What is the market's earnings forecast for Waystar Holding next quarter?

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What were the key takeaways from Waystar Holding's earnings call?

What is Waystar Holding's gross profit margin?

What is the revenue and EPS growth rate for Waystar Holding year over year?

What guidance did Waystar Holding's management provide for the next earnings period?

Did Waystar Holding beat or miss consensus estimates last quarter?

What factors drove the changes in Waystar Holding's revenue and profit?

- **Revenue Growth**: Q3 revenue up 12% YoY to $269 million, driven by client retention and Iodine acquisition.
- **Iodine Impact**: Expanded TAM by 15% and accelerated product roadmap by 2 years, with $12 million EBITDA contribution in Q4.
- **AI Innovation**: AI-powered solutions reduce denials by 95% and enable 90% faster appeal processing, with 98.5% first-pass clean claims.
- **Financial Strength**: EBITDA margin 42%, free cash flow conversion 85%, and leverage ratio reduced to 1.9x.
- **Guidance Update**: 2025 revenue raised to $1.085–$1.093 billion (+15% YoY), with $30 million Iodine contribution in Q4.
- **Client Confidence**: 93% client confidence and NRR of 113%, reflecting strong retention and expansion.


**【CEO Summary Section】**
- **Revenue Growth and Profitability**: Q3 revenue reached $269 million, up 12% YoY, with adjusted EBITDA margin of 42%. The company outperformed guidance on both metrics.
- **Iodine Acquisition**: Completed acquisition of Iodine Software, expanding total addressable market (TAM) by 15% and adding 150 health systems. Iodine's AI capabilities accelerate Waystar's product roadmap by nearly 2 years.
- **Innovation Highlights**: Introduced AI-powered solutions like Waystar AltitudeAI for denial prevention (reducing time by 95%) and patient cost estimation tools to reduce uncompensated care. Client satisfaction metrics remain strong, with NRR at 113%.
- **Market Recognition**: Named Fast Company's Best Workplaces for Innovators and awarded 2025 Healthcare Company of the Year.

**【CFO Financial Commentary】**
- **Financial Performance**: GAAP revenue $269 million (+12% YoY), adjusted EBITDA $113 million (+17% YoY). Unlevered free cash flow $96 million (85% of EBITDA).
- **Guidance Update**: Raised 2025 full-year revenue to $1.085–$1.093 billion (+15% YoY) and EBITDA to $451–$455 million. Includes $30 million contribution from Iodine in Q4.
- **Leverage and Synergies**: Leverage ratio reduced to 1.9x (from 2.9x at year-start). On track to achieve $15 million cost synergies from Iodine within 18–24 months.
- **Cash Position**: $421 million in cash, with $1.2 billion gross debt post-acquisition.

**【Q&A Highlights】**
- **Iodine Integration**: Cross-sell opportunities with 35–40% client overlap. Iodine's clinical data enhances Waystar's AI for prior authorization and denial recovery (e.g., 90% faster appeal package creation).
- **Patient Utilization Trends**: Third-quarter patient utilization reverted to historical growth rates, impacting volume-based revenue (-4% sequentially).
- **AI Monetization**: Pricing AI solutions to value, with annual price uplift and new SKUs. Internal AI use (e.g., Copilot) improves operational efficiency and developer productivity.
- **Competitive Position**: Differentiated by cloud-native platform, data richness, and 98.5% first-pass clean claim rate. Go-to-market strategy focuses on ROI-driven conversations and long-term client relationships.
- **Cybersecurity and Trust**: Ranked #1 trusted vendor, with 93% client confidence in Waystar as a partner.


