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Alignment Healthcare cuts 2026 adjusted EBITDA outlook

Full-year membership and revenue guidance was raised, while adjusted gross profit and adjusted EBITDA guidance was lowered.

(High)

Sentiment and the balance of points

Rhea-AI Sentiment reads the wording of the document, how positive or negative its language is on a 1 to 5 scale. The balance of points shown with the takes weighs what the document actually discloses, so the two can disagree, for example when a trial that missed its main goal is described in upbeat language.

Form Type
8-K

Rhea-AI Filing Summary

Alignment Healthcare, Inc. (ALHC) reported third-quarter 2026 revenue of $1,358.3 million, up 36.7% year over year, and approximately 301,200 health plan members, up 31.2%. Adjusted gross profit was $142.2 million, up 11.6%; the company recorded a $3.8 million operating loss and an $8.1 million net loss, compared with $3.7 million net income a year earlier. Adjusted EBITDA was $21.8 million, down 32.8%, and the medical benefits ratio based on adjusted gross profit was 89.5%, up approximately 240 basis points.

Alignment raised full-year 2026 membership and revenue guidance and lowered adjusted gross profit and adjusted EBITDA guidance, citing higher medical costs experienced in the third quarter. Fourth-quarter guidance is no less than 305,000 members, $1,316 million revenue, $104 million adjusted gross profit and $(28) million adjusted EBITDA; full-year guidance is no less than 305,000 members, $5,245 million revenue, $575 million adjusted gross profit and $100 million adjusted EBITDA. The revised outlook assumes no benefit from actions underway.

3 points · 0 major

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Rhea-AI gives every point it takes from this document a weight. Minor counts 1, Moderate 3 and Major 9, so one Major point outweighs several Minor ones. The bar adds up the weights on each side, and when neither side holds more than 65% of the total the balance reads Mixed.

It reads the document as published, with the same rules for every company, and it does not look at what the market expected or at how the stock traded, so a point can be objectively good on a day the stock falls.

Rhea-AI Sentiment measures something else, the tone of the wording.

1 major · 4 points

Hollow bars mark forward-looking points. How the balance works

Positive

  • Moderate pointRevenue reached $1,358.3 million, up 36.7% year over year.
  • Moderate pointHealth plan membership was approximately 301,200, up 31.2% year over year.
  • Moderate pointNine-month net income was $39.924 million, versus $10.028 million in 2025.

Negative

  • Major point. Forward-looking: it has not happened yet and may not happen.Full-year adjusted gross profit and adjusted EBITDA guidance was lowered to no less than $575 million and $100 million.
  • Moderate pointAdjusted EBITDA declined 32.8% year over year to $21.8 million.
  • Moderate pointNine-month operating cash flow was $158.395 million, versus $190.302 million in 2025.
  • Minor pointThird-quarter net results shifted from $3.7 million income to an $8.1 million loss.

Filing Explained

The release reports Alignment Healthcare had 209,152,387 common shares issued and outstanding on September 30, 2026, versus 204,153,619 on December 31, 2025; for holders who did not add shares, the higher total reduces their percentage ownership.

