Astrana Health, Inc. Reports First Quarter 2026 Results
Company to Host Conference Call on
- Reports total revenue of
$965.1 million , up 56% year over year - Reports adjusted EBITDA(1) of
$66.3 million , up 82% year over year and free cash flow(2) of$64.1 million , up 372% year over year
"We had a strong start to 2026, delivering disciplined growth, strong medical cost performance, continued operating leverage, and early performance from new full-risk contracts in line with our expectations," said
Financial Highlights for First Quarter Ended March 31, 2026:
All comparisons are to the three months ended March 31, 2025 unless otherwise stated.
- Total revenue of
$965.1 million , up 56% from$620.4 million - Care Partners revenue of
$909.7 million , up 51% from$601.0 million - Net income attributable to Astrana of
$14.4 million , up 116% from$6.7 million - Earnings per share ("EPS") - diluted of
$0.29 , up 107% from$0.14 - Adjusted EBITDA(1) of
$66.3 million , up 82% from$36.4 million - Adjusted EPS - diluted(3) of
$0.74 , up 76% from$0.42 - Net cash provided by operating activities of
$68.1 million , up 309% from$16.6 million - Free cash flow(2) of
$64.1 million , up 372% from$13.6 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. |
(2) | See reconciliation provided with the condensed consolidated statements of cash flow and "Use of Non-GAAP Financial Measures" below for additional information. |
(3) | See "Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS - Diluted" and "Use of Non-GAAP Financial Measures" below for additional information. |
Recent Operating Highlights
- Delivered on its commitment to convert key contracts to full-risk arrangements, with approximately 80% of Care Partners capitation revenue and approximately 40% of consolidated membership now in full-risk arrangements.
- Launched Astrana's delegated full-risk model with a payer partner in
Texas , expanding Medicare Advantage membership in the market to more than 14,000 members. - Continued deleveraging ahead of schedule, with net leverage declining to approximately 2.3x on a pro forma trailing twelve-month basis and to 2.2x based on the midpoint of the Company's full-year guidance.
- Foothill Regional Medical Center ("FRMC") received Healthgrades' 2026 Patient Safety Excellence Award™ for the fourth consecutive year and was named among Healthgrades' America's 100 Best Hospitals for Joint Replacement in 2026. FRMC also received the Healthgrades Joint Replacement Excellence Award for the second consecutive year, reflecting continued strength in clinical quality and patient outcomes.
Segment Results for three months ended March 31, 2026:
All comparisons are to the three months ended March 31, 2025 unless otherwise stated.
Three Months Ended March 31, 2026 | ||||||||||||||||||||||||
(in thousands) | Care | Care | Care | Intersegment | Corporate | Consolidated | ||||||||||||||||||
Total revenues | $ | 909,703 | $ | 85,077 | $ | 87,745 | $ | (117,425) | $ | — | $ | 965,100 | ||||||||||||
% change vs. prior year quarter | 51 | % | 155 | % | 122 | % | ||||||||||||||||||
Cost of services | 785,531 | 72,544 | 48,704 | (47,423) | — | 859,356 | ||||||||||||||||||
General and administrative expenses | 72,546 | 14,374 | 17,259 | (69,974) | 27,532 | 61,737 | ||||||||||||||||||
Depreciation and amortization | 12,170 | 1,122 | 1,629 | — | 558 | 15,479 | ||||||||||||||||||
Total expenses | 870,247 | 88,040 | 67,592 | (117,397) | 28,090 | 936,572 | ||||||||||||||||||
Income (loss) from operations | $ | 39,456 | $ | (2,963) | $ | 20,153 | $ | (28) | (1) | $ | (28,090) | $ | 28,528 | |||||||||||
% change vs. prior year quarter | (11) | % | (5) | % | 470 | % | ||||||||||||||||||
(1) | Loss from operations for the intersegment elimination represents sublease income between segments. Sublease income is presented within other income, which is not presented in the table. |
2026 Guidance:
Astrana is providing the following guidance for total revenue and Adjusted EBITDA for the quarter ending
Three Months Ending | Year Ending | |||||||||||||||
($ in millions) | Low | High | Low | High | ||||||||||||
Total revenue | $ | 965 | $ | 1,000 | $ | 3,800 | $ | 4,100 | ||||||||
Adjusted EBITDA | $ | 65 | $ | 70 | $ | 250 | $ | 280 | ||||||||
Free cash flow | $ | 105 | $ | 132.5 | ||||||||||||
