Privia Health Group (NASDAQ:PRVA) executives said the company delivered what they described as a “very strong” 2025, driven by continued provider growth, expanding value-based attributed lives, and operating leverage that lifted profitability and free cash flow generation. Management also issued 2026 guidance calling for continued Adjusted EBITDA growth and said the company expects to become a full cash taxpayer in 2026, impacting free cash flow conversion.
2025 operational growth and value-based scale
Chief Executive Officer Parth Mehrotra said Privia continued to grow across markets while executing its strategy around value-based care. The company added 591 providers in 2025, representing 12.3% year-over-year growth, and ended the year with 5,380 implemented providers caring for more than 5.8 million patients.
Mehrotra also emphasized high reported gross provider retention of 98% and a patient Net Promoter Score of 87 across the company’s footprint.
Acquisitions and new market entry
Mehrotra said Privia expanded its national footprint to 24 states and the District of Columbia, including the contribution from an acquisition completed late in the year. On December 5, Privia closed its acquisition of Evolent Health’s ACO business, which added more than 120,000 value-based attributed lives across existing and new states.
Separately, Privia entered Arizona in April with anchor partner IMS. Mehrotra said IMS was implemented on the Privia platform at the end of the third quarter and that the company is seeing “strong sales momentum” in the state. In response to analyst questions, management characterized Arizona as an attractive market given population growth, Medicare Advantage dynamics, and opportunities with independent providers, while stressing that building density is a multi-year effort.
Financial results: Q4 and full-year 2025
Chief Financial Officer David Mountcastle said operational momentum continued through the fourth quarter. Implemented providers increased by 130 sequentially from the third quarter to 5,380 at year-end. Practice collections rose 9.6% year over year in Q4 to $868.7 million, which Mountcastle attributed to implemented provider growth, solid value-based performance, and ambulatory utilization trends.
Adjusted EBITDA in Q4 increased 26.4% over the prior-year quarter to $31.5 million, representing 27% of Care Margin, which Mountcastle said was a 390-basis-point margin improvement year over year.
For full-year 2025, Mountcastle said the company exceeded the high end of the updated guidance it provided in November for key operating and financial metrics. Practice collections increased 16.9% to $3.47 billion, Care Margin grew 14.4%, and Adjusted EBITDA climbed 38.8% to $125.5 million. Mehrotra added that EBITDA margin as a percentage of Care Margin expanded 480 basis points to 27.2% for the year.
Management also highlighted cash generation. Mehrotra said Privia converted 130% of EBITDA to free cash flow in 2025. The company deployed $180 million for the Evolent ACO acquisition and the Arizona entry and ended 2025 with about $480 million in cash, which executives said was only $11 million below the prior year’s level due to strong cash flow.
2026 guidance and key moving pieces
Mountcastle outlined 2026 guidance using midpoint assumptions:
- Implemented providers expected to grow 10.6% year over year to 5,950 by year-end
- Attributed lives expected to be approximately 1.58 million
- Practice collections expected to grow 6.6%
- Care Margin expected to grow 13%
- Adjusted EBITDA expected to grow 19.5% to a midpoint of $150 million
On free cash flow, Mountcastle said Privia expects about 80% of 2026 Adjusted EBITDA to convert to free cash flow as the company becomes a full cash taxpayer in 2026. Mehrotra and Mountcastle both said Privia expects to end 2026 with approximately $600 million in cash, assuming no additional capital deployment for new business development.
Executives addressed questions about why practice collections growth is expected to moderate in 2026. Mehrotra pointed to several year-over-year factors, including prior-period true-ups recognized in 2025 and a rise in capitated revenue of close to $100 million in 2025 that management said it is not assuming will repeat in 2026. He also said Care Margin is the company’s key focus for comparing performance over time.
Strategy updates: AI, utilization, contracting, and capital deployment
Mehrotra described AI as a multi-year opportunity and said Privia is positioned to benefit given what he described as a data-rich environment across clinical records, claims, and patient interactions. He outlined several areas of focus, including corporate functions (noting Privia is on Google Cloud and Google Workspace and is implementing Gemini in a HIPAA-compliant manner), physician practice workflows across fee-for-service and value-based care, patient engagement, and care delivery productivity. He also referenced Privia’s prior investment in Navina for clinical decision support and documentation support.
On utilization, Mehrotra said ambulatory utilization remains elevated post-COVID and that the company expects it to stay elevated, characterizing ambulatory care as a lower-cost setting. He also said Privia expects churn tied to ACA and Medicaid dynamics, but argued the company’s diversification across lines of business and relatively smaller exposure to Medicaid and exchange populations positions it well.
Regarding Medicare Advantage contracting, Mehrotra said the environment is nuanced and geography- and payer-specific, emphasizing the importance of shared risk structures and adequate compensation for physicians. He said Privia remains forward-leaning on risk when contracts appropriately compensate the company and physicians.
On capital deployment, Mehrotra said the company’s priority is to continue deploying capital to compound growth, citing opportunities to acquire assets across the ecosystem, while maintaining a “rainy day” cash balance and avoiding leverage given potential variability in shared savings. He added that returning capital remains an option if the stock deviates meaningfully from what management views as intrinsic value, but reiterated that the primary focus is continued investment and disciplined M&A.
About Privia Health Group (NASDAQ:PRVA)
Privia Health Group (NASDAQ: PRVA) is a physician enablement company that partners with independent physicians, medical groups and health systems to transform the delivery of patient care. Through a clinically integrated network and a proprietary technology platform, the company supports providers in managing population health, delivering coordinated care and optimizing financial performance under both fee-for-service and value-based reimbursement models.
Founded in 2016 and headquartered in McLean, Virginia, Privia Health has rapidly expanded its footprint to serve multiple metropolitan markets across the United States.
