Astrana Health, Inc. Reports Second Quarter 2026 Results

• Reports revenue of $972.5 million, up 49% year-over-year, net income of $18.5 million, up 81% year-over-year, and adjusted EBITDA (1) of $68.9 million, up 43% year-over-year for the three months ended June 30, 2026

• Reports net cash provided by operating activities of $100.8 million and free cash flow (2) of $92.9 million for the six months ended June 30, 2026

ALHAMBRA, Calif., Aug. 6, 2026 /PRNewswire/ -- Astrana Health, Inc. ("Astrana," and together with its subsidiaries and affiliated entities, the "Company") (NASDAQ: ASTH), a physician-centric, technology-enabled healthcare company empowering providers to deliver accessible, high-quality, and high-value care to all, today announced its consolidated financial results for the second quarter ended June 30, 2026.

"Our second quarter results reflect the strength of Astrana's physician-centric, AI-native healthcare operating system and the disciplined execution of our team," said Brandon Sim, President and Chief Executive Officer of Astrana Health. "We continue to see accelerating demand from both providers and payers for our platform, driving strong growth, record-high adjusted diluted EPS, and robust free cash flow generation. Our performance gives us the confidence to raise our adjusted EBITDA guidance for 2026 even as we reinvest a substantial portion of our first-half outperformance into attractive growth opportunities that we believe will further strengthen our earnings power over time."

All comparisons are to the three months ended June 30, 2025 unless otherwise stated.

• Total revenue of $972.5 million, up 49% from $654.8 million

• Care Partners revenue of $932.8 million, up 48% from $631.4 million

• Net income attributable to Astrana of $19.7 million, up 109% from $9.4 million

• Earnings per share ("EPS") - diluted of $0.40, up 111% from $0.19

• Adjusted EBITDA (1) of $68.9 million, up 43% from $48.1 million

• Adjusted EPS - diluted (3) of $0.80, up 45% from $0.55

All comparisons are to the six months ended June 30, 2025 unless otherwise stated.

• Total revenue of $1,937.6 million, up 52% from $1,275.2 million

• Care Partners revenue of $1,842.5 million, up 50% from $1,232.4 million

• Net income attributable to Astrana of $34.2 million, up 112% from $16.1 million

• EPS - diluted of $0.69, up 109% from $0.33

• Adjusted EBITDA (1) of $135.2 million, up 60% from $84.5 million

• Adjusted EPS - diluted (3) of $1.54, up 59% from $0.97

• Net cash provided by operating activities of $100.8 million

• Free cash flow (2) of $92.9 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.

• Daniel Rothman joined as President of Physician Enterprise and Vishal Gupta joined as Senior Vice President of Enterprise Transformation, further strengthening the executive leadership team as the Company continues to scale its physician-centric, AI-native operating platform for value-based care.

• Astrana's affiliated Accountable Care Organizations ("ACOs") generated $120.4 million in gross shared savings for the 2024 performance year, and Astrana Care Partners ACO ranked seventh nationwide in net shared savings per beneficiary in its first performance year.

• Astrana continued to expand its Medicare Advantage footprint, including new agreements in Hawaii and Texas. The Texas agreement added approximately 3,000 new Medicare Advantage professional-risk lives.

All comparisons are to the three months ended June 30, 2025 unless otherwise stated.

Total revenues

$

932,836

$

74,696

$

85,598

$

(120,610)

$

—

$

972,520

% change vs. prior year quarter

48

%

95

%

109

%

Cost of services

805,469

61,923

51,665

(50,559)

—

868,498

General and administrative expenses

72,133

14,552

16,158

(70,091)

21,398

54,150

Depreciation and amortization

12,362

1,188

1,378

—

622

15,550

Total expenses

889,964

77,663

69,201

(120,650)

22,020

938,198

Income (loss) from operations

$

42,872

$

(2,967)

$

16,397

$

40

(1)

$

(22,020)

$

34,322

% change vs. prior year quarter

(14)

%

(238)

%

* Percentage change of over 500%.

(1)

Income 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.

Based on the Company's existing business, current view of existing market conditions, and assumptions, Astrana is providing the following guidance for total revenue and Adjusted EBITDA for the three months ending September 30, 2026, updating Adjusted EBITDA guidance for the year ending December 31, 2026, and reaffirming revenue and free cash flow guidance for the year ending December 31, 2026.

