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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549

 

FORM 8-K

 

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the

Securities Exchange Act of 1934

 

Date of report (Date of earliest event reported): November 6, 2025

 

ASTRANA HEALTH, INC.

(Exact Name of Registrant as Specified in its Charter)

 

Delaware 001-37392 95-4472349
(State or Other Jurisdiction (Commission (I.R.S. Employer
of Incorporation) File Number) Identification No.)

 

1668 S. Garfield Avenue, 2nd Floor, Alhambra, California 91801

(Address of Principal Executive Offices) (Zip Code)

 

(626) 282-0288

Registrant’s Telephone Number, Including Area Code

 

 

(Former Name or Former Address, if Changed Since Last Report)

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

¨ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

¨ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

¨ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

¨ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

  

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class Trading Symbol(s) Name of each exchange on which registered
Common Stock ASTH The Nasdaq Stock Market LLC

 

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

 

Emerging growth company ¨

 

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨

  

 

 

   

 

 

Item 2.02Results of Operations and Financial Condition.

 

On November 6, 2025, Astrana Health, Inc. (the “Company”) issued a press release announcing its financial results for the three and nine months ended September 30, 2025. A copy of the press release is furnished with this Current Report on Form 8-K as Exhibit 99.1 and incorporated herein by reference.

 

The information furnished pursuant to this Item 2.02 to this Current Report on Form 8-K, including the exhibit, is being “furnished” and, as such, shall not be deemed to be “filed” for the purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of that section, nor shall it be incorporated by reference into any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as shall be expressly set forth by specific reference in such filing.

 

Item 7.01 Regulation FD Disclosure.

 

The Company has scheduled a conference call and webcast at 2:30 p.m. Pacific Time/5:30 p.m. Eastern Time today on November 6, 2025 to discuss the Company’s financial results for the three and nine months ended September 30, 2025. In addition to the press release, an earnings presentation will be made available on the Company’s investor relations page at ir.astranahealth.com. A copy of the earnings presentation is furnished as Exhibit 99.2 to this Current Report on Form 8-K and incorporated herein by reference.

 

The information furnished pursuant to this Item 7.01 to this Current Report on Form 8-K, including the exhibit, is being “furnished” and, as such, shall not be deemed to be “filed” for the purposes of Section 18 of the Exchange Act, or otherwise subject to the liabilities of that section, nor shall it be incorporated by reference into any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as shall be expressly set forth by specific reference in such filing.

 

Item 9.01Financial Statements and Exhibits.

 

(d) Exhibits.

 

Exhibit No.   Description
99.1   Press Release of Astrana Health, Inc. Regarding its Financial Results for the Three and Nine Months Ended September 30, 2025, dated November 6, 2025
99.2   Supplemental Data of Astrana Health, Inc., dated November 6, 2025.
104   Cover Page Interactive Data File (the cover page XBRL tags are embedded within the inline XBRL document).

 

 

 

 

SIGNATURES

 

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

  ASTRANA HEALTH, INC.
   
Date: November 6, 2025 By: /s/ Brandon K. Sim
  Name: Brandon K. Sim
  Title: Chief Executive Officer and President

 

 

 

 

Exhibit 99.1

 

 

Astrana Health, Inc. Reports Third Quarter 2025 Results

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., November 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)  Care
Partners
   Care
Delivery
   Care
Enablement
   Intersegment
Elimination
    Corporate
Costs
   Consolidated
Total
 
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 a 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 Ending
December 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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November 2025 Third Quarter 2025 Earnings Supplement

