Claritev - Q4 2025

Transcript

Operator (participant)

Ladies and gentlemen, thank you for joining us, and welcome to the Claritev Fourth Quarter 2025 earnings call. After today's prepared remarks, we will host a question and answer session. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one again. I will now hand the conference over to Todd Friedman, Head of Investor Relations. Todd, please go ahead.

Todd Friedman (Head of Investor Relations)

Thank you, operator. Good afternoon, everyone, welcome to Claritev's Fourth Quarter 2025 earnings call. Joining me today are Travis Dalton, President and CEO, and Doug Garis, Chief Financial Officer. Jerry Hogge, our Chief Operating Officer, will also join us for the Q&A. During our call, we will refer to the supplemental slide deck that's available in the investor portion of our website, along with the Fourth Quarter 2025 earnings press release issued earlier this afternoon. Our remarks are statements. These forward-looking statements represent management's beliefs and expectations only as the date of this call.

Actual results may differ materially from these forward-looking statements due to a number of risks. A summary of these risks can be found in the supplemental slide deck, and a more detailed description in our annual report, and other documents that we follow the SEC. We'll also be referring to several non-GAAP measures, which we believe provide investors with a more complete understanding of Claritev's underlying operating results. An explanation of these non-GAAP measures and reconciliations to their comparable GAAP measures can be found in the release in the supplemental slide deck. With that, I turn the call over to Travis.

Travis Dalton (President and CEO)

Thank you, Todd. Good afternoon, everyone, thank you for your time today. I'm excited to share our Q4 results, 2026 guidance, and transformation progress. First, I would like to reflect for a moment on the state of our journey here at Claritev in the industry. As I near my second anniversary as CEO, I've helped reflect on what we've accomplished and what lies ahead. When I joined the company, we faced a set of challenges that require a well-thought-out, long-term strategy plan. We set out very intentionally to create Vision 2030 and are very committed to that. That is not meant to be dismissive of immediate results and short-term objectives. To be clear, our goal and the focus of this management team is to build a well-run, disciplined healthcare technology company that delivers sustainable, profitable growth.

The business real and pressing problems in healthcare today and the future, specifically with laser focus in the areas of transparency and affordability, which are key to better health outcomes and economic forward. I'm exceedingly proud of the work we have done to lay a foundation, clarify our purpose, align and recruit talent, and focus our company and associates for performance. That combination of Claritev, alignment, and focus by our digital transformation and the introduction of horizontal new vertical markets has allowed us to turn to profitable growth sooner than expected. Simply put, our strategy is working. Most importantly, allowed us to prioritize with urgency to help our clients with their most. One comment on my remark that we have returned to profitable growth sooner than expected. One year ago, we stood on this call and provincial guidance of flat to down revenue was significant free cash.

I'd be remiss to not take a moment and give recognition to nearly 3,000 associates at Claritev who have showed up every day, aligned to our making healthcare affordable for everyone, in line with our Vision 2030 plan, and delivered these results that have far exceeded what we could do entering the year of the turn. On that note, let me foundational reasons why Claritev is positioned to keep winning in this market. Operating a highly complex and sometimes fragmented, misaligned industry. Our fundamental belief is that increased transparency, better data and technology, providers and employers will lead to more alignment and better decision-making. Costs continue to rise. High claims are increasing, the regulatory environment is fluid, and are real challenges to tackle.

As of our results, we are well positioned to meet these pressing needs, network innovation, claims intelligence, transparency, and predictive models that ultimately benefit the healthcare industry. That combination of solutions and augment each other when used together is the real strength of our business. I'm often asked about our true competitive advantage, and I say it centers around us. One, the comprehensive network that we have developed over many decades. Two, the deep workflow knowledge and substance of our client relationships has inspired renewals and sales growth. Three, proprietary IP, business ability to analyze data, flexibility to adapt, and technology scale. High provider acceptance. For all the noise around provider, we achieve greater than 90% across our solutions. Five, a long history of regulatory expertise that is invaluable to our clients trying to adapt to a constantly changing state and federal environment.

About our competitive advantages, let me take this moment to comment about AI. Technology is a massive force improving health. AI is giving us the opportunity to tackle the biggest results, fragmentation and sensitivity of data, and incentives, complexity of work, and access. AI is reshaping the way we develop and our collective future. These persistent challenges are the opportunity, are the opportunity for us. Our working with clients across the ecosystem are major, major advantage, along with the competitive moat we have created with the new IP. The competitive advantages I just listed become even more pronounced, considered alongside our strategy. There will be winners and losers in this market. We believe key three core ingredients are going forward. One, embedded domain expertise.

