American Shared Hospital Q2 Results: Revenue up 19% to $8.4 million
American Shared Hospital Services posted Q2 2026 revenue of $8.4 million, up 19% YoY, driven by a 40% surge in direct patient services. Adjusted EBITDA fell to $1.3 million due to cost structures, though operating cash flow hit $4.4 million in H1, raising cash balances by 80% to $6.8 million.
*this image is generated using AI for illustrative purposes only.
American Shared Hospital Services (AMEX: AMS) delivered strong top-line growth in the second quarter of 2026, with revenue rising 19% year-over-year to $8.4 million. This performance marks an acceleration from the first-half revenue growth of 18%, which totaled $15.5 million for the period ended June 30, 2026.
The results underscore the company’s strategic shift from equipment leasing toward a diversified radiation oncology platform. Direct patient services emerged as the primary growth engine, contributing significantly to the overall revenue expansion alongside improved performance in international operations and Proton Beam Radiation Therapy.
Financial Performance
Revenue growth was broad-based but driven distinctly by specific segments. The direct patient services segment saw revenue surge approximately 40% year-over-year to $4.9 million in the quarter. This contrasts with the medical equipment leasing segment, where overall revenue remained relatively stable compared to the prior year.
Within leasing, Proton Beam Radiation Therapy revenue increased 22% to approximately $2.3 million, benefiting from higher treatment volumes and favorable reimbursement trends. This gain substantially offset the impact of one expired domestic Gamma Knife customer agreement in 2025. International Gamma Knife operations also showed modest revenue increases as procedure volumes recovered following technology upgrades in Peru.
| Metric | Q2 2026 | Q2 2025 | Change |
|---|---|---|---|
| Total Revenue | $8.4 million | $7.1 million | +19% |
| Direct Patient Services Revenue | $4.9 million | ~$3.5 million* | +40% |
| Proton Beam Revenue | $2.3 million | ~$1.9 million* | +22% |
| H1 Total Revenue | $15.5 million | $13.2 million | +18% |
*Figures derived from percentage changes stated in source.
What the Numbers Show
The divergence between revenue growth and profitability metrics highlights the transitional nature of the business model. While total revenue grew 19%, adjusted EBITDA declined to approximately $1.3 million from $1.7 million in the prior-year quarter. This contraction occurred despite gross margin improving sequentially from the first quarter of 2026 to approximately $1.4 million. The data suggests that while the company is successfully scaling high-growth direct patient services, the associated cost structure is currently absorbing a significant portion of the incremental revenue before translating into operating profit.
Balance Sheet and Liquidity
Liquidity positions strengthened materially during the first half of 2026. Operating activities generated $4.4 million in cash, enabling the company to fund scheduled debt repayments and minority partner distributions while increasing its cash balance by over 80% to $6.8 million at the end of the second quarter. This compares to $3.7 million in cash, cash equivalents, and restricted cash at the end of 2025.
Interest expense declined during the quarter as average debt balances decreased. However, reported net loss was impacted by two significant non-operating items: a $909,000 charge for credit losses on Rhode Island receivables dating back to May 31, 2025, and $285,000 in legal and professional costs related to credit agreement negotiations.
Strategic Outlook
Management emphasized continued focus on increasing utilization across its network, particularly in Rhode Island where three radiation oncology centers are seeing higher patient volumes. Internationally, the company is advancing opportunities in Latin America, including a partnership with Hospital San Xavier in Guadalajara, Mexico, to upgrade its Gamma Knife center.
Subsequent to the quarter end, American Shared Hospital entered into a Third Amendment and Forbearance Agreement with Fifth Third Bank. Additionally, a new company formed by Executive Chairman Ray Stokowiak purchased additional shares and provided $2 million in subordinated financing. These moves aim to provide financial flexibility while management pursues longer-term capital solutions.
How long will it take for the high-growth direct patient services segment to achieve economies of scale that reverse the current decline in adjusted EBITDA?
What specific milestones must be met in the Latin American expansion, particularly with Hospital San Xavier, to justify continued capital allocation over domestic growth?
Will the $2 million in subordinated financing and the Third Amendment with Fifth Third Bank provide sufficient runway for AMS to secure permanent equity or debt financing without dilutive terms?
17
Create Custom Screeners 
Access 200+ Pre-built Filters 
Use 50+ Readymade Screener 
