Waystar Holding Corp.

Thank you for standing by. Welcome to the Waystar Second Quarter 2026 Earnings Conference Call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Edward Parker, Head of Investor Relations. Please go ahead.

Thank you, Operator. Good afternoon, everyone, and thank you for joining Waystar's second quarter 2026 earnings call. Joining me today are Matt Hawkins, Waystar's Chief Executive Officer, and Steven Oreskovich, Waystar's Chief Financial Officer. This afternoon, we issued a press release announcing our financial results and published an accompanying presentation deck. You can find these materials at investors.waystar.com. Before we begin, I would like to remind you that this call contains forward-looking statements, which are predictions or beliefs about future events or performance. for a full discussion of the risks and other factors that may impact these forward-looking statements, please refer to this afternoon's press release and the reports we file with the SEC, all of which are available on the investor relations page of our website. Any forward-looking statements made on this call are only as of today and will not be updated unless required by law. We will also discuss certain non-GAAP financial measures. These measures are intended to provide additional insight into our performance and should not be considered in isolation or as a substitute for financial information prepared in accordance with GAAP. We have provided reconciliations with the non-GAAP financial measures included in our remarks to the most directly comparable GAAP measures, together with explanations of these measures in the appendix of the presentation slide deck and our earnings release. With that, I'd like to turn the call over to Matt.

