Waystar Holding Corp. Q4 2025 Earnings Call Summary

Core Insights - The company achieved revenue exceeding $1 billion in 2025, driven by 13% organic growth and the strategic acquisition of Iodine Software, which expanded its addressable market into clinical mid-cycle intelligence [1] - Strong Q4 performance was attributed to record bookings and a significant increase in high-value clients, with those spending over $100,000 annually more than doubling since the previous quarter [1] - The platform is positioned as mission-critical infrastructure with a 97% gross revenue retention, emphasizing its integral role in the flow of dollars and denials rather than being a lightweight overlay [1] AI and Data Utilization - The company leveraged a proprietary dataset that encompasses one-third of all U.S. hospital discharges and 7 billion annual transactions to train AI models that general-purpose LLM vendors cannot replicate [1] - Approximately 40% of total revenue is now driven by AI embedded in mission-critical workflows, with 30% of new bookings specifically coming from AI-powered capabilities [1] Financial Performance - The company maintained a 'Rule of 50' profile by pairing 24% total revenue growth with a 42.5% adjusted EBITDA margin, exceeding long-term profitability targets through operational efficiency [1] - A competitive moat is highlighted, built on 100,000 live integrations across the healthcare ecosystem, creating a multisided network that strengthens with every transaction [1]