# HealthStream, Inc. (HSTM)

> Source: Nexqual · https://nexqual.com/HSTM · data as of 2026-10-22 20:00 UTC · cite as "Nexqual, HealthStream, Inc. (HSTM), nexqual.com/HSTM" · informational, not investment advice.

**Price:** USD 34.59 (+3.22% on the day) · last close of Oct 22, 2026; US market pre market, not a live price. Prev close 34.59 · day 33.74–34.67 · 52w 19.5–34.67 · market cap null · NMS

## Key facts
- Last four reported quarters (through Jun 30, 2026): revenue $321M, net income $21.2M (6.6% margin), free cash flow $69.8M (SEC filings).
- 1 of 80 tracked superinvestors hold HSTM (13F, Q2 2026): 0 new, 1 added, 0 reduced, 0 unchanged.
- Insider open-market sales, last ~7 months: 5 Form 4 filings, $4.6M; 2 not under a Rule 10b5-1 plan ($4.3M); 0 by opportunistic insiders, 0 by routine insiders (three-year test, Cohen, Malloy & Pomorski 2012).
- Total return with dividends: 1Y +31.3% vs S&P 500 +14.9%; 5Y +24.3% vs S&P 500 +80.3%.
- Next earnings: 2026-11-02, EPS estimate USD 0.15, revenue estimate $82.2M.

## Financials (SEC 10-K; TTM = last four 10-Q/10-K quarters)
| USD | FY2021 | FY2022 | FY2023 | FY2024 | FY2025 | TTM |
|---|---|---|---|---|---|---|
| Revenue | $257M | $267M | $279M | $292M | $304M | $321M |
| Operating income | $8.1M | $12.4M | $16.0M | $21.3M | $20.2M | $25.8M |
| Net income | $5.8M | $12.1M | $15.2M | $20.0M | $18.3M | $21.2M |
| EPS (diluted) | $0.18 | $0.39 | $0.50 | $0.66 | $0.61 | — |
| Free cash flow | $39.0M | $49.4M | $61.8M | $56.3M | $59.6M | $69.8M |
| Operating margin | 3.1% | 4.7% | 5.7% | 7.3% | 6.7% | 8.0% |
| Net margin | 2.3% | 4.5% | 5.5% | 6.9% | 6.0% | 6.6% |
| Revenue growth | +4.9% | +3.9% | +4.6% | +4.5% | +4.3% | — |
| Cash + short-term investments | $51.9M | $53.9M | $71.1M | $97.2M | $57.0M | — |
Fiscal years end Dec. EPS is split-adjusted.

## Valuation (price ÷ last four quarters, through Jun 30, 2026)

P/E at fiscal year-ends: Dec 2025 37.9x, Dec 2024 48.5x, Dec 2023 54.5x.

## Superinvestors (SEC 13F-HR, Q2 2026)
1 of 80 tracked investors hold HSTM. Each row is the investor's latest 13F; change is vs their prior-quarter share count.
| Investor | Firm | % of portfolio | Value | Change |
|---|---|---|---|---|
| First Eagle Investment | First Eagle Investment Management | 0.03% | $16.1M | Added +39.0% |

## Insider sales (SEC Form 4, open-market, last ~7 months)
3 of 5 under a Rule 10b5-1 trading plan (scheduled in advance). Unplanned sales were timed by the insider.
| Trade date | Insider | Role | Shares | Value | % of holdings sold | 10b5-1 plan | Insider type |
|---|---|---|---|---|---|---|---|
| 2026-09-14 | Frist Robert A Jr | CEO and Chairman | 144,068 | $4.3M | 2.8% | No | Too little history (no open-market trades in 2023–2025) |
| 2026-07-06 | Rebrovick Linda | Director | 6,000 | $174K | 10.5% | Yes (adopted November 21, 2025) | Too little history (no open-market trades in 2023–2025) |
| 2026-06-01 | Rebrovick Linda | Director | 2,000 | $50K | 3.6% | Yes (adopted November 21, 2025) | Too little history (no open-market trades in 2023–2025) |
| 2026-05-28 | Rebrovick Linda | Director | 2,000 | $50K | 3.4% | Yes (adopted November 21, 2025) | Too little history (no open-market trades in 2023–2025) |
| 2026-05-20 | O'Hara Kevin P | Executive Vice President | 3,000 | $72K | 12.5% | No | Too little history (no open-market trades in 2023) |
% of holdings sold = shares sold ÷ (shares sold + all holdings the insider reported on that Form 4, direct and through trusts).
Insider type follows Cohen, Malloy & Pomorski (Journal of Finance, 2012). An insider who traded the stock in the same calendar month in each of the past three years is a routine trader; one who traded in each of those years without such a pattern is an opportunistic trader. In their study, trades by opportunistic insiders predicted future returns and trades by routine insiders did not. Counts open-market purchases and sales only (SEC Form 4 codes P and S) by that insider in that company. Not investment advice.

