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Date

Tuesday, May 5, 2026 at 4:30 p.m. ET

Call participants

  • Co-Founder and Chief Executive Officer — Daniel Perez
  • Chief Financial Officer — James Budge
  • Head of Investor Relations — Bianca Buck
  • Operator

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Takeaways

  • Revenue -- $182 million, up 47% year over year, surpassing the guidance range of $171 million to $173 million.
  • Calculated billings -- $770 million for the last twelve months, reflecting 52% growth from $507 million a year ago.
  • Gross margin -- 85%, a 400 basis point increase over fiscal Q1 2025 (period ended Mar. 31, 2025), driven by AI and automation efficiencies and higher Enso device distribution.
  • Operating margin -- 25%, translating to $46 million operating income, ahead of the $30 million to $32 million guided range and up from 12% in fiscal Q1 2025.
  • Free cash flow -- $42 million, a tenfold increase year over year, resulting in a 23% margin (up from 3%).
  • Cash and share repurchases -- Ended the quarter with $407 million in cash; repurchased 2.5 million shares for $105 million, reducing diluted weighted average share count to 82.4 million (down 2.5%).
  • Diluted net income per share -- $0.45 for the quarter.
  • Guidance raise -- Full-year revenue guidance increased to $798 million to $804 million (36% growth at midpoint), up from prior $732 million to $742 million; income from operations guidance raised to $205 million to $215 million (26% margin midpoint) from $151 million to $156 million (21%).
  • Client base -- Nearly 3,000 clients, 60+ health plans, PBMs, and TPAs, with distribution scale described as "difficult-to-replicate".
  • Pricing model -- Approximately 80% of contracted lives are now on the engagement-based pricing structure, projected to remain stable throughout the year.
  • Migraine care launch -- Migraine care program rolling out during May with FDA 510(k) clearance for the Enso neuromodulation device, already adopted by over 125 clients, representing more than 2 million eligible lives; meaningful revenue impact expected in 2027.
  • Yield improvement -- Yield (percentage of engaged eligible lives) trending "slightly north of 4%" for the year; long-term target stated as 9% to 15% through access and program expansion.
  • Hinge Select expansion -- Ended quarter with 4,100 provider locations; expanded through a national PBM and three of the five largest national health plans by self-insured lives.
  • Pipeline growth -- Commercial pipeline in fiscal Q1 2026 was "substantially more" than fiscal Q1 2025, with SMB pipeline more than doubling year over year.
  • Q2 and share count guidance -- Q2 revenue guide: $194 million to $196 million (up 40% at midpoint); projected 2026 year-end diluted shares: 82 million to 84 million, excluding further buybacks.

Summary

Hinge Health (HNGE +1.76%) delivered significantly higher than expected financial and operational results, prompting a substantial increase in full-year revenue and operating income guidance. Management reported strong momentum from its core musculoskeletal platform, deployment of the new migraine program, and expansion of engagement-based pricing to most of its client contracts. The company highlighted rapid adoption of its migraine product, citing over 125 clients and 2 million eligible lives within weeks of launch, and described its proprietary data and distribution network as key to future product scalability and adoption. Strategic investments in AI and operational efficiencies enabled improved gross and operating margins, scaled member engagement, and supported a meaningful ramp in both free cash flow and share repurchases. Management stated that yield expansion and eligible lives growth contributed roughly equally to raised guidance, with most new clients adopting the engagement model and legacy clients maintaining stable pricing. On the product side, FDA-cleared Enso devices underpin migraine care, and Hinge Select’s reach has expanded to more key payor partners, while commercial pipeline growth—especially in SMB—sets the stage for further sales acceleration in the second half of the year.

  • Management confirmed that improvements in member engagement and post-enrollment activity were key drivers of yield gains above 4%.
  • The migraine program’s AI-powered tracking and exercise therapy are designed to reduce both severity and frequency of attacks, and the majority of cost associated with Enso deployment has been offset by care team efficiency.
  • New sales capacity and representatives in SMB led to a doubling of pipeline size in that segment, supported by faster sales cycles versus enterprise accounts.
  • Federal and fully insured plan segments showed particular growth in new lives, and the company noted an "order of magnitude more fully insured customers than second place in digital MSK."
  • Share repurchases and capital deployment policies were affirmed as ongoing, fully utilizing available liquidity without altering planned hiring or investment in innovation.
  • Hinge Health clarified its deliberate decision not to participate in the CMS ACCESS program, citing concerns about clinical oversight and triple aim alignment.

Industry glossary

  • MSK: Musculoskeletal; refers to care related to muscles, bones, and joints.
  • PBM: Pharmacy Benefit Manager; a third-party administrator managing prescription drug programs for payors.
  • TPA: Third Party Administrator; provides administrative services for insurance plans and benefit programs.
  • PEPM: Per Employee Per Month; a pricing structure in healthcare benefits contracts.
  • Enso: Hinge Health’s proprietary FDA-cleared neuromodulation device for pain relief, used within its digital care programs.
  • Hinge Select: The company’s curated provider network for in-person musculoskeletal care, with session-based admin fees.
  • Yield: The percentage of eligible lives who actively engage with the company’s platform.

