Summary of Waystar Holding Conference Call Company Overview - **Company**: Waystar Holding (NasdaqGS: WAY) - **Industry**: Healthcare Revenue Cycle Management - **CEO**: Matt Hawkins - **Conference Date**: September 10, 2025 Key Points Company Background - Waystar was formed in 2017 by merging two revenue cycle technology businesses, Zirmed and Navicure, to create a cloud-native software platform [7][8] - The company focuses on helping healthcare providers get paid faster and more accurately from various insurance companies and patients [8] Market Opportunity - The U.S. healthcare administrative sector experiences approximately **$450 billion** in annual waste due to inefficiencies and denied claims [13] - There are **450 million** denied claims each year, with a **17%** denial rate for initial claims submitted by providers [17] - Waystar targets a **$15 billion** market for replacing legacy software and a **$100 billion** market for manual services in healthcare [33] Product and Technology - Waystar's software utilizes a cloud-based rules engine and AI capabilities to improve claim acceptance rates, achieving nearly **99%** first-pass acceptance across its network [17][22] - The company processes over **6 billion** insurance transactions annually, amounting to over **$1 trillion** in gross claim charges [18] - The recent acquisition of Iodine Software aims to enhance Waystar's capabilities in structuring clinical data and improving claim accuracy [49][58] Competitive Landscape - Waystar differentiates itself as a cloud-native platform using AI, with a strong focus on both ambulatory and hospital settings [46] - Major competitors include Change Healthcare, TriZetto, and Availity, with Waystar achieving an **80%** win rate against these competitors [46] Financial Performance - Waystar has experienced five consecutive quarters of double-digit revenue growth, exceeding its long-term growth rate of **10%** [30][34] - The company maintains a gross revenue retention rate of **97%** and a net revenue retention rate of **108% to 110%** [34] Future Outlook - The company is focused on the successful integration of the Iodine acquisition and leveraging combined data sets to enhance AI capabilities [75] - Waystar aims to continue delighting clients and expanding its market share in the healthcare revenue cycle management space [75] Risks and Considerations - The healthcare industry is characterized by risk aversion among decision-makers due to the potential impact on patient care and cash flow [41] - Waystar's growth may be influenced by external factors such as patient visit volumes and the overall healthcare utilization trends, which are currently seeing a **4%** annual increase [73] Conclusion - Waystar is well-positioned to capitalize on the inefficiencies in the healthcare revenue cycle management market through its innovative cloud-based solutions and AI capabilities, with a strong focus on client satisfaction and market expansion [75]

Core Insights - Waystar reported strong Q2 2025 earnings, with GAAP revenue of $270.7 million, exceeding estimates by $11.17 million, and non-GAAP EPS of $0.36, above the expected $0.34 [1][5][13] - The company raised its full-year 2025 guidance, indicating robust demand and rapid client onboarding, while maintaining high adjusted EBITDA margins of 41.6% [1][13] Financial Performance - Q2 2025 revenue increased by 15.4% year-over-year, driven by strong demand for provider solutions and AI-powered features [2][5] - Non-GAAP EPS rose by 38.5% from $0.26 in Q2 2024 to $0.36 in Q2 2025 [2][6] - Adjusted EBITDA reached $112.6 million, a 19.9% increase from $93.9 million in Q2 2024 [2][6] - Unlevered free cash flow surged by 120.1% to $110.8 million compared to $50.3 million in Q2 2024 [2][6] Business Overview - Waystar specializes in cloud-based healthcare payment technology, processing over six billion transactions annually [3] - The company aims to enhance AI integration in revenue cycle management and deepen relationships with major hospital systems [4] Strategic Initiatives - The company is focused on rapid client onboarding and expanding its capabilities through partnerships and acquisitions [4][10] - Waystar's AltitudeAI software has improved appeal productivity by 70% and helped prevent nearly $6 billion in denied claims [8][12] Client and Revenue Dynamics - Three large clients were onboarded faster than expected, contributing to immediate and future subscription revenue [7] - Provider solutions account for about 70% of total revenue, with subscription revenue reaching $131.1 million [6][11] Future Outlook - Waystar raised its full-year 2025 revenue guidance to $1.03 billion to $1.04 billion, with adjusted EBITDA guidance of $418 million to $426 million [13] - The company anticipates revenue in the second half of 2025 to be lower than the first half due to seasonality and patient payment trends [14]

Investment Rating - The report maintains a "Buy" rating for OneStream (OS), Vertex (VERX), and Waystar (WAY) based on increasing conviction following Q1 results and recent events [5][6][13]. Core Insights - The median stock in the SMID-cap software coverage is down approximately 15% year-to-date, contrasting with the S&P 500's decline of about 1%. Despite this, Q1 results were generally better than feared, with no companies lowering the high-end of their FY revenue guidance [17][19]. - The report emphasizes that management messaging has become crucial for share performance, with companies that provided clear guidance being rewarded, while those with less clarity faced negative reactions [37][39]. Key Themes Emerging from Q1 Results 1. Revenue performance was better than expected, with median revenue coming in about 1% ahead of consensus expectations [18][22]. 2. Profitability margins exceeded consensus by approximately 1.3%, although full-year outlooks remained largely unchanged [27][29]. 3. Management commentary was critical, influencing share performance more than formal guidance in some cases [37][38]. 4. Buyer behavior remained stable despite macro uncertainty, with some companies emphasizing faster time-to-value to address budget scrutiny [42][44]. 5. AI strategies are gaining focus, with companies beginning to discuss their AI roadmaps more deliberately [45][46]. Sub-Sector Takeaways - **Vertical Software**: Stocks are down about 10% year-to-date but have shown resilience with a median revenue and profitability performance coming in 2% and 9% ahead of consensus expectations, respectively [49][51]. - **Back Office Software**: Stocks are down approximately 10% year-to-date but have improved by about 16% since Q1 results, with median revenue and profitability also exceeding expectations [52][53]. - **Front Office Software**: Stocks have seen a significant decline of around 29% year-to-date, but median revenue and profitability were 1% and 6% ahead of guidance, respectively [54][56].