Press Release: Astrana Health, Inc. Reports Fourth Quarter and Year End 2025 Results

Dow Jones
Mar 02

Company to Host Conference Call on Monday, March 2, 2026, at 5:30 a.m. PT/8:30 a.m. ET

   -- Reports total revenue for the year ended of $3,181.8 million, up 56% 
      year-over-year, and at the higher end of guidance 
 
   -- Reports adjusted EBITDA for the year ended of $205.4 million and free 
      cash flow(1) of $104.5 million 

ALHAMBRA, Calif., March 2, 2026 /PRNewswire/ -- Astrana Health, Inc. ("Astrana," and together with its subsidiaries and affiliated entities, the "Company") (NASDAQ: ASTH), a leading physician-centric, technology-powered, risk-bearing healthcare management company enabling providers to deliver accessible, high-quality, and high-value care to all, today announced its consolidated financial results for the fourth quarter and year ended December 31, 2025.

"Astrana delivered record revenue, adjusted EBITDA, and free cash flow in 2025, demonstrating the strength and predictability of our fully delegated, payer-agnostic care model and AI-enabled technology platform in a dynamic operating environment," said Brandon Sim, President and Chief Executive Officer of Astrana Health. "Our disciplined approach to risk, strong physician alignment, and technology-enabled clinical infrastructure drove consistent performance while creating measurable value for patients through improved outcomes, greater access, and lower total cost of care. As we move through 2026, with Prospect Health integration ahead of schedule, we are confident in our ability to deliver on guidance that reflects approximately 24% revenue growth and 29% adjusted EBITDA growth at the midpoint."

Financial Highlights for Year Ended December 31, 2025:

All comparisons are to the year ended December 31, 2024 unless otherwise stated.

   -- Total revenue of $3,181.8 million, up 56% from $2,034.5 million 
 
   -- Care Partners revenue of $3,022.6 million, up 55% from $1,949.0 million 
 
   -- Net income attributable to Astrana of $22.5 million 
 
   -- Earnings per share ("EPS") - diluted of $0.46 
 
   -- Adjusted EBITDA(2) of $205.4 million, up 21% from $170.4 million 
 
   -- Adjusted EPS - diluted(3) of $2.20 

Financial Highlights for the Fourth Quarter 2025:

All comparisons are to the quarter ended December 31, 2024 unless otherwise stated.

   -- Total revenue of $950.5 million, up 43% from $665.2 million 
 
   -- Care Partners revenue of $892.5 million up 38% from $647.7 million 
 
   -- Net income attributable to Astrana of $6.0 million 
 
   -- EPS - diluted of $0.12 
 
   -- Adjusted EBITDA(2) of $52.5 million, up 50% from $35.0 million 
 
   -- Adjusted EPS - diluted(3) of $0.54 
 
(1)  See reconciliation provided with the condensed consolidated statements of 
     cash flow and "Use of Non-GAAP Financial Measures" below for additional 
     information. 
(2)  See "Reconciliation of Net Income (Loss) to Adjusted Net Income 
     Attributable to Astrana and Adjusted EPS - Diluted" and "Use of Non-GAAP 
     Financial Measures" below for additional information. 
(3)  See "Reconciliation of Net Income (Loss) to EBITDA, Adjusted EBITDA and 
     Adjusted EBITDA Margin" and "Use of Non-GAAP Financial Measures" below 
     for additional information. 
 

Update on Annual Report Filing

The Company will be filing a Form 12b-25 with the Securities and Exchange Commission to extend the deadline for its Annual Report on Form 10-K for the year ended December 31, 2025 (the "2025 Form 10-K") due to a material weakness in internal control over financial reporting, which is expected to relate to, but may not be limited to, the Company's acquisition and purchase accounting processes. This matter relates to the timing and documentation of certain control procedures and does not reflect any material misstatement of the Company's financial results, nor does it result in any restatements of historical periods. The Company currently expects to file the 2025 Form 10-K within the fifteen-day extension period provided under Rule 12b-25 of the Securities Exchange Act of 1934, as amended, and is making targeted investments in our accounting organization to accelerate remediation.

Stock Repurchase Program

The Board of Directors has increased the maximum aggregate amount of shares of the Company's common stock that may be purchased under the Company's existing share repurchase program from $50 million to $100 million. Repurchases may be made through a variety of methods, which could include open market purchases, accelerated share repurchase transactions, negotiated block transactions, 10b5-1 plans, other transactions that may be structured through investment banking institutions or privately negotiated, or a combination of the foregoing. The amount and timing of future repurchases, if any, may vary depending on management's assessment of the intrinsic value of the Company's common stock, the market price of the Company's common stock, general market and economic conditions, available liquidity, compliance with the Company's debt and other agreements, applicable legal requirements, the level of operating, financing and other investing activities, and other considerations. The repurchase authorization does not have an expiration date.