See "Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA," "Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow," 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
+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=HHhCPjaF
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. Non-controlling interests represent third party equity ownership interests in the Company's consolidated entities (including certain VIEs). The amount of net income or loss attributable to non-controlling 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 approximately 1.55 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 quarter ending
FOR MORE INFORMATION, PLEASE CONTACT:
[email protected]
ASTRANA HEALTH, INC. | ||||||||
CONDENSED CONSOLIDATED BALANCE SHEETS | ||||||||
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA) | ||||||||
March 31, | December 31, | |||||||
(Unaudited) | ||||||||
Assets | ||||||||
Current assets | ||||||||
Cash and cash equivalents | $ | 478,383 | $ | 429,474 | ||||
Receivables, net (including amounts from related parties) | 467,395 | 374,465 | ||||||
Income taxes receivable | — | 1,799 | ||||||
Other receivables | 28,017 | 26,385 | ||||||
Prepaid expenses and other current assets | 25,647 | 26,264 | ||||||
Loans receivable | 4,658 | 4,926 | ||||||
Total current assets | 1,004,100 | 863,313 | ||||||
Non-current assets | ||||||||
Property and equipment, net | 59,546 | 57,332 | ||||||
Intangible assets, net | 257,118 | 270,968 | ||||||
Goodwill | 874,799 | 865,305 | ||||||
Income taxes receivable, net of current portion | 26,220 | 26,220 | ||||||
Loans receivable, net of current portion | 49,068 | 48,724 | ||||||
Investments in other entities – equity method | 27,257 | 25,637 | ||||||
Operating lease right-of-use assets | 33,933 | 35,738 | ||||||
Other assets | 26,786 | 25,424 | ||||||
Total non-current assets | 1,354,727 | 1,355,348 | ||||||
Total assets (1) | $ | 2,358,827 | $ | 2,218,661 | ||||
Liabilities, Mezzanine Deficit, and Stockholders' Equity | ||||||||
Current liabilities | ||||||||
Accounts payable and accrued expenses | $ | 221,389 | $ | 195,912 | ||||
Fiduciary accounts payable | 3,706 | 3,524 | ||||||
Income taxes payable | 2,507 | — | ||||||
Medical liabilities | 439,259 | 335,705 | ||||||
Operating lease liabilities | 7,557 | 7,809 | ||||||
Current portion of long-term debt | 47,865 | 47,865 | ||||||
Other liabilities | 23,086 | 24,458 | ||||||
Total current liabilities | 745,369 | 615,273 | ||||||
Non-current liabilities | ||||||||
Deferred tax liability | 7,399 | 5,491 | ||||||
Operating lease liabilities, net of current portion | 30,006 | 31,552 | ||||||
Long-term debt, net of current portion and deferred financing costs | 979,764 | 990,904 | ||||||
Other long-term liabilities | 18,833 | 17,107 | ||||||
Total non-current liabilities | 1,036,002 | 1,045,054 | ||||||
Total liabilities (1) | 1,781,371 | 1,660,327 | ||||||
Mezzanine deficit | ||||||||
Non-controlling interest in Allied Physicians of | (237,739) | (234,962) | ||||||
Stockholders' equity | ||||||||
Preferred stock, | — | — | ||||||
Common stock, | 49 | 49 | ||||||
Additional paid-in capital | 477,508 | 470,863 | ||||||
Retained earnings | 322,711 | 308,379 | ||||||
Total stockholders' equity | 800,268 | 779,291 | ||||||
Non-controlling interests | 14,927 | 14,005 | ||||||
Total equity | 815,195 | 793,296 | ||||||
Total liabilities, mezzanine deficit, and stockholders' equity | $ | 2,358,827 | $ | 2,218,661 | ||||
(1) | The Company's condensed consolidated balance sheets include the assets and liabilities of its consolidated VIEs. The condensed consolidated balance sheets include (a) total assets of |
ASTRANA HEALTH, INC. | ||||||||
CONDENSED CONSOLIDATED STATEMENTS OF INCOME | ||||||||
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE AMOUNTS) | ||||||||
(UNAUDITED) | ||||||||
Three Months Ended | ||||||||
2026 | 2025 | |||||||
Revenue | ||||||||
Capitation, net | $ | 892,908 | $ | 583,963 | ||||
Risk pool settlements and incentives | 12,486 | 14,491 | ||||||
Management fee income | 15,685 | 2,310 | ||||||
Fee-for-service, net | 37,831 | 14,890 | ||||||
Other revenue | 6,190 | 4,736 | ||||||
Total revenue | 965,100 | 620,390 | ||||||
Operating expenses | ||||||||
Cost of services, excluding depreciation and amortization | 859,356 | 549,061 | ||||||
General and administrative expenses | 61,737 | 43,897 | ||||||
Depreciation and amortization | 15,479 | 6,849 | ||||||