Total revenue

$

1,000

$

1,030

$

3,800

$

4,100

Adjusted EBITDA

$

72.5

$

77.5

$

255

$

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.

Astrana will host a conference call at 2:30 p.m. PT/5:30 p.m. ET today (Thursday, August 6, 2026), during which management will discuss the results of the second quarter ended June 30, 2026. 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=w7Ip0KQB

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.

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.

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 1.5 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.

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 September 30, 2026 and the year ending December 31, 2026, 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, as well as statements regarding the material weakness in internal control over financial reporting and the Company's ability to remediate such material weakness in a timely manner. 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, 2025, and 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.

(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)

Cash and cash equivalents

$

400,792

$

429,474

Receivables, net (including amounts from related parties)

465,080

374,465

Income taxes receivable

—

1,799

Other receivables

24,113

26,385

Prepaid expenses and other current assets

25,857

26,264

Loans receivable

3,318

4,926

Total current assets

919,160

863,313

Property and equipment, net

62,567

57,332

Intangible assets, net

243,312

270,968

Goodwill

886,995

865,305

Income taxes receivable, net of current portion

26,220

26,220

Loans receivable, net of current portion

49,273

48,724

Investments in other entities – equity method

27,805

25,637

Operating lease right-of-use assets

39,194

35,738

Other assets

27,554

25,424

Total non-current assets

1,362,920

1,355,348

$

2,282,080

$

2,218,661

Accounts payable and accrued expenses

$

245,860

$

195,912

Fiduciary accounts payable

3,771

3,524

Income taxes payable

2,082

—

Medical liabilities

415,765

335,705

Operating lease liabilities

8,938

7,809

Current portion of long-term debt

53,848

47,865

Other liabilities

17,375

24,458

Total current liabilities

747,639

615,273

Deferred tax liability

8,795

5,491

Operating lease liabilities, net of current portion

33,975

31,552

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

882,650

990,904

Other long-term liabilities

10,442

17,107

Total non-current liabilities

935,862

1,045,054

1,683,501

1,660,327

Non-controlling interest in Allied Physicians of California, a Professional Medical Corporation ("APC")

(242,261)

(234,962)

Preferred stock, $0.001 par value per share; 5,000,000 shares authorized; and zero shares issued and outstanding as of June 30, 2026 and December 31, 2025

—

—

Common stock, $0.001 par value per share; 100,000,000 shares authorized, 49,226,943 and 48,885,358 shares issued and outstanding, excluding 10,695,758 and 10,571,011 treasury shares, as of June 30, 2026 and December 31, 2025, respectively

49

49

Additional paid-in capital

487,820

470,863

Retained earnings

342,355

308,379

Total stockholders' equity

830,224

779,291

Non-controlling interests

10,616

14,005

Total equity

840,840

793,296

$

2,282,080

$

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 $1,268.9 million and $1,276.5 million as of June 30, 2026 and December 31, 2025, respectively, that can be used only to settle obligations of the Company's consolidated VIEs and (b) total liabilities of the consolidated VIEs of $366.9 million and $376.0 million as of June 30, 2026 and December 31, 2025, respectively, for which creditors do not have recourse to the general credit of the Company, the VIE's primary beneficiary. These VIE balances do not include $284.6 million of investment in affiliates and $25.1 million of amount due from affiliates as of June 30, 2026 and $152.2 million of investment in affiliates and $58.3 million of amount due from affiliates as of December 31, 2025, as these are eliminated upon consolidation and not presented within the condensed consolidated balance sheets.

(IN THOUSANDS, EXCEPT SHARE AND PER SHARE AMOUNTS)

(UNAUDITED)

Capitation and other revenue, net

$

972,520

$

654,808

$

1,937,620

$

1,275,196

Cost of services, excluding depreciation and amortization

868,498

576,839

1,727,855

1,125,900

General and administrative expenses

54,150

50,725

115,888

94,623

Depreciation and amortization

15,550

6,904

31,028

13,752

Total expenses

938,198

634,468

1,874,771

1,234,275

34,322

20,340

62,849

40,921

Income (loss) from equity method investments

548

381

2,268

(486)

Interest expense

(15,997)

(7,382)

(32,098)

(14,690)

Interest income

5,907

2,336

9,723

4,647

Unrealized gain (loss) on investments

4,732

14

5,816

(30)

Other (loss) income

(2,302)

1,136

(1,640)

(3,934)

