At a glance
Healthstream Inc is worth $986.3M, about 55 times its fiscal 2025 earnings. Revenue grew 4.3% to $304.1M in fiscal 2025, with 6.0% kept as profit; over 5 years it has grown 4.4% a year. It pays a 0.44% dividend yield, raised every year for at least 3 years, and returned $77.3M to shareholders in dividends and buybacks over FY2021–FY2025. The stock returned +31.4% over the past year with dividends reinvested and +5.4% a year over five years, against +11.5% and +11.7% for the S&P 500. At its worst it fell 23.6% in the 2020 crash (S&P 500: 33.7%) and 28.2% in the 2022 bear market (S&P 500: 24.5%), and was back at its earlier high 14 months and 13 months after the lows.
The business in plain English
HealthStream, based in Nashville, Tennessee, sells software and online training that help hospitals and other healthcare organizations manage their workforce. It began selling online products in 1999. It started with courses for training that hospital staff must complete under government rules and accreditation standards, such as workplace safety and patient privacy. Its products now cover learning, credentialing and staff scheduling.
Most of its products are software-as-a-service (SaaS). That means customers pay a subscription to use the software over the internet rather than paying once for a license. Clients subscribe to course libraries with content from nursing associations and medical publishers, and to scheduling tools that let staff swap and fill shifts. They also use CredentialStream, which automates checking the licenses of doctors and other providers, granting hospital privileges and enrolling providers with insurers. Part of revenue depends on how many users each client has. The company's hStream platform, launched in 2018, links these apps and increasingly adds AI features.
Revenue was $304.1 million in fiscal 2025, which ended December 31, 2025. That was up 4.3% from the prior year and about 4.4% a year on average since fiscal 2020. A significant portion comes from a relatively small number of customers. HealthStream has reported as a single business segment since January 1, 2023, and its annual report gives no clean revenue split by product or region.
Price history
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HSTM +31.4% over the year to Oct 28, 2026, total return with dividends reinvested.
Latest results
- In Q2 FY2026 (ended Jun 30, 2026), revenue was $83.7M, up 12.5% from a year earlier, and net income was $6.7M (+23.8%).
- For fiscal 2025, revenue was $304.1M (+4.3% year over year; +4.4% a year from FY2020 to FY2025) with a 6% net margin.
Financial health check
| Revenue growth a year (FY2020–FY2025) | +4.4% watch |
|---|---|
| Operating margin | 6.7% watch |
| Free cash flow margin | 19.6% good |
| Return on equity (FY2025) | 5.2% weak |
| Return on assets (FY2025) | 3.5% watch |
| Cash and investments | $66.7M (no borrowings found in the filings) good |
| Fiscal year | Revenue | Net income | Free cash flow |
|---|---|---|---|
| FY2020 | $244.8M | $14.1M | $33.9M |
| FY2021 | $256.7M | $5.8M | $39.0M |
| FY2022 | $266.8M | $12.1M | $49.4M |
| FY2023 | $279.1M | $15.2M | $61.8M |
| FY2024 | $291.6M | $20.0M | $56.3M |
| FY2025 | $304.1M | $18.3M | $59.6M |
Valuation snapshot
| Market value | $986.3M |
|---|---|
| P/E ratio | 55.3 |
| Dividend yield | 0.44% |
Rank among 1514 US companies
Market value at each year end
Healthstream’s market value went from $795.1M at the end of 2016 to $986.3M on Oct 28, 2026, up 24%; since the end of 2025 it is up 44%.
Show as a table
| Year end | Market value | Change |
|---|---|---|
| Oct 28, 2026 | $986.3M | +44.1% |
| 2025 | $684.4M | -29.2% |
| 2024 | $967.2M | +18.2% |
| 2023 | $818.6M | +7.8% |
| 2022 | $759.4M | -8.7% |
| 2021 | $832.0M | +20.3% |
| 2020 | $691.8M | -21.4% |
| 2019 | $880.7M | +12.8% |
| 2018 | $780.7M | +5.7% |
| 2017 | $738.7M | -7.1% |
| 2016 | $795.1M |
Price behavior
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | |
|---|---|---|---|---|---|
| HSTM price data to Oct 28, 2026 | +46.9% | +31.4% | +11.6% | +5.4% | +3.0% |
Show as a table
| Year | Price data |
|---|---|
| 2026 (to date) | +46.9% |
| 2025 | -27.1% |
| 2024 | +18.2% |
| 2023 | +9.3% |
| 2022 | -5.8% |
| 2021 | +20.7% |
| 2020 | -19.7% |
| 2019 | +12.6% |
| 2018 | +8.6% |
| 2017 | -7.5% |
| 2016 | +13.9% |
| 2015 | -25.4% |
| 2014 | -9.6% |
| 2013 | +34.2% |
| 2012 | +31.8% |
| 2011 | +129.5% |
| 2010 | +103.5% |
| 2009 | +69.5% |
| 2008 | -33.4% |
| 2007 | -11.4% |
| 2006 | +69.5% |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Lost 45.5% over that stretch · deepest drop along the way 54.4%, back to its old high 5.2 months after the low |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Lost 10.7% over that stretch · deepest drop along the way 23.6%, back to its old high 14.2 months after the low |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Lost 20.7% over that stretch · deepest drop along the way 28.2%, back to its old high 12.8 months after the low |
Insider activity
Form 4 filings from 2025-11-03 to 2026-11-03 (25 read): 0 open-market purchases and 1 sales ($420K), 1 of them under pre-arranged 10b5-1 trading plans.
