Financial Data and Key Metrics Changes - In Q4 2025, revenue reached $304 million, growing 24% year-over-year and 12% organically, with full-year revenue increasing 17% to $1.1 billion [21][22] - Adjusted EBITDA for Q4 was $129 million, up 29% year-over-year, with an adjusted EBITDA margin of 42.5%, exceeding the long-term target of 40% [10][24] - Unlevered free cash flow was $80 million in Q4 and $365 million for the full year, converting 79% of adjusted EBITDA to unlevered free cash flow [25] Business Line Data and Key Metrics Changes - Subscription revenue for Q4 was $168 million, increasing 38% year-over-year, while volume-based revenue was $134 million, up 11% year-over-year [23] - For the full year, subscription revenue totaled $558 million, a 22% increase, and volume-based revenue reached $535 million, also up 11% year-over-year [24] Market Data and Key Metrics Changes - Waystar added 85 clients with trailing twelve-month spend above $100,000 in Q4, a 16% year-over-year increase, with a net revenue retention rate of 112% [9][22] - The company processed over 7 billion transactions annually, touching approximately 60% of the U.S. patient population each year [17] Company Strategy and Development Direction - The acquisition of Iodine Software expanded Waystar's addressable market and client base, adding over 1,000 hospitals and health systems [7][11] - Waystar aims to lead in AI-powered revenue cycle automation, with approximately 50% of its solutions leveraging AI [14][20] - The company is focused on delivering a fully autonomous revenue cycle, integrating clinical and financial data to enhance operational efficiency [12][87] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the durability of their business model, expecting normalized organic growth of approximately 10% for 2026 [26] - The company anticipates continued healthy patient utilization and strong demand for its platform, which is expected to insulate it from reimbursement rate pressures [26][66] Other Important Information - The company expects to realize over 90% of committed cost synergies from the Iodine acquisition in fiscal 2026 [11][29] - Waystar's commercial model aligns with consumption, directly matching how value is created in the revenue cycle [15] Q&A Session Summary Question: Customer appetite for AI integration - Management noted that most clients prefer to integrate AI capabilities into their existing systems rather than build their own, highlighting the importance of a trusted partner [41] Question: Incremental revenue opportunities from new AI agents - New AI agents are expected to provide both incremental revenue opportunities and enhance the existing AI offerings, contributing to client retention and value [43][44] Question: Impact of Iodine on margins and cost centers - The increase in G&A, R&D, and SG&A costs is attributed to the full quarter contribution from Iodine, with expectations for continued margin improvement through cost synergies [48][49] Question: AI market growth in healthcare - Management sees significant opportunities in AI within healthcare, emphasizing the need for secure, scalable, and accurate solutions [60][62] Question: Patient healthcare utilization assumptions - The company expects patient utilization to remain healthy, projecting growth above the historical baseline of 1%-2% [66] Question: Trends in patient deductible timelines - Management observed a decrease in patient volumes as patients hit their deductibles, but this was offset by growth in provider solutions [70][71] Question: Competitive landscape and ROI - Management highlighted robust win rates and the importance of a platform approach, which is increasingly preferred by clients over point solutions [83][84]