Total other expense, net

(7,112)

(3,515)

(15,931)

(14,493)

27,210

16,825

46,918

26,428

Provision for income taxes

8,758

6,609

15,335

9,991

18,452

10,216

31,583

16,437

Net (loss) income attributable to non-controlling interests

(1,287)

793

(2,592)

322

$

19,739

$

9,423

$

34,175

$

16,115

$

0.40

$

0.19

$

0.70

$

0.33

$

0.40

$

0.19

$

0.69

$

0.33

Weighted average shares of common stock outstanding – basic

49,115,835

49,187,885

48,986,953

48,831,265

Weighted average shares of common stock outstanding – diluted

49,778,028

49,470,677

49,418,278

49,162,653

Revenue consisted of the following (in thousands):

Capitation, net

$

905,804

$

614,108

$

1,798,712

$

1,198,071

Risk pool settlements and incentives

21,816

15,402

34,302

29,893

Management fee income

13,211

2,577

28,896

4,887

Fee-for-service, net

22,982

17,878

60,813

32,769

Other revenue

8,707

4,843

14,897

9,576

Capitation and other revenue, net

$

972,520

$

654,808

$

1,937,620

$

1,275,196

(IN THOUSANDS)

(UNAUDITED)

Net income

$

31,583

$

16,437

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

Depreciation and amortization

31,028

13,752

Amortization of debt issuance cost

2,280

1,740

Share-based compensation

21,682

19,519

Non-cash lease expense

4,131

2,559

Deferred tax

2,734

(1,961)

Change in fair value of contingent consideration liabilities

(4,820)

3,351

Other

(6,735)

560

Changes in operating assets and liabilities, net of business combinations

18,921

51,571

Net cash provided by operating activities

100,804

107,528

Payments for business and assets acquisition, net of cash acquired

(3,739)

—

Purchases of property and equipment

(7,878)

(4,490)

Other

2,545

1,019

Net cash used in investing activities

(9,072)

(3,471)

Dividends paid

(199)

(6,233)

Borrowings on debt

—

412,000

Repayment of debt

(103,933)

(431,357)

Deferred financing cost

—

(17,241)

Payment of contingent liabilities

(2,864)

(3,631)

Taxes paid from net share settlement of restricted stock

(3,834)

(5,053)

Repurchase of treasury shares

(4,364)

(1,316)

Other

(4,840)

23

Net cash used in financing activities

(120,034)

(52,808)

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

(28,302)

51,249

434,045

289,101

$

405,743

$

340,350

Cash paid for income taxes

(1)

$

4,728

Cash paid for interest

$

29,348

$

13,535

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

$

2,795

$

7,110

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 quarterly period ended June 30, 2026, under Item 1 of the Company's Quarterly Report on Form 10-Q.

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):

Cash and cash equivalents

$

400,792

$

429,474

$

339,703

Restricted cash (1)

4,951

4,571

647

$

405,743

$

434,045

$

340,350

(1)

Restricted cash is included in other assets on the condensed consolidated balance sheets.

Net cash provided by operating activities

$

100,804

$

107,528

Purchases of property and equipment

(7,878)

(4,490)

$

92,926

$

103,038

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 and six months ended June 30, 2026 and 2025. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.

Net income

$

18,452

$

10,216

$

31,583

$

16,437

Interest expense

15,997

7,382

32,098

14,690

Interest income

(5,907)

(2,336)

(9,723)

(4,647)

Provision for income taxes

8,758

6,609

15,335

9,991

Depreciation and amortization

15,550

6,904

31,028

13,752

52,850

28,775

100,321

50,223

(Income) loss from equity method investments

(548)

(381)

(2,268)

486

Other, net

4,800

(1)

7,998

(2)

15,450

(3)

14,257

(4)

Stock-based compensation

11,787

11,709

21,682

19,519

$

68,889

$

48,101

$

135,185

$

84,485

$

972,520

$

654,808

$

1,937,620

$

1,275,196

7

%

7

%

7

%

7

%

(1)

Other, net, for the three months ended June 30, 2026, relates to post-acquisition integration costs, non-cash update to the fair value of an equity purchase financing obligation, accruals for non-routine legal matters, and severance.

(2)

Other, net, for the three months ended June 30, 2025, relates to transaction and other costs related to our acquisitions including Prospect, non-cash changes in the fair value of our call option and collar agreement, and severance.