Full Conference Call Transcript

Daniel Perez, our Co-Founder and CEO, and James Budge, our CFO. Our President, James Pursley, is spending this week advancing relationships with some of the largest state and local governments in the country, so he cannot be with us today. I want to thank everyone for joining us. As a reminder, this conference call is being recorded. All relevant materials are available on the Investor Relations section of our website. Today’s discussion will include forward-looking statements that are subject to various risks, uncertainties, and assumptions. These statements reflect our current views and expectations regarding future events including expected performance of our business, future financial results, and growth strategies.

While these statements represent our good faith judgment and beliefs, actual results may differ materially from those projected or implied. We undertake no obligation to update any forward-looking statements except as required by law. For a detailed discussion of the risks, please refer to our SEC filings, including our Annual Report on Form 10-K for the year ended December 31, 2025. We expect to file our latest Quarterly Report on Form 10-Q in the coming days. All income statement financial measures discussed today are non-GAAP, except for revenue, which is GAAP. These measures should be viewed in addition to and not as a substitute for our GAAP results.

Reconciliations to the most comparable GAAP measures are included in our earnings release appendix. With that, I will turn it over to Daniel.

Daniel Perez: Thanks, Bianca. I am excited to share our first quarter 2026 results. It was a strong start to the year, and let me tell you why. I will cover three things today. First, our Q1 financial performance, which came in well above expectations. Second, the launch of our migraine care program—our first expansion beyond muscle and joint pain—and a proof point that our platform can automate care delivery across multiple conditions. Third, where we stand commercially as we head into the sales season. Then I will hand it over to James to go deeper into our financials and updated guidance. After that, we will take your questions. Let us get into it.

We delivered strong results across all key financial metrics this quarter, outperforming our expectations and demonstrating the continued strength of our business. Starting with revenue, we generated $182 million in Q1, representing 47% year-over-year growth compared to $124 million in 2025. This performance came in well above our guidance range of $171 million to $173 million, showing the continued strong demand we are seeing across our client and member base. Our last twelve months calculated billings reached $770 million, up an impressive 52% from $507 million in the prior year period, reflecting the continued expansion of our member base and strong engagement with our platform.

On profitability, we achieved a gross margin of 85%, demonstrating continued care team and hardware efficiency as we scale our platform. Our operating margin was 25%, generating $46 million in operating income, exceeding our guidance range of $30 million to $32 million for the quarter. Our free cash flow performance was excellent once again. At $42 million, it was 10x higher year over year, for a free cash flow margin of 23%. These are strong numbers, and they reflect something important: our business is scaling efficiently. Our AI and automation investments are driving real operating leverage. We are serving more members, delivering improved outcomes, and reducing costs for clients, all while expanding margins.

That is the triple aim in action, and it is also what makes this model durable in a world where every company is being asked what AI means for their business. For us, AI is an accelerant—helping us better deliver the triple aim whilst building a uniquely efficient business. We have spent over a decade building the number one rated digital MSK app, leveraging data from the millions of members we have served to develop technology that automates over 95% of clinician hours associated with traditional PT. Combine that with our distribution—almost 3,000 clients, 60+ health plans, PBMs, TPAs, and ecosystem partnerships—and we have a double-walled moat: advanced platform capabilities on one side, difficult-to-replicate commercial reach on the other.

Frankly, in the age of AI, when things are easier to build than ever, proprietary data and preferential access to clients is a recipe for outsized returns. James will unpack the financials in more detail shortly, including our raised guidance for the year. Now let me shift to product and an expansion I have been waiting a long time to talk to you about. Our vision is to use technology to automate care, transforming outcomes, improving experiences, and reducing costs. We have proven this in 2 million people served, 21 peer-reviewed papers with demonstrable outcomes, and the top-rated digital musculoskeletal app.

But here is the thing: we spent years building a unified platform for our core technical and clinical capabilities—from enrollment to treatment, outcomes collection, member engagement, nerve stimulation, and more. Combined with a leading go-to-market motion, we are well positioned to extend into adjacent conditions. This quarter, I am excited to share that we are launching our migraine care program. Migraine is a form of chronic pain that shares neurological roots with the neck and spine conditions we already treat. Nerves in the neck and head converge in a shared pain processing center, so not surprisingly, roughly 75% of people with migraine also have MSK pain.

Our existing neck program members have already reported fewer migraine days and lower medication usage, simply from engaging with our existing product. The scale of the problem is massive. One in six American adults has migraine, and the prevalence rate is twice as high for women. On average, migraine sufferers drive more than $16,000 in annual healthcare spend—over double that of people without migraine. Nationally, migraine costs U.S. businesses an estimated $78 billion each year and drives absenteeism and reduced productivity. Our migraine care program delivers three things. First, rapid drug-free pain relief using our groundbreaking neuromodulation device, Enso. We just received 510(k) clearance from the FDA to extend Enso into migraine care.

