Astrana Health Inc. · NASDAQ:ASTH
Astrana Health — Investor Presentation (March 2024)
37 slides from Astrana Health's investor presentation, Mar 11, 2024
Slide 1: Powered by Technology. Built by Doctors. For Patients.
March 2024 Powered by Technology. Built by Doctors. For Patients.
Slide 2: Forward Looking Statements
2 Forward Looking Statements This presentation contains forward - looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act and Section 21E of the Exchange Act. Forward - looking statements include any statements about the Compan
Slide 3: Astrana Health platform overview
3 Care Enablement Full - stack technology and solutions platform , empowering providers to deliver the best possible care to all patients in their communities Care Delivery Flexible footprint of owned primary care and multi - specialty clinics with employed providers who deliver personalized care Ca
Slide 4: Improves access, powers quality outcomes, drives high-value care
4 Improves access to care Powers high - quality outcomes Drives high - value care We successfully serve our communities by building broad networks of affiliated Primary and Specialty care providers & supplementing them with our employed providers Our flexible model meets all patients across all care
Slide 5: The Astrana Health Model
5 We organize and partner with providers to create risk - bearing organizations in our Care Partners (“CP”) segment Our CP entities contract with payers, entering value - based care (“VBC”) arrangements Through our Care Enablement platform, we provide comprehensive technology and support solutions t
Slide 6: Care Partners, Care Enablement and Care Delivery structure
6 + ~20 Others Care Partners Care Enablement Third - Party Clients Data Infrastructure and Provider Solutions Clinical and Care Coordination Solutions Payer Delegation Solutions Ops A u t om a t i o n VBE 1 Suite & Data Lake Point of Care Tools Analytics & Reporting Quality Clinical P r og ra m s RP
Slide 7: Care Partners segment
7 Care Enablement Care Partners + ~20 Others Care Delivery Primary Care Ancillary Services Multi - Specialty Outpatient Clinics Affiliate Providers Primary Care Ancillary Services Multi - Specialty Outpatient Clinics 7,200+ Affiliated Astrana Providers 1 ~850k Members in VBC Contracts ~90% Astrana H
Slide 8: Care Delivery segment
8 Clinical and Care Coordination Solutions Data Infrastructure and Provider Solutions Payer Delegation Solutions Care Enablement Care Partners Care Delivery Primary Care Ancillary Services Multi - Specialty Outpatient Clinics Affiliate Providers Primary Care Ancillary Services Multi - Specialty Outp
Slide 9: Care Enablement segment
9 Clinical and Care Coordination Solutions Data Infrastructure and Provider Solutions Payer Delegation Solutions Care Enablement Care Partners Care Delivery Primary Care Ancillary Services Multi - Specialty Outpatient Clinics Affiliate Providers Primary Care Ancillary Services Multi - Specialty Outp
Slide 10: Patient demographics and provider retention
10 Diverse patient d em o g r a p h i c s 96% Total members in full - risk or partial risk arrangements 98% Avg annual provider retention 2 Significant risk - taking o pp o rt u n i ty Robust provider r etent i o n 11.1 Average provider tenure of Astrana Health - owned IPAs Ex p e r i en c ed provid
Slide 11: Provider empowerment, care management and analytics
11 Provider Empowerment and Engagement All - in - one point - of - care tool for both providers and practices Check member eligibility Submit & receive auto - approval for prior auths View & act on quality and risk adjustment gaps Collaborate w/ Care Teams 1 View longitudinal patient records, SDOH 2
Slide 12: Clinical outcomes: hospital admissions, ER visits, MCR
12 Hospital admissions per k, % change vs. benchmark 1 48% ER visits per k, % change vs. benchmark 1 43% Improvement in MCR 2 per year, since 2019 We keep patients healthier and out of the hospital unnecessarily… … as well as minimize unnecessary visits to the Emergency Room Proven path to profitabi
