Astrana Health Inc. · NASDAQ:ASTH
Astrana Health — Investor Presentation (May 2024)
34 slides from Astrana Health's investor presentation, May 15, 2024
Slide 1: Powered by Technology. Built by Doctors. For Patients.
May 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 Company's
Slide 3: Astrana Health at-a-glance
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 Care Pa
Slide 4: The Astrana Health Model
4 The Astrana Health Model 1. Includes contracted and employed providers in our provider network, across all specialties, and including both Consolidated and Managed providers 2. Astrana Health figures based on analysis of Jan-Dec 2023 internal data from all consolidated IPAs (Medicare Advantage) an
Slide 5: The Astrana Health model transforms the status quo into a coordinated healthcare ecosystem
5 The Astrana Health model transforms the status quo into a highly coordinated, high-value, accessible healthcare ecosystem 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
Slide 6: Our flexible model optimizes delivery of accessible, high-quality, high-value care
6 Our flexible model optimizes delivery of accessible, high-quality, high-value care + ~20 Others Care Partners Care Enablement Data Infrastructure and Provider Solutions Clinical and Care Coordination Solutions Payer Delegation Solutions Ops Automation VBE1 Suite & Data Lake Point of Care Tools Ana
Slide 7: Care Partners: High-performing network of aligned provider partners
7 Care Partners: High-performing network of aligned provider partners 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 A
Slide 8: Care Delivery: Extensive, high-quality network of employed providers
8 Care Delivery: Extensive, high-quality network of employed providers 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 Affilia
Slide 9: Care Enablement: End-to-end integrated clinical, operational, financial, and administrative platform
9 Care Enablement: End-to-end integrated clinical, operational, financial, and administrative platform Clinical and Care Coordination Solutions Data Infrastructure and Provider Solutions Payer Delegation Solutions Care Enablement Care Partners Care Delivery Primary Care Ancillary Services Multi-Spec
Slide 10: Astrana Health's diverse member base is served by its experienced provider network
10 Astrana Health’s diverse member base is served by its experienced and loyal provider network through all stages of life ~1M Total value-based lives Diverse patient demographics 96% Total members in full-risk or partial risk arrangements Significant risk-taking opportunity 98% Avg annual provider
Slide 11: Provider Empowerment and Engagement
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 Teams1 View longitudinal patient records, SDOH2, and popula
Slide 12: Provider network, technology and solutions drive superior clinical outcomes
12 Our dedicated provider network, technology and solutions platform combine to drive superior clinical outcomes 48% 43% Hospital admissions per k, % change vs. benchmark1 ER visits per k, % change vs. benchmark1 Improvement in MCR2 per year, since 2019 We keep patients healthier and out of the hosp
Slide 13: Our multi-pronged growth strategy positions Astrana Health to capture significant embedded upside
13 Our multi-pronged growth strategy positions Astrana Health to capture significant embedded upside Advance Contracts Across Risk Spectrum Migrate member lives under partial-risk contracts into full-risk and total cost of care arrangements Grow Within Existing Markets Continue to enhance core South
Slide 14: Significant whitespace to continue expanding our footprint in our core market
14 We have significant whitespace to continue expanding our footprint in our core market… Demonstrable success of our playbook: Reduced MCR across our California markets by 1,200 bps6 1985 2019 2021-2022 2023 Built density in Southern CA San Bernardino 2.2M pop. 1 Riverside 2.5M pop. 1 MCR Improveme
Slide 15: Opportunities to build out recently entered markets
15 … and will continue to look for opportunities to build out recently entered markets to further diversify outside of California Source: U.S. Census Bureau; population data as of each respective year; Centers for Medicare and Medicaid Services, Office ofthe Actuary, National Health Statistics Group
Slide 16: As we move across the risk spectrum, our unit economics improve
16 As we move across the risk spectrum, our unit economics improve demonstrably 3 100% 40% Total Premium Retained by Health Plan Institutional cap Revenue to Cost of care OpEx EBITDA to 100% 85% Total Premium Retained by Health Plan Revenue to Cost of care OpEx EBITDA to 2 3 ~9-17% 2 3 ~5-10% Partia
Slide 17: Advancing our contracts across the risk spectrum
