Astrana Health, Inc. Reports Third Quarter 2025 Results

About this update from Astrana Health Inc.

Company to Host Conference Call on Thursday, November 6, 2025 , at 2:30 p.m. PT / 5:30 p.m. ET Reports total revenue of $956.0 million , up 100% year-over-year, and at the higher end of guidance Reports adjusted EBITDA of $68.5 million , at the higher end of guidance Closes Prospect Health acquisition where standalone third quarter performance exceeded expectations Continuing to control medical costs well; reiterating full-year trend expectations Updates full-year 2025 guidance to account for full-risk contract delays unrelated to core performance ALHAMBRA, Calif. , Nov. 6, 2025 /PRNewswire/ -- Astrana Health, Inc. ("Astrana," and together with its subsidiaries and affiliated entities, the "Company") (NASDAQ: ASTH), a leading provider-centric, technology-powered healthcare company enabling providers to deliver accessible, high-quality, and high-value care to all, today announced its consolidated financial results for the third quarter ended September 30, 2025 . "Astrana delivered solid third quarter results and demonstrated strong momentum in our first quarter of combined operations with Prospect Health ," said Brandon Sim , President and Chief Executive Officer. "Prospect's performance exceeded our expectations, and integration is progressing well, expanding our scale, capabilities, and physician reach across key markets. While our full-year outlook reflects the updated timing of certain full-risk contract transitions, which we expect to complete in the first quarter of 2026, underlying clinical and cost trend performance across both the legacy Astrana and Prospect businesses remain strong. We continue to execute with discipline and focus on building a more coordinated, high-quality, and accessible care delivery platform for the long term." Financial Highlights for Third Quarter Ended September 30, 2025 : All comparisons are to the three months ended September 30, 2024 unless otherwise stated. Total revenue of $956.0 million , up 100% from $478.7 million Care Partners revenue of $897.7 million , up 97% from $455.8 million Net income attributable to Astrana of $0.4 million Earnings per share - diluted of $0.01 Adjusted EBITDA(1) of $68.5 million , up 52% from $45.2 million Financial Highlights for Nine Months Ended September 30, 2025 : All comparisons are to the nine months ended September 30, 2024 unless otherwise stated. Total revenue of $2,231.2 million , up 63% from $1,369.3 million Care Partners revenue of $2,130.1 million up 64% from $1,301.4 million Net income attributable to Astrana of $16.5 million Earnings per share - diluted of $0.33 Adjusted EBITDA(1) of $153.0 million , up 13% from $135.3 million (1) See "Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin" and "Use of Non-GAAP Financial Measures" below for additional information. Recent Operating Highlights On July 1, 2025 , the Company completed its previously announced acquisition of Prospect Health , including its California -licensed health plan (Prospect Health Plan), its medical groups in multiple states (Prospect Medical Groups), its management service organization ( Prospect Medical Systems ), its pharmacy (RightRx), and Foothill Regional Medical Center . Announced a strategic partnership with Intermountain Health to expand access to coordinated, high-quality care across southern Nevada . The collaboration integrates Astrana's provider network and clinics with Intermountain's health system capabilities, with the goal of enhancing primary care access, improving patient outcomes, and advancing the region's healthcare infrastructure through shared technology and care management programs. Announced a new partnership with a provider group in Southern California within the Care Enablement business. The group serves more than 40,000 members in value-based care arrangements across all lines of business and will onboard to the Astrana platform in the first half of 2026. Segment Results for three months ended September 30, 2025 : All comparisons are to the three months ended September 30, 2024 unless otherwise stated. Three Months Ended September 30, 2025 (in thousands) CarePartners CareDelivery CareEnablement IntersegmentElimination CorporateCosts ConsolidatedTotal Total revenues $ 897,730 $ 86,871 $ 87,340 $ (115,893) $ — $ 956,048 % change vs. prior year quarter 97 % 150 % 113 % Cost of services 788,427 72,210 44,067 (45,848) — 858,856 General and administrative 72,066 14,346 17,756 (69,964) 28,183 62,387 Depreciation and amortization 11,953 1,332 2,115 — 195 15,595 Total expenses 872,446 87,888 63,938 (115,812) 28,378 936,838 Income (loss) from operations $ 25,284 $ (1,017) $ 23,402 $ (81) (1) $ (28,378) $ 19,210 % change vs. prior year quarter (35) % (25) % 271 % (1) Income from operations for the intersegment elimination represents rental income from segments renting from other segments. Rental income is presented within other income which is not presented in the table. 