Waystar Holding Corp. (WAY) Q3 2025 Earnings Call Transcript

- **$1.25B Iodine Acquisition**: Expands TAM by 15%, immediately accretive to margins with $120M+ subscription revenue and 75% gross margin. Advent International receives 100% stock consideration.
- **Q2 Financials**: $271M revenue (+15% YoY), $113M EBITDA (42% margin). Raised 2025 guidance to $1.30-$1.42B revenue and $418-$426M EBITDA.
- **AI Innovation**: AltitudeAI boosts appeal overturn rates by 40%, preventing $6B in denied claims. Iodine's 160M clinical encounters/year create cross-sell opportunities.
- **Competitive Edge**: 115% net retention rate, 90% touchless prior authorizations, and resilience to Medicaid funding changes (1% revenue impact max).
- **Leverage & Cash Flow**: 2.2x net debt/EBITDA, targeting 1x annual deleverage. Post-Iodine leverage ~3.5x, with $15M+ synergies.


**【CEO Summary Section】**
- Announced $1.25 billion acquisition of Iodine Software, a leader in AI-powered clinical intelligence, expected to close by year-end. The deal expands Waystar's total addressable market by over 15% and is immediately accretive to gross margin and EBITDA margin. Iodine's subscription-based model aligns with Waystar's financial profile, and the transaction includes 100% stock consideration for Advent International, Iodine's largest shareholder.
- Q2 revenue reached $271 million, up 15% YoY, with adjusted EBITDA of $113 million (42% margin). The company raised full-year guidance to $1.30-$1.42 billion in revenue and $418-$426 million in adjusted EBITDA.
- Highlighted AI innovations like AltitudeAI, which boosts appeal productivity by 70%, and the company's ability to prevent $6 billion in denied claims year-to-date. Cross-sell opportunities with Iodine's 160 million clinical encounters per year are expected to drive long-term growth.
- Discussed regulatory resilience, with less than 1% revenue impact from a hypothetical 15% Medicaid funding reduction, and the advantage of serving all payer types on a single platform.

**【CFO Financial Commentary】**
- Subscription revenue grew 17% YoY to $131 million, while volume-based revenue increased 14% YoY to $138 million, driven by rapid onboarding of large clients. Net revenue retention rate remained strong at 115%.
- Unlevered free cash flow was $111 million (98% of EBITDA), with a net debt to EBITDA ratio of 2.2x, down 0.6x year-to-date. The company expects to deleverage by ~1x annually.
- Iodine's standalone 2025 revenue is projected at $120-$125 million (75% gross margin, 40% EBITDA margin), with $15+ million in cost synergies within two years. Post-acquisition leverage is expected to be ~3.5x.

**【Q&A Highlights】**
- **Client Onboarding & Revenue Sustainability**: 3 large clients were onboarded faster than expected, contributing to Q2 upside. Subscription and volume-based revenue trends reflect strong demand and operational efficiency. Q3/Q4 revenue is expected to be similar, with patient deductible seasonality impacting volume-based revenue.
- **Competitive Dynamics**: Waystar maintains strong win rates against competitors, with 1/3 of Iodine clients already using Waystar. The company is a share gainer in the post-cyberattack competitor client base.
- **Regulatory Impact**: The One Big Beautiful Bill Act and prior authorization pledge are opportunities for Waystar's AI-driven solutions, which automate 90% of prior authorizations and prevent denials.
- **AI & Innovation**: AltitudeAI's Gen AI models are reducing manual work in denial prevention and appeals, with midsized health systems seeing capacity equivalent to 10+ FTEs freed up.


Waystar Holding Corp. (WAY) Q2 2025 Earnings Call Transcript

- **Revenue Growth**: 14% YoY to $256M, fueled by 15% expansion in high-revenue clients and 114% NRR.
- **AI Impact**: Auth Accelerate achieves 85% auto-approval rate; AltitudeAI overturns claims 40% faster.
- **Financial Strength**: 42% EBITDA margin, $79M free cash flow, and 2.5x net leverage.
- **Guidance Update**: FY2025 revenue raised to $1.014B midpoint, supported by strong Q1 and AI-driven growth.
- **Market Resilience**: 100% client retention, 70% service requests resolved same day, and 92% providers prioritizing AI.