Item 2.02 Results of Operations and Financial Condition Financial
Disclosure of earnings results, typically an earnings press release or preliminary financials.
Item 9.01 Financial Statements and Exhibits Exhibits
Financial statements, pro forma financial information, or exhibit attachments filed with this report.
Total revenue $1,358.3 million Third quarter 2026; up 36.7% year over year
Health plan membership Approximately 301,200 members At the end of the third quarter 2026; up 31.2% year over year
Adjusted gross profit $142.2 million Third quarter 2026; up 11.6% year over year
Adjusted EBITDA $21.8 million Third quarter 2026; down 32.8% year over year
Net loss $8.1 million Third quarter 2026; compared with $3.7 million net income in third quarter 2025
Medical benefits ratio 89.5% Third quarter 2026; increased approximately 240 basis points year over year
Net income $39.924 million Nine months ended September 30, 2026; compared with $10.028 million in 2025
Net cash provided by operating activities $158.395 million Nine months ended September 30, 2026; compared with $190.302 million in 2025
Adjusted gross profit financial
"Adjusted gross profit is a non-GAAP financial measure"
Adjusted gross profit is a company’s revenue from selling goods or services minus the direct costs of producing them, with one-time or unusual items added back or removed to show the core margin. Investors use it like a cleaned-up snapshot of how much a business actually earns on its products, similar to measuring body weight after removing heavy clothes, because it helps compare performance across periods and companies without noise from rare events.
Adjusted EBITDA financial
"Adjusted EBITDA is a non-GAAP financial measure"
Adjusted EBITDA is a way companies measure how much money they make from their core operations, like running a business, by removing certain costs or income that aren’t part of regular business activities. It helps investors see how well a company is doing without distractions from unusual expenses or gains, making it easier to compare companies or track performance over time.
Medical benefits ratio financial
"Medical benefits ratio based on adjusted gross profit"
The medical benefits ratio is the share of an insurer’s premium income that is paid out for customers’ medical care and health services, expressed as a percentage. Investors use it like a car’s fuel gauge: a higher percentage means more of each dollar goes to care rather than administration or profits, signaling tight margins or strong claim activity, while a lower percentage can indicate greater profitability or under‑provision of care.
Part D seasonality medical
"previously expected changes in Part D seasonality"
Total revenue $1,358.3 million Up 36.7% year over year
Health plan membership Approximately 301,200 members Up 31.2% year over year
Adjusted gross profit $142.2 million Up 11.6% year over year
Adjusted EBITDA $21.8 million Down 32.8% year over year
Net income (loss) Net loss of $8.1 million Compared with net income of $3.7 million in third quarter 2025
Medical benefits ratio based on adjusted gross profit 89.5% Increased approximately 240 basis points year over year
Guidance

Fourth-quarter 2026: no less than 305,000 members, $1,316 million revenue, $104 million adjusted gross profit and $(28) million adjusted EBITDA. Full-year 2026: no less than 305,000 members, $5,245 million revenue, $575 million adjusted gross profit and $100 million adjusted EBITDA. Membership and revenue guidance was raised; adjusted gross profit and adjusted EBITDA guidance was lowered.

FAQ

AI-generated questions and answers. How Rhea-AI works. Not financial advice.

What were ALHC's third-quarter 2026 results?

ALHC reported third-quarter revenue of $1,358.3 million, up 36.7% year over year, and approximately 301,200 members, up 31.2%. Adjusted gross profit was $142.2 million, adjusted EBITDA was $21.8 million, and net loss was $8.1 million, compared with $3.7 million net income a year earlier.

What is ALHC's 2026 financial guidance?

For full-year 2026, guidance is no less than 305,000 members, $5,245 million revenue, $575 million adjusted gross profit and $100 million adjusted EBITDA. Fourth-quarter guidance is no less than 305,000 members, $1,316 million revenue, $104 million adjusted gross profit and $(28) million adjusted EBITDA. Membership and revenue guidance rose; adjusted gross profit and adjusted EBITDA guidance fell.

Why did ALHC's medical benefits ratio increase?

The medical benefits ratio based on adjusted gross profit was 89.5%, up approximately 240 basis points year over year. Alignment said this reflected previously expected changes in Part D seasonality and timing of clinical investments, as well as higher costs from elevated appeals and disputes and increased costs in catastrophic cases and skilled nursing categories.

AI-generated analysis. How Rhea-AI works. Not financial advice.

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False000183246600018324662026-10-292026-10-29iso4217:USDxbrli:sharesiso4217:USDxbrli:shares
 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

_________________

FORM 8-K

_________________

CURRENT REPORT

Pursuant to Section 13 or 15(d)
of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported):  October 29, 2026

_______________________________

Alignment Healthcare, Inc.

