TruBridge (NASDAQ:TBRG) executives highlighted modest revenue growth expectations for 2026, continued margin expansion, and ongoing efforts to strengthen financial reporting during the company’s full-year and fourth-quarter earnings call. Management also discussed a strategic review process and described product, operational, and artificial intelligence initiatives aimed at improving performance and customer outcomes.
10-K filing, audit adjustments, and strategic review
President and CEO Chris Fowler opened the call by noting the company filed its Form 10-K with the SEC “in compliance with the extension period” after identifying “certain out-of-period adjustments during final audit procedures with our new external auditor.” Fowler said the adjustments were “primarily related to revenue recognition and related costs, capitalized software development costs, and non-routine transactions,” emphasizing they were “non-cash and not material” to fiscal 2025 financial statements or previously issued financials.
Fowler also said the company has been engaged in “a strategic review process considering a range of alternatives to maximize shareholder value.” As a result, TruBridge is not issuing formal guidance, though Fowler said the company expects “modest revenue growth in 2026” and “approximately 200 basis points of improvement in Adjusted EBITDA margins.” In the Q&A, Fowler told BMO Capital’s Sean Dodge that the company does not have a timeline for completing the review, adding the board is focused on “getting to the right outcome” rather than meeting a deadline.
Quarterly and full-year results: revenue steady, EBITDA and cash flow higher
For the fourth quarter, TruBridge reported total revenue of $87.2 million, which Fowler said was in line with the midpoint of revised guidance provided previously. Adjusted EBITDA was $19.2 million, at the high end of guidance, and Fowler said it represented “a slight expansion in margins compared to the prior year.”
Bassi said fourth-quarter revenue declined about 1% year-over-year, noting the comparison included approximately $1 million from the sunset of the Centriq product in the Patient Care business; normalizing for Centriq, he said revenue would have been “roughly flat” year-over-year. Fourth-quarter gross margin was 53%, flat versus the prior year and up 120 basis points sequentially. Adjusted EBITDA margin expanded to 22% from 20.4% in the fourth quarter of 2024, according to Bassi.
For the full year 2025, Fowler said total revenue was $346.8 million, up 1.4% versus 2024, and Adjusted EBITDA was $68.7 million, up 23% year-over-year. Free cash flow totaled $20 million for the year, up $5 million from 2024. Bassi said cash flow from operations was $37 million, up 19% year-over-year, driven by stronger profitability, working capital management, and expense discipline.
Segment performance: Financial Health growth led by Encoder; Patient Care impacted by Centriq sunset
Bassi said fourth-quarter Financial Health revenue totaled $56.2 million, about 65% of company revenue, representing 2% year-over-year growth “primarily due to strong growth in the Encoder business.” Patient Care revenue was $31.0 million, down 6.6% year-over-year, “primarily due to the sunset of the Centriq product.” Financial Health gross margin improved to 50%, up 65 basis points versus the prior period, which Bassi attributed to the offshore transition, labor efficiencies, and process improvements. Patient Care gross margin was 59%, down 75 basis points year-over-year due to revenue mix and timing.
On a full-year basis, Bassi said Financial Health revenue was $221.7 million, up 2% year-over-year, with growth in CBO and Encoder partially offset by client attrition and slower growth in other products. Patient Care revenue was $125.2 million, roughly flat year-over-year; excluding Centriq, he said Patient Care revenue growth would have been about 4%, driven by SaaS bookings and new customer implementations.
Bookings, pipeline, and implementation timing
TruBridge reported fourth-quarter bookings of $19.8 million on a total contract value (TCV) basis, compared to $15.5 million sequentially and $14.3 million a year ago, Fowler said. Bassi said fourth-quarter TCV bookings were up $6 million year-over-year and up $4 million sequentially, while total 2025 bookings were $82.9 million on a TCV basis, up 1% versus the prior year. On an annual contract value (ACV) basis, Bassi said total bookings were $70.9 million for 2025.
Fowler attributed bookings support in the quarter to growing SaaS, strategic partners including Microsoft, the company’s “exclusive Dragon Copilot integration with TruBridge EHR,” and demand for its revenue cycle technology and services platform.