**【CEO Summary Section】**
- Q1 2025 revenue grew 14% YoY to $256 million, driven by 15% YoY increase in clients generating >$100k in trailing 12-month revenue.
- Net Revenue Retention (NRR) of 114% reflects strong client retention and expansion, with 1,244 clients now in the high-revenue cohort.
- AI-powered innovations like Auth Accelerate (85% auto-approval rate) and AltitudeAI denial appeal tool (40% overturn rate improvement) are driving client value and cross-sell opportunities.
- 100% U.S.-based client support with 70% service requests resolved on the same day, maintaining industry-leading client satisfaction.

**【CFO Financial Commentary】**
- Adjusted EBITDA of $108 million (+16% YoY) with margin of 42%, aligning with long-term 40% target.
- Unlevered free cash flow of $79 million (73% of EBITDA), reducing net leverage to 2.5x.
- Raised FY2025 guidance to $1.006-1.022 billion revenue (midpoint +$6M) and $406-414 million EBITDA (midpoint +$7M).
- Subscription revenue up 18% YoY, with 30% of revenue tied to patient payment solutions exhibiting seasonal trends.

**【Q&A Key Takeaways】**
- Q1 outperformance driven by patient payment utilization (benefit of $10M vs. Q1 2024), with 1-2% annual utilization growth modeled.
- AI adoption creating new spend pools outside traditional IT budgets, with early adopters seeing 70% reduction in authorization time.
- Recession resistance validated by 114% NRR and 100% client retention, with 92% providers prioritizing AI in RCM.
- M&A pipeline active, focusing on tech/companies aligning with AI-driven RCM strategy.

Waystar Holding (WAY)-30 Apr 25-2025 Q1 Earnings call transcript

- **Revenue Surpass**: Q4 2024 revenue up 18% YoY to $244M, driven by 30%+ cross-sell adoption among new clients.
- **AI-Driven Efficiency**: Waystar Altitude reduces denial appeal time by 3x, with 15% YoY growth in high-revenue clients.
- **Profitability Targets**: 40.6% EBITDA margin vs. 40% target, $265M free cash flow enabling 0.25x leverage reduction.
- **2025 Outlook**: 10% normalized growth, $1B+ revenue, with 1-2% patient volume growth returning to historical norms.

**【CEO Key Highlights】**
- **Revenue Growth**: Q4 2024 revenue reached $244 million, up 18% YoY, with full-year revenue of $944 million (19% YoY growth). 
- **Client Expansion**: Clients generating >$100k LTM revenue grew to 1,203 (15% YoY), with 30% of new clients post-cyberattack exploring cross-sell opportunities.
- **AI Innovation**: Launch of Waystar Altitude AI, enabling 3x faster denial appeals and 16min time savings per package.
- **Client Satisfaction**: Ranked #1 in claims management and patient access solutions, with 98% client retention.

**【CFO Financial Breakdown】**
- **Profitability**: Q4 adjusted EBITDA of $100 million (16% YoY), full-year margin 40.6% vs. target 40%.
- **Cash Flow**: Unlevered free cash flow of $265 million (69% EBITDA conversion), reducing net leverage to 2.8x.
- **2025 Guidance**: Revenue $1.0-1.016 billion (7% YoY, 10% normalized), non-GAAP EPS $1.29-1.32 (19% growth).

**【Q&A Key Takeaways】**
- **Volume Dynamics**: 2024 patient payment volume growth (34%) unsustainable; 2025 expected to return to 1-2% historical rate.
- **M&A Impact**: 2024 M&A contributed $34 million, with 2025 focus on integrating acquired clients onto core platform.
- **Policy Outlook**: Favorable regulatory environment for efficiency-focused solutions; 75% of providers prioritize ROI in IT spend.
- **Product Demand**: Strong interest in denial prevention (eligibility automation, prior auth AI) and AI-powered appeals.


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