P3 Health Partners (PIII) Q1 2026 earnings summary

Executive summary

• Q1 2026 marked a significant turnaround with $3.0 million net income, reversing a $44.2 million loss in Q1 2025, and adjusted EBITDA of $25.8 million, reflecting operational improvements, contract restructuring, and structural changes over the past two years.

• Revenue increased 4% year-over-year to $386 million, despite a 10% decline in at-risk membership due to deliberate portfolio actions and network rationalization.

• Deliberate operational and strategic actions, including contract restructuring and operational redesign, have led to sustainable improvements in earnings and business fundamentals.

• Focus remains on expanding medical margin, improving contract economics, and scaling in markets where the model performs best.

Financial highlights

• Q1 2026 revenue was $386 million, up from $373 million year-over-year, with medical margin at $73.7 million and gross profit at $50.4 million.

• Adjusted EBITDA reached $25.8 million, compared to a $22.2 million loss in Q1 2025; underlying adjusted EBITDA was $8 million excluding prior year items.

• Medical loss ratio was 85.2% after adjustments; medical claims expense was $306 million, including $17 million favorable prior year development and payer settlements.

• Medical expense decreased 10% to $336 million, aided by favorable reserve development and a $13.5 million reduction in prior period claims expense.

• Adjusted operating expense was $24.7 million, consistent with the established cost structure.

Outlook and guidance

• Full-year 2026 adjusted EBITDA guidance was raised to a midpoint of $40 million, with a range of $20–$60 million, reflecting Q1 strength and confidence in operating trajectory.

• Full-year revenue guidance is $1.5–$1.65 billion; medical margin guidance is $149–$180 million.

• Outlook incorporates favorable prior year development, payer settlements, and continued execution on cost and quality initiatives.

• Projected at-risk membership for year-end 2026 is 103,000–110,000.

• Management expects continued focus on operational efficiency, medical cost management, and capital structure optimization.