PaySign Q1 2026 Earnings Call: Complete Transcript

PaySign (NASDAQ:PAYS) held its first-quarter earnings conference call on Tuesday. Below is the complete transcript from the call.

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Summary

PaySign reported a record start to 2026 with a 50.8% increase in revenue to $28 million, surpassing expected guidance.

Net income rose 110% to $5.4 million, and adjusted EBITDA increased by 113% to $10.6 million, highlighting significant operational leverage.

The company launched four new programs in its patient affordability segment, with a total of 135 active programs, and aims to exceed the 55 net program additions from 2025.

Plasma business revenue grew by 25% to $11.7 million despite a reduction in the number of plasma centers due to strategic closures of underperforming sites.

PaySign anticipates full-year revenue growth of 30-35%, with future strategic focus on expanding its SaaS solutions and engaging in new pharmaceutical and plasma collection partnerships.

Full Transcript

OPERATOR

It. Good afternoon, My name is Kevin and I'll be your conference operator today. At this time I'd like to welcome everyone to Pay Sign Inc. first quarter 2026 earnings conference call. After the Speaker's remarks, there will be a question and answer session. You may be placed into question queue at any time by pressing Star1 on your telephone keypad. As a reminder, this conference is being recorded. If anyone should require operator assistance, please press star zero. The comments on today's call regarding PaySign's financial results will be on a GAAP basis unless otherwise noted. PaySign's earnings release was disseminated to the SEC earlier today and can be found in the Investor Relations section of our website paysign.com which includes reconciliations of non GAAP measures to GAAP reported amounts. Additionally, as set forth in more detail in our earnings release, I'd like to remind everyone that today's call include forward looking statements regarding PaySign's future performance. Actual performance could differ materially from these forward looking statements. Information about the factors that could affect future performance is summarized at the end of Pay Sign's earnings release and in our section of SEC recent SEC filings. Lastly, a replay of this call will be available on August 12th until August 12th, 2026. Please see PaySign's first quarter 2026 earnings call announcement for details on how to access the replay. It's now my pleasure to turn the floor to Mr. Mark Newcomer, President and CEO. Please go ahead.

Mark Newcomer (President and Chief Executive Officer)

