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

ALHAMBRA, Calif., Nov. 6, 2025 /PRNewswire/ -- Astrana Health, Inc. ("Astrana," and together with its subsidiaries and affiliated entities, the "Company") (NASDAQ: ASTH), a leading provider-centric, technology-powered healthcare company enabling providers to deliver accessible, high-quality, and high-value care to all, today announced its consolidated financial results for the third quarter ended September 30, 2025.

"Astrana delivered solid third quarter results and demonstrated strong momentum in our first quarter of combined operations with Prospect Health," said Brandon Sim, President and Chief Executive Officer. "Prospect's performance exceeded our expectations, and integration is progressing well, expanding our scale, capabilities, and physician reach across key markets. While our full-year outlook reflects the updated timing of certain full-risk contract transitions, which we expect to complete in the first quarter of 2026, underlying clinical and cost trend performance across both the legacy Astrana and Prospect businesses remain strong. We continue to execute with discipline and focus on building a more coordinated, high-quality, and accessible care delivery platform for the long term."

Financial Highlights for Third Quarter Ended September 30, 2025:

All comparisons are to the three months ended September 30, 2024 unless otherwise stated.

Financial Highlights for Nine Months Ended September 30, 2025:

All comparisons are to the nine months ended September 30, 2024 unless otherwise stated.

(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

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

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

grant.hesser@astranahealth.com

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

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

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

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

1.05

Earnings per share – diluted

0.01

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

(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

EBITDA

124,000

134,000

Income from equity method investments

(2,000)

Other, net

42,000

Stock-based compensation

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.

SOURCE Astrana Health, Inc.