The healthcare services and HCIT analyst here, William Blair. It's my great pleasure to be with Matt Hawkins from Waystar. This is the first presentation at the Growth Stock Conference for Waystar. Super excited to have the company here today. Sandy Draper is also in the audience. There he is in the back waving, who runs investor relations. He used to be a peer of mine. Worked with Sandy a lot over the years. Really happy to have both Matt and Sandy here with us today. A couple quick things. We'll be up in Jenny A for the breakout session after this, so we'll have the Q&A up there. I also want to just remind everyone that our disclosures are on our website at williamblair.com. Now for the meat of the presentation. Again, really excited to have this company here.
I think it's a great example of the type of durable business franchise that we look for at William Blair. It's a great management team. It's a great product offering, industry leader, highly visible revenue stream, phenomenal margin and cash flow profile. We think it's just a great asset for these challenging times. This is a name we've used a lot over the last few quarters as a top idea. We just think the durability of the model is fantastic. The one thing that Matt probably won't talk about today, maybe will, is the culture of the organization. One of the things that I think my team and I have really come to appreciate is it's an organization that really cares about their customers.
During our channel checks, I think we heard every time that this is an organization that is willing to do anything they can to help us, you know, work weekends, work overnight. They get it done. They do not say why. They do not ask questions. They just get it done for us. I wanted to plug that because I think it is an important part of the story and probably something that is not in the slide deck. Really excited to have the team here. Again, we will be out at Jenny A for the breakout. With that, I will turn it over to Matt.
Really appreciate it. Thank you.
Good afternoon, everybody. I think I'm double mic'ed, so I'll do my best here. But it's a pleasure to be here today. And I'm grateful to be able to introduce Waystar to some of you and to familiarize Waystar in more detail with others of you who may know a little bit about our story. It's funny, we went public a year ago at this time. So tomorrow I'll be with our team and with our board in New York City to ring the closing bell on the NASDAQ. It's been a really fast year for us, but we've now, as a public company, delivered four consecutive quarters of double-digit revenue growth and adjusted EBITDA margins that are at 40% or in excess of that. We've deliberated the business over the course of our first year as a public company, just as we said we would do.
Our business model is really working. You can imagine how grateful I am, how thrilled I am to be able to introduce Waystar to you today. We'll jump right in. Oh, let me go back a little bit here. For those that are not familiar, let me give you some quick highlights on how we think about our business. We are a software business purpose-built for healthcare. We formed the company in 2017, backed by Bain Capital. I was the CEO the day one that we put these smaller companies together to form what we saw in the market as an opportunity to create an enterprise-caliber software business that helps provider organizations get paid. We looked around the market. We saw a tremendous amount of provider consolidation.
In fact, the Wall Street Journal referred to this period of time as the supersizing of American healthcare as hospitals were buying other hospitals and oftentimes buying physician networks or other post-acute, non-acute sites of care. What we saw at the time, all the way back in the second half of 2017, was that there was not really any modern enterprise-caliber software business that could help these increasingly complex and sophisticated organizations make sense of how they get paid as they interact with insurance companies and as they interact with patients. We formed this software business. The work that we do is mission-critical in nature. We help provider organizations who are often strapped for cash and operate on razor-thin margins to get paid. We do that at market-leading rates, which I will describe in a little more detail in just a moment.
Because we do, as provider organization decision-makers make their own priorities and set their own agendas, they're oftentimes moving from what's absolutely necessary to what's more discretionary in the things that they spend money on. We tend to be on the favorable side of that prioritization because of the mission criticality of the work that we do. We're cloud-based, so we're coming along and displacing in a very large addressable market opportunity. Legacy software vendors that have done similar work to us, but they're struggling to move from on-premise to hosted to SaaS. We're cloud-native, and we're delivering hundreds and hundreds of feature improvements and product capabilities each and every quarter. We like to tell our clients that as you use the Waystar software platform, you can future-proof the use of how you get paid when you work with us.
We integrate to over 500 different electronic health record and practice management solutions. Of those 500 integrations, more than 200 are active channel partners. They are referencing us, and they are referring us into their installed base of EHR users or practice management hospital information system users. We are grateful for that integration because it allows us to reach all the different types of providers that serve across all the specialties and subspecialties in healthcare. We have been pioneers in the use of AI and machine learning on our platform. You think about first order of business when it comes to AI, you know, automation of high-volume, low-complexity tasks, smart field inputs that reduce the likelihood that errors occur, the prioritization of work to help an end user who is using our software focus on the next most important task in their workflow of tasks.
