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Here's How Tempus AI Demonstrates Improving Operating Leverage

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Key Takeaways

  • Tempus AI's Q2 revenues rose 22% to $382.5M, while adjusted EBITDA improved $13.6M to a positive $8M.
  • Tempus AI expects its $460M convertible notes offering to cut annual interest expenses by more than $30M.
  • Tempus AI raised its 2026 revenue outlook to $1.595-$1.605B, maintaining adjusted EBITDA guidance of $65M.

Tempus AI (TEM - Free Report) demonstrates improving operating leverage as revenues scaled in the second quarter of 2026. Second-quarter revenues increased 22% year over year to $382.5 million. Meanwhile, adjusted EBITDA reached $8 million, marking a $13.6 million improvement from a loss of $5.6 million in the year-ago quarter. GAAP net income was $5.6 million and cash used in operating activities narrowed to $7.5 million. 

The company ended the quarter with $820.7 million in cash, cash equivalents and marketable securities. It also completed a $460 million offering of 0.0% convertible senior notes due 2032, using part of the proceeds to repay its outstanding loan from Ares Capital. It expects the transaction to reduce annual interest expense by more than $30 million and support its goal of achieving positive free cash flow by year-end 2026. 

Against this backdrop, Tempus raised its full-year 2026 revenue guidance to $1.595-$1.605 billion, implying approximately 25% growth, while maintaining adjusted EBITDA guidance of about $65 million. 

Additionally, this combination of stronger revenue growth, positive quarterly adjusted EBITDA and lower expected interest costs supports the company’s progress toward positive free cash flow. However, achieving its year-end target remains a key execution milestone.

Peer Update

Inspire Medical (INSP - Free Report) exited the second quarter of 2026 with cash and cash equivalents and short-term investments of $320.7 million compared with $283.8 million at the end of first-quarter 2026. INSP does not have any debt on its balance sheet. Therefore, there appears to be no near-term threat to Inspire Medical’s solvency. 

Cumulative net cash provided by operating activities at the end of second-quarter 2026 was $36.1 million compared to the cumulative net cash used in operating activities of $4 million a year ago.

iRhythm Holdings (IRTC - Free Report) exited the second quarter of 2026 with cash and cash equivalents and marketable securities of $591 million compared with $550 million at the end of the first quarter of 2026. IRTC does not have any current-year payable debt. Therefore, there appears to be no near-term threat to iRhythm’s solvency. However, the balance sheet is somewhat leveraged. Total debt of $651 million at the end of second-quarter 2026 has remained unchanged sequentially.

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