This means for many people, we could deliver drug-free migraine relief in minutes. Second, AI-powered tracking that helps members identify personal triggers across environmental, lifestyle, and dietary factors. Third, proactive prevention through exercise therapy and clinically proven lifestyle guidance from our care teams, designed to reduce both the frequency and severity of attacks. Our migraine care program will roll out later this month. The client response has been overwhelming. In just a few weeks, we have had over 125 clients adopt the program, representing more than 2 million eligible lives. Time and again, our clients mention that they themselves, a family member, or someone they know is afflicted with migraine.

We expect revenue contribution to be minimal this year, with a more meaningful impact beginning in 2027. But the real significance is what this demonstrates. We did not come this far with digital physical therapy to stop at digital physical therapy. Migraine is a compelling data point in the broader applicability of our platform. The clinical overlap is strong, our capabilities translate directly, and the speed of client adoption—over 2 million lives approved within weeks—underlines the credibility we have built with our clients and partners. This is exactly the kind of innovation that gets us excited about the decades of work ahead. We are building infrastructure to automate healthcare delivery across multiple conditions.

Migraine is our next step, but it will not be the last. With that, let me speak to our commercial progress. As many of you know, our sales cycle follows a predictable seasonal pattern. The first half of the year is primarily focused on building our pipeline and nurturing prospects. We typically close the majority of new clients during the second half of the year, as employers finalize their benefits decisions for the following year. This quarter, we created substantially more pipeline compared to Q1 2025, which gives us confidence as we look ahead to the back half of the year.

The interest level from prospects continues to be strong, and we are seeing good momentum across our client verticals and markets. Our investments in the SMB space are also paying off, where we are seeing substantially more pipeline generated in that category than in years past. We continue to win at record rates, and the competitive takeaway trends we saw last year have persisted, which speaks to the strength of our platform and the value proposition we are delivering to clients. Our Hinge Select offering is also seeing positive momentum. We ended Q1 with 4,100 provider locations.

We are also thrilled to share that we recently expanded Hinge Select access through one of our national PBM partners and three of the five largest national health plans by self-insured lives. We expect this to help accelerate client adoption during our sales season in the second half of the year. I do not want to get ahead of ourselves, but the fundamentals we are seeing give us good reason to be optimistic. We expect the combination of strong pipeline development, solid win rates, and the added value we can now offer through our migraine care and Hinge Select programs to position us well for the foreseeable future. With that, let me turn it over to James.

James Budge: Calculated billings are driven by three key components: the number of average eligible lives, multiplied by our yield—which is the percentage of those lives that actually engage with us—multiplied by our average selling price per engaged member. For Q1, our LTM calculated billings reached $770 million, representing an exceptional 52% year-over-year growth rate compared to $507 million in the prior year period. Revenue came in at $182 million, up 47% from $124 million in Q1 2025. This result meaningfully exceeded our guidance range of $171 million to $173 million. This revenue beat was driven by better-than-expected billings, stemming from strong performance in both yields and lives.

On the yield front, we are seeing two continuing and encouraging trends: we are converting members from new clients at a faster rate, and our legacy clients are also growing yields. This demonstrates that our platform continues to resonate with members across all segments and that our AI-powered personalization and targeted enrollment improvements are driving real results. On the lives side, we have seen two beneficial drivers. First, as in prior years, newly launched clients have come in with more lives than we anticipated. Second, our legacy clients have also increased in size overall, suggesting no impact on our business from any AI-driven employee displacement.

This increase in eligible lives speaks to the diversification of our client base across industries and the essential nature of MSK care in employee benefits packages to create better outcomes for members and lower costs for clients. Moving to pricing, as of 2026, around 80% of our contracted lives were using our new engagement-based pricing model. We expect this percentage to stay consistent throughout the rest of the year. Moving to profitability metrics, our gross margin for Q1 was 85%, up from 81% in Q1 2025.

This 400 basis point improvement reflects our continued care team efficiency gains as we leverage AI and automation to serve more members without proportional increases in care delivery costs, all while sending Ensos to more members than in prior years. We achieved strong operating leverage across all expense categories. Total operating expenses were 60% of revenue in Q1, down from 69% in the prior year period, demonstrating our ability to continue to scale efficiently as we grow. This translated to strong profitability with $46 million in income from operations, well above our guidance range of $30 million to $32 million for Q1.

Our operating margin was 25% compared to 12% in Q1 2025, an improvement of over 1,300 basis points year over year. Free cash flow performance was excellent at $42 million for Q1, compared to $4 million in Q1 2025. This represents a free cash flow margin of 23%, up from 3% in the prior year period, primarily driven by higher billings and improved efficiency. From a balance sheet perspective, we ended Q1 with $407 million in cash and cash equivalents. During the quarter, we continued executing on our share repurchase program, purchasing 2.5 million shares for $105 million. Our diluted weighted average share count as of Q1 dropped to 82.4 million shares, down 2.5% compared to the ending 2025 figure.