Management also pointed to an improving sales pipeline. Fowler said the dollar value of the overall sales pipeline is the highest in nine quarters and has increased 53% since the beginning of the third quarter. He said opportunities greater than 100 beds rose to about 30% of the pipeline versus 14% earlier last year, and recurring deals represent more than 70% of the pipeline compared to about 57% last summer. Fowler also said the encoder pipeline grew 74% during the period, driven by new business and channel partners.
In response to Deutsche Bank’s Maxine Juvelier on conversion timing, Fowler said there were “no capacity constraints,” but noted TruBridge is “a little bit at the mercy of the customer for the timing,” citing factors such as existing technology contract terms and facility-level onboarding/off-boarding dynamics for services.
Retention headwinds, margin drivers, AI initiatives, and balance sheet updates
Fowler said customer retention in CBO was pressured as the company worked through its global workforce transition, with onshore and offshore teams learning to operate together. He said TruBridge implemented a more structured transition model earlier last year, with stronger oversight and deeper customer collaboration, and said the company is seeing early progress. He also noted the opening of a new Global Capacity Center in Chennai as a milestone for its cross-shore delivery model.
On profitability, Bassi said Adjusted EBITDA margins expanded 350 basis points in 2025, driven by cost optimization and disciplined expense management across IT, cloud operations, vendor optimization, and patient care support. Over the last two years, he said margins expanded by more than 650 basis points, citing the global workforce transition and targeted cost actions. Looking ahead, management reiterated an expectation of about 200 basis points of Adjusted EBITDA margin expansion in 2026, though without formal guidance due to the strategic review. Bassi told RBC Capital Markets’ Ryan Halsted the margin expansion is expected to come from “a variety of factors,” including the offshore transition, cost optimization, and revenue mix. In a follow-up with Deutsche Bank, Bassi also said mix could help as higher-margin technology solutions like Encoder grow.
Fowler discussed an AI strategy across four pillars: financial health, patient care, customer service, and internal development. In Financial Health, he said the company is piloting a homegrown solution to predict claims denials earlier, using data such as remittance information and claim status transactions. He told Cantor Fitzgerald’s Sarah James the initiative is in “the very early innings,” with model training underway and no KPIs yet. Fowler said the target is to improve performance in the portion of claims that are denied, describing an opportunity to improve “15%” of claims after edits, while reducing the time-consuming follow-up work involved in resubmissions and payer calls.
In Patient Care, Fowler said TruBridge is leveraging ambient technology through partnerships with Microsoft and noted a pilot at a regional hospital where providers are spending more time with patients and less time documenting. He referenced a customer example cited in a recent press release, stating it generated “50%-75% less time documenting” for providers. In customer service, Fowler said an internal AI-driven support bot has improved support consistency and turnaround time, and the company is developing a customer-facing version while maintaining live support. He also said the company is leveraging AI tools for development to modernize its technology stack and improve delivery speed, implementations, and margins.
On the balance sheet, Bassi said the company ended the quarter with $24.9 million in cash, more than double the $12.3 million at the end of 2024. Net debt was reduced to approximately $139.8 million, and net leverage improved to 2x. Fowler also referenced a net leverage ratio of approximately 2x and a strong cash position.
Bassi said TruBridge lowered net debt by approximately $19.5 million year-to-date and highlighted a new amended and restated credit agreement entered in November 2025. He said the agreement extends maturity to 2030 and provides up to $250 million in credit facilities.
In additional partnership commentary, Fowler told Freedom Capital Markets’ Gene Mannheimer that the company does not expect a “meaningful impact” in 2026 from its partnership with RevSpring, but anticipates traction in the back half of the year and into 2027 as TruBridge pursues a “best-in-class patient collections initiative,” combining call center services with RevSpring’s digital bill-pay experience. Bassi added the company expects cost benefits from the digital component as the partnership becomes more strategic.
Fowler closed by saying the company is seeing positive progress, believes it is on the right trajectory, and will continue evaluating strategies to drive shareholder value.
About TruBridge (NASDAQ:TBRG)
TruBridge, Inc is a technology solutions provider specializing in digital transformation and managed services for enterprise clients. The company focuses on helping organizations modernize and optimize their IT environments by leveraging cloud technologies, collaboration platforms, and security solutions. TruBridge’s core business activities include consulting, implementation, migration, training and ongoing support for Microsoft 365, Azure and related cloud services.
TruBridge offers a comprehensive suite of services designed to guide clients through every stage of their cloud adoption journey.
