Astrana Health, Inc. Reports Third Quarter 2025 Results

⁽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.

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.

($ in millions)

Year Ending
December 31, 2025

Guidance Range

Low

High

Total revenue

$

3,100

$

3,180

Adjusted EBITDA

$

200

$

210

U.S. & Canada (Toll-Free):

+1 (877) 858-9810

International (Toll):

+1 (201) 689-8517

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

—

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.

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 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