Our diluted net income per share attributable to common shareholders for the quarter was $0.45. Looking forward, based on our strong Q1 performance and strong outlook for the remainder of the year, we are raising the expected outcomes for all elements of our guidance. For Q2 2026, we expect revenue to be in the range of $104 million to $196 million, representing 40% year-over-year growth at the midpoint. For income from operations, we are projecting $47 million to $49 million for the second quarter, or a 25% margin at the midpoint. For the full year 2026, we are raising our revenue guidance to $798 million to $804 million, up from our previous guidance of $732 million to $742 million.

At the midpoint of $801 million, this represents 36% year-over-year growth, up from the 25% previously expected at the midpoint. We are also raising our full year income from operations guidance to $205 million to $215 million, or a 26% margin at the midpoint, up from our previous range of $151 million to $156 million, or a 21% margin at the midpoint. Several factors are driving this upward revision to our guidance. Average eligible lives for the year are expected to be slightly higher than what we previously shared, as we are seeing stronger-than-anticipated growth from both new client launches and expansion within our existing client base.

Additionally, our yield is trending up to slightly north of 4%, as both new and legacy clients are seeing better member yields than we projected. Of our guidance raise, approximately half is attributable to yield improvements and half from lives growth. The increase in our income from operations and margin expansion comes from two primary sources: first, the top-line outperformance, and second, some slower hiring than anticipated, as AI has increased our efficiency across all operating categories. We do still expect to catch up on hiring as we move throughout the year, and in the meantime, these savings give us additional operating leverage while still maintaining our commitment to investing and expanding our product portfolio and commercial reach.

For share count expectations in 2026, we anticipate ending the year with 82 million to 84 million diluted shares outstanding, which does not include the impact of the continued execution of our share repurchase program. Before I turn it back to Daniel, I want to remind everyone that we will be hosting our annual client conference, Movement, in Chicago on June 10. This year, we are excited to welcome analysts and investors to attend our inaugural investor track alongside the main conference. You will have the opportunity to hear directly from leaders across our company and get to mingle with the people who make Hinge Health, Inc. a success: our clients, members, and partners.

You can register on our investor relations website where we also just uploaded an agenda, and we would love to see you there. With that, let me turn it back over to Daniel to wrap up.

Daniel Perez: Thanks, James. Looking at our strong Q1 performance and the trajectory we are on, I am incredibly optimistic about Hinge Health, Inc.’s future. I am bullish on our business for several key reasons. First, our core MSK market remains massive and underpenetrated. We have a tremendous runway for growth even before expanding into new areas. Second, our expansion into migraine care and strong client demand in this space signify that our platform can successfully automate healthcare delivery for other conditions. Our distribution affords us uniquely powerful paths to market, and we are deepening the value we deliver to clients. AI now lets us build faster than ever, but our distribution channels turn innovation into adoption at scale.

Third, our financial performance continues to demonstrate the scalability and durability of our business model. We are generating strong cash flows, investing in innovation and growth, all while returning capital to shareholders. What excites me most is that we are just scratching the surface of what is possible. Healthcare remains one of our economy’s last redoubts of manual labor, and we have the opportunity to transform how care is delivered across multiple conditions. Our vision to build a new health system that uses technology to scale and automate care delivery is not just a long-term aspiration. It is happening right now, one condition at a time. We are moving with urgency to extend our leadership position.

Our journey is just getting started. We have decades of work ahead, and I am confident our best days are still in front of us. Thank you all for joining us today and for your continued support of our mission. Bianca, let us open it up for questions.

Bianca Buck: Thanks, Daniel. We will now open the call for questions. Operator, we are ready to take questions.

Operator: We will now begin the question and answer session. Please limit yourself to one question and one follow-up. If you would like to ask a question, please raise your hand now. If you have dialed in to today’s call, please press 9 to raise your hand and 6 to unmute. Please stand by while we compile the Q&A roster. Your first question comes from the line of Saket Kalia with Barclays.

Saket Kalia: Okay, great. Hey, can you hear me okay? Excellent. Thanks for taking my questions here, and great start to the year—congrats. Daniel, I would love to start with you and dig into the migraine program a little bit. How do you think about the market opportunity for Hinge Health, Inc. in that market? And I am sure you went through some exhaustive testing—what were some of your findings on how effective Enso and the combined offering were in addressing that problem?

Daniel Perez: Great question. Overall, our vision is to transform outcomes, experience, and cost by using technology to automate care delivery, and we see migraine as a natural extension of that vision. The clinical need for better migraine care is overwhelming—one in six American adults suffer from migraine—yet there are only about 700 headache specialists in the entire country to serve tens of millions of people. Our early outcomes and member demand have been very strong.

But a big unmet clinical need alone would not have justified our entry; we are extending into migraine because our existing platform makes us uniquely capable of delivering care well, at scale, and you can see that with our 125 customers who have adopted migraine so quickly. It tells us the clinical need is as acute as we believed, and our enterprise reputation and distribution are doing real work there. On distribution, the hardest part in healthcare is not actually building the product; it is getting paid for it. We spent a decade building a client base of nearly 3,000 logos and 60+ health plan, PBM, and other partner relationships.