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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 business, financial condition, operating results, plans, objectives, expectations and intentions, expansion plans, estimates of our total addressable market, our ability to successfully complete and realize the benefits of anticipated acquisitions, integration of acquired companies and any projections of earnings, revenue, EBITDA, Adjusted EBITDA or other financial items, such as the Company's projected capitation and future liquidity, and may be identified by the use of forward-looking terms such as “anticipate,” “could,” “can,” “may,” “might,” “potential,” “predict,” “should,” “estimate,” “expect,” “project,” “believe,” “plan,” “envision,” “intend,” “continue,” “target,” “seek,” “will,” “would,” and the negative of such terms, other variations on such terms or other similar or comparable words, phrases or terminology. 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 U.S. Securities and Exchange Commission (the “SEC”), including without limitation the risk factors discussed in the Company’s last Annual Report on Form 10-K and subsequent quarterly reports on Form 10-Q filed with the SEC. Because the factors referred to above could cause actual results or outcomes to differ materially from those expressed or implied in any forward-looking statements, you should not place undue reliance on any such forward-looking statements. Any forward-looking statements speak only as of the date of this presentation and, unless legally required, the Company does not undertake any obligation to update any forward-looking statement, as a result of new information, future events or otherwise. This presentation may contain statistics and other data that in some cases has been obtained from or compiled from information made available by third-party service providers. The Company makes no representation or warranty, express or implied, with respect to the accuracy, reasonableness or completeness of such information. Use of Non-GAAP Financial Measures This presentation 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, stock-based compensation, and, for periods on or prior to December 31, 2023, APC excluded assets costs. Beginning in the third quarter ended September 30, 2022, the Company has revised the calculation for Adjusted EBITDA to exclude provider bonus payments and losses from recently acquired IPAs, which it believes to be more reflective of its business. 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 Presentation 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 in the Appendix. The Company has not provided a quantitative reconciliation of applicable non-GAAP measures, such as the projected adjusted EBITDA and adjusted EBITDA margin in 2024 and in future years for planned acquisitions, to the most comparable GAAP measure, such as net income, on a forward-looking basis within this presentation because the Company is unable, without unreasonable efforts, to provide reconciling information with respect to certain line items that cannot be calculated. These items, which could materially affect the computation of forward-looking GAAP net income, are inherently uncertain and depend on various factors, some of which are outside of the Company’s control.

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3 Q3 2025 Financial Results Revenue $956.0 Net Income attr. to ASTH $0.4 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non-GAAP Financial Measures” slides for more information. Third Quarter 2025 Performance Highlights ($ in millions, except for per share information) Adjusted EBITDA1 $68.5 EPS – Diluted $0.01

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4 Q3 2025 Financial Results 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA,” “Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non-GAAP Financial Measures” slides for more information There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See “Forward-Looking Statements” on slide 2 ($ in millions) Actual FY 2024 Results FY 2025 Guidance Range1 Total Revenue $2,034.5 $3,100 - $3,180 Adjusted EBITDA1 $170.4 $200 - $210 FY2025 Guidance Revenue $956.0 Adjusted EBITDA1 $68.5

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5 Growth Third Quarter 2025 Highlights and Recent Updates Risk Progression Increasing alignment through total cost of care responsibility in value-based arrangements 77% of our revenues coming from fully capitated arrangements versus 60% a year ago and 75% in the first quarter Outcomes and Cost Achieving superior patient outcomes while managing cost Medical cost trends across both Prospect and legacy Astrana remained firmly within expectations in the third quarter Operating Leverage Driving operating leverage across our business through our Care Enablement suite We expect to achieve $12-15M in OpEx synergies from the Prospect transaction within 12-18 months Growth Sustainably growing membership to bring better care to more Americans Closed acquisition of Prospect; Astrana is now serving over 1.6 million patients in value-based arrangements Approximately 1.4 million members in our Care Partners segment

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6 Prudently transitioning to full-risk contracts to better align incentives around patient outcomes and improve unit economics Projected Full-risk Partial-risk 1. Revenue by risk arrangement represents capitation revenue only 2. Members by risk arrangement represent Care Partners membership only as of September 30, 2025 Members by Risk Arrangement2 35% 47% 73% 77% 77% 100% 65% 53% 27% 23% 23% 2021 2022 2023 2024 2025 Q3 2025E 34% 66% 2025 Q3 Capitated Revenue by Risk Arrangement1 Our partial-risk membership presents an embedded opportunity for increased platform value and risk alignment. We succeed in these contracts by continuing to drive positive patient outcomes. Risk Progression