(Exact name of registrant as specified in its charter)

_______________________________

Delaware001-4029546-5596242
(State or Other Jurisdiction of Incorporation)(Commission File Number)(I.R.S. Employer Identification No.)

1100 W. Town and Country Road, Suite 1600

Orange, California 92868

(Address of Principal Executive Offices) (Zip Code)

(844) 310-2247

(Registrant's telephone number, including area code)

N/A

(Former name or former address, if changed since last report)

_______________________________

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

☐Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
☐Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
☐Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
☐Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, par value $0.001 per shareALHCThe NASDAQ Stock Market LLC

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

Emerging growth company ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

 
 
Item 2.02. Results of Operations and Financial Condition.

 

On October 29, 2026, Alignment Healthcare, Inc. issued a press release announcing its financial results for its third quarter ended September 30, 2026. A copy of the press release is furnished herewith as Exhibit 99.1 and incorporated herein by reference.

 

The information contained in this Current Report on Form 8-K and in the accompanying exhibit are “furnished” and shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of that section, and shall not be incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act regardless of any general incorporation language in such filing, unless expressly incorporated by specific reference in such filing.

 

Item 9.01. Financial Statements and Exhibits.

 

(d) Exhibits

 

Exhibit Number Description
   
99.1 Press Release dated October 29, 2026
104 Cover Page Interactive Data File (embedded within the Inline XBRL document)

 

 
 

SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 Alignment Healthcare, Inc.
   
  
Date: October 29, 2026By: /s/ James M. Head        
  James M. Head
  Chief Financial Officer
  

 

EXHIBIT 99.1

Alignment Healthcare Reports Third Quarter 2026 Results, Updates Full-Year Outlook

  • Reports third-quarter revenue of $1.36 billion, representing 36.7% year-over-year growth
  • Grows health plan membership 31.2% year-over-year to 301,200 members
  • Issues fourth-quarter guidance and lowers full-year 2026 adjusted gross profit and adjusted EBITDA guidance

ORANGE, Calif., Oct. 29, 2026 (GLOBE NEWSWIRE) -- Alignment Healthcare, Inc. (NASDAQ: ALHC), today reported financial results for its third quarter ended Sept. 30, 2026.

“Our third-quarter membership and revenue growth demonstrate continued demand for Alignment’s products and services, while medical trends ran higher than expected,” said John Kao, chairman and CEO. “We are taking a prudent approach to the fourth quarter and lowering our outlook based on current headwinds. Our revised guidance does not assume any benefit from the actions underway. We are confident we can deliver against these expectations. Our focus now is on execution and taking the steps necessary to drive more consistent performance as we scale and deliver profitable growth over the long term.”

Third Quarter 2026 Financial Highlights
All comparisons, unless otherwise noted, are to the three months ended September 30, 2025.

  • Health plan membership at the end of the quarter was approximately 301,200, up 31.2% year-over-year
  • Total revenue was $1,358.3 million, up 36.7% year-over-year
  • Adjusted gross profit* was $142.2 million, up 11.6% year-over-year, and loss from operations was $3.8 million
    • Adjusted gross profit excludes depreciation and amortization of $8.1 million and selling, general, and administrative expenses of $136.4 million (which includes $16.0 million of equity-based compensation). Adjusted gross profit also excludes $1.5 million of equity-based compensation recorded within medical expenses
    • Medical benefits ratio based on adjusted gross profit was 89.5%, an increase of approximately 240 basis points year-over-year. The medical benefits ratio result reflects previously expected changes in Part D seasonality and timing of clinical investments, along with higher costs from elevated appeals and disputes and increased costs within catastrophic cases and skilled nursing categories
  • Adjusted EBITDA* of $21.8 million represented an adjusted EBITDA margin of 1.6% and declined 32.8% year-over-year, while net loss was $8.1 million, compared to net income of $3.7 million the year prior

* Please see “Third Quarter 2026 Non-GAAP Reconciliation Tables” below for more information on the non-GAAP financial measures reported here as supplemental information.