Thank you Kevin Good afternoon everyone and thank you for joining us today. For Pay Sign's first quarter 2026 earnings call, I'm Mark Newcomer, President and Chief Executive Officer. Joining me today is Jeff Baker, our Chief Financial Officer. Also on the call are Matt Turner, our President of Patient Affordability, and Matt Lanford, our Chief Payments Officer, both of whom will be available for Q and A following our prepared remarks. Earlier today we announced our first quarter financial results which marked the strongest start to a year in PaySign's history. Revenue grew 50.8% to $28 million, exceeding the high end of guidance we provided in March. Net income increased 110% to $5.4 million and adjusted EBITDA increased 113% to $10.6 million. Most notably, operating margins increased 1,040 basis points or 10.4% year over year, demonstrating the operating leverage inherent in our business. As we scale across healthcare and financial ecosystems, we continue to see strong growth across the patient affordability business. In the first quarter, revenue grew 82% year over year to 15.7 million and claim volume was approximately 49% higher than Q1 2025, driven by a combination of new programs launched over the past year, organic growth within the existing programs, and the continued ramp of our largest pharmaceutical clients. As expected, this rate reflects a larger and more established revenue base than a year ago. In Q1 alone, patient affordability generated nearly as much revenue as it did in the first half of 2025. During the quarter, our patient affordability business delivered more than $540 million in financial assistance to patients, a meaningful step up from approximately 320 million in the first quarter of last year. That growth reflects both the increased number of patients we are serving and the expanding role our business plays in supporting access to high cost branded therapies. Our Dynamic Business Rules Technology continues to deliver substantial economic value to our pharmaceutical clients and the patients that rely upon their therapy, demonstrating both the scale our platform now operates at and the differentiated value our technology provides in helping manufacturers navigate copay, maximizer and accumulator programs. We launched four new programs in the first quarter, bringing total active programs to 135. As is typical for the industry, Q1 is the most operationally constrained period of the year as manufacturers, payers and pharmacy partners work through plan year transitions, formulary changes and deductible resets. Against that backdrop, our pipeline remains robust and we are on track to exceed the 55 net program additions we launched in 2025. Strength of that pipeline reflects the trust pharmaceutical manufacturers continue to place in pay sign as a partner in helping patients access and afford the therapies they need. Taken together, the increase we are seeing in program count, claim volume and benefit dollars deployed reinforce both the scalability of our platform and the durability of demand for our solutions. Last month we attended the Asembia Specialty Pharmacy Summit Asembia 2026 in Las Vegas. Asembia is the most important annual gathering in the specialty pharmaceutical industry and consistently one of the most productive pipeline generating events on our calendar. It is where the decision makers across pharmaceutical manufacturers, specialty pharmacies, hub providers and payer partners come together in one place and the conversations we had during those three days helped shape our commercial roadmap for the balance of the year. Asembia 2026 was no exception. We conducted more than 50 meetings over three days and closed new business while on site. The breadth and depth of these conversations combined with the deals we secured in real time reinforce our confidence in both the demand environment and the strength of our pipeline heading into the remainder of 2026. Turning to our Plasma donor compensation business in the first quarter, Plasma contributed 11.7 million in revenue, a 25% increase over 9.4 million in Q1 2025. Our Plasma business also remains a strong source of cash generation, facilitating investments in high opportunity areas. Looking ahead, we expect continued revenue growth as existing centers fill excess capacity, much of which has been unlocked by recent advances in plasmapheresis hardware, bringing significant efficiencies to the plasmapheresis process. In response to that capacity gain, several of our larger collectors have consolidated operations, closing some lower performing centers. Historically, these closures have had minimal impact on our results as donors typically transition to nearby centers and we expect that same pattern to play out following our clients closure of 19 centers in early May. We exited the quarter with 573 centers, an increase of 89 centers over the previous year, but 22 less than the end of 2025 as several low performing centers were either sold to collectors that do not utilize our services or closed again. We do not believe these closings will negatively affect our growth outlook and we continue to pursue the remaining plasma collection companies that we do not currently service. In late April we sponsored the International Plasma Protein Congress in Milan, Italy where we engaged with plasma collectors, device manufacturers and industry participants from the U.S. europe and Asia. The conference generated meaningful progress for our software as a service suite of solutions, including the discussions with plasma collection companies across all three regions and with plasmaphoresis device manufacturers regarding direct integration to our platform. Direct integration of our software with plasmapheresis device eliminates manual steps that can introduce human error in the collection process. It also streamlines implementation and reduces friction for collection centers when transitioning to our platform, creating a clear operational benefit. Beyond the US we continue to view Europe and Asia as significant long term opportunities for our SAS solutions across the blood and plasma collection industries. In summary, the first quarter marked an outstanding start to 2026 and a meaningful inflection point for pay sign. We delivered record results across the business and more importantly validated strategic direction. We have set purpose built platforms grounded in deep industry expertise. Scaling with discipline as we grow with strong momentum in patient affordability, a robust pipeline and expanding opportunities both within and beyond healthcare, we are well positioned to drive sustain growth and create long term value for shareholders, customers and the individuals we ultimately serve. With that, I'll turn it over to Jeff for additional details on our first quarter financial results.

Jeff Baker (Chief Financial Officer)

