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Healthstream (HSTM)
NASDAQ:HSTM
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HealthStream (HSTM) AI Stock Analysis

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HSTM

HealthStream

(NASDAQ:HSTM)

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Outperform 79 (OpenAI - 5.2)
Rating:79Outperform
Price Target:
$32.00
▲(47.26% Upside)
Action:Reiterated
Date:05/09/26
HSTM scores well primarily on financial quality (low leverage, strong cash generation, and solid margins) and a positive earnings update with reaffirmed guidance and strong backlog/RPO visibility. Technicals are supportive but not emphatically long-term bullish given proximity to the 200-day average. The main constraint on the score is valuation, with a mid-to-high P/E and modest dividend yield.
Positive Factors
Conservative balance sheet
Very low leverage and a strong cash position provide durable financial flexibility. With virtually no long-term debt and an untapped credit line, the company can fund acquisitions, R&D, buybacks, or weather downturns without forcing dilutive financing, preserving strategic optionality over 2–6 months.
Negative Factors
Legacy product migration drag
Declines in legacy credentialing/scheduling revenue reflect migration-related churn that can pressure near-term top-line growth. Migrating long-term customers is strategic but creates temporary revenue gaps and prolongs the pace at which new solution adoption fully offsets attrition.
Read all positive and negative factors
Positive Factors
Negative Factors
Conservative balance sheet
Very low leverage and a strong cash position provide durable financial flexibility. With virtually no long-term debt and an untapped credit line, the company can fund acquisitions, R&D, buybacks, or weather downturns without forcing dilutive financing, preserving strategic optionality over 2–6 months.
Read all positive factors

HealthStream Key Performance Indicators (KPIs)

Any
Any
Revenue by Segment
Revenue by Segment
Breaks revenue down by product and service lines (for example, subscription software, professional services, and content licensing) to show which parts of the business drive growth and profits. A larger recurring subscription mix suggests more predictable cash flow and higher margins, while reliance on one-time or services revenue can mean lower margin potential and less revenue visibility. Shifts in these shares highlight where the company is gaining traction, facing competitive pressure, or exposed to customer concentration or healthcare spending cycles.
Chart InsightsSubscription is the clear growth engine—steady, accelerating recurring sales that helped deliver record revenue—while Professional Services have trended lower and become more episodic, with a late‑2024 project bump. Management confirms strong traction in core subscription suites (CredentialStream, ShiftWizard, Competency), but declining legacy product and services revenue plus higher cloud/hosting costs are compressing gross margins. The Virsys12 acquisition offers only modest near‑term offset (~$0.9M), so margin recovery and successful cross‑sell of services into the expanding subscription base are key catalysts to watch.
Data provided by:The Fly

HealthStream (HSTM) vs. SPDR S&P 500 ETF (SPY)

HealthStream Business Overview & Revenue Model

Company Description
HealthStream, Inc., established in 1990 and headquartered in Nashville, Tennessee, delivers specialized workforce and provider solutions to healthcare organizations throughout the United States. Its operations are divided into two primary segments...
How the Company Makes Money
HealthStream generates revenue primarily by selling subscription-based software and content to healthcare organizations. A key driver is recurring revenue from cloud-delivered platforms used for workforce learning and development (training adminis...

HealthStream Earnings Call Summary

Earnings Call Date:May 04, 2026
(Q1-2026)
|
% Change Since: |
Next Earnings Date:Jul 27, 2026
Earnings Call Sentiment Positive
The call highlighted robust top-line and margin expansion (record revenue and adjusted EBITDA), strong product-level growth (CredentialStream, ShiftWizard, Competency Suite), successful acquisition integrations, a healthy balance sheet and cash generation, and reaffirmed full-year guidance. Management also outlined deliberate, accelerated investments (career networks, My Clinical Exchange infrastructure, sales hiring, and AI) which will modestly increase operating spend and may temper near-term margin cadence. Legacy product migration and potential margin pressure from cloud initiatives are the primary operational risks noted, but they are balanced against strong organic momentum and strategic investments that aim to expand addressable markets and long-term growth.
Positive Updates
Record Revenue and Adjusted EBITDA
Revenue of $81.2M in Q1 2026, up 10.5% year-over-year; adjusted EBITDA reached a record $20.1M, up 24.1% year-over-year, with adjusted EBITDA margin improving to 24.8% from 22% a year ago.
Negative Updates
Minor Receivables and DSO Change
Days sales outstanding modestly increased to 39 days from 37 days a year ago (target 40–45), which slightly affected operating cash flows and is a point to monitor.
Read all updates
Q1-2026 Updates
Negative
Record Revenue and Adjusted EBITDA
Revenue of $81.2M in Q1 2026, up 10.5% year-over-year; adjusted EBITDA reached a record $20.1M, up 24.1% year-over-year, with adjusted EBITDA margin improving to 24.8% from 22% a year ago.
Read all positive updates
Company Guidance
HealthStream reaffirmed its 2026 guidance, targeting consolidated revenue of $323.0–$330.0 million, net income of $20.4–$22.8 million, adjusted EBITDA of $73.0–$77.0 million, and capital expenditures of $31–$34 million; for Q2 management expects revenue growth of approximately 9.5% and an adjusted EBITDA margin of about 23%. The company noted $687 million of remaining performance obligations (with ~39% expected to convert to revenue in 12 months and ~67% in 24 months), ended Q1 with $66.5 million of cash and investments, reported Q1 free cash flow of $19.7 million and operating cash flow of $27.1 million, and carries no long-term debt with an untapped line of credit. Q1 actions included $7.5 million of share repurchases (under two Board-authorized programs), a newly-declared quarterly dividend of $0.035 per share payable May 29, and repurchases continuing into Q2; management also warned the guidance excludes the impact of any future acquisitions/dispositions, changes in fair value of non‑marketable equity or contingent consideration, or asset impairments and highlighted planned Q2 operating investments (higher labor, marketing, and technology spend).