Outlook for Fourth Quarter and Fiscal Year 2026
Full-year health plan membership and revenue guidance was raised to reflect continued sales momentum, while adjusted gross profit and adjusted EBITDA guidance was lowered to reflect higher medical costs experienced during the third quarter.

  Three Months Ending
December 31, 2026
 Twelve Months Ending
December 31, 2026
 
$ Millions
No Less Than No Less Than 
Health Plan Membership
305,000 305,000 
Revenue
$1,316 $5,245 
Adjusted Gross Profit(1)
$104 $575 
Adjusted EBITDA(1)
$(28) $100 
      
      
      
(1) Adjusted gross profit and adjusted EBITDA are non-GAAP financial measures presented as supplemental disclosure. We cannot provide estimated ranges for the most directly comparable GAAP measures without unreasonable efforts because of the uncertainty around certain items that may impact such GAAP measures, including equity-based compensation expense and depreciation and amortization, that are not within our control or cannot be reasonably predicted. See “Third Quarter 2026 Non-GAAP Reconciliation Tables” for additional information. 
  

Third Quarter 2026 Non-GAAP Reconciliation Tables

Adjusted Gross Profit(1) is reconciled as follows:

  Three Months Ended September 30, Nine Months Ended September 30, 
  2026
 2025
 2026
 2025
 
(dollars in thousands)
             
Income (loss) from operations
$(3,794) $7,681 $53,809 $25,036 
Add back:
             
 Equity-based compensation (medical expenses) 1,511   1,775  4,815  4,521 
 Depreciation (medical expenses) 7   8  33  74 
 Depreciation and amortization(2) 8,108   7,977  23,801  22,574 
 Selling, general, and administrative expenses 136,373   110,015  388,514  317,643 
 Total add back 145,999   119,775  417,163  344,812 
Adjusted gross profit
$142,205  $127,456 $470,972 $369,848 
               
(1) Adjusted gross profit is a non-GAAP financial measure that is presented as supplemental disclosure, that we define as income (loss) from operations before depreciation and amortization, medical equity-based compensation expense, and selling, general, and administrative expenses. 
               
(2) Amortization expense for the nine months ended September 30, 2025, includes $0.6 million in impairment expense related to the remeasurement of goodwill associated with one of our subsidiaries. There was no impairment expense for the three months ended September 30, 2025. 
               

Adjusted EBITDA(1) is reconciled as follows:

  Three Months Ended September 30, Nine Months Ended September 30, 
  2026
 2025
 2026
 2025
 
(dollars in thousands)
               
Net income (loss)
$(8,052) $3,729 $39,924  $10,028  
Less: Net loss attributable to noncontrolling
interest
 —   —  —   (254) 
Adjustments:
               
 Interest expense 4,280   3,950  12,617   11,850  
 Depreciation and amortization(2) 8,115   7,985  23,834   22,648  
 Income tax expense (22)  2  1,269   3,247  
 Equity-based compensation(3) 17,487   16,227  49,680   48,967  
 Litigation costs(4) —   546  481   1,608  
 Gain on sale of property and equipment —   —  (1)  (72) 
Adjusted EBITDA
$21,808  $32,439 $127,804  $98,530  
                 
(1) Adjusted EBITDA is a non-GAAP financial measure that is presented as supplemental disclosure, that we define as net income (loss) before interest expense, income taxes, depreciation and amortization expense, certain litigation costs, gains or losses on sale of property and equipment, and equity-based compensation expense. 
                 
(2) Amortization expense for the nine months ended September 30, 2025 includes $0.6 million in impairment expense related to the remeasurement of goodwill associated with one of our subsidiaries. There was no impairment expense for the three months ended September 30, 2025. 
                 