That is not something a new entrant—AI-enabled or otherwise—replicates in a quarter or even a year. It requires contracts, clinical evidence, trust, and integrations built over time. Our migraine launch sits on top of our clinical evidence base, proprietary data compounding with every member, our hardware that is not commodity in the age of AI, and our distribution moat. Those ingredients are a recipe for a durable competitive advantage, and you are seeing it show up in our free cash flow and return on invested capital. Regarding outcomes, 56% of people in our trial demonstrated that their pain went down from severe or moderate to mild or none with at least one of our Enso waveforms.

Compared to placebo, members were 1.9x more likely to reduce pain with our Enso device. We submitted our packet to the FDA in December and were excited to get clearance in April.

Saket Kalia: Super helpful and exciting outcomes. James, maybe for my follow-up, staying on that topic—how do you think about pricing for the migraine program from a high level? Physical therapy has ongoing exercises through your device, whereas this is more Enso-based. How would you compare and contrast the pricing models?

James Budge: Maybe I will give a few tidbits, and then Daniel can add. As we said in our prepared remarks, do not expect a lot of revenue this year, but do in 2027. This year is about sign-ups, and we have already got over 125 clients with 2 million+ lives attached. With about 80% of our clients now on the engagement-based model, more usage—whether Enso connections for migraine or any other indication—means more opportunities to bill.

Daniel Perez: We are using our engagement-based billing model for migraine as well—the same as our digital physical therapy model. We want to keep things as simple for our clients as possible. We have in-app treatment sessions for digital physical therapy and in-app treatment sessions for migraine. While many migraine treatment sessions are mediated by our FDA-cleared neuromodulation device, Enso, we also have exercise treatment sessions for migraine, as 75% of migraine sufferers also have comorbid musculoskeletal pain, particularly neck pain. Overall, our aim is to have a bigger impact for clients by improving outcomes and experience while lowering costs.

Operator: Your next question comes from the line of Jailendra Singh with Truist Securities. Your line is open. Please go ahead.

Jailendra Singh: Thank you, and congrats on a very strong quarter. It is encouraging to see consistent yield improvement and outperformance, now slightly north of 4% in the quarter. Given what you have been seeing in legacy clients, trends of new lives, and the impact from your initiatives, how do you think about the long-term view on where yield can get to? What is the ceiling there, and will that be dependent on rolling out new programs like migraine, or can you achieve that with existing offerings?

Daniel Perez: Good question. About 9% of people see a physical therapist in any given year. We think with better access and lower cost, that should be closer to 12% to 15% of people. About half of us have a musculoskeletal condition in any given year. We are currently trending to a little over 4% yield this year for our digital physical therapy program, but you can see where we are targeting long term—at least 9%, and we think we are expanding the TAM of people who could see a physical therapist. Migraine typically extends that opportunity while de-risking our ability to continue growing yield overall by giving us more shots on goal.

Overall, we are chasing clinical impact: helping more people every day with our care programs to transform outcomes, experience, and cost structure.

Jailendra Singh: And then on the CMS ACCESS program—can you expand on what you needed to see to participate? It seems the company had an intent to apply but ultimately decided against it.

Daniel Perez: We applaud CMS’s goal of expanding access to evidence-based care, and it is great to see CMS be entrepreneurial. You are right—we did not apply. We believe the ACCESS program as currently designed will not deliver any aspect of the triple aim. Moreover, it is structured in such a way as to necessitate the removal of any clinical oversight, putting one of the most vulnerable patient populations, in our opinion—Medicare—at risk. Even for employer populations, who are a full generation younger, we provide a care team. We have had conversations with CMS and are hopeful they will continue to iterate and develop models that increase access to high-quality care for Americans on Medicare.

Right now, we will stay on the sidelines.

Operator: Your next question comes from the line of Richard Close with Canaccord Genuity. Your line is open. Please go ahead.

Richard Close: Congratulations. Daniel, could you add details on the commentary regarding the pipeline being substantially higher? And then I have a follow-up for James.

Daniel Perez: We are seeing broad-based interest across several different client segments, from SMB employers to large enterprises. In our SMB segment, we recently hired several new reps and are delivering very strong results—the number of lives added to the pipeline in that segment in Q1 is up over 100% year over year. What is really encouraging is the interest in our expanded capabilities as well. Prospects—clients who have been on the sidelines or with a different solution—are very excited about our migraine program and Hinge Select, which gives us more ways to add value and start conversations.

Our sales cycles have not materially changed and still follow a seasonal pattern where most decisions happen in the back half of the year, but the quality of conversations has improved because we are solving more problems for our clients.

Richard Close: As a follow-up, James, you mentioned eligible lives coming in higher and driving the guidance revision. How does that work? Do you not know the lives when you sign a client? Is it just coming in with more lives when all is said and done?