Not too dissimilar from like a Salesforce.com type model or a Workday model. We're leveraging AI. I'll tell you, we'll also highlight in the course of this short presentation the generative AI capability that we've introduced and infused onto the software platform. We believe that we can be an important contributor and major player as we help providers adopt GenAI as well. We create enduring and lasting relationships with clients. It is the case that our gross revenue retention starts at 97%. When clients begin to use us, the primary reasons that they leave us are because of retirement or they go out of business. We're not losing them to competition. They stay with us. We've got great visibility to our growth model. Our gross revenue retention is at 97%. As I mentioned, our net revenue retention in Q1, as reported, was 114%.
We create these relationships, and they stay with us, and they grow with us, which we're grateful for. That gives us great visibility into our business model. Much of our business is software subscription in nature, so it's kind of that visible, predictable model. There's a portion of the providers that we serve that are of a size and scale where a software subscription model doesn't work most effectively. In those situations, we've created a volumetric relationship where there's often a volume-based minimum, and then there's overages based on the actual patient visits that they have. It aligns really nicely with what actually is occurring in the market. As Ryan mentioned at the outset, you know, high visibility, double-digit revenue growth, and a long-term adjusted EBITDA margin target of 40%, which we've been grateful to meet and exceed in our quarters as a public company.
Our mission is super relevant and important right now, today. In the world where the flashpoint of dialogue in the U.S. is around denied claims and the pain that that causes in the industry to providers and to patients, our mission from day one has been to simplify healthcare payments using modern cloud software and advanced capability so that providers can spend more time caring for patients and less time worried about how they're going to get their organizations paid. This is something that if you were to step inside our business, and I'm grateful for your kind words on our culture, our team, who I'm thrilled to work alongside, is passionate about this mission. We often talk about drawing a straight line from your daily work and your role on this team to how you contribute to our mission.
We're thrilled to work alongside people who get it, who buy in, and know that as we develop and deliver great software, we can disrupt the status quo in a time that we really need it, and we can bring fairness and transparency to an industry that has had some challenges over the last several decades as providers have worked to interact with payers. Our software is beautiful. It's easy to use. I wish I could give you all a live demonstration right now. It's well-architected and modern in scale. We're starting to build scale where we can really have impact. We work with over a million providers across every care setting. Our top 10 clients account for approximately 11% of our revenue. We're well-diversified.
We work with the largest hospitals and health systems, the most prestigious hospitals and health systems in the United States. In fact, 16 of the top 20, as measured by U.S. News, work with Waystar today, with room to grow in those institutions and facilities. We also work, and by the way, those large institutions have dedicated IT teams and very sophisticated buying behavior and decision-making. We also work with, you can picture this in your mind, the group of five doctors practicing together, you know, delivering primary care, or the group of cardiologists or orthopedic surgeons or laboratories or, you know, skilled nursing facilities, et cetera, where in some cases, they may not even have a dedicated IT person on their staff. Our software is easy to use. It delights the end user, and it is intuitive with prompts and things throughout.
Even in cases where they do not have a dedicated IT person, they can get to work quickly and make sense of things. These million providers reach approximately 50% of the U.S. patient population each year. That scale is beginning to matter and be relevant. We do not do all the work for that 50% reach, but we are at least touching them and doing part of the work. That tends to be a motivator for us. Every time we think, gosh, if we could develop software that benefits more than a million providers and more than that 50% of the patient population they reach, we have got ourselves an important ball game where if we do something right, it can impact the lives in good ways of lots of people. We are processing over 6 billion insurance transactions each year. We are not a fly-by-night company. We are here to stay.
That predictability, you know, we see these transactions as they flow through our software each and every day. We track a lot of details internally. We can see what's going on across the United States in different types of care settings through these transactions. In aggregate, they account to over, you know, a trillion dollars, as you can see, of gross claim charges on our platform. We use all of that insight to also then understand what the patient financial responsibility is or will be. We'll talk about what we're doing to contribute to that as we go after this large addressable market. We do know that the status quo is unsustainable and, quite frankly, unacceptable.
As I started with, the industry is fraught with, you know, tension right now as the denied claim commentary is alive and people are talking about the negative impact that that has on the lives of people in the United States. It's a fact that there's nearly half a trillion dollars of administrative waste in the system today. In the United States, we're spending over $4 trillion a year on healthcare. You think about that amount of administrative waste, much of that in pursuit of helping providers get paid. If we can do things that make that easier, that automate capability, that bring more transparency, then we can really help do something good. You can see some of the statistics that are alarming. You know, staffing shortages make this difficult. Denial and payer complexity make this hard.