(3) Represents equity-based compensation related to grants made in the applicable year. 
                 
(4) Represents litigation costs considered outside of the ordinary course of business based on the following considerations which we assess regularly: (i) the frequency of similar cases that have been brought to date, or are expected to be brought within two years, (ii) complexity of the case, (iii) nature of the remedies sought, (iv) litigation posture of the Company, (v) counterparty involved, and (vi) the Company's overall litigation strategy. 
  

Conference Call Details
The company will host a conference call at 5 p.m. EDT today to discuss these results and management’s outlook for future financial and operational performance. A live audio webcast will be available online at https://ir.alignmenthealth.com/. At the start of the conference call, participants may access the webcast at the following link: https://edge.media-server.com/mmc/p/o7dsxqqm. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web links, and will remain available for approximately 12 months.

About Alignment Health
Alignment Health is championing a new path in senior care that empowers members to age well and live their most vibrant lives. A consumer brand name of Alignment Healthcare (NASDAQ: ALHC), Alignment Health’s mission-focused team makes high-quality, low-cost care a reality for its Medicare Advantage members every day. Based in California, the company partners with nationally recognized and trusted local providers to deliver coordinated care, powered by its customized care model, 24/7 concierge care team and purpose-built technology, AVA®. As it expands its offerings and grows its national footprint, Alignment upholds its core values of leading with a serving heart and putting the senior first. For more information, visit www.alignmenthealth.com.

Forward-Looking Statements
This release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, and the Private Securities Litigation Reform Act of 1995, as amended. These forward-looking statements include statements regarding our future growth and our financial outlook for the quarter and year ending Dec. 31, 2026. Forward-looking statements are subject to risks and uncertainties and are based on assumptions that may prove to be inaccurate, which could cause actual results to differ materially from those expected or implied by the forward-looking statements. Actual results may differ materially from the results predicted, and reported results should not be considered as an indication of future performance. Important risks and uncertainties that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following: our ability to successfully execute our business plan and achieve anticipated operational improvements and financial results; our ability to manage changes in medical costs and healthcare utilization, and our ability to accurately estimate, price for and manage such costs and utilization; our ability to attract new members and enter new markets, including the need for certain governmental approvals; our ability to achieve and maintain a high rating for our plans on the Five Star Quality Rating System; our ability to develop and maintain satisfactory relationships with care providers that service our members; risks associated with being a government contractor, including potential federal reductions in MA funding; changes in laws and regulations applicable to our business model; risks related to our indebtedness; changes in market or industry conditions and receptivity to our technology and services; results of litigation or a security incident; and the impact of shortages of qualified personnel and related increases in our labor costs. For a detailed discussion of the risk factors that could affect our actual results, please refer to the risk factors identified in our Annual Report on Form 10-K for the year ended Dec. 31, 2025, our Quarterly Report on Form 10-Q for the quarter ended September 30, 2026 and the other periodic reports we file with the SEC. All information provided in this release and in the attachments is as of the date hereof, and we undertake no duty to update or revise this information unless required by law.

Condensed Consolidated Balance Sheets
(in thousands, except par value and share amounts)
(Unaudited)
 
