Astrana Health, Inc. Reports First Quarter 2025 Results

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May 8, 2025 4:05 PM EDT

Company to Host Conference Call on Thursday, May 8, 2025, at 2:30 p.m. PT/5:30 p.m. ET

ALHAMBRA, Calif., May 8, 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 first quarter ended March 31, 2025.

"Astrana's strong start to the year reflects the continued momentum behind our mission to build the nation's leading patient-centered healthcare platform. Our differentiated clinical capabilities and technology-enabled delegated model continue to drive strong, profitable growth while delivering better outcomes for both patients and providers. Even in a complex regulatory and economic environment, we continue to prove that value-based care can deliver meaningful impact at scale with long-term sustainability," said Brandon Sim, President and CEO of Astrana Health. 

Financial Highlights for three months ended March 31, 2025:

All comparisons are to the three months ended March 31, 2024 unless otherwise stated.

  • Total revenue of $620.4 million, up 53% from $404.4 million
  • Care Partners revenue of $601.0 million, up 57% from $382.3 million
  • Net income attributable to Astrana of $6.7 million, compared to $14.8 million
  • Earnings per share - diluted ("EPS - diluted") of $0.14, compared to $0.31
  • Adjusted EBITDA(1) of $36.4 million, compared to $42.2 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

  • Astrana announced several additions to its leadership team to support continued growth and execution. The Company welcomes Georgie Sam, Chief Data & Analytics Officer, who will oversee enterprise-wide data and analytics strategy to deliver even faster, more actionable insights to our stakeholders, and Glenn Sobotka, Chief Accounting Officer, who brings deep experience to support Astrana's continued financial discipline and scalability. Rita Pew was promoted to the role of Chief People Officer, helping Astrana further invest in the talent and culture that drive Astrana forward.
  • Astrana successfully completed the integration of Collaborative Health Systems ("CHS") and onboarded the entity to the Company's proprietary technology platform, already resulting in material general and administrative ("G&A") efficiencies.
  • Astrana received Hart-Scott-Rodino ("HSR") approval for its pending acquisition of Prospect Health, which remains on track to close this summer.

Segment Results for three months ended March 31, 2025:
All comparisons are to the three months ended March 31, 2024 unless otherwise stated.



Three Months Ended March 31, 2025


(in thousands)


Care
Partners



Care
Delivery



Care
Enablement



Intersegment
Elimination



Corporate
Costs



Consolidated
Total


Total revenues


$

600,951



$

33,388



$

39,562



$

(53,511)



$

—



$

620,390


% change vs. prior year quarter



57

%



9

%



19

%





























Cost of services



512,668




27,139




25,818




(16,564)




—




549,061


General and administrative(1)



44,068




9,357




10,209




(36,950)




24,062




50,746


Total expenses



556,736




36,496




36,027




(53,514)




24,062




599,807





















Income (loss) from operations


$

44,215



$

(3,108)



$

3,535



$

3


(2)

$

(24,062)



$

20,583


% change vs. prior year quarter



2

%


*




1

%











* Percentage change of over 500%

(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.

2025 Guidance:

Astrana is providing the following guidance for total revenue and Adjusted EBITDA for the quarter ended June 30, 2025 and reiterating guidance for the year ended December 31, 2025 based on the Company's existing business, current view of existing market conditions, and assumptions. The following guidance for the year ended December 31, 2025 includes approximately $15 million in expected costs associated with continued strategic investments in automation and AI, as well as ongoing and expected integration costs associated with planned acquisitions, but does not include contributions from any acquisitions which have not yet closed.

($ in millions)


Three Months Ended
June 30, 2025



Year Ended
December 31, 2025



Guidance Range



Guidance Range



Low



High



Low



High

Total revenue


$

615



$

655



$

2,500



$

2,700

Adjusted EBITDA


$

45



$

50



$

170



$

190

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, May 8, 2025), during which management will discuss the results of the first quarter ended March 31, 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=HE6dr7eJ 

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, technology-enabled healthcare company committed to delivering access to high-quality, patient-centered care. Through its proprietary end-to-end technology platform, Astrana empowers providers to deliver more proactive, preventive care - improving patient outcomes, elevating patient experiences, improving the well-being of providers, and driving greater value.

