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Alignment Healthcare
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Latest analysis
Updated Oct 29, 2026
Alignment Healthcare cuts 2026 EBITDA guidance to $100M floor as claims system migration triggers provider appeal surge and elevated SNF/catastrophic costs.
A mid-year migration to the Facets claims adjudication platform created processing volatility that enabled a notable surge in provider-led appeals and disputes, driving Q3 2026 adjusted MBR to 89.5% — 240 basis points above the prior-year quarter. Management has lowered full-year 2026 adjusted EBITDA guidance to no less than $100 million and adjusted gross profit to no less than $575 million, with Q4 guidance embedding peak-rate appeals continuation and zero credit for in-flight payment integrity initiatives. Despite the cost pressures, membership grew 31% year-over-year to 301,200, and management expressed confidence in 20%-plus top-line growth for 2027 based on early AEP indications and recalibrated product-market bids.
Tone: defensiveRevenue
$3.9B
ALHC 10-K · FY 2025
Employees
1,849
Revenue FY2024
$2.7B
Founded
2013
Profile
ALHC 10-K Item 1 · Feb 27, 2026Alignment Healthcare is a Medicare Advantage plan operator focused exclusively on seniors, combining a proprietary technology platform (AVA) with employed clinical teams to manage care proactively and reduce medical costs. The company acts as both payor and active care manager, taking capitated per-member-per-month payments from CMS and reinvesting medical cost savings into richer member benefits. As of December 31, 2025, it served 236,300 members across 45 markets in five states.
Read filing description ↓ Collapse description ↑
Alignment is a next generation, consumer-centric and clinically focused platform designed to improve the healthcare experience for seniors enrolled in Medicare who choose a private Medicare Advantage plan. Our goal is to provide seniors with easier access to care, better coordination among providers, fewer gaps in care and avoidable hospital visits, and support that meets them where they are—at home, online, or in their community. We deliver this experience through our wide variety of Medicare Advantage plans, which offer varied benefits tailored to the diverse needs, preferences, and lifestyles of seniors. We believe our plans are differentiated because of our unique ability to manage costs by delivering proactive care and manage chronic conditions through an integrated clinical and technology model. Our licensed Medicare Advantage plans contract directly with the Centers for Medicare & Medicaid Services. In exchange for a capitated, fixed monthly payment for each enrolled member (i.e., revenue per member per month or 'PMPM'), we take responsibility for coordinating and managing our members' healthcare—both their health outcomes and the total costs of their care. We have grown Health Plan Membership, which we define as members enrolled in our health maintenance organization ('HMO') and preferred provider organization ('PPO') contracts (the 'Alignment Health Plan'), from approximately 13,000 at inception to 236,300 as of December 31, 2025, representing a 30% compound annual growth rate. For the 2025 plan year, Alignment offered Medicare Advantage plans in 45 markets across California (22 markets), North Carolina (16 markets), Nevada (2 markets), Arizona (3 markets) and Texas (2 markets). These markets collectively include approximately 8.4 million Medicare-eligible seniors.
Primary products
- Medicare Advantage plans (HMO)
- Medicare Advantage plans (PPO)
- Care Anywhere
- AVA proprietary technology platform
End markets
Geographies
Named customers
“We routinely take market share from large established players in highly competitive markets, a key source of our health plan membership growth in excess of the industry average.” Competitive position, as stated in the filing
Revenue commentary · FY 2025
Total revenues grew from approximately $2.70 billion in 2024 to approximately $3.95 billion in 2025, driven primarily by growth in earned premiums as Health Plan Membership expanded to 236,300 members.
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