Hinge Health (NYSE:HNGE) reported strong fourth-quarter and full-year 2025 results, highlighting rapid revenue growth, expanding profitability, and significant free cash flow generation, alongside continued investment in AI-driven care delivery and the early rollout of its Hinge Select provider network.
Financial results topped guidance as margins expanded
For the fourth quarter, Hinge Health posted revenue of $171 million, up 46% year over year and above its prior guidance range of $155 million to $157 million. Full-year 2025 revenue reached $588 million, an increase of 51% from 2024 and above guidance of $572 million to $574 million.
Profitability also improved. Gross margin was 85% in Q4 and 83% for full-year 2025, up from 82% in Q4 2024 and 78% for full-year 2024. Operating margin reached 28% in Q4 and 20% for the full year. CFO James Budge said the company generated $48 million of income from operations in Q4 (above guidance of $34 million to $36 million) and $119 million for 2025, compared with a -7% operating margin in 2024.
Free cash flow was a key highlight: $62 million in Q4 (a 36% margin) and $180 million for the year (a 31% margin), up from $45 million and 12% in 2024. Management also cited a “Rule of 40” metric of 82 in Q4 and 81 for 2025.
AI tools and automation drove care team efficiency
CEO Daniel Perez said the company surpassed 100 million lifetime member activity sessions, including 41 million in 2025. He emphasized that data generated from sessions helps improve programs and supports the company’s “triple aim” of better outcomes, better experience, and lower costs.
Management said AI-enabled automation has improved care delivery efficiency without sacrificing member experience. Perez noted that in 2025 the company served 47% more members while keeping care team costs flat, helped by automated, AI-powered communications for routine messaging. The company said average time spent by the care team in asynchronous sessions fell 28% from Q3 to Q4 2025.
Hinge Health also discussed “Robin,” its AI care assistant. Perez said Robin is still early in rollout, but members engaging with it have given it a 92% positive rating, with higher response rates than interactions with the human care team. Perez added that member NPS is at an all-time high and said the company is planning to keep the size of the care team flat again in 2026, while investing more in the member experience, including broader deployment of the company’s Enso device. He said members who receive Enso see meaningfully higher NPS and complete about 70% more exercise therapy sessions.
During Q&A, Perez also described AI adoption across product development and operations, saying engineering throughput, measured by pull requests per engineer per week, was up 2x in 2025. He also pointed to operating costs as a percentage of revenue declining from 84% in 2024 to 64% in 2025, attributing the improvement in part to efficiency gains from AI across functions including finance, HR, operations, and supply chain.
Sales season drove contracted life growth and expansion beyond self-insured
President Jim Pursley said the 2025 sales season was “exceptional,” with 4.8 million net new contracted lives, ending the year at approximately 24.6 million contracted lives across over 2,800 clients. The company reported 22 million self-insured lives and 2.6 million lives across fully insured, Medicare Advantage, and the federal employee program (FEP).
Pursley said the non-self-insured segment grew 135% from 1 million lives at the end of 2024, with the largest growth from fully insured and FEP, helped by unlocking expansions within existing clients due to “strong ROI outcomes.” He also said the company’s clients represent 53% of the Fortune 100 and 45% of the Fortune 500, and cited an annual client retention rate of 97% in 2025.
Management highlighted competitive momentum, including a large enterprise client with over 200,000 lives that switched from a competitor late in the year. Pursley attributed competitive conversions to unified care that integrates digital and in-person elements (including Hinge Select), ongoing product experience improvements, and ROI and clinical outcomes. He added that when prospective clients trial Hinge’s offering alongside a competitor’s, the company’s win rate increases.
On partnerships, Pursley said Hinge Health now has more than 60 health plan, PBM, TPA, and ecosystem partners. He also noted that three out of five of the largest national health plans by self-insured lives offer Hinge Health to their own employee populations, with two of those wins occurring in 2025.
The company also referenced its 21st peer-reviewed research study, published in the Journal of Health Economics and Outcomes Research. Management said the study found participants in its chronic back program had 60% fewer imaging visits for low back pain at three months compared with a similar control group.
Hinge Select early data, engagement-based pricing, and 2026 outlook
Management said Hinge Select, its high-performance provider network, was available to “several hundred thousand eligible lives” in Q4. Perez said early member pathways range from in-person physical therapy to hybrid care, and described cases where members who anticipated surgery avoided elective procedures after consultations with orthopedic specialists. He said about 85% of Hinge Select members moved forward with conservative care plans, most often digital physical therapy, and that early comparisons to commercial benchmarks show more “good spend” and less low-value spend such as imaging, procedures, and surgery. The company reiterated it does not expect much revenue impact from Hinge Select until at least 2027.
On pricing, Budge said about 50% of eligible lives had moved to the company’s engagement-based pricing model by Q4. In response to analyst questions, he said the primary change is billing timing—usage-based bills go out as engagement occurs, typically over a two- to three-month period, rather than mostly upfront—while revenue recognition starts on day one of treatment under either method. Management said average selling price was essentially flat in 2025 and is expected to remain essentially flat in 2026, with Perez noting the model was designed to provide clients pricing clarity in the first year of adoption.
Looking ahead, the company guided to Q1 2026 revenue of $171 million to $173 million and non-GAAP operating income of $30 million to $32 million. For full-year 2026, Hinge Health forecast revenue of $732 million to $742 million and non-GAAP operating income of $151 million to $156 million, with operating margin expected to improve about 100 basis points year over year despite planned investments in R&D and targeted sales and marketing initiatives, including support for Hinge Select expansion and growth in small and medium business markets.
Management also discussed capital allocation, noting it ended Q4 with $479 million in cash and equivalents and repurchased 1.4 million shares for $65 million under a board-authorized repurchase program of up to $250 million. Budge said the company expects GAAP profitability in 2026 and noted dilution was below 3% in 2025 and is expected to be lower in 2026.
In addition, executives said they were monitoring CMS’s evolving “access program” for traditional Medicare, describing it as an attractive long-term opportunity given the scale of the market, while indicating they would not expect a meaningful contribution until 2027 and beyond.
About Hinge Health (NYSE:HNGE)
Hinge Health (NYSE: HNGE) is a digital musculoskeletal (MSK) clinic that provides end-to-end solutions for the prevention and management of musculoskeletal conditions. The company’s platform combines wearable motion sensors, personalized exercise therapy guided by licensed physical therapists, and behavioral health coaching to deliver tailored treatment plans. By integrating technology with evidence-based clinical protocols, Hinge Health aims to reduce pain, improve mobility and decrease reliance on more invasive interventions such as surgery or opioid prescriptions.
Founded in 2015 and headquartered in San Francisco, Hinge Health partners with employers, health plans and other payers to offer its self-directed, app-based programs.