James Budge: Great question. Two parts. We added roughly 5 million utilized lives last year. About 80% of our new lives coming into this year came from existing clients. Half of our upside in lives comes from those existing clients when they give us the new files coming into the new year—they showed up with a lot more lives than we expected. Our clients are growing in headcount, which is great for them and for us, and it goes against the narrative that everybody is getting rid of employees. The other half is our new clients that come on board.

When we sign them, we take an estimate of the number of employees, informed by our contacts at the client, but we do not get the final count until we get their official files when we get into the launch sequence early in the year. We always take a conservative estimate so we come in above it, and that happened again—final files came in quite a bit higher.

Operator: Your next question comes from the line of Ryan Daniels. Your line is open. Please go ahead.

Analyst: Congrats on the strong results, and thanks for taking the question. Just one on Hinge Select—looks like continued momentum there in both number of providers and covered lives. Can you talk more about what you are hearing in the marketplace about demand for that offering? And are you considering expanding that to other areas like ambulatory surgery centers or broader patient navigation opportunities?

Daniel Perez: Great question. Our key focus areas as we invest in Hinge Select are: one, improving the density of our provider network—we have surpassed 4,100 provider locations and want to get that substantially higher over the course of the year; two, expanding access within our book of business, particularly making Hinge Select available via our distribution partners. We are proud to say that now three of the top five national health plans are allowing Hinge Select to be bought via our partnership with them and with our shared clients. We also want to continue to expand distribution broadly.

It is having a big impact: about 85% of members who engage are able to move forward with conservative care, avoiding low-value, high-cost care—imaging, procedures, elective surgeries—and these are the highest-risk members to begin with. That is exactly the outcome we are going for, and it allows us to expand ROI conversations with clients. We anticipate most of the pipeline that we close for Hinge Select will be in the second half of the year. It is a more complicated sale than migraine.

Analyst: As a follow-up, given your chronic pain focus and now migraine, there seems to be correlation to behavioral or mental health conditions. How do you view that as a potential expansion area?

Daniel Perez: Our vision is to use technology to scale and automate care delivery, and we think most care delivery will eventually be amenable to automation. It will take many years, even decades, to capture most of healthcare. With roughly $640 million of trailing twelve months revenue, we are only about 1% of the PT market in America, and PT itself is about 1% of total healthcare spend—so we are 1% of 1%. We have a lot of growth ahead within Hinge Health, Inc. On the roadmap, one of the few things I can say with confidence is not in our near- or medium-term roadmap is mental health. It is a crowded space.

There are many other areas where you are almost competing with non-consumption. Neurology is vastly underserved and long overdue for care automation; we are excited about planting a flag there as well as in several other areas we are evaluating. Never say never on mental health—plans could change—but at the moment, it is not on our roadmap.

Operator: Your next question comes from the line of Craig Hettenbach with Morgan Stanley. Your line is open. Please go ahead.

Craig Hettenbach: Thanks. A question on the continued progress on member yield expansion. Any other details you can share—be it Hinge Connect, effective marketing strategies—on what is keeping that momentum going?

Daniel Perez: New clients are seeing faster member adoption, which we attribute to a better product launching with our latest features from day one, combined with improved outreach techniques, including targeted enrollment initiatives that leverage our Hinge Connect data. For legacy clients, yield growth is coming from improved product and member experience—we are capturing more members beginning care and bringing members back at higher rates—coupled with those improved enrollment initiatives. We like these trends, which is why we are raising yield expectations to slightly north of 4%. It is not just enrollment performing well—we have invested enormously in post-enrollment engagement. If someone enrolls but does not do treatment, we will not improve outcomes or reduce costs.

Our post-enrollment engagement is performing really well—we believe it is trending 2x to 3x higher than second place—and that is where we drive much of our clients’ ROI.

Craig Hettenbach: As a follow-up, we can see AI efficiencies in the numbers. What is your confidence in sustaining that as members increase? The care team has been running roughly flattish—how are you thinking about AI and technology continuing to scale?

Daniel Perez: We are investing in AI across the organization. About a third of our headcount is in R&D, so many teammates are using AI in their day-to-day, allowing us to weave it throughout the organization. On care team efficiencies, there is more room to grow, but not just there—we are looking at efficiencies across our cost structure. We like where gross margin is at 85%. We want to continue investing in the product experience, including the care team experience, even if that means treading water on gross margin moving forward.

James Budge: Maybe I would add a reminder: we doubled the distribution percentage of our Enso devices in 2025 relative to 2024, and we have said we will send even more Enso devices in 2026. That competes against care team efficiencies and flattens gross margin around 85%, maybe with a little more room to grow because of care team efficiencies. We are sending more Enso devices because it produces better outcomes and more opportunities to use our product—engagement in therapy sessions goes up dramatically when someone uses Enso, improving the ROI story. There is still opportunity in operating margin.

We have largely hit our IPO target margins—gross margin 82% to 85% (we are at the high end) and operating margin at 25% (we are at our target). At Movement, we will provide an updated model; you can reasonably conclude there will be higher operating margin targets than what we have today.