Slide 13: Growth strategy
13 Grow Within Existing Markets Continue to enhance core Southern California market, build out newly established Northern and Central CA markets, and build out recently entered TX/NV markets Expand Into New Markets Transform healthcare for local communities across the country by leveraging our adapt
Slide 14: California playbook reduced MCR by 1,200 bps
14 Demonstrable success of our playbook: Reduced MCR across our California markets by 1,200 bps 6 1 9 85 2 0 1 9 2021 - 2022 2023 Built density in Southern CA San Bernardino 2.2M pop. 1 Riverside 2.5M pop. 1 MCR Improvement: ~(750) bps 2 Expanded into Northern CA Bay Area 6.2M pop. 1 MCR Improvement
Slide 15: Expansion into Texas and Nevada
15 Source: U.S. Census Bureau; population data as of each respective year; Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group 1. Figures represent 2022 TAM; current TAM includes total healthcare expenditure within California, Texas, and Nevada; U.S. T
Slide 16: Economics of partial-risk and full-risk contracts
16 3 1 00 % 4 0 % Total P r e m i u m R e t a i n ed by Health Plan Revenue to EBITDA to 1 00 % 8 5 % Total P r e m i u m R e t a i n ed by Health Plan Revenue to EBITDA to Cost of care 2 OpEx 3 ~ 9 - 1 7% Cost of ca r e 2 OpEx 3 ~5 - 10% P a r t ia l - risk Fu l l - risk 12.5 – 25% EBITDA Margin to
Slide 17: Capitated revenue by risk arrangement
17 3 Substantial opportunity to drive embedded platform value through advancing contracts across the risk spectrum Proven track record of managing risk profitably with significant upside potential while delivering whole - person care 35% 4 7 % 4 9 % 1 0 0 % 6 5 % 53% 5 1% 2 0 21 Jan 2024 2022 Full R
Slide 18: Community Family Care acquisition
18 Scaled Medicaid - focused group with 200K+ patients across Medicare, Medicaid and Commercial payors in LA CFC already bears full - risk on Medicaid members via RKK health plan license Unique network of providers focused on Medicaid strengthens our ability to reach underserved populations Highly a
Slide 19: Q4 2023 results and 2024 guidance
19 ($ in millions, except for per share information) Q4 2023 Financial Results Revenue $353.0 Net Income attr. to ASTH $12.4 Adjusted EBITDA 1 $29.0 EPS – Diluted $0.26 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA,” “Guidance Reconciliation of Net Income to EBITDA and Adjusted
Slide 20: Revenue and Adjusted EBITDA growth
20 Note: For more information, see “Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non - GAAP Financial Measures“ slides for more information 1. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue 2. 2020 - 2021 Adj. EBITDA benefitted from tailwi
Slide 21: Leadership team
21 Brandon Sim, MS Chan Basho, MBA Dinesh Kumar, MD Jeremy Jackson, MD Jaime Melkonoff, MBA President & CEO Chief Operating & Financial Officer Chief Medical Officer Chief Quality Officer President, Texas & SVP, Corporate Development
Slide 22: Investment highlights
22 Admits/K 48% below benchmark; ER visits 43% below benchmark 3 Tech - powered, integrated care delivery model results in industry - leading clinical outcomes 26% 5 - year adj. EBITDA CAGR 2 ; Proven ability to consistently scale business at 10 – 20% EBITDA margins Proven track record of consistent
Slide 23: Slide 23
Slide 24: Appendix
Appendix .+. Astrana Health
Slide 25: Peer comparison
25 Affiliate provider model ~118K 18 $1,225M ($40M) $1,500M $30.0M O O P 3 Years Affiliate provider model Affiliate and owned provider model 477K 273K 25 7 $4,316M $764M ($95M) $13M $6,385M N/A $50.0M N/A O O O O P P 7 Years 12 Years Affiliate and owned Affiliate provider model provider model ~900K
Slide 26: Revenue by payer, type and risk arrangement