Thank you Mark Good afternoon everyone. As Mark highlighted, our first quarter results reflect the continued momentum in our business, the growing financial impact of our patient affordability platform and the inflection point we have reached as it relates to operating leverage. For the first quarter, Total revenues increased 50.8% year over year to $28 million. Pharma industry revenue increased 81.9% year over year to $15.7 million, driven by 45 net pharma patient affordability programs launched during the past 12 months and a corresponding increase in monthly management fees, setup fees, claim processing fees and other billable services such as dynamic business rules and customer service contact center support. Process claims increased by approximately 49% compared to the first quarter of 2025. For the first time, pharma surpassed plasma to become our largest revenue contributor in the quarter, a milestone that reflects the strategic direction we have been executing against and the growing importance patient affordability plays in our business. Plasma revenue increased 24.9% year over year to $11.7 million. The average monthly revenue per center increased to $6,671 versus $6,517 and the average number of loads per center increased on a year over year basis for the first time since the industry experienced an inventory correction that began in 2024. As Mark noted, we exited the quarter with 573 centers below our guidance of 589 as one customer notified us they had sold all their centers to a competing provider. These Centers contributed approximately $650,000 in 2025 revenue and averaged less than $3,500 per month in revenue, which is below the corporate average of $6,671. Gross profit margin expanded to 65% from 62.9% in the first quarter 2025, reflecting a greater mix of pharma revenue which carries higher gross margins than our plasma business. Cost of revenues increased 42.2%, driven mainly by increased call center support expense associated with the growth in both our plasma and pharma businesses, and higher processing and commission costs, all of which grew well below our revenue growth of 50.8%, demonstrating the operating leverage inherent in our business. Total operating expenses were $11.6 million, an increase of 25.5% from $9.2 million in the first quarter of 2025, again well below our revenue growth rate. Selling general and Administrative expenses increased 20.5% to $8.9 million, which includes stock based compensation of $1.3 million. Depreciation and amortization increased $835,000 due primarily to the amortization of intangible assets from our gamma acquisition and capitalization of new software development costs. A highlight of the quarter is overall operating leverage amidst strong revenue growth. Operating margin expanded to 23.8% from 13.4% in the first quarter of 2025, an improvement of over 1,000 basis points. Put another way, we converted approximately $9.4 million in incremental revenue into $4.2 million in operating income. Here are a few other important details for the quarter. Income before taxes increased to $7.5 million from $3.3 million in the first quarter of 2025. The company recorded an income tax provision of $2 million, resulting in an effective tax rate of 27.2% compared to 20.5% in the first quarter of 2025. The higher rate reflects discrete item adjustments primarily related to the increase in our stock price at March 31, 2026 compared to the same period last year which reduced the tax benefit from stock based compensation relative to the prior year period. Net income for the quarter totaled $5.4 million or $0.09 per fully diluted share, an increase from $2.6 million or $0.05 per fully diluted share in the first quarter 2025. Adjusted EBITDA, which excludes stock based compensation and is used by management to evaluate core operating performance, increased 113.4% to $10.6 million or $0.17 per fully diluted share versus $5 million or $0.09 per fully diluted share in the first quarter of 2025. Adjusted EBITDA margin expanded to 37.8% from 26.7% a year ago. The fully diluted share count used in calculating per share amounts was 61 million versus 55.1 million in the prior year period. We exited the quarter with $20.5 million in unrestricted cash and zero bank debt. Restricted cash increased $15 million to $159 million, primarily related to customer program deposits for our plasma and pharma customers and an increase in funds on card. Now turning to our outlook, our first quarter results exceeded our guidance across every line of the income statement. Revenue of $28 million exceeded the high end of our 27 to $27.5 million guidance range. Operating margin of 23.8% finished above our guided range of 20 to 22%. A net margin of 19.4% exceeded the top of our 17 to 19% range. Based on our strong start to the year, we are increasingly confident in our ability to achieve the upper end of our 2026 guidance ranges. We continue to expect full year revenue of 106.5 to $110.5 million, representing 30 to 35% year over year growth with gross profit margins between 60 and 62%. Net income is expected to be in the range of $13 million to $16 million or $0.21 to $0.26 per diluted share and adjusted EBITDA is expected to be a range of 30 million to $33 million or $0.49 to $0.53 per diluted share. As of today, we have 141 active patient affordability programs and expect to exit the quarter with 147 to 150 active programs. We also expect our active plasma center count to decline to 555 to 560 centers. As a customer closed 19 underperforming centers in May. As in the past, we do not expect any financial impact from these closures as we expect cardholders from these underperforming centers to transition to other centers. As a reminder, there is seasonality in both our main businesses. Pharma revenues are typically highest in the first quarter as patient affordability claims peak with annual insurance deductible resets and then moderate throughout the balance of the year. Plasma revenues, by contrast, tend to be softest in the first quarter and build through the remainder of the year as donor activity normalizes following tax refund season. These seasonal dynamics are anticipated and fully reflected in our full year guidance. Overall, our first quarter results validate the financial framework we laid out in March and the operating leverage we are generating gives us confidence in our ability to continue delivering on the forecast we have outlined for 2026. With that, I would like to turn the call back over to Kevin for question and answers.