Today, Astrana supports more than 12,000 providers and over one million Americans in value-based arrangements through its affiliated provider networks, management services organization, and primary, specialty, and ancillary care delivery clinics. Together, Astrana is building what our healthcare system should be - 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 quarter ending June 30, 2025 and 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 any subsequent quarterly reports on Form 10-Q. Any forward-looking statement 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:

Investor Relations
(626) 943-6491
[email protected] 

ASTRANA HEALTH, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)




March 31,
2025



December 31,
2024




(Unaudited)












Assets














Current assets









Cash and cash equivalents


$

258,517



$

288,455


Investment in marketable securities



2,397




2,378


Receivables, net



241,078




225,733


Receivables, net – related parties



56,846




50,257


Income taxes receivable



15,802




19,316


Other receivables



14,919




29,496


Prepaid expenses and other current assets



23,711




22,861









Total current assets



613,270




638,496









Non-current assets







Property and equipment, net



16,849




14,274


Intangible assets, net



111,916




118,179


Goodwill



416,386




419,253


Income taxes receivable



15,943




15,943


Loans receivable, non-current



48,134




51,266


Investments in other entities – equity method



38,005




39,319


Investments in privately held entities



8,896




8,896


Restricted cash



647




646


Operating lease right-of-use assets



30,698




32,601


Other assets



30,512




16,021









Total non-current assets



717,986




716,398









Total assets(1)


$

1,331,256



$

1,354,894









Liabilities, Mezzanine Deficit, and Stockholders' Equity














Current liabilities







Accounts payable and accrued expenses


$

105,559



$

106,142


Fiduciary accounts payable



4,840




8,223


Medical liabilities



204,101




209,039


Dividend payable



638




638


Finance lease liabilities



471




554


Operating lease liabilities



4,979




5,350


Current portion of long-term debt



12,500




9,375


Other liabilities



28,180




26,287









Total current liabilities



361,268




365,608









Non-current liabilities







Deferred tax liability



4,197




4,555


Finance lease liabilities, net of current portion



543




607


Operating lease liabilities, net of current portion



28,963




30,654


Long-term debt, net of current portion and deferred financing costs



403,894




425,299


Other long-term liabilities



14,685




14,003









Total non-current liabilities



452,282




475,118









Total liabilities(1)



813,550




840,726









Mezzanine deficit







Noncontrolling interest in Allied Physicians of California, a Professional Medical Corporation ("APC")



(232,733)




(202,558)









Stockholders' equity







Preferred stock, $0.001 par value per share; 5,000,000 shares authorized as of
March 31, 2025 and December 31, 2024







Series A Preferred stock, zero authorized and issued and zero outstanding as of
March 31, 2025 and zero authorized and issued and zero outstanding as of
December 31, 2024



—




—


Series B Preferred stock, zero authorized and issued and zero outstanding as of
March 31, 2025 and zero authorized and issued and zero outstanding as of
December 31, 2024



—




—


Common stock, $0.001 par value per share; 100,000,000 shares authorized,
49,028,624(2) and 47,929,872 shares issued and outstanding, excluding 9,903,953
and 10,603,849 treasury shares, as of March 31, 2025 and December 31, 2024,
respectively



49




48


Additional paid-in capital



452,439




426,389


Retained earnings



292,880




286,283


Total stockholders' equity



745,368




712,720









Non-controlling interest



5,071




4,006









Total equity



750,439




716,726









Total liabilities, mezzanine deficit, and stockholders' equity


$

1,331,256



$

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 $678.1 million and $712.3 million as of March 31, 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 $212.1 million and $207.9 million as of March 31, 2025 and December 31, 2024, respectively. These VIE balances do not include $190.2 million of investment in affiliates and $4.5 million of amounts due to affiliates as of March 31, 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.

