Starling Oncology Reports Q2 2026 Revenue Surge, Raises Full-Year Guidance as Adjusted EBITDA Turns Positive
核心洞察
Starling Oncology (搜索) reported Q2 2026 consolidated revenue of $161.3 million, a 34.6% increase year-over-year, driven by record specialty pharmacy fills and capitated lives growth.
Adjusted EBITDA turned positive at $229,000 compared to a loss of $4.1 million in the prior-year quarter, marking a key financial milestone for the company.
The company raised its full-year 2026 revenue guidance to $650–$670 million and gross profit guidance to $105–$110 million, reflecting strong first-half momentum.
Starling Oncology (搜索), Inc. (NASDAQ: STLN), one of the largest value-based community oncology groups in the United States, reported financial results for the second quarter ended June 30, 2026, posting a 34.6% year-over-year revenue increase and achieving positive Adjusted EBITDA for the first time. The company also raised its full-year 2026 guidance across multiple metrics, citing robust operational momentum and expanding capitated lives.
Consolidated revenue for the quarter reached $161.3 million, up from $119.8 million in the same period last year. Gross profit rose 55.2% to $27.2 million, while net loss narrowed to $9.8 million, or $(0.08) per share, compared to a net loss of $17.0 million, or $(0.15) per share, in Q2 2025. Adjusted EBITDA swung to positive $229,000 from a loss of $(4.1) million a year earlier.
Specialty Pharmacy and Capitated Revenue Drive Growth
Specialty Pharmacy revenue surged 58% compared to the prior-year quarter, fueled by record Part D prescription fills and the continued onboarding of new capitated lives onto the platform. The company attributed this strength to the ongoing ramp of its Florida delegated arrangements and expanding prescription fill volumes.
Capitated revenue for the quarter totaled $27.97 million, a 48.5% increase from $18.84 million in Q2 2025. The medical loss ratio (MLR) related to capitated contracts was 85.5%, compared to 71.0% in the prior-year period, reflecting the company's investment in scaling its delegated model.
Daniel Virnich, CEO of Starling Oncology (搜索), stated: "The second quarter of 2026 was a milestone quarter for our company, with revenue up 35% year over year and Adjusted EBITDA turning positive in Q2. We signed our first delegated contracts outside of Florida, in Nevada and Oregon, and reached an exclusivity agreement with one of our largest partners across California. Both of these achievements will drive robust capitated revenue growth going forward."
Strategic Expansion and Technology Investment
The company achieved exclusivity in California with one of its largest partners across all of their delegated medical groups, a relationship previously split with another entity. This agreement added approximately 230,000 capitated lives to Starling's platform. As of June 30, 2026, the company reported 2.1 million lives under value-based contracts, up from 1.9 million a year earlier.
Starling is also preparing to launch its proprietary provider portal, Starling Nexus, in mid-August. The platform is designed to strengthen provider engagement and drive continued adherence to clinical pathways, particularly among network physicians.
"In mid-August, we are launching our new provider portal, Starling Oncology (搜索) Nexus, which we expect will deepen provider engagement and further support adherence to our clinical pathways," Virnich added.
Updated Full-Year 2026 Guidance
Based on first-half results, Starling raised its full-year 2026 outlook. Revenue guidance increased to a range of $650 million to $670 million, up from the previous $630 million to $650 million. Gross profit guidance was lifted to $105 million to $110 million, compared to the prior $97 million to $107 million. Adjusted EBITDA guidance was narrowed to $2 million to $7 million, while free cash flow guidance remained unchanged at $5 million to $15 million.
The company expects approximately $150 million in capitated revenue in 2026 and anticipates its MLR will range between 80% and 90% over the next twelve months.
For the third quarter of 2026, Starling projects Adjusted EBITDA of $500,000 to $1.5 million as it continues onboarding and ramping Florida delegated lives.
Financial Position
Cash and cash equivalents stood at $41.1 million as of June 30, 2026. Free cash flow for the first six months of 2026 was $9.5 million, a significant improvement from $(14.6) million in the prior-year period. The company operated 301 affiliated and network clinics across 17 markets at quarter-end.
Starling Oncology (搜索), formerly known as The Oncology Institute, delivers value-based cancer (搜索) care to approximately 2.1 million patients through over 400 employed and network clinicians across more than 100 clinics and network locations in five states.