 September 30,
2026
 December 31,
2025
 
Assets        
Current Assets:        
Cash and cash equivalents$727,694  $575,817  
Accounts receivable (less allowance for credit losses of $699 at September 30, 2026 and
   $833 at December 31, 2025)
 242,545   253,207  
Investments - current 15,260   28,413  
Prepaid expenses and other current assets 192,808   94,140  
Total current assets 1,178,307   951,577  
Property and equipment, net 66,439   64,251  
Right of use asset, net 7,206   7,019  
Goodwill 32,060   32,060  
Intangible assets, net 4,550   4,550  
Other assets 8,301   6,329  
Total assets$1,296,863  $1,065,786  
Liabilities and Stockholders' Equity        
Current Liabilities:        
Medical expenses payable$621,746  $474,569  
Accounts payable and accrued expenses 34,562   33,284  
Accrued compensation 32,744   49,013  
Total current liabilities 689,052   556,866  
Long-term debt, net of debt issuance costs 324,497   323,176  
Long-term portion of lease liabilities 6,202   6,467  
Total liabilities 1,019,751   886,509  
Stockholders' Equity:        
Preferred stock, $0.001 par value; 100,000,000 shares authorized as of
   September 30, 2026 and December 31, 2025, respectively; no shares issued and
   outstanding as of September 30, 2026 and December 31, 2025
 —   —  
Common stock, $0.001 par value; 1,000,000,000 shares authorized as of
   September 30, 2026 and December 31, 2025; 209,152,387 and 204,153,619 shares
   issued and outstanding as of September 30, 2026 and December 31, 2025,
   respectively
 209   205  
Additional paid-in capital 1,245,996   1,188,089  
Accumulated deficit (969,093)  (1,009,017) 
Total stockholders' equity 277,112   179,277  
   Total liabilities and stockholders' equity$1,296,863  $1,065,786  
 


Condensed Consolidated Statements of Operations
(in thousands, except per share amounts)
(Unaudited)
 
 Three Months Ended September 30, Nine Months Ended September 30, 
 2026
 2025
 2026
 2025
 
Revenues:               
Earned premiums$1,348,256  $983,681 $3,901,447  $2,907,927  
Other 10,034   10,014  27,673   27,988  
Total revenues 1,358,290   993,695  3,929,120   2,935,915  
Expenses:               
Medical expenses 1,217,603   868,022  3,462,996   2,570,662  
Selling, general, and administrative expenses 136,373   110,015  388,514   317,643  
Depreciation and amortization 8,108   7,977  23,801   22,574  
Total expenses 1,362,084   986,014  3,875,311   2,910,879  
Income (loss) from operations (3,794)  7,681  53,809   25,036  
Other expenses:               
Interest expense 4,280   3,950  12,617   11,850  
Other income, net —   —  (1)  (89) 
Total other expense 4,280   3,950  12,616   11,761  
Income (loss) before income taxes (8,074)  3,731  41,193   13,275  
Provision (benefit) for income taxes (22)  2  1,269   3,247  
Net income (loss)$(8,052) $3,729 $39,924  $10,028  
Less: Net loss attributable to noncontrolling interest —   —  —   (254) 
Net income (loss) attributable to Alignment Healthcare,
  Inc.
$(8,052) $3,729 $39,924  $10,282  
                
Net income (loss) per share attributable to Alignment
  Healthcare, Inc.:
               
Basic (0.04)  0.02  0.19   0.05  
Diluted (0.04)  0.02  0.19   0.05  
Weighted-average common shares outstanding:               
Basic 208,556,942   199,026,808  207,132,468   197,007,141  
Diluted 208,556,942   208,927,980  214,815,296   208,439,200  
 


Condensed Consolidated Statements of Cash Flows
(in thousands)
(Unaudited)
 