26 63% 20% 12% 5% Medicare Medicaid Commerical Other Third Parties 87% 5% 3% 4% 1% Capitation, net Risk Pool Settlements & Incentives Management Fee Income Fee - for - service, net Other Income Revenue by Risk Arrangement 1 47% 53% F u l l - ri sk P a r t i a l - r i sk Revenue by Type Revenue By Pa
Slide 27: Recent segment developments
27 Care Delivery Added 3 clinics in San Francisco, CA into our Care Delivery segment Astrana Health Executed spinoff of APC real estate Excluded Assets at the end of Dec 26, 2023 Leadership changes effective Jan 19, 2024 Closed part one of CFC IPA asset purchase on Jan 31, 2024 Changed name to Astra
Slide 28: Consolidated income statement summary
28 Three Months Ended December 31, Twelve Months Ended December 31, $ in 000s except per share data 2023 2022 2023 2022 Revenue Capitation, net $ 30 9, 184 $ 2 5 2 , 878 $ 1,215,614 $ 9 30 , 1 3 1 Risk pool settlements and incentives 1 4 , 8 6 3 1 5, 53 7 63,468 1 1 7 , 2 5 4 Management fee income 6
Slide 29: Segment results, twelve months 2023
29 $ in 000s Care Partners Care Delivery Care Enablement Other Intersegment Elimination Corporate Costs Consolidated Total Total revenues $ 1,300,112 119,904 135,824 937 (170,116) 1,386,661 % change vs prior year 24% 25% 13% 21% Cost of services 1,182,484 96,265 59,075 296 (166,417) 0 1,171,703 Gene
Slide 30: Liquidity and balance sheet highlights
30 $ in millions 12/31/2023 12/31/2022 $ Change Cash and cash equivalents and investments in marketable securities 1 $296.31 $293.59 $2.72 Working capital $242.83 $279.52 ($36.69) Total stockholders’ equity $616.65 $544.31 $72.34 1. Excluding restricted cash
Slide 31: Net income to EBITDA and Adjusted EBITDA
31 Three Months Ended December 31, Twelve Months Ended December 31, $ in 000s 2 0 2 3 2022 2023 2022 Net (loss) Income $ ( 9 4) $ ( 88 3 ) $ 5 7, 849 $ 4 5 ,7 41 Interest Expense 5 , 4 22 2 , 5 72 16 , 1 0 2 7 , 9 20 Interest income ( 4 , 59 1) ( 1,28 6 ) ( 1 4 , 2 0 8) ( 1, 9 7 6 ) Provision for in
Slide 32: Adjusted EBITDA reconciliation footnotes
1 See “Use of Non - GAAP Financial Measures” slide for more information; 2 Other, net for the year ended December 31, 2023 consists of nonrecurring transaction costs and tax restructuring fees incurred, non - cash gains and losses related to the changes in the fair value of our financing obligation
Slide 33: EBITDA reconciliation 2023 and 2019
33 For the twelve months ended $ in millions 2023 2019 Net Income $ 2 5 . 6 $ 7 . 8 Provision for income taxes 0 . 3 0 . 1 Depreciation and amortization 0 . 0 0 . 0 Interest expense (income) ( 1.1) (0 .3) Other 1 0 . 0 (0 . 1) EBITDA $ 24 . 8 $ 7 . 5 1. Other is comprised of realized and unrealized
Slide 34: 2024 guidance reconciliation
34 Note: See “Use of Non - GAAP Financial Measures” slide for more information. 2024 Guidance Range ($ in 000s except per share data) Low High Net Income 71,500 8 5 , 50 0 Interest expense 14,500 12, 50 0 Provision for income taxes 36,500 44 , 50 0 Depreciation and amortization 14,500 14 , 50 0 EBIT
Slide 35: Results with excluded assets
35 $ in millions December 31, 2023 December 31, 2022 Astrana Health Consolidated Excluded Assets Astrana Health Assets Astrana Health Consolidated Excluded Assets Astrana Health Assets Revenue Capitation, net $ 1, 2 1 5 . 6 - 1, 2 1 5 . 6 $ 930 . 1 - 930 . 1 Risk pool settlements and incentives 63 .
Slide 36: Consolidated balance sheet assets
36 $ in millions December 31, 2023 December 31, Astrana Health Consolidated E xc l u d e d Assets As t r a n a Health Assets Astrana Health Consolidated Current assets Cash and cash equivalents $ 293.8 - 293.8 $ 288.0 Investments in marketable securities 2 . 5 - 2 . 5 5 . 6 Receivables, net 76.8 - 7
Slide 37: Consolidated balance sheet liabilities
37 $ in millions December 31, 2023 December 31, 2022 Astrana Health Consolidated E xc l u d e d Assets Astrana H e a l t h As s e t s Astrana Health Consolidated E xc l u d e d Assets 1 Astrana H e a l t h As s e t s Current liabilities Fiduciary payable, accounts payable and accrued liabilities $ 6