HealthStream Financial Statement Overview

Summary
Strong overall fundamentals supported by very low leverage (debt-to-equity ~0.04), solid and improving profitability (TTM gross margin ~64.9%, EBITDA margin ~22.0%), and robust cash generation (TTM operating cash flow ~$63.4M; TTM free cash flow ~$60.0M with good cash conversion). Offsetting factors are modest recent revenue growth and some net margin softness versus 2024, plus historical free-cash-flow volatility (notably the 2024 dip).
Income Statement
78
Positive
Balance Sheet
90
Very Positive
Cash Flow
84
Very Positive
BreakdownTTMDec 2025Dec 2024Dec 2023Dec 2022Dec 2021
Income Statement
Total Revenue311.78M304.06M291.65M279.06M266.83M256.71M
Gross Profit202.30M196.85M193.71M184.04M175.68M165.68M
EBITDA69.88M66.70M66.05M59.59M53.53M44.58M
Net Income19.92M18.34M20.01M15.21M12.09M5.84M
Balance Sheet
Total Assets527.44M520.37M510.77M499.94M497.74M486.75M
Cash, Cash Equivalents and Short-Term Investments66.50M57.00M97.22M71.13M53.91M51.95M
Total Debt14.07M14.68M20.17M20.25M23.32M29.11M
Total Liabilities175.45M166.35M151.41M159.19M163.68M147.73M
Stockholders Equity351.99M354.02M359.36M340.75M334.06M339.02M
Cash Flow
Free Cash Flow60.01M59.63M29.52M61.77M49.42M38.97M
Operating Cash Flow63.38M63.32M57.66M63.97M51.19M42.38M
Investing Cash Flow-49.42M-50.35M-33.97M-56.60M-28.39M-25.72M
Financing Cash Flow-42.59M-36.27M-4.52M-13.04M-23.70M-6.21M

HealthStream Technical Analysis

Technical Analysis Sentiment
Positive
Last Price21.73
Price Trends
50DMA
24.93
Positive
100DMA
22.93
Positive
200DMA
23.61
Positive
Market Momentum
MACD
1.01
Negative
RSI
64.30
Neutral
STOCH
59.48
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For HSTM, the sentiment is Positive. The current price of 21.73 is below the 20-day moving average (MA) of 26.82, below the 50-day MA of 24.93, and below the 200-day MA of 23.61, indicating a bullish trend. The MACD of 1.01 indicates Negative momentum. The RSI at 64.30 is Neutral, neither overbought nor oversold. The STOCH value of 59.48 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for HSTM.

HealthStream Risk Analysis

HealthStream disclosed 38 risk factors in its most recent earnings report. HealthStream reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks

HealthStream Peers Comparison

Overall Rating
UnderperformOutperform
Sector (51)
Financial Indicators
Name
Overall Rating
Market Cap
P/E Ratio
ROE
Dividend Yield
Revenue Growth
EPS Growth
79
Outperform
$823.28M42.105.67%0.52%6.64%6.54%
74
Outperform
$1.24B13.6431.39%40.95%4.15%
70
Outperform
$1.37B-205.32-2.81%49.36%83.76%
53
Neutral
$629.89M-1.20-77.89%-21.26%-290.08%
52
Neutral
$162.57M-0.60-99.78%-2.83%-223.32%
52
Neutral
$116.71M-0.49-67.07%-3.89%63.03%
51
Neutral
$7.86B-0.30-43.30%2.27%22.53%-2.21%
* Healthcare Sector Average
Performance Comparison
Ticker
Company Name
Price
Change
% Change
HSTM
HealthStream
28.02
1.57
5.93%
EVH
Evolent Health
5.63
-5.55
-49.64%
HCAT
Health Catalyst
2.24
-1.65
-42.42%
NUTX
Clinigence Holdings
183.36
68.75
59.99%
DH
Definitive Healthcare Corp
0.80
-3.12
-79.57%
OMDA
Omada Health, Inc.
23.55
5.88
33.28%

HealthStream Corporate Events

Business Operations and StrategyExecutive/Board ChangesFinancial Disclosures
HealthStream Elevates Collier to COO, Enhances Executive Incentives
Positive
May 8, 2026
HealthStream has promoted Michael M. Collier to chief operating officer and executive vice president, as disclosed in a May 4, 2026 release on first-quarter results, expanding his remit to lead enterprise operations, from customer experience and c...
Business Operations and StrategyExecutive/Board ChangesStock BuybackDividendsFinancial Disclosures
HealthStream Posts Record Q1 2026 Results, Reaffirms Outlook
Positive
May 4, 2026
On May 4, 2026, HealthStream reported record first-quarter 2026 revenue of $81.2 million, up 10.5% year over year, with operating income rising 71.6% to $7.5 million and net income climbing 36.4% to $5.9 million, or $0.20 per diluted share, driven...
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.

Disclaimer

This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.Date of analysis: May 09, 2026