Waystar Holding Corp.

Q2 revenue was $320 million, up 18% year over year. Adjusted EBITDA was $137 million, up 21.5% year over year, with a 43% margin. Organic revenue grew 7% year over year, or about 10% normalized for previously discussed comparability items; subscription revenue was $176 million, up 34%, and volume-based revenue was $142 million, up 3%. Unlevered free cash flow was $64 million, and the company converted 47% of adjusted EBITDA to unlevered free cash flow. Cash, equivalents, and short-term investments were $192 million, gross debt was $1.5 billion, and net leverage was 2.5x. For 2026, Waystar raised revenue guidance to $1.276 billion-$1.294 billion and adjusted EBITDA guidance to $535 million-$545 million.

Matt Hawkins said the quarter reflected “solid” execution, healthy demand, and continued progress toward a more autonomous revenue cycle. He highlighted platform consolidation, larger enterprise wins, cross-sell of Iodine, and AI-powered solutions as the main growth drivers, saying Waystar sits at the center of the healthcare payment ecosystem and can improve outcomes across the full payment life cycle. His tone was confident and strategic, with repeated emphasis that AI is already embedded, monetized, and central to the company’s long-term vision.

Steve Oreskovich focused on the numbers and capital discipline. He reiterated the quarter’s 18% revenue growth to $320 million, 43% adjusted EBITDA margin, $64 million of unlevered free cash flow, and 47% conversion, noting tax timing affected cash flow. He also pointed to $192 million of cash and investments, $1.5 billion of gross debt, $13 million of buybacks at an average $19.24 per share, and net leverage improving to 2.5x from 2.7x last quarter. On spending, he said capitalized software development was up meaningfully as Waystar invests in AI platform capabilities and that this higher spend should continue through the rest of 2026, while still supporting strong margins and cash generation.

Analysts pressed on transaction volume trends, NRR, AI-related bookings, capitalized software spend, and whether large health systems may favor EHR vendors or internal AI tools. Management said utilization is back to the long-term 1% to 2% range, volume-based revenue was up 3% in Q2 but about 8% on a normalized basis, and NRR at 108% remains healthy within the historical 108% to 110% range. They also said AI-enabled solutions were about 40% of bookings again this quarter, and that larger deals often take 6 to 18 months to close and then take time to implement.