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Privia Health Group, Inc. (PRVA)·Q3 2025 Earnings Summary

Executive Summary

  • Q3 2025 was a strong quarter: revenue rose 32.5% year over year to $580.4M, GAAP diluted EPS was $0.05, and Adjusted EBITDA increased 61.6% to $38.2M, driven by MSSP performance, ambulatory utilization strength, and provider growth .
  • The company raised full-year 2025 guidance above the prior ranges across all key operating and financial metrics (revenue, practice collections, care margin, platform contribution, Adjusted EBITDA) .
  • Versus Wall Street: Q3 revenue and normalized EPS were above consensus (Revenue: $580.4M vs $495.9M; EPS Normalized: $0.29 vs $0.217; both beats). More than 80% of FY25 Adjusted EBITDA is expected to convert to free cash flow* .
  • Strategic catalysts: $234.1M aggregate MSSP shared savings for 2024 (+32.6% YoY) and the signed acquisition of an ACO business caring for 120K+ lives (expected to close in Q4’25; $100M upfront, up to $13M earnout), with positive Adjusted EBITDA contribution in 2026; pro forma cash ~$409.9M, no debt .

What Went Well and What Went Wrong

What Went Well

  • Strong value-based care results: MSSP shared savings totaled $234.1M (+32.6% YoY), with an 11% savings rate in a large Mid-Atlantic ACO; management highlighted operational execution and margin leverage: “Adjusted EBITDA increased 61.6%… expanding 720 bps to 30.5%” .
  • Growth and scalability: Implemented providers grew 13.1% YoY to 5,250; attributed lives rose 12.8% to 1.406M; practice collections climbed 27.1% to $940.4M, underscoring broad-based momentum .
  • Confidence and guidance: “This outstanding performance gives us confidence to raise our 2025 outlook above the high end of our previous ranges” (CEO); pro forma cash ~$409.9M and no debt provide flexibility for BD/M&A .

What Went Wrong

  • Capitated revenue timing: Management noted Q3 likely represents a high mark for capitation due to favorable timing/retro adjustments; they do not expect the exact trend to continue in Q4 .
  • Conservative posture for Q4: The team refrained from quarterly guidance and implied conservatism (including variable comp accruals) despite strong YTD results, preferring to focus on annual performance .
  • Elevated utilization persists: Ambulatory utilization remains elevated across payer classes; while positive for FFS, it requires careful planning in value-based contracts amid MA headwinds .

Financial Results

P&L and EPS (GAAP and Adjusted)

MetricQ3 2024Q1 2025Q2 2025Q3 2025
Revenue ($USD Millions)$437.9 $480.1 $521.2 $580.4
Gross Profit ($USD Millions)$99.9 $103.6 $112.8 $122.6
Operating Income ($USD Millions)$5.8 $5.2 $3.3 $14.4
Net Income ($USD Millions)$3.5 $4.2 $2.7 $6.9
Diluted EPS (GAAP, $)$0.03 $0.03 $0.02 $0.05
Adjusted Net Income per Share (Diluted, $)$0.20 $0.22 $0.24 $0.29

Notes: Adjusted metrics reconciled in press release tables .

Estimates vs Actual (Q3 2025)

MetricConsensusActualSurprise
Revenue ($USD Millions)$495.9*$580.4 +$84.5; Beat
EPS Normalized ($)$0.217*$0.29 +$0.073; Beat

Values retrieved from S&P Global*.

Revenue by Source

Revenue Source ($USD Thousands)Q3 2024Q2 2025Q3 2025
FFS - Patient Care$283,278 $331,464 $352,604
FFS - Administrative Services$30,697 $35,116 $33,616
Capitated Revenue$53,393 $75,511 $90,906
Shared Savings$47,438 $60,021 $79,994
Care Management Fees (PMPM)$21,060 $16,919 $20,992
Other Revenue$2,055 $2,122 $2,307
Total Revenue$437,921 $521,153 $580,419

KPIs and Non-GAAP Operating Metrics

KPI / MetricQ3 2024Q2 2025Q3 2025
Implemented Providers (Count)4,642 5,125 5,250
Attributed Lives (Count)1,247,000 1,382,000 1,406,000
Practice Collections ($USD Millions)$739.9 $862.9 $940.4
Care Margin ($USD Thousands)$101,420 $115,161 $125,210
Platform Contribution ($USD Thousands)$50,257 $57,466 $70,555
Platform Contribution Margin (%)49.6% 49.9% 56.3%
Adjusted EBITDA ($USD Thousands)$23,624 $28,992 $38,187
Adjusted EBITDA Margin (%)23.3% 25.2% 30.5%

Guidance Changes

MetricPeriodPrevious Guidance (Initial 2/27/25)Current Guidance (11/6/25)Change
Implemented ProvidersFY 20255,200 – 5,300 5,300 – 5,350 Raised
Attributed LivesFY 20251,300,000 – 1,400,000 1,400,000 – 1,425,000 Raised
Practice Collections ($USD Millions)FY 2025$3,150 – $3,250 $3,450 – $3,500 Raised
GAAP Revenue ($USD Millions)FY 2025$1,800 – $1,900 $2,050 – $2,100 Raised
Care Margin ($USD Millions)FY 2025$435 – $445 $455 – $460 Raised
Platform Contribution ($USD Millions)FY 2025$208 – $218 $230 – $235 Raised
Adjusted EBITDA ($USD Millions)FY 2025$105 – $110 $118 – $121 Raised

Notes: Guidance excludes impact from pending ACO acquisition; >80% FY25 Adjusted EBITDA expected to convert to free cash flow .