Total expenses | 936,572 | 599,807 | ||||||
Income from operations | 28,528 | 20,583 | ||||||
Other (expense) income | ||||||||
Income (loss) from equity method investments | 1,720 | (867) | ||||||
Interest expense | (16,101) | (7,308) | ||||||
Interest income | 3,816 | 2,312 | ||||||
Unrealized gain (loss) on investments | 1,084 | (44) | ||||||
Other income (loss) | 662 | (5,072) | ||||||
Total other expense, net | (8,819) | (10,979) | ||||||
Income before provision for income taxes | 19,709 | 9,604 | ||||||
Provision for income taxes | 6,578 | 3,383 | ||||||
Net income | 13,131 | 6,221 | ||||||
Net loss attributable to non-controlling interests | (1,305) | (471) | ||||||
Net income attributable to Astrana Health, Inc. | $ | 14,436 | $ | 6,692 | ||||
Earnings per share – basic | $ | 0.30 | $ | 0.14 | ||||
Earnings per share – diluted | $ | 0.29 | $ | 0.14 | ||||
Weighted average shares of common stock outstanding – basic | 48,853,678 | 48,470,682 | ||||||
Weighted average shares of common stock outstanding – diluted | 49,054,135 | 48,850,666 | ||||||
ASTRANA HEALTH, INC. | ||||||||
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS | ||||||||
(IN THOUSANDS) | ||||||||
(UNAUDITED) | ||||||||
Three Months Ended | ||||||||
2026 | 2025 | |||||||
Cash flows from operating activities | ||||||||
Net income | $ | 13,131 | $ | 6,221 | ||||
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||
Depreciation and amortization | 15,479 | 6,849 | ||||||
Amortization of debt issuance cost | 1,134 | 691 | ||||||
Share-based compensation | 9,895 | 7,811 | ||||||
Non-cash lease expense | 2,005 | 1,287 | ||||||
Deferred tax | 1,907 | (358) | ||||||
Change in fair value of contingent consideration liabilities | 581 | 1,407 | ||||||
Other | (2,564) | 729 | ||||||
Changes in operating assets and liabilities, net of business combinations | 26,488 | (8,010) | ||||||
Net cash provided by operating activities | 68,056 | 16,627 | ||||||
Cash flows from investing activities | ||||||||
Purchases of property and equipment | (4,000) | (3,070) | ||||||
Other | 1,156 | 676 | ||||||
Net cash used in investing activities | (2,844) | (2,394) | ||||||
Cash flows from financing activities | ||||||||
Dividends paid | (104) | (5,455) | ||||||
Borrowings on debt | — | 412,000 | ||||||
Repayment of debt | (11,967) | (428,232) | ||||||
Deferred financing cost | — | (17,241) | ||||||
Taxes paid from net share settlement of restricted stock | (1,172) | (4,052) | ||||||
Repurchase of treasury shares | (2,906) | — | ||||||
Other | 189 | (1,190) | ||||||
Net cash used in financing activities | (15,960) | (44,170) | ||||||
Net increase (decrease) in cash, cash equivalents, and restricted cash | 49,252 | (29,937) | ||||||
Cash, cash equivalents, and restricted cash, beginning of period | 434,045 | 289,101 | ||||||
Cash, cash equivalents, and restricted cash, end of period | $ | 483,297 | $ | 259,164 | ||||
Supplemental disclosures of cash flow information | ||||||||
Cash paid for income taxes | (1) | $ | 4,338 | |||||
Cash paid for interest | $ | 14,723 | $ | 7,360 | ||||
Supplemental disclosures of non-cash investing and financing activities | ||||||||
Right-of-use assets obtained in exchange for operating lease liabilities | $ | 350 | $ | 5,729 | ||||
Dividend paid in the form of common stock | $ | — | $ | 21,935 | ||||
(1) | Following the adoption of ASC 2023-09 "Income Taxes (Topics 740): Improvements to Income Tax Disclosures", cash paid for income taxes is presented net of tax refunds, for the quarter ended |
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, | ||||||||
2026 | 2025 | |||||||
Cash and cash equivalents | $ | 478,383 | $ | 258,517 | ||||
Restricted cash (1) | 4,914 | 647 | ||||||
Total cash, cash equivalents, and restricted cash shown in the statement of cash | $ | 483,297 | $ | 259,164 | ||||
(1) | Restricted cash is included in other assets on the condensed consolidated balance sheets. |
Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow | |||||||||
Three Months Ended | |||||||||
(in thousands) | 2026 | 2025 | |||||||
Net cash provided by operating activities | $ | 68,056 | $ | 16,627 | |||||
Purchases of property and equipment | (4,000) | (3,070) | |||||||
Free cash flow | $ | 64,056 | $ | 13,557 | |||||
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 reconciliations to Adjusted EBITDA margin for the three months ended