17 Advancing our contracts across the risk spectrum allows us to better deliver whole-person care and drives outsized economics 3 Substantial opportunity to drive embedded platform value through advancing contracts across the risk spectrum Proven track record of managing risk profitably with signifi
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 attra
Slide 19: Astrana Reiterates Guidance for 2024
19 Astrana Reiterates Guidance for 2024 Q1 2024 financial results Revenue $404.4 Net Incomeattr. to ASTH $14.8 Adjusted EBITDA1 $42.2 EPS – Diluted $0.31 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA,” “Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Us
Slide 20: Financial Profile
20 Financial Profile 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 benefitt
Slide 21: Astrana Health Leadership Team
21 Astrana Health Leadership Team 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: Key Takeaways
22 Key Takeaways Admits/K 48% below benchmark; ER visits 43% below benchmark3 Tech-powered, integrated care delivery model results in industry-leading clinical outcomes 26% 5-year adj. EBITDA CAGR2; Proven ability to consistently scale business at 10-15% EBITDA margins Proven track record of consist
Slide 23: Slide 23
Slide 24: Appendix
24 Appendix
Slide 25: Highly differentiated, scaled platform is a leader in value-based care
25 Highly differentiated, scaled platform is a leader in value-based care Affiliate and owned provider model ~1M 30+ $1,387M $147M $1,771M $177M 39 Years Affiliate provider model ~523K 25 $4,316M ($95M) $6,233M ($42M) 8 Years Affiliate provider model ~127K 27 $1,266M ($86M) $1,525M $5M 4 Years Affil
Slide 26: Diversified mix of businesses and payer types
26 61% 20% 12% 7% Medicare Medicaid Commerical Other Third Parties 88% 5% 2% 4% 1% Capitation, net Risk Pool Settlements & Incentives Management Fee Income Fee-for-service, net Other Income 60% 40% Full-risk Partial-risk We serve a highly diversified mix of businesses and payer types Revenue by Risk
Slide 27: Recent Highlights
27 Recent Highlights Opened 2 new de novo clinics in Nevada in April Closed acquisition of Advanced Diagnostic Surgical Center on Jan 1, 2024 Care Delivery Community Family Care Health Plan acquisition closed March 31, 2024 Prime Community Care of Central Valley joins our Care Partners segment Start
Slide 28: Summary of Selected Financial Results
28 Three Months Ended March 31, $ in 000s except per share data 2024 2023 Revenue Capitation, net $ 365,910 $ 300,204 $ Risk pool settlements and incentives 17,377 13,462 Management fee income 4,078 9,896 Fee-for-service, net 15,937 12,062 Other revenue 1,054 1,620 Total revenue 404,356 337,244 Tota
Slide 29: Segment Results
29 $ in 000s Care Partners Care Delivery Care Enablement Other Intersegment Elimination Corporate Costs Consolidated Total Total revenues $ 397,095 30,719 33,274 - (56,732) - 404,356 % change vs prior year 26% 21% 9% 20% Cost of services 314,966 24,794 17,373 - (26,734) - 330,399 General and adminis
Slide 30: Balance Sheet Highlights
30 $ in millions 3/31/2024 12/31/2023 $ Change Cash and cash equivalents and investments in marketable securities1 $337.29 $296.31 $40.98 Working capital $183.54 $242.83 $(59.29) Total stockholders’ equity $657.98 $616.65 $41.33 1. Excluding restricted cash Balance Sheet Highlights
Slide 31: Reconciliation of Net Income to EBITDA and Adjusted EBITDA
31 Three Months Ended March 31, $ in 000s 2024 2023 Net Income $ 16,862 $ 12,488 Interest Expense 7,585 3,269 Interest income (3,996) (3,009) Provision for income taxes 7,142 6,921 Depreciation and amortization 5,096 4,292 EBITDA 32,689 23,961 Income from equity method investments (632) (249) Other,
Slide 32: Reconciliation of Net Income to EBITDA and Adjusted EBITDA (TTM and annual)
32 For the twelve months ended TTM Ended Year Ended $ in millions March, 31, 2024 2023 2022 2021 2020 2019 Net Income $ 62.2 $ 57.8 $ 45.7 $ 46.1 $ 122.1 $ 15.8 Interest expense 20.4 16.1 7.9 5.4 9.5 4.7 Interest income (15.2) (14.2) (2.0) (1.6) (2.8) (2.0) Provision for income taxes 32.2 32.0 40.9
Slide 33: Reconciliation of Net Income to EBITDA – Community Family Care
33 For the twelve months ended $ in millions 2023 2019 Net Income $ 19.0 $ 7.8 Provision for income taxes 4.1 0.1 Depreciation and amortization 0.0 0.0 Interest expense (income) (1.1) (0.3) (0.1) EBITDA $ 22.0 $ 7.5 Reconciliation of Net Income to EBITDA – Community Family Care
Slide 34: Guidance Reconciliation of Net Income to EBITDA & Adjusted EBITDA
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 85,500 Interest expense 14,500 12,500 Provision for income taxes 36,500 44,500 Depreciation and amortization 14,500 14,500 EBITDA 137,000 157