OPERATOR

Thank you. We'll now be conducting a question and answer session. If you'd like to be placed in the question queue, please press 1 on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star 2 if you'd like to move your question from the queue. For participants using speaker equipment, it may be necessary to pick up your headset before pressing Star one. Our first question is coming from Jacob Stephan from Lake Street Capital Markets. Your line is now live.

Jacob Stephan (Analyst at Lake Street Capital Markets)

Yeah, hey guys, appreciate you taking the questions. Congrats on a nice quarter here. Mark, you made a comment that in the beginning of the call you said you expect to exceed 55 net program adds that you did in 2025. I guess for starters, what's kind of driving the confidence in the strength in the pipeline? Is there a one time event out there that you're seeing or is this mostly and maybe the part b Is this mostly new or existing customers that are additive in the back half of the year?

Matt Turner (President of Patient Affordability)

Hey, this is Matt Turner. So I think if you were to look at what the pipeline looks right now, there's a pretty good mix, probably around 50, 50 when you look at the program count, you know, that we're talking about now, like, you know, going over 55, where half are going to be entirely new clients and the other half is going to be growth inside of existing clients. I don't think it's any, you know, there's not one moment of inflection point. You know, last time we were on the call, we talked about kind of what inning were we in. And I think, you know, this is showing that what we built on, you know, in the first inning. Right. Is coming true now. So we've got a larger client base, so we're going to continue to see new programs from those clients. And then also selling never stops. So we're always trying to bring new clients onto the platform.

Jacob Stephan (Analyst at Lake Street Capital Markets)

And I mean, if I'm running the numbers, that kind of implies like 190 programs exiting 20, 26, I guess from a capacity standpoint, you know, do you guys feel like you have the extra bandwidth? What's needed to fully add those programs?

Matt Turner (President of Patient Affordability)

I don't think there's anything else needed. I mean, we'll continue to hire people to support the business. Even on the account management side, from an IT perspective, the systems are robust and well positioned to handle the growth that we have this year and any years coming. So we've built systems that are high availability, high demand. The partners that we have in the space are all used to higher claim volumes like this. So we're confident that we have everything in place that we need to continue to scale the growth year after year.

Jacob Stephan (Analyst at Lake Street Capital Markets)

And then maybe if we could just touch on some of the guidance commentary. I know you guys said you expect revenue to be roughly equal. Looking at kind of the, you know, the plasma centers, obviously you're expecting a decline in Q2 here. I think that implies a pretty significant ramp in the back half for plasma revenue, if I'm catching that right.

Matt Turner (President of Patient Affordability)

No, revenue for plasma should be up sequentially and continue to grow throughout the rest of the year. So the centers that we called out for the quarter that were sold were garbage centers, to be quite honest with you. And they were below our corporate averages. And then the centers that were consolidated or shut down, that company has other centers within the proximity of the ones that they close. So what's going to happen is those cars are holders are just going to move over. But we, you know, there are some there. I put some comments out there to give you kind of a heads up. I mean we saw average loads per center up for the first time since 2024 on a year over year basis. So we talked about the inventory overhang that we experienced all throughout 2025 and we're seeing early indications that we're through that now. What you're seeing is some of the plasma companies trying to become more efficient. They're closing underperforming centers. We've run the numbers on those centers. They should have closed them a long time ago, to be honest with you. But matter of fact that we've gone through this before pretty much every year and it doesn't impact the number. So we expect plasma to continue to grow throughout the year and hold to that 5050 mix right now as we see it subject to change as we move forward.

Jacob Stephan (Analyst at Lake Street Capital Markets)

Okay, appreciate the color guys. Congrats again. Thanks, Jacob.

OPERATOR

Thank you. Next question is coming from Gary Prestipino from Barrington Research. Your line is now live.

Gary Prestipino (Analyst at Barrington Research)

Hey, good afternoon everyone. Jeff, you guys were throwing around a lot of numbers here. I want to make sure that I've got this right. By your press release you say you have 135 pharma programs right now, correct?

Jeff Baker (Chief Financial Officer)

No. Per the press release for the quarter, we exited the quarter with 135 programs. As I sit here today at 5:20, we have 141 active programs. By the end of, by the end of the second quarter, I have told you that we will have between 147 to 150 active programs.

