EHealth (NASDAQ:EHTH) delivered a sizzling performance in 2019 with its shares skyrocketing 150%. Its stock is also off to a great start in 2020, up more than 35% so far this year. 

The online health-insurance exchange provider announced its 2019 fourth-quarter and full-year results after the market closed on Thursday. And eHealth's year is already looking even better. Here are the highlights from the company's Q4 update.

Health insurance application on tablet

Image source: Getty Images.

By the numbers

Revenue in the fourth quarter was $301.7 million, soaring 124% year over year. This result also trounced the average analyst estimate of $234.87 million.

The company announced Q4 net income of $88.8 million, or $3.58 per share, based on generally accepted accounting principles (GAAP). This represented a huge jump from GAAP earnings of $26.1 million, or $1.25 per share, posted in the same quarter of 2018. 

EHealth's adjusted bottom line looked really good, too. The company reported adjusted net income of $102.5 million, or $4.13 per share, up significantly from adjusted earnings of $35.7 million, or $1.72 per share, recorded in the prior-year period. This result handily beat the consensus Wall Street adjusted earnings estimate of $2.43 per share.

Behind the numbers

EHealth's Q4 revenue number received a big boost from a change in estimate for expected cash commission collections. The company said that this change increased its revenue in the quarter by $50.8 million, with $42.3 million of the total related to Medicare Advantage plans that it began selling in Q3 of 2019.

That wasn't the only factor driving revenue growth, though. Medicare revenue excluding the impact of this change totaled $240.3 million in Q4, nearly double the $121.6 million from the prior-year period. In addition, eHealth reported revenue from its individual, family, and small-business segment of $19.1 million, up 44% year over year.

The key to eHealth's impressive revenue in Q4 was the company's expanding membership base. It reported that its total estimated membership as of the end of 2019 was 1,146,115 -- a 20% year-over-year jump. Medicare membership soared 46% year over year to 710,649. However, membership in eHealth's major medical individual and family plans fell 15% to 128,487.

Looking ahead

The company projects full-year 2020 revenue will be between $580 million and $620 million. Medicare segment revenue is expected to be between $533 million and $569 million, with individual, family, and small-business segment revenue for full-year 2020 between $47 million and $51 million.

The company looks for GAAP net income per diluted share in 2020 in the range of $2.64 to $3.23. Adjusted earnings are expected to come in between $3.56 and $4.09 per share.

CEO Scott Flanders said, "[W]e anticipate the momentum we have built over the past two years to continue into 2020, and we believe we are well positioned to continue outpacing the overall Medicare market growth as a result of our strong consumer value proposition, the depth of our technology platform, and our demand generation expertise."

The big question mark for eHealth this year, though, is how the presidential election might affect the company. Healthcare stocks could be especially volatile if Sen. Bernie Sanders, the current leading Democratic presidential candidate, ultimately becomes the Democratic nominee. Sen. Sanders is a vocal proponent of a single-payer healthcare system.

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