Operator: Your next question comes from the line of Jessica Tassan with Piper Sandler. A kind reminder to press 6 to unmute yourself locally. Your line is open. Please go ahead.

Jessica Tassan: Hi, thank you, and congrats on the results. We are looking forward to the Movement conference. On the migraine product, how are you delivering ROI? Are you helping clients avoid prescription drugs or mitigate some of that incremental $8,000 of average healthcare spend per migraine patient per year? Are you holding new products to the same 4:1 ROI standard as the existing MSK product?

Daniel Perez: You are right that a lot of migraine costs are driven by peripheral healthcare costs—people with migraine often do not sleep as well and may have broader health impacts, so addressing migraine can help reduce total healthcare spend. A big component of direct migraine spend is newer migraine drugs, which we are not opposed to—they can be very effective—but they are pricey, often $800 to $1,400 per month, and they do not come without side effects. By giving people a non-pharmaceutical option in their toolkit, our hope is that it complements pharmaceutical regimens, reduces reliance and frequency, and lowers costs overall.

We will be publishing ROI studies on our impact for migraine, and we will hold ourselves to rigorous ROI standards.

Jessica Tassan: As a follow-up on Hinge Select, when you go to market this selling season, how are you planning to price or commercialize this offering? Should we think about it as increasing ARPU via sessions, similar to Enso or virtual MSK sessions, or something else for modeling 2027?

Daniel Perez: You are thinking about it the right way. An in-person visit arranged through Hinge Select carries an admin fee per in-person session delivered—whether PT, imaging, or a doctor visit—and that fee is added to our revenue for brokering that in-person visit as part of our network. It is not a PEPM; it is tied to utilization. We will share more about the Hinge Select model at our Movement investor conference.

Operator: Your next question comes from the line of Rishi Jaluria with RBC Capital Markets. Your line is open. Please go ahead.

Rishi Jaluria: Thanks for taking my questions, and great to see continued strong execution. Daniel, on migraine—what incremental investments do you have to make? What does the timeline to get market-ready look like? Is the current Enso device ready for that, or do you need to retool it? And what about marketing and driving awareness within your customer base?

Daniel Perez: Great question. We have spent the last several years preparing to be multiproduct—“platforming” our capabilities so they can be mixed, matched, and reused. That includes enrollment, member outreach, outcomes collection, treatment delivery, and more. Migraine exemplifies that strategy and largely leverages what we have already built—roughly 75% was already in our infrastructure. The long pole for migraine was hardware; hardware is almost always slower than software. We had a head start and adjusted Enso for migraine, gathered data, and then submitted to the FDA, culminating in clearance. We continuously evaluate conditions where we can meaningfully transform outcomes and experience at a fraction of today’s cost and move with pace.

The resources needed for migraine were very efficient relative to building digital PT where it is today. We anticipate future products to be similarly capital-efficient as they leverage our existing capabilities.

Rishi Jaluria: Thanks. And James, as a growing portion of your base is on the engagement model, what are you observing? Do those clients exhibit higher yield because of lower adoption costs? Is it helping ARPU as they get over the 13-session breakeven you have talked about? Is it helping land new logos?

James Budge: Great question. All of those observations are relevant at the client level. For the member, there is no distinction—members do not know whether their employer is on the engagement model or paid-upfront model, so there is no usage difference attributable to pricing model. At the client level, the engagement model helps conversations—it lowers perceived risk and aligns incentives.

Daniel Perez: It also addresses cynicism in digital health about paying PEPMs or case rates without usage or outcomes. Our engagement model demonstrates confidence that people will use the product and get better. We put our fees at risk for ROI, clinical outcomes, and engagement. Others have struggled to match this client-friendly model, which underlines that they do not have our engagement. We believe we have 2x to 3x higher engagement per member than anybody else in digital MSK. We build products people want to use, and you see it in our numbers.

Operator: Your next question comes from the line of Elizabeth Anderson with Evercore ISI. Your line is open. Please go ahead.

Elizabeth Anderson: Good afternoon, and thanks for the question. Daniel, could you talk a bit more about your MA and full-risk strategy? I know it is not as key as some other parts, but it is still an important area of expansion. How do you see things going into 2027?

Daniel Perez: Great question. In the U.S., there are three key groups of covered lives we target: self-insured, fully insured, and Medicare Advantage. Medicare Advantage is going through a lot of change right now, so we have been particularly focused on our self-insured and fully insured groups. Fully insured last year was up the highest it has ever been, and in Q1, it probably contributed more to new lives than any Q1 we have had. We are also seeing strong growth in our federal plans, which have a distinct decision-making process. Fully insured and ASO are growing robustly, particularly fully insured. That underlines the ROI we deliver.

We likely have an order of magnitude more fully insured customers than second place in digital MSK. We like when fully insured customers buy Hinge Health, Inc. because actuaries have underwritten the cost based on our ROI, which is a powerful validation of our outcomes.

Operator: Next question comes from the line of Brian Patterson with Raymond James. Your line is open. Please go ahead.