Thank you, Edward, and good afternoon, everyone. Thank you for joining our Q2 2026 earnings call. We delivered another solid quarter as we executed our strategy, supported our clients, and advanced the Waystar platform toward a more autonomous revenue cycle. During the quarter, we delivered revenue of $320 million, representing 18% year-over-year growth, and adjusted EBITDA of $137 million, resulting in an adjusted EBITDA margin of 43%, which exceeded consensus expectations for the quarter. We also delivered another strong quarter of bookings supported by ongoing momentum with larger provider organizations, expansion across our client base, and sustained demand for Waystar's AI-powered solutions. While the operating environment continues to evolve, the breadth of our platform The diversity of our client base and the mission critical nature of our solutions support healthy demand across the business. At Waystar, our focus is to help providers lower the costs to collect, accelerate reimbursement, and improve payment accuracy across the revenue cycle. In Q2, we saw healthy demand across the business, ongoing client expansion, and broader adoption of Waystar solutions. Large platform deployments drove strong bookings during the quarter, including a double digit number of $1 million plus ACV bookings, reinforcing the trend we have discussed over the past several quarters and our view that providers increasingly value a connected platform approach. Larger client relationships also continue to grow Clients generating more than $100,000 of trailing 12-month revenue grew to $1,453, up 15% year-over-year. Within this cohort, clients have expanded their use of Waystar solutions over the past several years, demonstrating the compounding value clients realize as they adopt additional Waystar capabilities over time. Net revenue retention was 108% within our historical range, demonstrating continued expansion within our existing client base. At the same time, new clients are increasingly selecting multiple Waystar solutions as part of their initial purchase decision. Platform consolidation continues to accelerate as providers move away from fragmented point solutions in favor of a single connected software platform. Class Research's inaugural revenue cycle management suites report reflects that shift. Among providers using multiple solutions from a single vendor, the study found that Waystar clients reported some of the strongest improvements in collections performance and cost to collect, providing independent validation of the operational and financial benefits providers can achieve when more of the revenue cycle is managed on a single platform. One of our million dollar plus ACV bookings is a nonprofit health system serving Central New Jersey and Southeastern Pennsylvania. The win reflects the value of Waystar's platform with the provider selecting Waystar to replace three separate vendors across claims management, patient financial care, clinical documentation integrity, and revenue capture. We also continue to see existing clients expand their relationships with Waystar. This quarter, one of the largest nonprofit health systems in the country began implementing an expanded partnership across eligibility verification and insurance coverage detection. Already a seven-figure Waystar client, The added solutions are expected to generate more than $1 million in incremental annual revenue, reinforcing the advantage of a single connected platform over a patchwork of point solutions. Another established client and multi-billion dollar academic health system with more than 3,000 beds and 9,000 positions also recently went live with additional Waystar Altitude AI capabilities designed to prevent denials as part of its strategy to centralize revenue cycle operations. The go-live increases the client's annual investment in Waystar by an incremental seven figures while helping lower its costs to collect, reduce manual follow-up, and operate more efficiently at enterprise scale. During the quarter, we also saw encouraging adoption of iodine solutions within the existing Waystar client base. More than $6 million of bookings came from existing Waystar clients purchasing iodine capabilities, an early proof point of our expanding cross-sell opportunity as clients bring together financial and clinical data to improve outcomes. As coverage dynamics evolve and self-pay populations grow, providers need stronger capabilities to identify available coverage and protect reimbursement. In a newly published success story, ProMedica, a hospital and physician network serving 4.7 million patients annually, leveraged Waystar's patient insurance coverage solution to uncover nearly $10 million in previously unidentified billing opportunities that may have otherwise been missed. This quarter, we published an in-depth analysis of data from hundreds of hospitals using Waystar's clinical integrity and revenue capture capabilities. The analysis showed clients experienced outsized returns, including three times greater financial impact from integrated clinical documentation workflows, generating $2.17 million in incremental reimbursement for 10,000 discharges. and a 90% year-over-year increase in rebuild dollars caught by our revenue leakage protection capabilities. Collectively, these examples demonstrate the value of the WayStar platform. As clients adopt more capabilities, they reduce complexity, improve performance and drive stronger financial outcomes. The momentum we're seeing across the business reflects more than strong execution it reflects the position Waystar occupies within the healthcare payment ecosystem and the advantages that position creates for our clients. Waystar sits at the center of the healthcare payment ecosystem, connecting providers and payers through critical workflows that span the payment life cycle from authorization and claim submission through adjudication, payment and reimbursement. Providers see their workflows Payers see their workflows, waste or connects, and acts autonomously across both. Operating at that intersection gives us insight into the interactions, dependencies, and friction points between providers and payers. That perspective enables us to improve performance across the revenue cycle and deliver better payment outcomes. Every transaction provides intelligence about how payments move through the system, As payer requirements change, Waystar helps identify friction, adapt quickly, and continuously improve performance across the network. The result is stronger operational and financial performance for clients, including faster payment decisions, accelerated time to payment, fewer errors, and less rework across the revenue cycle. Waystar processes more than 7.5 billion transactions annually. The scale of that network creates a unique combination of connectivity, data, workflow intelligence, and payment intelligence that strengthens the value of the platform, supports innovation across the business, and increasingly enables the application of AI across the revenue cycle. These advantages are reinforced by the four structural foundations you've heard me discuss previously. Mission critical infrastructure, proprietary data, and extensively deployed network and deep domain expertise. We believe these advantages contribute to the strong win rates we achieve and support our ability to compete successfully against point solutions, broader software platforms, end-to-end service providers and newer market entrants. Taken together, these strengths create a durable advantage that is difficult to replicate and increasingly valuable as providers look to reduce administrative burden, improve efficiency, and drive better financial outcomes. As we've discussed over the last several quarters, we continue advancing our vision of creating the industry's first economist revenue cycle. Our goal is not simply to deploy AI, it is to orchestrate the right AI at the right moment across the revenue cycle to reduce administrative burden improve performance, and deliver better outcomes for providers. Our AI deployment is not experimental. It is embedded and monetized, and it delivers meaningful outcomes inside the mission-critical workflows our clients rely on every day. External recognition during the quarter provided additional validation of these efforts. With Waystar named to the Time 100 Most Influential Companies list, and earning the Time Impacting AI Award. More than a dozen clients have committed to our next generation anomaly detection solution during the first half of the year. This solution represents an important step forward because it combines Iodine's clinical documentation capabilities with Waystar's revenue capture engine. We are encouraged by the interest it is generating from large hospitals and health systems. Early adopters are seeing approximately $3 million in incremental revenue recovered per 10,000 admissions through automated revenue leakage detection. We are also seeing promising results from our newest Waystar Altitude AI-powered solution focused on payer take-backs. US Renal Care, a dialysis provider with more than 500 centers across 32 states, achieved and 88% autonomous match rate between recoupments and original claims, reducing the time spent managing recoupments by approximately 80%. As we look ahead, we are focused on the same priorities that have guided us over the last several quarters, simplifying healthcare payments, driving innovation and delivering meaningful value for our clients, our team members and our shareholders. The fundamentals of the business are strong, client partnerships are healthy, and our long-term opportunity is significant. We look forward to sharing more about our strategy, client adoption trends, and long-term vision at the Investor Day in August. Before I turn the call over to Steve, I want to take a moment to recognize him and thank him for everything he has done for Waystar. As we announced earlier today, Steve will be transitioning from the Chief Financial Officer role after eight years with the company. Steve has been a tremendous leader, trusted advisor, and great friend. He has played a critical role in helping build Waystar into the company we are today, helping us scale the business, build a world-class finance organization, navigate our IPO, and establish the strong financial foundation that supports our continued growth today. More importantly, Steve has been an invaluable partner to me and our leadership team. His judgment, integrity, and steady leadership have had a lasting impact on this company, and we are all better because of his contributions. While Steve will be transitioning from the CFO role, he will remain with Waystar as an advisor over the coming months to help ensure a smooth transition. We are pleased to welcome Alpana Wegner, who joined Waystar this week as our next CFO. Alpana brings extensive public company finance and software industry leadership experience, having served as CFO at several public software companies and held a variety of senior finance and operating leadership roles throughout her career. I look forward to introducing her to you in the coming weeks. Steve, thank you again. You've been a great partner and a great friend. On behalf of all of us at Waystar, thank you for your leadership, your friendship, and everything you've done for this company. We wish you and your family the very best. With that, I'll turn it over to you.