Earnings Call Themes & Trends

TopicQ1 2025 (Previous Mentions)Q2 2025 (Previous Mentions)Q3 2025 (Current)Trend
Value-Based Care (MSSP)Guidance assumed minimal YoY increase in shared savings accruals given environment Guidance raised above high end for several metrics; continued strength $234.1M shared savings (+32.6% YoY); 11% savings rate in large ACO; guidance raised across metrics Improving performance
MA Capitation Strategy——Small cap book (20–22K lives); Q3 likely high mark due to timing; maintain cautious approach; prefer shared risk models Prudent, cautious
New Markets & M&AEntered Arizona (IMS, $95M cash), profitable from Q4 Cash $390.1M; no debt; strong BD pipeline Signed ACO business acquisition ($100M + up to $13M earnout); positive 2026 Adjusted EBITDA; pro forma cash ~$409.9M Accelerating footprint
Ambulatory Utilization—Strength in same-store growth Elevated trends likely persist; positive for FFS; plan for VBC Elevated/beneficial
Cash & FCF—≥80% Adjusted EBITDA conversion to FCF; de minimis capex ≥80% FY25 conversion; pro forma cash ≥$410M; no debt Strengthening
Ancillary/Platform Monetization——Building multi-specialty groups; potential expansion in labs, PBM, ASCs, clinical research; scale monetization Expanding initiatives

Management Commentary

  • CEO: “This outstanding performance gives us confidence to raise our 2025 outlook above the high end of our previous ranges.”
  • CFO: “Adjusted EBITDA increased 61.6%… representing 30.5% of care margin… we posted better-than-expected results across our value-based care book, which helped generate significant operating leverage.”
  • CEO on ACO acquisition: “This business will add over 120,000 value-based care attributed lives… expected to positively contribute to adjusted EBITDA in 2026.”
  • CFO on cash: “Pro forma cash at the end of the third quarter was $409.9 million with no debt… we expect to end the year with at least $410 million in cash.”

Q&A Highlights

  • MSSP guidance mechanics: Management will factor actual outperformance and updated program data into forward guidance, consistent with past practice .
  • FFS and collections per provider: Broad-based drivers include utilization strength, ahead-of-accrual value-based results, and ramp in new markets (e.g., Arizona, Indiana) .
  • Capitation: Small MA cap book with favorable retro/data timing in Q3; likely the quarterly high; continued prudence given V28/star/utilization pressures .
  • Growth algorithm & M&A: Maintain cadence of 1–2 full-model new markets annually; ACO acquisition adds states with lighter model; disciplined on price; leverage cash position to pursue opportunities .
  • Payer relationships: Broad, state-level contracting with value-based elements across commercial/MA/Medicaid; strong performance supports expanding VBC constructs .
  • Variable comp: Bonus accruals fully reflected; expect increased Q1 cash outflows aligned with outperformance .

Estimates Context

  • Q3 2025: Revenue $580.4M vs consensus $495.9M; EPS Normalized $0.29 vs consensus $0.217 → both beats*.
  • Q4 2025: Street sees normalized EPS ~$0.195 and revenue ~$514.1M*; management remains conservative intra-quarter and does not provide quarterly guidance .
  • FY 2025: Consensus revenue ~$2.0898B vs company guidance $2.05–$2.10B; consensus EBITDA ~$119.8M vs guidance $118–$121M → aligned with raised guidance*.
    Values retrieved from S&P Global*.

Key Takeaways for Investors

  • The quarter delivered broad-based upside in revenue and normalized EPS versus Street, driven by MSSP outperformance and utilization, with strong operating leverage to Adjusted EBITDA .
  • Guidance was raised across all operating/financial metrics; Street FY25 revenue/EBITDA align with updated ranges, reducing estimate-risk and supporting narrative momentum .
  • Q3 capitation strength included favorable timing; expect normalization in Q4, but underlying FFS/utilization and VBC performance remain supportive .
  • Balance sheet flexibility (≥$410M cash, no debt pro forma) plus pending ACO transaction expand attributed lives and future synergy/scale opportunities .
  • Watch the integration and cross-sell of ACO providers into full Privia medical groups and ancillary monetization (labs/ASCs/PBM) to sustain contribution margins .
  • Near-term trading: narrative favors companies with proven VBC execution, cash generation, and raised guidance; monitor Q4 cadence and any MSSP/MA updates that could influence estimates .
  • Medium-term thesis: diversified payer mix, scalable provider platform, disciplined BD/M&A, and high FCF conversion underpin sustained adjusted EBITDA growth and strategic optionality .