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7 90% 3% 2% 4% 1% Capitation, net Risk Pool Settlements & Incentives Management Fee Income Fee-for-service, net Other Income Revenue by Type1 1. Revenue for the quarter ended September 30, 2025 2. Revenue by risk arrangement represents capitation revenue only 3. Members by risk arrangement represent Care Partners membership only as of September 30, 2025 60% 25% 9% 6% Medicare Medicaid Commercial Other Third Parties Revenue By Payer Type1 77% 23% Full-risk Partial-risk Revenue by Risk Arrangement1,2 34% 66% Full-risk Partial-risk Members by Risk Arrangement3 Our Value-Based Care Business is Diverse

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8 Note: For more information, see “Reconciliation of Net Income to EBITDA and Adjusted EBITDA”, “Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA”, and “Use of Non-GAAP Financial Measures“ slides for more information Revenue ($ in millions) Adj. EBITDA ($ in millions) $561 $687 $774 $1,144 $1,387 $2,035 2019 2020 2021 2022 2023 ~33% CAGR 2024 $54.2 $102.8 $133.5 $140.0 $146.6 $170.4 2019 2020 2021 2022 2023 2024 ~25% CAGR Astrana grows profitably across all market conditions 2025E $3,100 – $3,180 $200 - $210 2025E

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9 Quarter over Quarter Segment Revenue Revenue $ in millions Q3 2024 Q4 2024 Q1 2025 Q2 2025 Q3 2025 Care Partners High-performing network of aligned providers $455.8 $647.7 $601.0 $631.4 Care Delivery High-quality system of employed providers $34.7 $36.4 $33.4 $38.4 Care Enablement Full-stack tech, clinical, and operations platform $40.9 $45.1 $39.6 $40.9 Inter-company $(52.7) $(63.9) $(53.5) $(55.9) Total $478.7 $665.2 $620.4 $654.8 Note: Numbers may not total due to rounding. Certain amounts disclosed in the prior periods have been recast to conform to the current period presentation. Specifically, segments are presented net of intrasegment eliminations. $897.7 $86.9 $87.3 $(115.9) $956.0

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10 Selected Financial Results

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11 Three Months Ended September 30, $ in thousands except per share data 2025 2024 Revenue Capitation, net $ 863,380 $ 431,401 Risk pool settlements and incentives 30,798 21,779 Management fee income 15,217 2,747 Fee-for-service, net 40,080 18,692 Other revenue 6,573 4,091 Total revenue 956,048 478,710 Total expenses 936,838 450,285 Income from operations 19,210 28,425 Net income $ 1,077 $ 18,981 Net income attributable to noncontrolling interests 704 2,887 Net income attributable to Astrana Health $ 373 $ 16,094 Earnings per share – diluted $ 0.01 $ 0.33 EBITDA1 $ 35,462 $ 39,154 Adjusted EBITDA1 $ 68,482 $ 45,170 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non-GAAP Financial Measures” slides for more information. Summary of Selected Financial Results

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12 $ in thousands Care Partners Care Delivery Care Enablement Intersegment Elimination Corporate Costs Consolidated Total Total revenues $ 897,730 86,871 87,340 (115,893) - 956,048 % change vs prior year quarter 97% 150% 113% 99% Cost of services 788,427 72,210 44,067 (45,848) - 858,856 General and administrative expenses1 84,019 15,678 19,871 (69,964) 28,378 77,982 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)2 (28,378) 19,210 % change vs prior year quarter (35)% (25)% 271% For the three months ended September 30, 2025 1. Balance includes general and administrative expenses and depreciation and amortization. 2. Income from operations for the intersegment elimination represents sublease income between segments. Sublease income is presented within other income that is not presented in the table. Segment Results

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13 $ in millions 9/30/2025 12/31/2024 $ Change Cash and cash equivalents and investments in marketable securities1 $463.4 $290.8 $172.6 Working capital $253.7 $272.9 $(19.2) Total stockholders’ equity $789.1 $716.7 $72.4 1. Excluding restricted cash Balance Sheet Highlights