Bad debt, cybersecurity issues and concerns really impact what's going on in the United States. That is where Waystar Software comes to work. Again, we have examples of our software on our website. We recently conducted an innovation showcase where we showcased three challenges that providers face, what Waystar Software does to combat those challenges or difficulties. We showcase providers themselves speaking about the impact on their organizations given their use of Waystar Software. We talk about our software being end-to-end in nature, meaning and I'll take just a second to talk about that.
For those maybe not as familiar with what's affectionately referred to as the revenue cycle, even the word kind of makes me shudder just a bit because basically what happens, providers, as they meet a patient and begin to interact with a patient, early on in that exercise, they're trying to understand if that patient has access to insurance and can they bill insurance for a portion of the services that they deliver to that patient. They'll understand, does a patient have a, do they have insurance? Are they participating in a high-deductible health plan? As that patient begins to move through the system, so to speak, there are a series of steps, billing and collecting steps involved in helping providers interact with both insurance companies as well as with patients to get an accurate and full payment.
If you're a patient in the United States today that does have access to commercial insurance, you're highly likely to be participating in a health plan that has a high deductible where you have to pay out of pocket for the first $1,000 of the healthcare fees that you receive for the services that you receive in a year. Providers haven't been historically equipped to be able to, you know, interact with a patient and collect with them. That's why they wait for insurance to adjudicate. They wait to figure out what insurance is going to cover. Then 30, 60, 90 days later, they'll follow up with a patient and say, "Okay, Matt, now you owe us $283 for what occurred 90 days ago." It creates frustration and complexity and oftentimes leaves providers just giving up on trying to collect from patients.
Our software helps to organize this all in a single platform as we built a series of workflow capabilities across this platform. We begin by helping to accurately and very quickly and automatically help the provider understand who the patient is, ascertain whether or not they have insurance, detect insurance coverage for a patient when they may not even know that they have access to insurance. That's a really, we think that's noble work. You think about the parent walking in with their child and they're worried sick about whether or not they can help their child get healthy and they don't know how they're going to pay for it. We're helping to detect coverage. We're automating the necessary authorizations that certain payers impose on providers before they perform complex healthcare medical procedures. We're gathering that authorization.
As we help them create claims and form claims in a highly accurate way, we are reducing the complexity dramatically using modern software and AI to streamline the workflow, ultimately leading to a better experience for providers, a higher collection rate, a more simple experience for patients as well. You will hear me talk a little more about some of the fantastic results that we help providers achieve. In January of this year, we launched something that we call Altitude AI. It is a pervasive suite of GenAI capabilities that we have embedded into the Waystar Software platform. Our approach, given our massive data set of over 6 billion insurance transactions annually, and that just keeps growing. We like to say every incremental insurance transaction we process makes our network smarter, but also gives us more GenAI capability. In January, we launched Altitude AI.
I think about it in two or three basic ways today. We are leveraging GenAI to automate work, to autonomously gather content and information that will create a smarter claim much more rapidly. We're taking some, in some cases, work that is three days in length to accurately create a claim and to double-check that claim that it's accurate before submission. We're doing that in three seconds. We are compressing work very dramatically as we submit claims across our whole network. Our average first-pass claim acceptance rate is just shy of 99% across our whole network of over a million providers connecting to every payer in the U.S. As we go in and displace incumbent competitors who we compete against, we're often hearing that their first-pass claim acceptance rate is in the low 90%.
That difference between low 90 and very, very high 90s allows our software to help reduce extra work for the provider, reduce the likelihood that a claim gets denied, et cetera. When a claim does get denied, we're helping the provider to rapidly follow up on a claim denial. In appeal management, we're using GenAI to autonomously generate letters by gathering appropriate administrative and clinical content that allows for us to, again, dramatically compress manual work to moments where previously it took hours and then allow that provider to submit the appeal letter contesting that denied claim back to the payer. We're seeing at least a 40% improvement on what we were already producing when they use our GenAI-based solution with accuracy rates of gathering information and autonomously producing a letter that's greater than a human can produce. We think we're just getting started.
Our focus is to leverage GenAI responsibly and safely. There's an element of data safety here given our need for HIPAA compliance and everything else. We attest to cybersecurity across our platform. We know in a recent survey that we did with the Health Management Academy that 90% of hospital decision-makers want to use AI, but the vast majority of them are just getting started in thinking about how they plan to use it. What they tell us is that while they want to use it, the things that are on their mind include cybersecurity, include the safety and responsible use of how will you use data that often involves de-identified patient information or contractual information that needs to be responsibly used.