| Date | Insider | Type | Value |
|---|---|---|---|
| Oct 23, 2026 | Linda Rebrovick Director | sell (plan) | $420K |
Who owns it
Large shareholders (13G filings)
| BlackRock, Inc. | 11.9% | Mar 31, 2025 |
| Dimensional Fund Advisors LP | 5.3% | Jun 30, 2026 |
ETFs with the most weight in HSTM
| FDLS Inspire Fidelis Multi Factor ETF | 1.07% |
| PSCH Invesco S&P SmallCap Health Care ETF | 0.54% |
| SQLV Royce Quant Small‑Cap Quality Value ETF | 0.43% |
| MMSC First Trust Multi-Manager Small Cap Opportunities ETF | 0.43% |
| SIXL ETC 6 Meridian Low Beta Equity ETF | 0.42% |
| SMIZ Zacks Small/Mid Cap ETF | 0.35% |
| IWC iShares Micro-Cap ETF | 0.24% |
| ISMD Inspire Small/Mid Cap ETF | 0.21% |
What could go wrong
- Rules on required training could change. Many of HealthStream's courses help hospital staff complete training that regulators and accreditors require. The company warns that any reduction or change in rules on healthcare continuing education could hurt its business.
- Credentialing errors could bring claims. Hospitals use CredentialStream to verify providers' licenses, grant privileges and handle insurer enrollment. Errors or omissions in that software or its processes could lead to action against HealthStream and damage its business.
- Reliance on a few large customers. A significant portion of revenue comes from relatively few customers, and a large share of the business depends on renewals. Losing a major client at renewal time could hurt results.
- Hospital budgets are under strain. Clients face staff shortages, high wages and lower payments from insurers and government programs. A July 4, 2025 federal law is expected to reduce insurance coverage. Tight budgets or hiring freezes can cut HealthStream's sales.
- AI could help or hurt. HealthStream is building AI into its hStream platform and products. Poorly designed or misused AI could cause reputational harm or legal liability, while falling behind on AI could weaken its products' appeal.
- Acquisitions and investments may disappoint. Growth plans rely partly on acquisitions, partnerships and stakes in other companies. Deals that fail to integrate well, or investments that lose value, could hurt earnings and lead to write-downs of balance-sheet assets.
Recent events
- Quarterly results released; Investor presentation or announcement; Other company announcement
- Executive or board change
- Major agreement signed; Unregistered sale of shares; Investor presentation or announcement
- Major agreement signed; New debt or financial obligation
- Quarterly results released; Investor presentation or announcement; Other company announcement
- Other company announcement
- Shareholder vote results
- Executive or board change
- Quarterly results released; Investor presentation or announcement; Other company announcement
- Major agreement signed; Other company announcement
For income and retirement investors
HealthStream pays a small quarterly dividend. Dividends per share were zero in fiscal 2021 and 2022, then $0.10, $0.112 and $0.124 in fiscal 2023 through 2025, a short record of increases. The fiscal 2025 payout used 20.3% of earnings and 6.3% of free cash flow (cash left after running and investing in the business). The yield was 0.44% as of October 28, 2026, so the stock provides little income, and the company warns it could cut or stop the dividend. Buybacks matter more: $67.1 million over fiscal 2021–2025, against $10.2 million in dividends. Shares outstanding fell 7.4% from October 2021 to August 2026.
In the 2008 financial crisis the shares fell 54.4% from peak to low, then recovered about five months after bottoming. They fell 23.6% in the 2020 COVID crash and 28.2% in the 2022 bear market, and took more than a year to recover each time. A single stock carries more risk than a diversified fund.
Questions investors ask
How does HealthStream make money?
HealthStream makes money mainly by selling software subscriptions to hospitals and other healthcare organizations. Clients pay for online course libraries that cover required staff training, for scheduling tools and for CredentialStream, which automates checking providers' licenses and enrolling them with insurers. Part of its revenue depends on how many users a client has. Revenue was $304.1 million in fiscal 2025, up 4.3%, and a significant portion came from a relatively small number of customers.
Does HealthStream pay a dividend?
Yes, but it is small. HealthStream paid $0.124 per share in fiscal 2025, up from $0.112 in fiscal 2024 and $0.10 in fiscal 2023. It paid nothing per share in fiscal 2021 and 2022. The yield was 0.44% as of October 28, 2026, and the fiscal 2025 dividend used 20.3% of earnings. The company spends far more on buybacks, $30.0 million in fiscal 2025, and warns the dividend could be cut or stopped.
Does HealthStream have any debt?
Its filings showed no borrowings as of June 30, 2026, when it held $66.7 million in cash and investments. That may have changed since. On September 14, 2026, HealthStream filed a report on a major agreement and a new debt or financial obligation. A filing the next day covered another major agreement and a sale of unregistered shares. Those filings give the size and terms of any new borrowing.
How has HealthStream stock performed?
Long-term returns have been modest, with big swings. As of October 28, 2026, the share price was up 46.9% for 2026 so far and 31.4% over one year. Over longer periods it averaged about 5.4% a year over five years and 3.0% a year over ten. The stock fell 27.1% in 2025. Its worst drop in the three years to October 28, 2026 was 41.5%, and its worst in about 21 years of trading history was 66.2%.
Is HealthStream stock expensive?
Its price is high relative to its earnings. As of October 28, 2026, the shares traded at about 55 times fiscal 2025 earnings of $0.61 per share. That figure is the price-to-earnings, or P/E, ratio. Revenue grew 4.3% in fiscal 2025 while net income fell 8.3%. Growth picked up in the quarter ended June 30, 2026, with revenue up 12.5% and net income up 23.8% from a year earlier. Free cash flow was $59.6 million in fiscal 2025, well above net income of $18.3 million.