Todd Friedman (Head of Investor Relations)

Guys, we're gonna pause for one second. We're getting notes that the audio is bad. Operator, if you can hold on one second, we're gonna go to a different line here, okay? There you go. The audio is bad. Operator, is that a better connection now? Can you hear us better?

Operator (participant)

Sounding clear?

Travis Dalton (President and CEO)

Complexity of workflows and access. AI is developing work in our collector. These persistent are the opportunity for impact. The time is now. Our four-plus decades of working with clients across the ecosystem are a major advantage of the competitive moat we have created with IP. The competitive advantages I just listed become even pronounced when considered alongside our strategy. Winners and losers in this market. We believe three core ingredients will be crucial going forward: embedded workflow domains. Two, client agreements and data rights access, and trust. We will work with our clients and by data partners where appropriate. We are prioritizing AI where it supports clear outcomes, revenue, cost reduction, can be embedded directly into workflows that find more value for our clients by cumbersome processes, measurable revenue growth, and taking real costs out of the business.

We have clear examples of success, including the use to advance our No Surprise Bills, advance our Payment and Revenue Integrity products, and workflow automation around credentialing and other key areas. AI must function within claims adjudication, payment workflows, contracting, and reconciliation processes that work across payers, providers, and employers. Limit trust. We have 40 years of making and keeping promise designs. They trust us to act responsibly, to govern well, the integrity of our data and solutions. The moat is no longer code. It is the data, workflow, distribution, and trust that will matter the most. Simple tools will go by the wayside. The long-term winners will be platforms that support rich workflow. Those will be the places where AI will enrich what we are capable of delivering. That is, when you add all that up, we not only like our position, but embrace the AI revolution.

We published a strategy briefing on dot-com that lays out our AI position in greater detail, and we will go deeper on this topic at our Investor Day on March 16. Quite simply, between the creation of our competitive advantage and our AI leadership, nobody is better positioned to meet the coming demand, impact, and affordability than we are. Turning to the results, we are on the way up, as evidenced by our Q4 highlights. Full year 2026 guidance. We achieved 6.2% revenue growth in Q4 year-over-year, continuing to demonstrate durability, but that our vertical market strategy is working in effect roadmap. Doug will give a fulsome update on the numbers. I'm also really pleased with our bookings of $23 million in Q4, running a record, record for the company.

That result, along with our expected full year bookings growth in 2026, bodes well for our future in creating sustainable growth. Let me give a few quick highlights. As previously reported, we have renewed our top clients and continue to expand our solutions and white space with them in areas like NSA and Payment and Revenue Integrity. We continued to expand our market presence with momentum in the TPA and broker verticals with additional Q4 client acquisition. The same can be said for our provider and government market segments. Exciting announcements to come soon. We deployed a number of partners and solutions that reinforce our culture of innovation. Our new solution, made possible through our digital transformation, is our Network Builder. Claritev Network of 1.4 million providers is one of the least appreciated assets we operate.

A key feature for our clients pass over the whole network, or a specifically tailored narrow network addressing geographic needs, like niche facilities or rural access gaps. While we have been delivering bespoke networks for decades, the Network Builder, we are now able to create those networks in minutes throughout, replaced to be a lengthy manual process. We will be showcasing this and many other relations during our Investor Day. We are expanding our footprint internationally in the Middle East, signing two additional clients that will create momentum for growth in 2026. Overall, in 2025, we acquired new logos across our vertical markets.

Our bookings in over year. We had more diversification in our selling activity, including significant expansion of our Payment and Revenue Integrity solutions. More telemetry into our session than ever before, allowing us to strengthen our win rates and increase our deal size. I expect 2026 to be an even bigger record sales year for planning, just getting started. We are well into our digital transformation that will create a stronger and more operating and technology platform for the long haul, complemented by our products and AI. All this bodes well for Claritev, but most importantly, for our and our ability to serve their emerging needs. I'll turn it to Doug.

Todd Friedman (Head of Investor Relations)

Doug, if you could wait one minute, we're going to change the audio here to Jason. Jason, can you turn your microphone on? Just push the microphone button on the phone. There we go. There we go. Can you hear us, operator?

Operator (participant)

Much clearer. Yes, can hear. I can hear. Thank you.

Todd Friedman (Head of Investor Relations)

Okay, go ahead, Doug.

Doug Garis (EVP and CFO)

Okay. Thank you, Travis. Good afternoon, everyone. I have a lot to cover today, so I'll move quickly through my remarks, highlighting Q4 and full year 2025. Before I give you the setup for what we believe will be the main catalyst for growth this year, we've also posted a supplemental deck on our investor relations website for more detail to support our remarks. To start, 2025 can be understood most clearly in the remarkable pivot in our financial performance that began in Q1 and progressed throughout the year. Revenue, adjusted EBITDA, and free cash flow all ended the year well ahead of our initial guide. Our 2026 guidance reinforces our posture as a business on the way up, with a growing top and bottom line and an emerging business model built for durable growth over many years to come.