Analyst: Thanks, and congrats on the strong quarter. I know you mentioned that you have 80% of customers on the new pricing model and that it would stay about the same. Why would that not migrate closer to 100%? Is there anything keeping that from a customer perspective?

James Budge: During selling season, almost 100% of new customers come on under the engagement model. For certain legacy clients on older arrangements, switching pricing models is not always their top priority, so the mix stays roughly stable in the near term.

Daniel Perez: Almost no new customer is on the older billing model—almost all new customers are on the engagement/consumption model.

Operator: Your next question comes from the line of Scott Schoenhaus with KeyBanc. Your line is open. Please go ahead.

Scott Schoenhaus: Hey, can you hear me? Okay, good. Thanks for taking my questions. On the new migraine program, Daniel, you talked about 12% to 15% yields as your prior ceiling. Where is that now with migraine? And how do you effectively target customers for this new program? Historically, you have leveraged claims data and EHR data—what else are you doing to target people in the migraine enrollment program?

Daniel Perez: For traditional physical therapy, about 9% of people see a PT in a given year across orthopedics, with some segments a little more or less. In our view, PT is underutilized due to access constraints, and increased spend on PT—digital or in person—leads to lower downstream costs. We would like to expand access so more people use PT, moving from ~9% closer to 12% to 15% over time. Migraine gives a parallel path for enrollments. Some will enroll in both migraine and digital PT, some only PT, some only migraine. We will share more on yield forecasts at Movement and over time.

With one in six adults impacted by migraine—about 20% of women and 10% of men—we are confident the unmet need is large. On targeting, approaches are similar to digital PT—broad awareness for those suffering in silence, claims, and EHR data—but for migraine, pharmacy data is often more relevant. Many migraine medications are not over the counter and will show up in Rx data. We also leverage member-to-member referrals. Overall, the same channels as digital PT, with added emphasis on Rx data.

Operator: Your next question comes from the line of Ryan MacDonald from Needham & Company. Your line is open. Please go ahead.

Ryan MacDonald: Thanks for taking my questions, and congrats on an amazing quarter. Two on migraine—one for Daniel and one for James. Daniel, as you talk to clients already adopting migraine—the 125 thus far—what do those conversations look like as they balance upfront costs with ROI on the back end? Are they going to have clinical eligibility requirements given the smaller clinically diagnosed population? Are they capping utilization in early stages as they experiment? And, James, given Enso is a core component of the migraine program, how should we think about the rate at which Enso deployment grows within the member base into next year and the potential impact on gross margins over time?

Daniel Perez: On enrollment and the sales process, conversations with employers have been very productive. Overwhelmingly, someone on the team—or a spouse—is afflicted with migraine. We have gotten inbound from customers asking how soon they or their spouse can enroll. If someone has a migraine, they are effectively out of commission—whether in-office or remote—so employers recognize the impact on productivity and the need for better care. There is a need for ROI, but also a recognition that employees and dependents need access to better care. We are seeing straightforward, supportive conversations.

James Budge: A quick reminder: in our cost of goods sold, about half is the care team and about half is Enso/devices. Increases in Enso deployment have largely been offset by efficiencies in the care team; we see that again in 2026 and likely in 2027. Specifically, we increased Enso distributions in 2025 by about 2x over 2024 as a percentage of members receiving it. This year, we will likely increase another ~40% over last year, given what we were already planning plus migraine. We had already factored migraine into our planning, so it is not brand new to our forecast.

Operator: For your final question today, we will go to Stanislav Berenshteyn with Wells Fargo. Your line is open. Please go ahead.

Stanislav Berenshteyn: Thanks for squeezing me in. Two quick ones. First, for the 20% of lives still on the subscription pricing, have there been any changes in pricing at renewal? And then on the pipeline, you called out Q1 as substantially higher versus prior year and SMB as materially stronger. Is the sales cycle any different for SMBs versus larger enterprise accounts?

James Budge: No changes—pricing on the upfront model has remained the same for several years now.

Daniel Perez: SMB sales cycles are much faster—smaller organizations make decisions more quickly, so it is a more efficient sale.

James Budge: As a reminder, we talked about adding more capacity and personnel on our SMB team on a couple of calls last year. It is great to see that when we invest—whether in product like migraine or in SMB on the commercial side—we drive more pipeline. We are being thoughtful about where we invest.

Operator: That is all the time we have for questions. I will now turn the call back to Daniel Perez for closing remarks.

Daniel Perez: First off, thank you, everybody, for dialing in and for learning more about our business, and to our investors who have put their capital into Hinge Health, Inc. As you can see from our results and our expanding product portfolio, we are not standing still. There is a lot of runway ahead. As I mentioned, we are just 1% of 1% right now in terms of the total TAM we believe we can tackle. We hope to have many decades ahead.

We are excited about the progress, and we hope to see many of you at our client conference, Movement, where we will also host our investor conference on June 10, as well as in the coming quarters as we share more products. Have a good rest of your day.

Operator: This concludes today’s call. Thank you for attending. You may now disconnect.