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14 Three Months Ended September 30, $ in thousands 2025 2024 Net Income $ 1,077 $ 18,981 Interest Expense 17,718 8,856 Interest income (3,522) (3,778) Provision for income taxes 4,594 7,831 Depreciation and amortization 15,595 7,264 EBITDA 35,462 39,154 Income from equity method investments (1,019) (1,353) Other, net 26,3402 (1,206)3 Stock-based compensation 7,699 6,163 Adjusted EBITDA $ 68,482 $ 45,170 Adjusted EBITDA margin1 7% 9% 1.The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue. 2. 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 transactions, non-cash changes related to the change in the fair value of our call option and Collar Agreement, and severance fees incurred. 3. 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. Reconciliation of Net Income to EBITDA & Adjusted EBITDA

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15 For the twelve months ended TTM Ended Year Ended $ in millions September 30, 2025 2024 2023 2022 2021 2020 2019 Net Income $ 9.7 $ 49.9 $ 57.8 $ 45.7 $ 46.1 $ 122.1 $ 15.8 Interest expense 40.5 33.1 16.1 7.9 5.4 9.5 4.7 Interest income (11.4) (14.5) (14.2) (2.0) (1.6) (2.8) (2.0) Provision for income taxes 20.5 30.9 32.0 40.9 31.7 56.3 10.0 Depreciation and amortization 37.5 27.9 17.7 17.5 17.5 18.4 18.3 EBITDA1 96.8 127.3 109.5 110.1 99.1 203.5 46.8 (Income) loss from equity method investments (2.1) (4.5) (5.1) (5.7)6 5.36 (0.3) 6 2.9 Gain on sale of equity method investment - - - - (2.2) - - Other, net 50.92 13.03 6.24 3.35 (1.7) 6 (0.5) 6 2.0 Stock-based compensation 42.5 34.5 22.0 16.1 6.7 3.4 0.9 APC excluded assets costs - - 14.0 16.28 26.48 (103.3) 8 1.5 Adjusted EBITDA1 $ 188.0 $ 170.4 $ 146.6 $ 140.0 $ 133.5 $ 102.8 54.2 Net Revenue $ 2,896.5 $ 2,034.5 $ 1,386.7 $ 1,144.2 $ 773.9 $ 687.2 560.6 Adjusted EBITDA Margin7 6% 8% 11% 12% 17% 15% 10% 1. See “Use of Non-GAAP Financial Measures” slide for more information 2. Other, net, for TTM ended September 30, 2025, relates to a legal matter with CFC HP, 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 transactions, non-cash changes related to change in the fair value of our call option and Collar Agreement, and severance fees incurred.;3. Other, net for the year ended December 31, 2024 relates to transaction costs incurred for our investments and tax restructuring fees, anticipated recoveries from one time losses relating to third party payer payments associated with the CHS transaction, financial guarantee via a letter of credit that we provided almost three years ago in support of two local provider-led ACOs, reimbursement from a related party of the Company for taxes associated with the December 2023 Excluded Assets Spin-off, non-cash gain on debt extinguishment related to one of our promissory note payables, non-cash realized loss from sale of one of our marketable equity securities, non-cash changes related to change in the fair value of our call option, our financing obligation to purchase the remaining equity interests in one of our investments, our contingent liabilities, and the Company's Collar Agreement; 4. Other, net for the year ended December 31, 2023 consists of nonrecurring transaction costs and tax restructuring fees incurred, non-cash changes in the fair value of our financing obligation to purchase the remaining equity interests, contingent liabilities, and the Company's Collar Agreement, and excise tax related to a nonrecurring buyback of the Company’s stock from APC.; 5. Other, net for the year ended December 31, 2022 consists of one-time transaction costs incurred and non-cash changes in the fair value of our financing obligation to purchase the remaining equity interests and contingent considerations.; 6. Other, net for the years ended December 31, 2021 and 2020 relate to COVID-19 relief payments recognized in 2021 and 2020; 7. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue; 8. Certain APC minority interests where APC owns the asset but not the right to the dividends is reclassified from APC excluded asset costs to income from equity method investments Reconciliation of Net Income to EBITDA & Adjusted EBITDA (continued)

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16 Note: See “Use of Non-GAAP Financial Measures” slide for more information. 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 Adj. EBITDA 200,000 210,000 Guidance Reconciliation of Net Income to EBITDA & Adjusted EBITDA

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