Let's get right to the numbers. Total revenue in Q4 was $246.6 million, up 6.2% year-over-year. Growth in Q4 came from both our core businesses and expansion areas. Recall, Q4 is the last quarter with a one-time revenue benefit of about $5 million in our P&C business, which falls under the network service line. In total, we had about $18 million of non-recurring revenue in 2025, with roughly $2 million of benefit in Q1 and $5 million of benefit in Q2, Q3, and Q4 that will not repeat this year. Adjusted EBITDA was $151.3 million for the quarter, up 7% at a 61.4% margin, and we generated $36.4 million of levered free cash flow in the quarter.

We also deployed about $5 million for a small tuck-in acquisition we completed in November. We ended the year with $28 million of total cash and $17 million of unrestricted cash. Our net leverage at the end of the year was 7.7x, an improvement of nearly 0.5 turn from our ending position at the time of our debt refinancing transaction in January. As a reminder, since the debt refinancing transaction concluded in January of last year, we expect Q1 and Q3 to be cash consumption quarters, and Q2 and Q4 to be cash-generating quarters in the near term. For the full year, revenue was $965.4 million, an increase of 3.7%, and Adjusted EBITDA was $602.6 million, an increase of 4.5% over 2024.

Most notably, levered free cash flow, which we forecasted it to be a use of $70 million to start the year, finished the year near the midpoint of our most recent guide with the use of $12.3 million. As I frame up our 2026 guide, I want to highlight a few areas that will be relevant to your models going forward. In Q4, we began to see the expected shift of some previously capitalized costs to OpEx, particularly around cloud computing cost, which is normal for technology companies that move from on-prem data center usage to the cloud. This will have a $0 cash flow impact this year, as we expect total capital investments to remain consistent. This transition will increase OpEx and thus decrease Adjusted EBITDA, with a corresponding reduction to related CapEx in 2026 and going forward.

I want to be clear that our primary financial objectives this year are driving revenue growth at good margins, combined with a key focus on improving free cash flow. As we move through our digital transformation, additional costs will shift to OpEx, and we fully expect to realize meaningful synergies as we outlined in previous calls. At the end of the day, we are focused on total dollars spent, whether expense or capital. You will hear us focus more on free cash flow and adjusted cash conversion as key metrics to highlight progress against our multi-year strategy. From a go-to-market perspective, Q4 capped a remarkable year of sales motion. We exceeded our internal expectations, finishing the year at $67 million in ACV booked and having closed more than 650 opportunities.

In 2025, we closed more than 100 deals of over $100,000 of ACV, up 30%, with the average deal size improving by 50% on a full year basis. The pipeline for 2026 is already strong, we expect to continue last year's momentum with both existing customer white space and new logo additions. We expect to deliver strong double-digit ACV bookings growth in 2026, which will begin to convert to revenue towards the end of this year and into 2027. These results are rooted in the strength of our core offerings, which were responsible for 94% of our total revenue in 2025.

This powerful combination of a durable core, alongside the investments we are making to deliver new and improved solutions to expanded end markets, gives us visibility and confidence in achieving the strategic and financial objectives we laid out last year with the Vision 2030 plan. Simply put, we're getting more hits with more at bats. Now on to revenue guidance. We are initiating 2026 revenue at $980 million-$1 billion, representing 2%-4% growth over 2025. Excluding the $18 million of one-time revenue in 2025, we're modeling 4%-6% growth this year. While we historically do not provide quarterly splits, given the addition of new ACV and the impact of the one-time revenue, we are providing direction to aid in your quarterly modeling.

We would expect low single-digit growth in Q1, with modest sequential growth in Q2 due to the one-time revenue headwind. As revenue from new ACV ramps, we expect our growth rate to increase to between 3%-5% for the second half of the year, adding up to the full year guide. We have included a summary on slide 15 of the supplemental deck to help bridge the major revenue drivers this year. It provides more color on how you should model Gross Revenue Retention, expansion, and ACV conversion to get to our revenue range. We are introducing full-year Adjusted EBITDA guidance of $605 million-$615 million, with margins of 61%-62%. For a year-over-year comparison, keep in mind that $18 million of one-time revenue in 2025 flowed through at a 100% margin.

When normalizing for that impact, our guidance implies a 3.5%-5% Adjusted EBITDA dollar growth on a like-for-like basis. As discussed earlier, we expect to incur $10 million-$15 million of OpEx costs previously classified as CapEx, related to the movement of our technology infrastructure to the cloud. Additionally, we plan to invest $20 million-$25 million in our go-to-market and delivery functions to maintain momentum and best support the strong double-digit ACV bookings growth we have planned. You'll also notice that we're returning to a dollar-based Adjusted EBITDA guide. We believe this better reflects how we're managing the business in 2026, with a clear emphasis on revenue growth, disciplined investment, and improving free cash flow. Importantly, should we outperform, we're prepared to thoughtfully reinvest incremental upside to further strengthen our growth trajectory.