(2) As of May 5, 2025, there were 56,061,712 shares of common stock of the registrant issued and outstanding, which includes 6,132,802 treasury shares that are owned by Allied Physicians of California, a Professional Medical Corporation d.b.a. Allied Pacific of California IPA ("APC"). The shares owned by APC are legally issued and outstanding but excluded from shares of common stock outstanding in the Company's consolidated financial statements. The shares are treated as treasury shares for accounting purposes and not included in the number of shares of common stock outstanding used to calculate the Company's earnings per share.

Included in the Company's common stock as outstanding in the consolidated financial statements are 41,048 holdback shares that have not been issued to certain former shareholders of the Company's subsidiary, Astrana Health Management, Inc. ("AHM"). The former AHM shareholders, who were AHM shareholders at the time of closing of the merger, have yet to submit properly completed letters of transmittal to Astrana in order to receive their pro rata portion of Astrana's common stock as contemplated under that certain Agreement and Plan of Merger, dated December 21, 2016, among Astrana, AHM, Apollo Acquisition Corp. ("Merger Subsidiary") and Kenneth Sim, M.D., as amended, pursuant to which Merger Subsidiary merged with and into AHM, with AHM as the surviving corporation. Pending such receipt, such former AHM shareholders have the right to receive, without interest, their pro rata share of dividends or distributions with a record date after the effectiveness of the merger. The Company's consolidated financial statements have treated such shares of common stock as outstanding, given the receipt of the letter of transmittal is considered perfunctory and Astrana is legally obligated to issue these shares in connection with the merger.

 

ASTRANA HEALTH, INC.

CONSOLIDATED STATEMENTS OF INCOME

(IN THOUSANDS, EXCEPT PER SHARE AMOUNTS)

(UNAUDITED)




Three Months Ended
March 31,




2025



2024


Revenue







Capitation, net


$

583,963



$

365,910


Risk pool settlements and incentives



14,491




17,377


Management fee income



2,310




4,078


Fee-for-service, net



14,890




15,937


Other revenue



4,736




1,054









Total revenue



620,390




404,356









Operating expenses







Cost of services, excluding depreciation and amortization



549,061




330,399


General and administrative expenses



43,897




38,722


Depreciation and amortization



6,849




5,096









Total expenses



599,807




374,217









Income from operations



20,583




30,139









Other expense







(Loss) income from equity method investments



(867)




632


Interest expense



(7,308)




(7,585)


Interest income



2,312




3,996


Unrealized (loss) gain on investments



(44)




1,099


Other loss



(5,072)




(4,277)









Total other expense, net



(10,979)




(6,135)









Income before provision for income taxes



9,604




24,004









Provision for income taxes



3,383




7,142









Net income



6,221




16,862









Net (loss) income attributable to non-controlling interest



(471)




2,027









Net income attributable to Astrana Health, Inc.


$

6,692



$

14,835









Earnings per share – basic


$

0.14



$

0.31









Earnings per share – diluted


$

0.14



$

0.31


 

ASTRANA HEALTH, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(IN THOUSANDS)

(UNAUDITED)




Three Months Ended
March 31,




2025



2024









Cash flows from operating activities







Net income


$

6,221



$

16,862


Adjustments to reconcile net income to net cash provided by operating activities:







Depreciation and amortization



6,849




5,096


Amortization of debt issuance cost



691




458


Share-based compensation



7,811




5,748


Non-cash lease expense



1,287




3,155


Change in fair value of contingent consideration liabilities



1,407




—


Loss on debt extinguishment



375




—


Unrealized loss (gain) on investments



44




(1,099)


Loss (income) from equity method investments



867




(632)


Deferred tax



(358)




(7,248)


Other



(557)




6,795


Changes in operating assets and liabilities, net of business combinations:







Receivables, net



(10,368)




(26,128)


Receivables, net – related parties



(6,589)




(3,374)


Other receivables



3,688




(1,403)


Prepaid expenses and other current assets



2,674




(4,255)


Other assets



(314)




92


Accounts payable and accrued expenses



8




905


Fiduciary accounts payable



(3,383)




56


Medical liabilities



3,319




(808)


Income taxes receivable



3,514




14,542


Operating lease liabilities



(1,090)




(3,083)