## Analysts
Rating changes, last 120 days:
| Date | Firm | Action | Rating | Price target |
|---|---|---|---|---|
| 2026-10-13 | Freedom Capital Markets | Initiated | Hold | $36 |
| 2026-07-21 | Canaccord Genuity | Target raised | Hold | $24 → $27 |

## Total return (dividends reinvested)
|  | 1Y (from 2025-10-23) | 5Y (from 2021-10-18) |
|---|---|---|
| Total return | +31.3% | +24.3% |
| S&P 500 (SPY) | +14.9% | +80.3% |
| Per year | +31.4% | +4.4% |
| Volatility (annualized) | 32.1% | 27.7% |
| Max drawdown | -24.9% (Oct 2025→Feb 2026) | -41.4% (Apr 2025→Apr 2026) |

## Peers (Health Information Services)
TDOC (Teladoc Health, Inc.) USD 6.32 +0.32% · OMDA (Omada Health, Inc.) USD 18.98 -3.46% · GDRX (GoodRx Holdings, Inc.) USD 3.62 +1.40% · PHR (Phreesia, Inc.) USD 12.72 +3.75% · CERT (Certara, Inc.) USD 10.09 -0.88% · OMCL (Omnicell, Inc.) USD 37.1 +2.09%

## More
Full page: https://nexqual.com/HSTM · Free keyless MCP server with the same data and citations: https://mcp.nexqual.com/mcp · Guide for agents: https://nexqual.com/agents · https://nexqual.com/llms.txt

## Revenue by product line (quarter ended 2026-06-30)

| Line | Revenue | Share | YoY |
|---|---|---|---|
| Subscription Services | $80.0M | 95.5% | +11.2% |
| Professional Services | $3.7M | 4.5% | +52.6% |
| Total revenue | $83.7M | 100% | — |

## Company outlook (8-K filed 2026-08-03)

- "Financial Outlook for 2026 The Company is updating its guidance for 2026 for the measures set forth below."
- "The Company's guidance for 2026, as set forth above, reflects the Company's assumptions regarding, among other things, expectations for new sales and renewals, and assumes that general economic conditions do not deteriorate."
- "This guidance does not include the impact of any future acquisitions or dispositions that we may complete during 2026, gains or losses from changes in the fair value of non-marketable equity investments or contingent consideration, or impairment of long-lived assets."

## Analyst estimates and revisions

| Period | EPS est. | 90d ago | Change | Revenue est. | Analysts |
|---|---|---|---|---|---|
| Current quarter (ends 2026-09-30) | $0.14 | $0.19 | -23.7% | $82.2M | 2 |
| Next quarter (ends 2026-12-31) | $0.15 | $0.20 | -25.0% | $82.9M | 2 |
| Current fiscal year (ends 2026-12-31) | $0.73 | $0.79 | -7.0% | $329.5M | 1 |
| Next fiscal year (ends 2027-12-31) | $0.89 | $0.86 | +2.3% | $344.6M | 2 |

## Options: expected move (Cboe, 15-min delayed)

Expected move by 2026-12-18 (includes earnings 2026-11-02): ±11.3%; last 8 reports averaged ±8.2%.

| Expiration | Days | ATM IV | Expected move |
|---|---|---|---|
| 2026-12-18 | 56 | 35.5% | ±11.3% |
| 2027-03-19 | 147 | 34.7% | ±17.6% |