2025 Guidance: Astrana is providing the following updated guidance for total revenue and Adjusted EBITDA for the year ending December 31, 2025 based on the Company's existing business, current view of existing market conditions, and assumptions. ($ in millions) Year Ending December 31, 2025 Guidance Range Low High Total revenue $ 3,100 $ 3,180 Adjusted EBITDA $ 200 $ 210 See "Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA" and "Use of Non-GAAP Financial Measures" below for additional information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See "Forward-Looking Statements" below for additional information. Conference Call and Webcast Information: Astrana will host a conference call at 2:30 p.m. PT / 5:30 p.m. ET today (Thursday, November 6, 2025 ), during which management will discuss the results of the third quarter ended September 30, 2025 . To participate in the conference call, please use the following dial-in numbers about 5 minutes prior to the scheduled conference call time: U.S. & Canada (Toll-Free): +1 (877) 858-9810 International (Toll): +1 (201) 689-8517 The conference call can also be accessed via webcast at: https://event.choruscall.com/mediaframe/webcast.html?webcastid=J8XerGef An accompanying slide presentation will be available in PDF format on the "IR Calendar" page of the Company's website ( https://ir.astranahealth.com/news-events/ir-calendar ) after issuance of the earnings release and will be furnished as an exhibit to Astrana's current report on Form 8-K to be filed with the SEC , accessible at www.sec.gov . Those who are unable to attend the live conference call may access the recording at the above webcast link, which will be made available shortly after the conclusion of the call. Note About Consolidated Entities The Company consolidates entities in which it has a controlling financial interest. The Company consolidates subsidiaries in which it holds, directly or indirectly, more than 50% of the voting rights, and variable interest entities ("VIEs") in which the Company is the primary beneficiary. Noncontrolling interests represent third party equity ownership interests in the Company's consolidated entities (including certain VIEs). The amount of net income attributable to noncontrolling interests is disclosed in the Company's consolidated statements of income. About Astrana Health, Inc. Astrana Health is a physician-centric, AI-powered healthcare company committed to delivering high-quality, patient-centered care. Built from the physician's perspective, Astrana combines its scalable care delivery infrastructure, proprietary technology platform, and aligned provider networks to enable proactive, preventive care at scale - improving patient outcomes, enhancing patient experiences, supporting provider well-being, and driving greater value across the healthcare system. Today, Astrana supports more than 20,000 providers and over 1.6 million patients in value-based care arrangements through its affiliated provider networks, management services organization, and integrated care delivery clinics spanning primary, specialty, and ancillary care. Together, Astrana is building the healthcare system we all deserve - one that delivers better care, better experiences, and better outcomes for all. For more information, visit www.astranahealth.com . Forward-Looking Statements This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, such as statements about the Company's guidance for the year ending December 31, 2025 , ability to meet operational goals, ability to meet expectations in deployment of care coordination and management capabilities, ability to decrease cost of care while improving quality and outcomes, ability to deliver sustainable revenue and EBITDA growth as well as long-term value, ability to respond to the changing environment, statements about the Company's liquidity, and successful completion and implementation of strategic growth plans, acquisition strategy, and merger integration efforts. Forward-looking statements reflect current views with respect to future events and financial performance and therefore cannot be guaranteed. Such statements are based on the current expectations and certain assumptions of the Company's management, and some or all of such expectations and assumptions may not materialize or may vary significantly from actual results. Actual results may also vary materially from forward-looking statements due to risks, uncertainties and other factors, known and unknown, including the risk factors described from time to time in the Company's reports to the SEC , including, without limitation the risk factors discussed in the Company's Annual Report on Form 10-K for the year ended December 31, 2024 , and subsequent quarterly reports on Form 10-Q. Any forward-looking statements made by the Company in this release speaks only as of the date on which it is made. The Company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future developments or otherwise, except as may be required by any applicable securities laws. FOR MORE INFORMATION, PLEASE CONTACT: Grant Hesser , Investor Relations [email protected] ASTRANA HEALTH , INC. CONDENSED CONSOLIDATED BALANCE SHEETS (IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA) September 30 ,2025 December 31 ,2024 (Unaudited) Assets Current assets Cash and cash equivalents $ 462,227 $ 288,455 Investment in marketable securities 1,221 2,378 Receivables, net (including amounts with related parties) 381,215 275,990 Income taxes receivable — 19,316 Other receivables 9,891 29,496 Prepaid expenses and other current assets 23,162 22,861 Loans receivable 5,913 — Total current assets 883,629 638,496 Non-current assets Property and equipment, net 56,164 14,274 Intangible assets, net 285,060 118,179 Goodwill 863,266 419,253 Income taxes receivable, non-current 15,943 15,943 Loans receivable, non-current 48,474 51,266 Investments in other entities – equity method 18,462 39,319 Investments in privately held entities 8,896 8,896 Operating lease right-of-use assets 33,936 32,601 Other assets 23,356 16,667 Total non-current assets 1,353,557 716,398 Total assets (1) $ 2,237,186 $ 1,354,894 Liabilities, Mezzanine Deficit, and Stockholders' Equity Current liabilities Accounts payable and accrued expenses $ 209,747 $ 106,142 Fiduciary accounts payable 4,476 8,223 Medical liabilities 333,969 209,039 Income taxes payable 4,919 — Operating lease liabilities 7,181 5,350 Current portion of long-term debt 47,865 9,375 Other liabilities 21,773 27,479 Total current liabilities 629,930 365,608 Non-current liabilities Deferred tax liability 4,429 4,555 Operating lease liabilities, net of current portion 30,171 30,654 Long-term debt, net of current portion and deferred financing costs 1,002,026 425,299 Other long-term liabilities 15,906 14,610 Total non-current liabilities 1,052,532 475,118 Total liabilities (1) 1,682,462 840,726 Mezzanine deficit Noncontrolling interest in Allied Physicians of California , a Professional Medical Corporation ("APC") (234,351) (202,558) Stockholders' equity Preferred stock, $0.001 par value per share; 5,000,000 shares authorized, and zero shares issued and outstanding as of September 30, 2025 and December 31, 2024 — — Common stock, $0.001 par value per share; 100,000,000 shares authorized, 49,383,857 and 47,929,872 shares issued and outstanding, excluding 9,937,167 and 10,603,849 treasury shares, as of September 30, 2025 and December 31, 2024 , respectively 49 48 Additional paid-in capital 473,008 426,389 Retained earnings 302,486 286,283 Total stockholders' equity 775,543 712,720 Non-controlling interest 13,532 4,006 Total equity 789,075 716,726 Total liabilities, mezzanine deficit, and stockholders' equity $ 2,237,186 $ 1,354,894 (1) The Company's condensed consolidated balance sheets include the assets and liabilities of its consolidated VIEs. The condensed consolidated balance sheets include total assets that can be used only to settle obligations of the Company's consolidated VIEs totaling $1,302.4 million and $712.3 million as of September 30, 2025 and December 31, 2024 , respectively, and total liabilities of the Company's consolidated VIEs for which creditors do not have recourse to the general credit of the primary beneficiary of $383.3 million and $207.9 million as of September 30, 2025 and December 31, 2024 , respectively. These VIE balances do not include $173.9 million of investment in affiliates and $30.6 million of amounts due from affiliates as of September 30, 2025 , and $224.9 million of investment in affiliates and $48.1 million of amounts due to affiliates as of December 31, 2024 , as these are eliminated upon consolidation and not presented within the condensed consolidated balance sheets. ASTRANA HEALTH , INC. CONSOLIDATED STATEMENTS OF INCOME (IN THOUSANDS, EXCEPT PER SHARE AMOUNTS) (UNAUDITED) Three Months Ended September 30 , Nine Months Ended September 30 , 2025 2024 2025 2024 Revenue Capitation, net $ 863,380 $ 431,401 $ 2,061,451 $ 1,239,885 Risk pool settlements and incentives 30,798 21,779 60,691 57,564 Management fee income 15,217 2,747 20,104 8,429 Fee-for-service, net 40,080 18,692 72,848 54,588 Other revenue 6,573 4,091 16,149 8,865 Total revenue 956,048 478,710 2,231,243 1,369,331 Operating expenses Cost of services, excluding depreciation and amortization 858,856 405,218 1,984,756 1,148,422 General and administrative