They also tell us that they don't want to necessarily use a narrow point solution that will obligate them to have to go figure out how that point solution integrates or is interoperable with everything else that is in use in their health system. We think that Waystar can be a scaled player here and a major contributor to the responsible and fulsome use of GenAI. We believe it'll be a very iterative process, but we're excited about the developments, the progress that we're making. Our software drives meaningful impact. It leads to greater staff productivity in a world where providers are facing staff shortages and need to constantly train new members of their staff on how to use this aspect of their system to help their organizations get paid.
It leads to quicker payment and dramatic reduction of Medicare-related AR days, for example, and other commercial AR days. It helps providers find an increased amount of revenue. First of all, we're compressing all this insurance information. Instead of requiring the provider to wait 30, 60, 90 days post-care, we're enabling the provider through the use of AI to predict what the financial responsibility of the patient is going to be pre-care, often to the dollar. With that information, enabling and empowering the provider to present the patient with a financial estimate of responsibility, putting a card on file, a line that we tokenize and secure that card, and allow the provider to set up a patient plan, which is leading to increased revenue, better financial visibility, and a rapid time to value for them. The work that we do is meaningful.
We know that it makes a difference in providers' lives. We know that it drives real tangible ROI. We're moving from kind of AI hype to ROI reality, if I can say it that way, in the use of AI when clients get started working with us. You know, these kind of results drive client satisfaction and industry recognition. Again, I was very grateful for what Ryan said at the outset and the customer calls that you've made. We strive to delight our clients. You know, it's often the case that we work hard to create beautiful software that delights clients. They'll call us and want to interact with us. Technology is ahead of where in some cases workflow processes are or even workforce culture is today. We have people, we use technology to allow for self-support, agentic experience, and they interact with us.
We have a team of dedicated people who make sure that clients are adopting and using the most of our software that they can. This is leading to clients that are delighted, highly referenceable, and industry recognition along the way. You can see some of the things that we leverage third parties to measure for us in the market. We create fantastic client and partner relationships, as I mentioned, and we work with many of the leading provider organizations in the U.S. Going after this large addressable market opportunity, it's $15 billion a year. As defined by the existing software that these types of entities use, we have approximately 5% market share in hospitals and about 8-9% market share on the ambulatory side. We have a long room to run.
When these types of impressive organizations are referenceable, many of them sit on our advisory board and they're talking to their peers. We're really thrilled to be able to work alongside them and welcome new clients as they join us. It's also an important fact in this industry where a lot of different technology is deployed. It's a very heterogeneous technology deployment that occurs in healthcare. There are over 500 different instances of electronic health record and practice management software. Over 200 of those are active channel partners to Waystar. We integrate to all 500. It's that integration that allows us to reach into all these different specialties and subspecialties and serve a variety of different types of providers. Of the 200 that are active channel partners with us, they're advocating for us. They're of scale and they are referring us into their installed base.
We're very grateful for that. It's also a fact that part of the industry chooses to outsource. If you're a decision maker in a large hospital or health system, you may say, "Hey, I don't want to do this work myself. I don't want to employ people who do. So I'm going to rely on a trusted business process outsourcer." In that case, we work with outsourcers who do the service work. They're often leveraging Waystar software behind the scenes to do that work. In that way, we tend to grow with the growers and our software is beginning to be more ubiquitously used across the industry. We're excited about the momentum that we've created by serving these clients and partners. We've got several growth priorities ahead of us and different levers for growth opportunity.
When you think about how our business can continue to perform, first, it begins with expanding relationships with our clients. We have a number of different software modules to sell and a strong list of existing clients. We often say if we did not add another client or did not build another new software module, we could double the size of our business by just selling every software module that we have to every client that could use it. There is a lot of effort internally to drive cross and upsell in our business, certainly adding new clients to our business. We do that regularly. We have dedicated teams of people oriented by the acute market as well as by the non-acute market to pursue new clients and also those that focus on cross-sell and upsell.
We have a very high-performing team, certainly focusing and adding channel partners to our group of active channel partner relationships. We tend to focus on the larger channel partners that have more of an install base, but there's work that a dedicated team from Waystar is always working on to add more channel partners. Certainly introducing new software capability, new software modules, new SKUs, so to speak, is part of our ways to grow. Lastly, part of our story has been to grow via acquisition. We've prosecuted nine acquisitions. In each and every case, we're uniting those acquired companies onto the Waystar platform using modern technical capability. I recognize that I'm at time, but I just would leave you with one or two quick highlights financially. As we reported in Q1, our revenue growth year over year was 14%.
We reported 42% adjusted Q1 EBITDA margins. We continue to launch several exciting innovations and deliver capability to our clients as they trust us and work with us. Here is another financial highlight that I would leave you with. Thank you so much for letting me introduce Waystar to you today. I hope you guys have a great rest of your stay here. Thanks.