National Research NASDAQ: NRC executives highlighted improving growth trends and a record customer win during the company’s first-quarter 2026 earnings call, pointing to rising recurring contract value, a return to year-over-year revenue growth, and expectations for margin expansion later in the year as new business implementations ramp.
First-quarter performance: TRCV reaches record high
CEO Trent Green said NRC Health “kicked off 2026 with strong sales and adjusted EBITDA performance,” led by a 13% year-over-year increase in Total Recurring Contract Value (TRCV) to an “all-time high” of $152 million. Green added that TRCV was up $8 million from the end of Q4 2025, while Q1 new sales bookings rose more than 200% from the prior-year period, driven primarily by a “landmark deal.”
Green also pointed to better customer retention, saying gross retention reached its highest level in more than seven years. He attributed the improvement to product and feature enhancements, more consistent customer engagement, and clearer messaging around outcomes delivered by NRC’s solutions.
CFO Shane Harrison said TRCV finished Q1 at $152.1 million, up 13% year-over-year and 5% sequentially. He described it as NRC’s sixth consecutive quarter of sequential TRCV growth and “our largest single quarter increase in at least seven years,” driven by the large win and strengthening gross retention.
Revenue returns to growth; adjusted EBITDA margin improves sequentially
Harrison reported Q1 revenue of $34.8 million, up 4% year-over-year, which he said marked the company’s first year-over-year revenue growth since 2023. Green similarly noted revenue increased 4% to $35 million. Harrison explained that revenue recognition typically lags TRCV due to implementation timelines, which can be extended with large, multi-site customers. He also said revenue declined slightly from Q4 due to seasonality tied to conference and point-in-time survey revenue.
On profitability, Harrison said Q1 adjusted EBITDA was $9.4 million, equating to a 27% margin, up 230 basis points from Q4. He added that the EBITDA margin was lower than Q1 2025 due to higher operating expenses related to executive team expansion (now complete), higher corporate expenses from “isolated brand and tax studies,” and annual merit increases. Harrison said NRC expects margin improvement “as revenue catches up to TRCV over the next few quarters.”
Harrison reported adjusted net income of $4.6 million and adjusted earnings of $0.21 per share, up $0.05 sequentially from Q4. Free cash flow rose nearly 50% year-over-year to $5.3 million, or $0.24 per share. NRC also paid a dividend of $0.16 per share during the quarter.
Landmark deal: phased rollout and near-term implementation investment
Green characterized the quarter’s largest customer agreement as “the largest deal in NRC Health’s history,” emphasizing that it was “not an experience measurement purchase” but rather “an experience improvement decision.” He said the customer selected NRC based on solution breadth across “Experience and enablement product families,” a focus on in-the-moment feedback and higher survey response rates, and a preference for “straightforward pricing and a streamlined contracting process” supported by an ongoing support model.
Harrison provided additional detail on the financial timing of the agreement, describing it as a multi-year contract expected to be implemented in two phases:
- Phase 1: Experience measurement platform, planned go-live in Q3 2026, representing roughly half of the total expected annualized revenue.
- Phase 2: Enablement platform, planned for Q3 2027, representing the other half of the total expected annualized revenue.
To support implementation across “hundreds of hospitals and outpatient facilities,” Harrison said NRC will expand delivery and customer success teams in Q2 and Q3. He said the deal is expected to be accretive to overall margins, though “less so in the near term,” because most implementation costs are concentrated in Phase 1. He added that contribution margins should increase after Phase 2 goes live due to limited incremental implementation costs.
From a companywide perspective, Harrison said rollout costs are expected to keep adjusted EBITDA margin “flattish sequentially in Q2,” with margins beginning to expand in Q3 and beyond as revenue more fully reflects TRCV trends.
Go-to-market, cross-sell opportunities, and competitive backdrop
In response to an analyst question about expansion within NRC’s customer base, Green said the company is already serving 70% of the top 100 U.S. health systems, while about 70% of those customers use only a single product—creating what he called “white space” opportunity. He credited recent go-to-market gains to a sales reorganization that created more focus by product line—such as Experience, Market Insights, and The Governance Institute—reflecting differences in buying centers. Green said pipeline increased 41% in the quarter versus the prior year.
Green also described efforts to “catalyze cross-product sales conversations” by connecting datasets and insights. He cited a research-driven analysis NRC calls the “trust gap,” which compares consumer sentiment to actual patient experience at hospital or service-line levels, and said it helped open doors, including in the landmark win. He added that the Rounding solution acquired in 2024 is now part of “nearly every Experience sale conversation,” sometimes outside traditional RFP processes.
Asked about the competitive landscape, Green said NRC anticipates the market could shift with the planned Qualtrics and Press Ganey combination, though the deal has not closed. He said it has “maybe slowed a few of our buying processes, but not in any way significantly,” and noted NRC remains active in sales processes where the two companies are still competing separately.
Capital allocation: dividends, buybacks, and a new repurchase authorization
Harrison reiterated that the company’s top capital allocation priority is investing in NRC, while also evaluating “strategic and accretive acquisitions” under a disciplined framework. After internal investment and M&A considerations, he said returning capital to shareholders remains a focus through dividends and “opportunistic share buybacks.”
In March, NRC’s board authorized a $60 million share repurchase program. Harrison said the company intends to deploy the authorization strategically while maintaining “a manageable leverage profile,” adding that NRC believes its current leverage is prudent and that it has capacity to borrow if high-return opportunities emerge.
Harrison also flagged an expected Q2 charge of $9.4 million related to changes to three executives’ 2025 restricted equity agreements that will accelerate vesting. He said the change was made to honor the original intent of aligning executives with shareholders by delivering fully vested shares with tax basis after a tax analysis identified personal tax uncertainties. Harrison said the charge will not impact adjusted EBITDA and includes $6.5 million of non-cash stock compensation expense and $2.8 million of cash bonuses intended to fund taxes due on the acceleration.
Looking further out, Harrison said the business previously operated with EBITDA margins “in the 30s” and that management believes it can return to low-30% margins in the midterm and potentially mid-30% longer term, depending on sustaining top-line growth and balancing reinvestment with operating leverage.
In closing remarks, Green said NRC’s first-quarter results showed “a strong start to 2026,” citing double-digit TRCV growth, a return to year-over-year revenue growth, “healthy profitability,” and the landmark customer win. He said the company is taking a disciplined approach to balancing long-term growth investments with profitability and remains focused on execution and capital allocation to drive long-term shareholder value.
About National Research NASDAQ: NRC
National Research Corp NASDAQ: NRC, also known as NRC Health, is a healthcare analytics and performance improvement company specializing in patient and employee experience measurement. The company's cloud-based platform enables healthcare providers to collect real-time feedback through patient satisfaction surveys, post-discharge outreach, and employee engagement tools. NRC Health integrates clinical, operational and financial data to deliver actionable insights that support quality improvement initiatives and value-based care programs.
Since its founding in the early 1990s and headquartered in Lincoln, Nebraska, National Research has expanded beyond its regional roots to serve more than 1,600 hospitals and 12,000 care sites across the United States and Canada.
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