expenses 62,387 37,803 157,009 112,478 Depreciation and amortization 15,595 7,264 29,348 19,801 Total expenses 936,838 450,285 2,171,113 1,280,701 Income from operations 19,210 28,425 60,130 88,630 Other (expense) income Income from equity method investments 1,019 1,353 532 2,887 Interest expense (17,718) (8,856) (32,408) (25,028) Interest income 3,522 3,778 8,170 11,287 Unrealized (loss) gain on investments (807) (561) (837) 415 Other income (loss) 445 2,673 (3,487) 4,522 Total other expense, net (13,539) (1,613) (28,030) (5,917) Income before provision for income taxes 5,671 26,812 32,100 82,713 Provision for income taxes 4,594 7,831 14,586 25,004 Net income 1,077 18,981 17,514 57,709 Net income attributable to non-controlling interest 704 2,887 1,026 7,609 Net income attributable to Astrana Health, Inc. $ 373 $ 16,094 $ 16,488 $ 50,100 Earnings per share – basic $ 0.01 $ 0.34 $ 0.34 $ 1.05 Earnings per share – diluted $ 0.01 $ 0.33 $ 0.33 $ 1.04 ASTRANA HEALTH , INC. CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (IN THOUSANDS) (UNAUDITED) Nine Months Ended September 30 , 2025 2024 Cash flows from operating activities Net income $ 17,514 $ 57,709 Adjustments to reconcile net income to net cash provided by operating activities: Depreciation and amortization 29,348 19,801 Amortization of debt issuance cost 2,892 1,374 Share-based compensation 27,219 19,301 Non-cash lease expense 4,348 3,946 Deferred tax (4,924) (7,596) Other 4,961 2,694 Changes in operating assets and liabilities, net of business combinations 36,125 (34,083) Net cash provided by operating activities 117,483 63,146 Cash flows from investing activities Payments for business acquisition, net of cash acquired (548,553) (115,494) Proceeds from sale of equity method investment 15,100 — Purchase of investment – equity method — (5,968) Purchase of call option issued in conjunction with equity method investment — (3,907) Issuance of loan receivable (1,708) (26,000) Purchases of property and equipment (7,042) (5,500) Other 4,261 (2,202) Net cash used in investing activities (537,942) (159,071) Cash flows from financing activities Dividends paid (6,329) (2,114) Borrowings on long-term debt 1,119,300 171,875 Repayment of long-term debt (483,323) (14,750) Deferred financing cost (19,205) — Payment of contingent liabilities (8,284) — Taxes paid from net share settlement of restricted stock (5,562) (3,975) Other (914) (623) Net cash provided by financing activities 595,683 150,413 Net increase in cash, cash equivalents, and restricted cash 175,224 54,488 Cash, cash equivalents, and restricted cash, beginning of period 289,102 294,152 Cash, cash equivalents, and restricted cash, end of period $ 464,326 $ 348,640 Supplemental disclosures of cash flow information Cash paid for income taxes $ 4,728 $ 38,270 Cash paid for interest $ 30,184 $ 23,190 Supplemental disclosures of non-cash investing and financing activities Right-of-use assets obtained in exchange for operating lease liabilities 7,780 13,303 Common stock issued in business combination — 21,952 Draw on letter of credit through Revolver Loan — 4,732 Common stock issued for contingent consideration payment 2,600 4,023 Elimination of note payable upon consolidation 9,488 — Dividend paid in the form of common stock 21,935 — The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total amounts of cash, cash equivalents, and restricted cash shown in the condensed consolidated statements of cash flows (in thousands): September 30 , 2025 2024 Cash and cash equivalents $ 462,227 $ 347,994 Restricted cash (1) 2,099 646 Total cash, cash equivalents, and restricted cash shown in the statement of cash flows $ 464,326 $ 348,640 (1) Restricted cash is included in other assets on the condensed consolidated balance sheets. Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin Set forth below are reconciliations of Net Income to EBITDA and Adjusted EBITDA as well as the reconciliation to Adjusted EBITDA margin for the three and nine months ended September 30, 2025 and 2024. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue. Three Months Ended September 30 , Nine Months Ended September 30 , (in thousands) 2025 2024 2025 2024 Net income $ 1,077 $ 18,981 $ 17,514 $ 57,709 Interest expense 17,718 8,856 32,408 25,028 Interest income (3,522) (3,778) (8,170) (11,287) Provision for income taxes 4,594 7,831 14,586 25,004 Depreciation and amortization 15,595 7,264 29,348 19,801 EBITDA 35,462 39,154 85,686 116,255 Income from equity method investments (1,019) (1,353) (532) (2,887) Other, net 26,340 (1) 1,206 (2) 40,597 (3) 2,663 (4) Stock-based compensation 7,699 6,163 27,219 19,301 Adjusted EBITDA $ 68,482 $ 45,170 $ 152,970 $ 135,332 Total revenue $ 956,048 $ 478,710 $ 2,231,243 $ 1,369,331 Adjusted EBITDA margin 7 % 9 % 7 % 10 % (1) Other, net, for