 Nine Months Ended September 30, 
 2026
 2025
 
Operating Activities:        
Net income$39,924  $10,028  
Adjustments to reconcile net income to net cash provided by operating activities:        
Provision for credit loss 699   548  
Gain on sale of property and equipment (1)  (72) 
Depreciation and amortization 23,834   22,648  
Amortization-investment discount (478)  (1,041) 
Amortization-debt issuance costs 1,790   1,321  
Equity-based compensation 49,680   48,967  
Non-cash lease expense 1,439   1,178  
Changes in operating assets and liabilities:        
   Accounts receivable 9,963   (66,451) 
   Prepaid expenses and other current assets (98,668)  (84,326) 
   Other assets (9)  (47) 
   Medical expenses payable 147,177   239,008  
   Accounts payable and accrued expenses 1,004   11,185  
   Accrued compensation (16,269)  8,349  
   Lease liabilities (1,690)  (993) 
       Net cash provided by operating activities 158,395   190,302  
Investing Activities:        
Purchase of investments (32,510)  (45,194) 
Sale of property and equipment —   75  
Maturities of investments 46,135   57,995  
Sale of business —   1,065  
Acquisition of property and equipment (25,952)  (21,752) 
       Net cash used in investing activities (12,327)  (7,811) 
Financing Activities:        
Debt issuance costs (2,397)  (26) 
Proceeds from stock option exercises 8,231   2,771  
       Net cash provided by financing activities 5,834   2,745  
Net increase in cash 151,902   185,236  
Cash, cash equivalents and restricted cash at beginning of period 577,937   434,942  
Cash, cash equivalents and restricted cash at end of period$729,839  $620,178  
Supplemental disclosure of cash flow information:        
       Cash paid for interest$7,013  $6,740  
Supplemental non-cash investing and financing activities:        
       Acquisition of property in accounts payable$9  $79  
 

The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the consolidated balance sheets to the total above:

 September 30,
2026
 September 30,
2025
 
Cash and cash equivalents$727,694 $618,067 
Restricted cash in other assets 2,145  2,111 
Total$729,839 $620,178 
 

Non-GAAP Financial Measures

Certain of these financial measures are considered “non-GAAP” financial measures within the meaning of Item 10 of Regulation S-K promulgated by the SEC. We believe that non-GAAP financial measures provide an additional way of viewing aspects of our operations that, when viewed with the GAAP results, provide a more complete understanding of our results of operations and the factors and trends affecting our business. These non-GAAP financial measures are also used by our management to evaluate financial results and to plan and forecast future periods. However, non-GAAP financial measures should be considered as a supplement to, and not as a substitute for, or superior to, the corresponding measures calculated in accordance with GAAP. Non-GAAP financial measures used by us may differ from the non-GAAP measures used by other companies, including our competitors. To supplement our consolidated financial statements presented on a GAAP basis, we disclose the following non-GAAP measures: Medical Benefits Ratio, Adjusted EBITDA and Adjusted Gross Profit as these are performance measures that our management uses to assess our operating performance. Because these measures facilitate internal comparisons of our historical operating performance on a more consistent basis, we use these measures for business planning purposes and in evaluating acquisition opportunities.

Adjusted EBITDA

Adjusted EBITDA is a non-GAAP financial measure that we define as net income (loss) before interest expense, income taxes, depreciation and amortization expense, certain litigation costs, gains or losses on sale of property and equipment, and equity-based compensation expense.

Adjusted EBITDA should not be considered in isolation of, or as an alternative to, measures prepared in accordance with GAAP. There are a number of limitations related to the use of Adjusted EBITDA in lieu of net income (loss), which is the most directly comparable financial measure calculated in accordance with GAAP.

Our use of the term Adjusted EBITDA may vary from the use of similar terms by other companies in our industry and accordingly may not be comparable to similarly titled measures used by other companies.

Medical Benefits Ratio (MBR)

We calculate our MBR by dividing total medical expenses, excluding depreciation, and medical equity-based compensation, by total revenues in a given period.

Adjusted Gross Profit

Adjusted gross profit is a non-GAAP financial measure that we define as income (loss) from operations before depreciation and amortization, medical equity-based compensation expense, and selling, general, and administrative expenses.

Adjusted gross profit should not be considered in isolation of, or as an alternative to, measures prepared in accordance with GAAP. There are a number of limitations related to the use of adjusted gross profit in lieu of income (loss) from operations, which is the most directly comparable financial measure calculated in accordance with GAAP.

Our use of the term adjusted gross profit may vary from the use of similar terms by other companies in our industry and accordingly may not be comparable to similarly titled measures used by other companies.

Investor Contact
Harrison Zhuo
hzhuo@ahcusa.com

Media Contact
Jerry Slowey
publicrelations@ahcusa.com

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