We are forecasting total capital of $160 million-$170 million, and we're projecting free cash flow of $0-$10 million this year. One final point on free cash flow: 2025 included our comprehensive debt refinancing transaction, which distorted some of our metrics. In 2026, we expect to deliver double-digit operating and unlevered free cash flow growth, with adjusted cash conversion normalized into pre-2025 levels at approximately 50%-55%. I'll add one last thread about the broader macro environment and how that impacts our internal projections. We have recently benefited from a few positive market tailwinds. While there are many market trends we monitor, a few stand out. Out-of-network claims volume, medical inflation, and claims mix are the three key factors that underpin our modeling and have the greatest impact on our PAVE revenue.

In the past five years, out-of-network claim volume has remained consistent, around 7% of total healthcare claims. Medical inflation has also remained at historically heightened levels. We have traditionally modeled for more conservative expectations for both volumes and inflation-related growth, which is reflected in our initial guide. Lastly, our mix has continued to favor certain out-of-network and higher-priced services like behavioral health, urgent care, and other specialties that can often occur at out-of-network providers from employer-sponsored health plans. I wanted to end by sharing that our capital allocation priorities are clear and unchanged. At the highest level, we continue to focus on organic investments to fuel our Vision 2030 plan. That's where most of our time and energy is directed. These investments are driving innovation, operational improvements, and enabling us to get fit for long-term and sustained growth.

At the same time, we're maintaining a high priority on debt reduction with a renewed focus on value-creating M&A, both of which will strengthen our balance sheet and position us for more flexibility in our capital structure going forward. All of this aligns with our guiding principles to diversify and accelerate, expanding our solutions, verticals, and channels to drive growth, while also deleveraging and de-risking our business to enhance cash flow and operating agility. With that, I will turn the call back over to Travis for some final remarks before taking your questions.

Travis Dalton (President and CEO)

Thanks, Doug. Before I turn the call over for questions, let me just make one last comment about moving forward from the year of the turn into the way up. The opportunity ahead is real and exciting. The tools for disruption, we think, are here, and that's a good thing. We made the turn successfully because of our focus on our clients and the competitive advantage that I described earlier. A moat's not enough. Companies will need clear and delineated strategies to deploy value to clients in a rapidly changing environment. We're prepared to do that. Despite the turmoil we read about in healthcare, I believe in those across the ecosystem that care deeply about access, quality, and cost. The value we bring will continue to lift Claritev into new heights. With that, let me turn it over for questions.

Todd Friedman (Head of Investor Relations)

Operator, before we go to questions, to everyone on the call, we know there were some audio difficulties at the beginning. Once we are done with the call, we will post the transcript of Travis's comments on our website for you, so you'll have easy access to them. With that, operator, we'll open up for questions.

Operator (participant)

Thank you. We will now begin the question and answer session. Please limit yourself to one question and one follow-up. If you would like to ask a question, please press star one on your telephone keypad. To withdraw your question, please press star one again. Please pick up your handset when asking a question. If you are muted locally, please remember to unmute your device. Please stand by while we compile the Q&A roster. Our first question comes from the line of Joshua Raskin with Nephron Research. Your line is open. Please go ahead.

Todd Friedman (Head of Investor Relations)

Josh, you might be muted. Operator, can you maybe move to the next one? We're not hearing Josh right now, and we can maybe get him back in queue.

Operator (participant)

Your next question comes from the line of Luismario Higuera with Citi. Your line is open. Please go ahead.

Todd Friedman (Head of Investor Relations)

Operator, if we can pause, I'm getting word that it sounds like the phone lines, you're not getting audio, but the webcast is. If that's true, can you please check that on the, on the speakers and see if you're getting audio from them? If so, pipe it through.

Operator (participant)

Yes, please hold. Thank you for your patience while we are experiencing some technical difficulties on today's event. We are currently troubleshooting with our internal team as we speak. I will revert back with an update as soon as possible.

Todd Friedman (Head of Investor Relations)

Alexandra, thank you. Can you hear us?

Operator (participant)

Hi. Yes, I can.

Todd Friedman (Head of Investor Relations)

I think given, to everyone on, on the call, I apologize for the technical difficulties. It sounds like the webcast is working, the phone lines are not. Given that, rather than, than hold this, we will, we will cut the call now, and we'll be glad to follow up with you after the call. If you have questions, please feel free to send questions to [email protected], or give a call. Thank you very much for your time.