Computer Programs and Systems, Inc.

TruBridge reported Q4 2025 revenue of $87.2 million, down approximately 1% year over year, and adjusted EBITDA of $19.2 million, with margin rising from 20.4% to 22% year over year. Full-year 2025 revenue was $346.8 million, up 1.4% versus 2024, and adjusted EBITDA was $68.7 million, up 23% year over year with 350 basis points of margin expansion. Full-year cash from operations was $37 million, up 19%, free cash flow was $20 million, up about $5 million, and year-end cash was $24.9 million with net debt at approximately $139.8 million and net leverage at 2x. The company said it is not giving formal guidance due to the strategic review, but it expects modest revenue growth in 2026 and about 200 basis points of adjusted EBITDA margin expansion.

Chris Fowler framed 2025 as a year of operational improvement, saying the business is on the right trajectory despite the delay in filing the 10-K and the ongoing strategic review. He emphasized several growth levers: a stronger pipeline, improved deal quality, a new global delivery center in Chennai, and a broader AI strategy across financial health, patient care, customer service, and internal development. His tone was cautiously optimistic; he repeatedly said progress is real but that the company is still a quarter or two away from more consistent quarterly performance.

Vinay Bassi focused on margin, cash flow, and balance sheet progress. He highlighted Q4 gross margin of 53% flat year over year and up 120 basis points sequentially, Financial Health gross margin of 50% up 65 basis points, and Patient Care gross margin of 59%. He also noted 2025 adjusted EBITDA margin expansion of 350 basis points, cash from operations of $37 million, free cash flow of $20 million, net debt reduction of about $19.5 million, and a new $250 million credit facility that matures in 2030. He said 2026 should still deliver modest revenue growth and about 200 basis points of EBITDA margin expansion, driven by offshore transition, cost optimization, and mix improvement.

Analysts focused on how to interpret the new ACV bookings metric, and management said the right way is to think about recurring revenue plus bookings conversion and attrition. Questions also centered on retention and the swing in bookings; Fowler said 2025 attrition in CBO/RCM remains a headwind into 2026, though the retention process is improving. On pipeline conversion, he said there are no capacity constraints and that timing depends heavily on customer contract cycles and onboarding dynamics. Analysts also pressed on the strategic review timeline, and Fowler said there is no set deadline and the Board is prioritizing shareholder value over speed.