前所未有”。
- 这是公司 8 年前愿景的体现。
Mgmt stance: 看涨（平台化趋势明确，客户需求强劲，管理层认为 momentum 和 deal size 验证了战略）。

Q&A Batch (6-10 of 12)

Q6 — Sean Dodge

Topic: AI定价到价值的时间线与定价模式演变
Key points:
- 管理层认为这是一个长期机会，旨在根据AI带来的价值（如减少人工劳动）进行定价。
- 已通过核心业务模式实现AI变现，并非新科学实验；采用基于消费量的定价模式，而非按席位收费。
- 不披露具体定价细节，但强调医疗领域人力成本是最高的支出项，AI可提升效率。
Mgmt stance: bullish — 强调长期价值已通过现有模式变现，且定价始终与客户成功挂钩。

Q7 — Stanislav Berenshteyn

Topic: 销售周期与新增SKU对转化率的影响
Key points:
- 医院/医疗系统销售周期通常为12–24个月；非医院组织周期更短。
- 销售周期未出现压缩或延长，且赢率（win rates）提升。
- 公司提供AI驱动新方案后，销售团队需求旺盛，培训体系完善。
Mgmt stance: bullish — 销售周期稳定且赢率上升，新方案获得积极市场反馈。

Q8 — Ryan MacDonald

Topic: 全年利润率路径与投资节奏
Key points:
- 一季度调整后EBITDA利润率为43%，全年指引中值为42%（Q1通常较低）。
- 投资重点不变：创新、客户体验、网络安全；一季度未推迟任何投资。
- 提供者解决方案增速更快且单位利润率更高，抵消患者支付业务季节性波动；预计全年季节性波幅小于往年。
Mgmt stance: neutral — 利润率符合预期，投资节奏正常，但需关注上下半年季节性变化。

Q9 — George Hill

Topic: Q2基于量收入的减速原因与全年展望
Key points:
- Q1受天气影响（流感、天气因素），后续不会重复；Q2减速主因是印刷转电子对账单的转换以及患者利用率变化。
- 历史上Q2是利用率较强的季度，但印刷转数字的抵消效应使Q2表现较弱。
- 大额交易通常需要18个月（6–18个月范围）才能完全贡献收入，部分客户可能提前上线从而拉动下半年。
Mgmt stance: neutral — 解释了季节性因素和打印转换的拖累，但对下半年大额交易转化持谨慎乐观态度。

Q10 — Unknown Analyst (Louis for Daniel)

Topic: AI驱动预订量的构成与需求广度
Key points:
- AI推动了40%的预订量（bookings）。
- 提供者对AI需求广泛，但倾向选择可信赖的平台型合作伙伴（而非点解决方案）；AI涵盖机器学习、数据科学等，产出洞察。
- Waystar的深度部署网络具有学习效应，能够提供集成、合规、效率及EHR系统整合等价值。
Mgmt stance: bullish — AI需求覆盖全产品组合，平台模式使Waystar成为提供者首选合作伙伴。

Q&A Batch (11-12 of 12)

Q11 — Elizabeth Anderson

Topic: Hospital financing difficulties and payer-provider tension impact on Waystar
Key points:
- Waystar’s solutions are “mission critical” and help organizations get paid, so they get prioritized in decision-making; pipeline, bookings, and financial results reflect this.
- Payers are deploying AI to deny claims for accuracy/waste/abuse; Waystar represents over 1 million providers and develops AI for coding accuracy and higher first-pass claim acceptance.
- Waystar sees outreach from payer organizations for real-time claim adjudication on a portion of claims, as they see Waystar bringing accurate plans.
Mgmt stance: Bullish — Waystar positions itself as a constructive intermediary that brings fairness and transparency, and sees payer outreach as evidence of value.

Q12 — Constantine Davides

Topic: Momentum and competitiveness in the acute (inpatient hospital) space
Key points:
- Waystar now works with 16 of the top 20 hospitals and health systems in the U.S. (up from a small handful 8 years ago).
- Approximately 40% of Waystar’s revenue today is hospital/health system or acute related.
- Message of a unified end-to-end revenue cycle platform marching toward autonomous revenue cycle is “taking hold” in the acute segment.
Mgmt stance: Bullish — sees nice momentum and continued growth in hospital/health systems, with progress across every care segment.