(3)

Other, net, for the six months ended June 30, 2026 relates to an allowance on receivables that the Company plans to recover from the payer, post-acquisition integration costs, non-cash update to the fair value of an equity purchase financing obligation, accruals for non-routine legal matters, and severance.

(4)

Other, net, for the six months ended June 30, 2025 relates to debt issuance costs expensed in connection with our Second Amended and Restated Credit Facility, transaction and other costs related to our acquisitions including Prospect, non-cash changes in the fair values of our call option and collar agreement, and severance.

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 and six months ended June 30, 2026 and 2025.

Net income

$

18,452

$

10,216

$

31,583

$

16,437

(Income) loss from equity method investments

(548)

(381)

(2,268)

486

Other, net (1)

4,800

7,998

15,450

14,257

Stock-based compensation

11,787

11,709

21,682

19,519

Amortization of intangible assets attributable to acquisitions

13,806

6,179

27,656

12,442

Tax adjustments

(5,965)

(2)

(4,637)

(3)

(13,490)

(2)

(9,238)

(3)

Adjusted net income attributable to non-controlling interests

(2,561)

(4)

(3,715)

(5)

(4,489)

(4)

(6,032)

(5)

$

39,771

$

27,369

$

76,124

$

47,871

Weighted average shares of common stock outstanding – diluted

49,778,028

49,470,677

49,418,278

49,162,653

$

0.80

$

0.55

$

1.54

$

0.97

(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 and six months ended June 30, 2026, includes the tax effect for, at a 27.4% statutory blended tax rate, the adjustments made to net income of $8.2 million and $17.0 million, respectively, partially offset by 162(m) impact of $2.2 million and $3.5 million, respectively.

(3)

Tax adjustments for the three and six months ended June 30, 2025, includes the tax effect for, at a 27.1% statutory blended tax rate, the adjustments made to net income of $6.9 million and $12.7 million, respectively, partially offset by 162(m) impact of $2.3 million and $3.4 million, respectively.

(4)

Includes net loss attributable to non-controlling interests ("NCI") of $1.3 million and $2.6 million, respectively, offset by adjustments attributable to NCI of $3.8 million and $7.1 million, respectively, for the three and six months ended June 30, 2026.

(5)

Includes net income attributable to NCI of $0.8 million and $0.3 million, respectively, as well as adjustments attributable to NCI of $2.9 million and $5.7 million, respectively, for the three and six months ended June 30, 2025.

Net income

$

59,000

$

74,000

Interest expense

49,000

53,000

Provision for income taxes

38,000

44,000

Depreciation and amortization

65,000

65,000

211,000

236,000

Income from equity method investments

(4,000)

(4,000)

Other, net

9,000

9,000

Stock-based compensation

39,000

39,000

$

255,000

$

280,000

The Company has not provided a quantitative reconciliation of EBITDA and Adjusted EBITDA for the three months ending September 30, 2026 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.

Net cash provided by operating activities

$

125,000

$

145,000

Cash used in purchases of property and equipment

(20,000)

(12,500)

$

105,000

$

132,500

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 U.S. generally accepted accounting principles ("GAAP") is net income. This press release also contains the non-GAAP financial measure free cash flow, of which the most directly comparable financial measure presented in accordance with U.S. GAAP is net cash provided by operating activities. 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. We use Adjusted EBITDA, Adjusted EBITDA margin, adjusted EPS – diluted, and free cash flow as supplemental performance measures of our operations, for financial and operational decision-making, and as supplemental means of evaluating period-to-period comparisons on a consistent basis and, for free cash flow, to reflect the cash flow trends in our business. Adjusted EBITDA is calculated as earnings before interest expense, interest income, income taxes, depreciation, and amortization, excluding income or loss from equity method investments, non-recurring and non-cash transactions, and stock-based compensation. We define Adjusted EBITDA margin as Adjusted EBITDA over total revenue. Adjusted net income attributable to Astrana is calculated as net income, excluding income or loss from equity method investments, non-recurring and non-cash transactions, stock-based compensation, amortization of intangible assets attributable to acquisitions, certain tax adjustments, and amounts related to net income or loss attributable to non-controlling interests. We define adjusted EPS – diluted as adjusted net income attributable to Astrana over weighted average shares of common stock outstanding – diluted. We define free cash flow as net cash provided by operating activities minus cash used in purchases of property and equipment.

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 EBITDA margin, 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.