the three months ended September 30, 2025 relates to $13.0 million for a legal matter with a provider associated with CFC Health Plan, Inc, ("CFC HP"), $12.7 million for transaction and integration costs primarily for the acquisition of Prospect, certain costs associated with the CHS transaction, non-cash changes related to the change in the fair value of our call option and Collar Agreement, and severance fees incurred. (2) Other, net, for the three months ended September 30, 2024, relates to non-cash changes related to change in the fair value of our financing obligation to purchase remaining equity interests in one of our investments, non-cash changes related to change in the fair value of the Company's Collar Agreement, non-cash gain on debt extinguishment related to one of our promissory note payables, and transaction costs incurred for our investments and tax restructuring fees. (3) Other, net, for the nine months ended September 30, 2025, relates to $13.0 million for a legal matter with a provider associated with CFC HP, $23.6 million for transaction and integration costs primarily for the acquisition of Prospect, debt issuance costs incurred in connection with our Second Amended and Restated Credit Facility, certain costs associated with the CHS transaction, non-cash changes related to change in the fair value of our call option and Collar Agreement, and severance fees incurred. (4) Other, net, for the nine months ended September 30, 2024, relates to financial guarantee via a letter of credit that we provided in support of two local provider-led ACOs, non-cash changes related to change in the fair value of our financing obligation to purchase the remaining equity interests in one of our investments, non-cash changes related to change in the fair value of the Company's Collar Agreement, non-cash gain on debt extinguishment related to one of our promissory note payables, transaction costs incurred for our investments and tax restructuring fees, and reimbursement from a related party of the Company for taxes associated with the Excluded Assets spin-off. Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA Year EndingDecember 31, 2025 Guidance Range (in thousands) Low High Net income $ 23,500 $ 28,500 Interest expense 37,000 38,000 Provision for income taxes 18,000 22,000 Depreciation and amortization 45,500 45,500 EBITDA 124,000 134,000 Income from equity method investments (2,000) (2,000) Other, net 42,000 42,000 Stock-based compensation 36,000 36,000 Adjusted EBITDA $ 200,000 $ 210,000 Use of Non-GAAP Financial Measures This press release contains the non-GAAP financial measures EBITDA and Adjusted EBITDA, of which the most directly comparable financial measure presented in accordance with U.S. generally accepted accounting principles ("GAAP") is net income. These measures are not in accordance with, or alternatives to GAAP, and may be calculated differently from similar non-GAAP financial measures used by other companies. The Company uses Adjusted EBITDA as a supplemental performance measure of our operations, for financial and operational decision-making, and as a supplemental means of evaluating period-to-period comparisons on a consistent basis. Adjusted EBITDA is calculated as earnings before interest, taxes, depreciation, and amortization, excluding income or loss from equity method investments, non-recurring and non-cash transactions, and stock-based compensation. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue. The Company believes the presentation of these non-GAAP financial measures provides investors with relevant and useful information, as it allows investors to evaluate the operating performance of the business activities without having to account for differences recognized because of non-core or non-recurring financial information. When GAAP financial measures are viewed in conjunction with non-GAAP financial measures, investors are provided with a more meaningful understanding of the Company's ongoing operating performance. In addition, these non-GAAP financial measures are among those indicators the Company uses as a basis for evaluating operational performance, allocating resources, and planning and forecasting future periods. Non-GAAP financial measures are not intended to be considered in isolation, or as a substitute for, GAAP financial measures. Other companies may calculate both EBITDA and Adjusted EBITDA differently, limiting the usefulness of these measures for comparative purposes. To the extent this release contains historical or future non-GAAP financial measures, the Company has provided corresponding GAAP financial measures for comparative purposes. The reconciliation between certain GAAP and non-GAAP measures is provided above. 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