Three Months Ended | |||||||||
(in thousands) | 2026 | 2025 | |||||||
Net income | $ | 13,131 | $ | 6,221 | |||||
Interest expense | 16,101 | 7,308 | |||||||
Interest income | (3,816) | (2,312) | |||||||
Provision for income taxes | 6,578 | 3,383 | |||||||
Depreciation and amortization | 15,479 | 6,849 | |||||||
EBITDA | 47,473 | 21,449 | |||||||
(Income) loss from equity method investments | (1,720) | 867 | |||||||
Other, net | 10,650 | (1) | 6,259 | (2) | |||||
Stock-based compensation | 9,895 | 7,811 | |||||||
Adjusted EBITDA | $ | 66,298 | $ | 36,386 | |||||
Total revenue | $ | 965,100 | $ | 620,390 | |||||
Adjusted EBITDA margin | 7 | % | 6 | % | |||||
(1) | Other, net, for the three months ended |
(2) | Other, net, for the three months ended |
Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS - Diluted
Set forth below are reconciliations of net income to adjusted net income attributable to Astrana as well as the reconciliation to adjusted EPS - diluted for the three months ended
Three Months Ended | |||||||||
(in thousands, except for share and per share data) | 2026 | 2025 | |||||||
Net income | $ | 13,131 | $ | 6,221 | |||||
(Income) loss from equity method investments | (1,720) | 867 | |||||||
Other, net (1) | 10,650 | 6,259 | |||||||
Stock-based compensation | 9,895 | 7,811 | |||||||
Amortization of intangible assets attributable to acquisitions | 13,850 | 6,263 | |||||||
Tax adjustments | (7,525) | (2) | (4,602) | (3) | |||||
Adjusted net income attributable to non-controlling interests | (1,928) | (4) | (2,317) | (5) | |||||
Adjusted net income attributable to Astrana Health, Inc. | $ | 36,353 | $ | 20,502 | |||||
Weighted average shares of common stock outstanding – diluted | 49,054,135 | 48,850,666 | |||||||
Adjusted earnings per share - diluted | $ | 0.74 | $ | 0.42 | |||||
(1) | The components of other, net, as set forth in the table above, are described in the footnotes to the table under "Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin". Please see the footnotes to such table for additional information. |
(2) | Tax adjustments for the three months ended |
(3) | Tax adjustments for the three months ended |
(4) | Includes net loss attributable to non-controlling interests ("NCI") of |
(5) | Includes net loss attributable to NCI of |
Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA | ||||||||
Year Ending | ||||||||
(in thousands) | Low | High | ||||||
Net income | $ | 54,000 | $ | 74,000 | ||||
Interest expense | 51,000 | 55,000 | ||||||
Provision for income taxes | 38,000 | 44,000 | ||||||
Depreciation and amortization | 65,000 | 65,000 | ||||||
EBITDA | 208,000 | 238,000 | ||||||
Income from equity method investments | (4,000) | (4,000) | ||||||
Other, net | 7,000 | 7,000 | ||||||
Stock-based compensation | 39,000 | 39,000 | ||||||
Adjusted EBITDA | $ | 250,000 | $ | 280,000 | ||||
The Company has not provided a quantitative reconciliation of EBITDA and Adjusted EBITDA for the quarter ending
Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow | ||||||||
Year Ending | ||||||||
(in thousands) | Low | High | ||||||
Net cash provided by operating activities | $ | 125,000 | $ | 145,000 | ||||
Cash used in purchases of property and equipment | (20,000) | (12,500) | ||||||
Free cash flow | $ | 105,000 | $ | 132,500 | ||||
Use of Non-GAAP Financial Measures
This press release contains the non-GAAP financial measures EBITDA, Adjusted EBITDA, Adjusted EBITDA margin, adjusted net income attributable to Astrana, and adjusted EPS - diluted, of which the most directly comparable financial measure presented in accordance with
We believe 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 our ongoing operating performance. In addition, these non-GAAP financial measures are among those indicators we use 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 EBITDA, Adjusted EBITDA, adjusted net income attributable to Astrana, adjusted EPS - diluted, and free cash flow differently, limiting the usefulness of these measures for comparative purposes. To the extent this press release contains historical or future non-GAAP financial measures, we have provided corresponding GAAP financial measures for comparative purposes. The reconciliations between certain GAAP and non-GAAP measures are provided above.
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SOURCE Astrana Health, Inc.
