Waystar NASDAQ: WAY reported second-quarter 2026 revenue of $320 million, up 18% from a year earlier, and adjusted EBITDA of $137 million, representing a 43% margin. Chief Executive Officer Matt Hawkins said the company’s results reflected continued client expansion, demand for its AI-powered revenue-cycle tools and momentum in larger platform deployments.
Organic revenue increased 7% year over year, while normalized organic growth was approximately 10% after excluding previously disclosed items affecting comparability, Chief Financial Officer Steve Oreskovich said. The company also raised the low end of its full-year revenue outlook and increased its adjusted EBITDA guidance.
Large Deals and Platform Adoption
Waystar said bookings included a double-digit number of engagements with annual contract values exceeding $1 million. Hawkins said providers are increasingly seeking to consolidate fragmented revenue-cycle point solutions onto connected platforms that span functions including claims management, patient financial care, clinical documentation integrity and revenue capture.
The company cited a nonprofit health system in central New Jersey and southeastern Pennsylvania that selected Waystar to replace three vendors across several workflows. It also highlighted an expanded relationship with one of the country’s largest nonprofit health systems, which is implementing Waystar’s eligibility-verification and insurance-coverage detection tools. The additional solutions are expected to generate more than $1 million in incremental annual revenue, according to Hawkins.
Clients generating more than $100,000 in trailing-12-month revenue totaled 1,453 at quarter end, up 15% year over year. Net revenue retention was 108%, within the company’s historical 108% to 110% range. Oreskovich said gross revenue retention remained strong at 97%.
Subscription revenue rose 34% year over year to $176 million, or 55% of total revenue. On an organic basis, subscription revenue grew 12%. Volume-based revenue was $142 million, up 3% year over year and 2% sequentially; Oreskovich said normalized volume-based revenue growth was closer to 8% after accounting for comparison items.
AI, Iodine Cross-Selling and Market Conditions
Waystar continued to emphasize its effort to build what Hawkins called an “autonomous revenue cycle,” using AI within provider payment workflows. The company said it processes more than 7.5 billion transactions annually and uses the resulting network, workflow and payment data to support automation and payment intelligence.
More than $6 million of quarterly bookings came from existing Waystar clients purchasing Iodine capabilities, an early indicator of cross-selling opportunities following the acquisition. Hawkins said the combined clinical and financial data capabilities are intended to help providers prevent denials before claims are submitted and identify potential revenue leakage.
More than a dozen clients committed to Waystar’s next-generation anomaly-detection solution during the first half of the year, according to Hawkins. The company said early adopters have recovered approximately $3 million in incremental revenue per 10,000 admissions through automated revenue-leakage detection.
Waystar also cited results from U.S. Renal Care, which operates more than 500 dialysis centers across 32 states. The provider achieved an 88% autonomous match rate between recoupments and original claims using a Waystar AltitudeAI-powered payer-takeback solution, reducing time spent managing recoupments by about 80%, Hawkins said.
During the question-and-answer session, Hawkins said healthcare transaction utilization has returned toward its long-term annual growth range of about 1% to 2%, after elevated growth of roughly 3% to 4% in recent years. He said declines in Medicaid coverage and growth in uninsured or self-pay populations could increase demand for tools that identify available insurance coverage, improve collection rates and lower providers’ cost to collect.
Hawkins also said Waystar is seeing more requests for proposals, including larger opportunities involving multiple front-, middle- and back-office revenue-cycle solutions. He said implementation timelines for larger contracts generally remain in the six- to 18-month range, although single-solution purchases can move more quickly.
Margins, Cash Flow and Updated Outlook
Adjusted EBITDA increased 21.5% year over year, with the 43% margin unchanged from the prior quarter. Oreskovich attributed the margin performance to the company’s scalable platform model, cost discipline and a favorable mix of higher-margin bookings.
Waystar generated $64 million in unlevered free cash flow during the quarter, converting 47% of adjusted EBITDA into unlevered free cash flow. The company ended June with $192 million in cash equivalents and short-term investments and $1.5 billion in gross debt. Net leverage declined to 2.5 times from 2.7 times at the end of the first quarter.
The board had previously authorized up to $200 million in share repurchases. During the second quarter, Waystar repurchased $13 million of stock at an average price of $19.24 per share.
The company increased its 2026 revenue guidance to $1.276 billion to $1.294 billion, lifting the low end by $2 million. The midpoint of $1.285 billion would represent 17% year-over-year growth. Adjusted EBITDA guidance was raised to $535 million to $545 million, up $5 million at the midpoint.
Management said it expects to continue investing in AI platform capabilities and capitalized software development, which Oreskovich said was roughly double the prior-year level during the first half. He said the company expects such investment to continue through the remainder of 2026 while maintaining its focus on free-cash-flow generation.
CFO Transition
Waystar also announced that Oreskovich will transition out of the CFO role after eight years with the company and remain as an adviser during the coming months. Alpana Wegner joined Waystar during the week as its next CFO. Hawkins said Wegner brings public-company finance and software-industry leadership experience, including prior CFO roles at several public software companies.
About Waystar (NASDAQ:WAY)
Waystar NASDAQ: WAY is a leading provider of cloud-based revenue cycle management and payment solutions for healthcare organizations. The company's unified platform streamlines the entire financial continuum of patient care, from eligibility verification and claim submission to payment reconciliation and patient billing. By automating key processes and improving claim accuracy, Waystar helps providers reduce administrative overhead, accelerate cash flow and enhance overall revenue performance.
At the core of Waystar's offering is a SaaS-based architecture that integrates seamlessly with existing electronic health record (EHR) systems and payer networks.
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