Healthcare solutions company Evolent Health (NYSE: EVH) missed Wall Street’s revenue expectations in Q1 CY2026 as sales rose 2.6% year on year to $496.2 million. On the other hand, the company’s outlook for the full year was close to analysts’ estimates with revenue guided to $2.5 billion at the midpoint. Its non-GAAP loss of $0.02 per share was $0.03 above analysts’ consensus estimates.
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Evolent Health (EVH) Q1 CY2026 Highlights:
- Revenue: $496.2 million vs analyst estimates of $532.9 million (2.6% year-on-year growth, 6.9% miss)
- Adjusted EPS: -$0.02 vs analyst estimates of -$0.05 ($0.03 beat)
- Adjusted EBITDA: $22.07 million vs analyst estimates of $18.55 million (4.4% margin, 19% beat)
- The company reconfirmed its revenue guidance for the full year of $2.5 billion at the midpoint
- EBITDA guidance for the full year is $125 million at the midpoint, above analyst estimates of $122.8 million
- Operating Margin: -2.1%, down from -0.3% in the same quarter last year
- Free Cash Flow was -$7.39 million compared to -$4.03 million in the same quarter last year
- Sales Volumes fell 1.3% year on year (6.6% in the same quarter last year)
- Market Capitalization: $436.7 million
Seth Blackley, Co-Founder and Chief Executive Officer of Evolent stated, "I am happy with the strong start to the year. We are on track with our plan and have had successful, on-time oncology launches at both Highmark and Aetna. As we look into 2027 and beyond, we remain focused on both extending our market leadership in oncology and addressing the big opportunity we have with AI, all while fulfilling our commitments to shareholders, employees and customers."
Company Overview
Founded in 2011 to transform how healthcare is delivered to patients with complex needs, Evolent Health (NYSE: EVH) provides specialty care management services and technology solutions that help health plans and providers deliver better care for patients with complex conditions.
Revenue Growth
A company’s long-term performance is an indicator of its overall quality. Even a bad business can shine for one or two quarters, but a top-tier one grows for years. Thankfully, Evolent Health’s 15.5% annualized revenue growth over the last five years was solid. Its growth beat the average healthcare company and shows its offerings resonate with customers.
Long-term growth is the most important, but within healthcare, a half-decade historical view may miss new innovations or demand cycles. Evolent Health’s recent performance marks a sharp pivot from its five-year trend as its revenue has shown annualized declines of 6.8% over the last two years. 
Evolent Health also reports its number of average lives on platform, which reached 76.1 million in the latest quarter. Over the last two years, Evolent Health’s average lives on platform averaged 4.1% year-on-year growth. Because this number is better than its revenue growth, we can see the company’s average selling price decreased. 
This quarter, Evolent Health’s revenue grew by 2.6% year on year to $496.2 million, falling short of Wall Street’s estimates.
Looking ahead, sell-side analysts expect revenue to grow 41.6% over the next 12 months, an improvement versus the last two years. This projection is eye-popping and suggests its newer products and services will fuel better top-line performance.
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Adjusted Operating Margin
Evolent Health’s adjusted operating margin has generally stayed the same over the last 12 months, averaging 5% over the last five years. This profitability was paltry for a healthcare business and caused by its suboptimal cost structure.
Looking at the trend in its profitability, Evolent Health’s adjusted operating margin of 4.5% for the trailing 12 months may be around the same as five years ago, but it has decreased by 2.6 percentage points over the last two years. This dynamic unfolded because it failed to adjust its fixed costs while demand fell.
This quarter, Evolent Health’s breakeven margin was 0%, down 5.4 percentage points year on year. This contraction shows it was less efficient because its expenses grew faster than its revenue.
Earnings Per Share
We track the long-term change in earnings per share (EPS) for the same reason as long-term revenue growth. Compared to revenue, however, EPS highlights whether a company’s growth is profitable.
Evolent Health’s full-year EPS flipped from negative to positive over the last five years. This is encouraging and shows it’s at a critical moment in its life.
In Q1, Evolent Health reported adjusted EPS of negative $0.02, down from $0.06 in the same quarter last year. Despite falling year on year, this print easily cleared analysts’ estimates. Over the next 12 months, Wall Street expects Evolent Health’s full-year EPS of $0.01 to grow 2,861%.
Key Takeaways from Evolent Health’s Q1 Results
It was good to see Evolent Health beat analysts’ EPS expectations this quarter. We were also glad its full-year EBITDA guidance exceeded Wall Street’s estimates. On the other hand, its revenue missed. Zooming out, we think this was a mixed quarter. The stock traded up 5.1% to $4.02 immediately following the results.
So do we think Evolent Health is an attractive buy at the current price? When making that decision, it’s important to consider its valuation, business qualities, as well as what has happened in the latest quarter. We cover that in our actionable full research report which you can read here (it’s free).