Other long-term liabilities



531




298


Net cash provided by operating activities



16,627




5,977









Cash flows from investing activities







Payments for business acquisition, net of cash acquired



—




(50,649)


Proceeds from repayment of promissory notes, including those with related parties



600




6


Purchase of marketable securities



(24)




(27)


Issuance of loan receivable



—




(20,000)


Purchases of property and equipment



(3,070)




(369)


Distribution from investment - equity method



100




—


Net cash used in investing activities



(2,394)




(71,039)









Cash flows from financing activities







Dividends paid



(5,455)




(95)


Borrowings on long-term debt



412,000




110,000


Repayment of long-term debt



(428,232)




(3,500)


Payment of finance lease obligations



(147)




(179)


Deferred financing cost



(17,241)




—


Proceeds from ESPP purchases



301




—


Taxes paid from net share settlement of restricted stock



(4,052)




—


Repurchase of treasury shares



(1,316)




—


Proceeds from sale of non-controlling interest



—




150


Purchase of non-controlling interest



(28)




(25)


Net cash (used in) provided by financing activities



(44,170)




106,351









Net (decrease) increase in cash, cash equivalents, and restricted cash



(29,937)




41,289









Cash, cash equivalents, and restricted cash, beginning of period



289,101




294,152









Cash, cash equivalents, and restricted cash, end of period


$

259,164



$

335,441









Supplemental disclosures of cash flow information







Cash paid for income taxes


$

4,338



$

194


Cash paid for interest


$

7,360



$

6,430









Supplemental disclosures of non-cash investing and financing activities







Business acquisition in accounts payable and accrued liabilities



—




63,935


Right-of-use assets obtained in exchange for operating lease liabilities



5,729




4,910


Common stock issued in business combination



—




21,952


Purchase of investments - equity method in accounts payable and accrued liabilities and other liabilities



—




9,487


Draw on letter of credit through Revolver Loan



—




4,759


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):



March 31,




2025



2024


Cash and cash equivalents


$

258,517



$

334,796


Restricted cash



647




645


Total cash, cash equivalents, and restricted cash shown in the statement of cash flows


$

259,164



$

335,441


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 months ended March 31, 2025 and 2024. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.



Three Months Ended
March 31,



(in thousands)


2025




2024



Net income


$

6,221




$

16,862



Interest expense



7,308





7,585



Interest income



(2,312)





(3,996)



Provision for income taxes



3,383





7,142



Depreciation and amortization



6,849





5,096



EBITDA



21,449





32,689












(Income) loss from equity method investments



867





(632)



Other, net



6,259


(1)



4,440


(2)

Stock-based compensation



7,811





5,748



Adjusted EBITDA


$

36,386




$

42,245












Total revenue


$

620,390




$

404,356












Adjusted EBITDA margin



6

%




10

%



(1) Other, net for the three months ended March 31, 2025, relates to debt issuance costs expensed in connection with our Second Amended and Restated Credit Facility, transaction costs for our acquisition of Prospect, data transition costs for our recent acquisitions, 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.

(2) Other, net for the three months ended March 31, 2024, relates to financial guarantee via a letter of credit that we provided almost three years ago 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, and transaction costs incurred for our investments and tax restructuring fees.

 

Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA






2025 Guidance Range


(in thousands)


Low



High


Net income


$

62,500



$

73,500


Interest expense



16,000




19,000


Provision for income taxes



34,000




40,000


Depreciation and amortization



32,500




32,500


EBITDA



145,000




165,000









Income from equity method investments



(5,500)




(5,500)


Other, net



9,500




9,500


Stock-based compensation



21,000




21,000


Adjusted EBITDA


$

170,000



$

190,000


The Company has not provided a quantitative reconciliation of EBITDA and Adjusted EBITDA for the quarter ending June 30, 2025 to the most comparable GAAP measure on a forward-looking basis within this press release because the Company is unable, without unreasonable efforts, to provide reconciling information with respect to certain line items that cannot be calculated for the three month period. 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.

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.

 

Cision View original content to download multimedia:https://www.prnewswire.com/news-releases/astrana-health-inc-reports-first-quarter-2025-results-302450483.html

SOURCE Astrana Health, Inc.


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