Gary Prestipino (Analyst at Barrington Research)

Okay, that's what I was confused about. And then for the plasma you have 573 and you're going to be between 550 and 560.

Jeff Baker (Chief Financial Officer)

Right? We were at 573 at the end of the quarter and then we had a customer notify us that they were shutting centers on May 5, 19 centers. And then I said that we expect it in the second quarter with between 555 and 560 because we have some other new centers opening in the pipeline.

Gary Prestipino (Analyst at Barrington Research)

Okay, that's helpful. I just want to make sure I got that right. So you talked a little bit, Mark, about your plasma platform and how you're integrating into these providers. What are the competitive advantages to an entity integrating into the platform? Number one, how does that work in conjunction with the app that you developed? And then are there any other players out there that have a platform with Your technological capabilities.

Mark Newcomer (President and Chief Executive Officer)

If we look at our entire ecosystem of what we've built, the platform with the various modules of the app, the CRM, the qualitative analysis and everything else, we do not see any other peers that are out there that have built anything like we've built. It's kind of, you know, some of the, you know, some of the feedback we've gotten from, you know, the various conferences we've gone to is it's a game changer. You know, the fact that all of the pieces of the software can communicate together and feed off one another is definitely a step up from what folks have had. So you know, if you look at it from, you know, from a plasma center perspective, it provides less friction for what they have currently and allows for a center to really not only have less friction but just more ease of use and how they interact with, with the donors engagement all the way through. So it really, you know, it's really about less friction and just better capabilities.

Gary Prestipino (Analyst at Barrington Research)

Okay, thank you. And then just a couple more and I'll jump off. I believe one of the individuals, and I forgot your name on this is that you're talking about the pharma programs and about 50% are takeaways. 50% of new programs. Is that about how your, your new wins are putting out a bit of a difference there?

Matt Turner (President of Patient Affordability)

I mean you're talking. But he was asking questions about new clients versus existing clients. So we look at a client as being a manufacturer. The manufacturer may have 30 drugs. So if they've given us five. Right. Last year and then they add on another two or three programs this year. Right. So we're going to say that's existing client additions that would be different than transitions, you know, versus launches. You know, I don't really have a set number right now that I can tell you. Hey, here's how we think that's going to line up because the pipeline is the pipeline. It's living and breathing. I think we will see a larger number of transitions than we see new product launches this year. But that's, you know, that's where we're sitting right now, you know, in May. But at the end of the day the outcome is still going to be the same where we're looking at hitting our guidance targets.

Gary Prestipino (Analyst at Barrington Research)

Okay. And then just last one is real quick and let somebody else get on it. Looks like you talked about the conversion of incremental revenue to incremental operating income. I'm measuring it differently. I'm looking at it as incremental adjusted ebitda conversion. And it looked like that was close to 60% in the quarter, Jeff. And then if you look at your guidance going forward, you know, I'm just looking at my numbers, it drops down considerably over the next three quarters. Now, is that just a function of mix? Because you're going to get more plasma revenue in the mix versus patient affordability. Or some. Okay, that's just it. There's no increase in spending for anything beyond just normal growth and stuff like that.

Jeff Baker (Chief Financial Officer)

No, I mean, it's all baked into the guidance. So if you go down and go back through all the guidance that we laid out in the tabular format that's in the press release, nothing's changed. So it's really just mix shift as we go throughout the year. You know, patient affordability should go down a little bit as we have claims that go down just like it did last year, offset by new programs that we add in. And then plasma will continue to grow, should continue to grow throughout the year, just like it did every year since we've been in the business. So, you know, the seasonal factors, unchanged. But that's what that will obviously cause a little shift on the margin side. The comment that we're making about the margin, you know, for the purists out there who, you know, want to look at operating margin, including depreciation, amortization, stock comp. That's what the numbers were. But your numbers are absolutely correct when you look at adjusted ebitda.

Gary Prestipino (Analyst at Barrington Research)

Okay, thank you. Yeah, ma', am. Thank you.

OPERATOR

As a reminder, that STAR wanted to be placed into question. Q. Our next question is coming from John Ekman from Radenburg Balmond. Your line is now live.