The Company is not obligated to purchase any shares under the repurchase program, and the program may be suspended, modified, or discontinued at any time without prior notice. During the three months ended December 31, 2025, 633,844 shares were repurchased under the Company's share repurchase plan. As of December 31, 2025, $35.9 million remained available under the repurchase plan. The Company may determine to continue to make repurchases under the program following the filing of the Form 10-K for the year ended December 31, 2025.

Segment Results for Year Ended December 31, 2025:

All comparisons are to the year ended December 31, 2024 unless otherwise stated.

 
                    Year Ended 
                   December 31, 
                       2025 
                   ------------      --------  ---  ---------  ------  ----------  ----  --------- 
                       Care            Care           Care          Intersegment        Corporate    Consolidated 
(in thousands)       Partners        Delivery      Enablement        Elimination           Costs         Total 
                   ------------      --------      ----------      --------------       ----------  -------------- 
Total revenues     $  3,022,602      $250,742      $  246,660       $   (338,235)       $       --   $   3,181,769 
% change vs. 
 prior year                  55%           83%             59% 
 
 Cost of services     2,615,578       203,895         148,629           (127,863)               --       2,840,239 
 General and 
  administrative        217,656        45,004          52,130           (210,400)          112,866         217,256 
 Depreciation and 
  amortization           34,401         3,858           6,185                  --            1,305          45,749 
                    -----------       -------       ---------          ----------        ---------      ---------- 
Total expenses        2,867,635       252,757         206,944           (338,263)          114,171       3,103,244 
 
Income (loss) 
 from operations   $    154,967      $(2,015)      $   39,716       $          28  (1)  $(114,171)   $      78,525 
                    ===========       =======       =========          ==========        =========      ========== 
% change vs. 
 prior year                  10%     *                    117% 
 
 
 
(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. 
*    Percentage change of over 500% 
 

2026 Guidance:

Astrana is providing the following guidance for total revenue and Adjusted EBITDA for the three months ending March 31, 2026 and the year ending December 31, 2026 based on the Company's existing business, current view of existing market conditions, and assumptions.

 
                   Three Months Ending       Year Ending 
($ in millions)       March 31, 2026      December 31, 2026 
                      Guidance Range       Guidance Range 
                   --------------------  ------------------- 
                     Low        High        Low       High 
                   --------  ----------  ---------  -------- 
Total revenue       $   900   $   1,000   $  3,800  $  4,100 
Adjusted EBITDA     $    60   $      70   $    250  $    280 
 

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 5:30 a.m. PT/8:30 a.m. ET today (Monday, March 2, 2026), during which management will discuss the results of the fourth quarter and year end December 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=CAALhYDU

An accompanying slide presentation will be available in PDF format on the "IR Calendar" page of the Company's website 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, 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 Company's expectations regarding the timing of filing its 2025 Form 10-K, the expected material weakness in internal control over financial reporting and the Company's ability to remediate any such material weakness in a timely manner, the consistency of the financial statements in the 2025 Form 10-K with the financial information in this earnings release and the completion of matters necessary to permit filing by the extension deadline. 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 last Annual Report on Form 10-K and any subsequent quarterly reports on Form 10-Q filed with the SEC. 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:

Investor Relations

Carolyne Sohn

investors@astranahealth.com

 
                  ASTRANA HEALTH, INC. 
              CONSOLIDATED BALANCE SHEETS 
    (in thousands, except share and per share data) 
 
                         December 31,    December 31, 
                             2025            2024 
                        --------------  -------------- 
Assets 
 
Current assets 
 Cash and cash 
  equivalents            $     429,474   $     288,455 
 Receivables, net 
  (including amounts 
  with related 
  parties)                     374,465         275,990 
 Income taxes 
  receivable                     1,799          19,316 
 Other receivables              26,385          29,496 
 Prepaid expenses and 
  other current 
  assets                        26,264          25,239 
 Loans receivable                4,926              -- 
                            ----------      ---------- 
 
Total current assets           863,313         638,496 
                            ----------      ---------- 
 
Non-current assets 
 Property and 
  equipment, net                58,693          14,274 
 Intangible assets, 
  net                          270,968         118,179 
 Goodwill                      863,944         419,253 
 Income taxes 
  receivable, 
  non-current                   26,220          15,943 
 Loans receivable, 
  non-current                   48,724          51,266 
 Investments in other 
  entities -- equity 
  method                        25,637          39,319 
 Investments in 
  privately held 
  entities                       2,896           8,896 
 Operating lease 
  right-of-use assets           35,738          32,601 
 Other assets                   22,528          16,667 
                            ----------      ---------- 
 
Total non-current 
 assets                      1,355,348         716,398 
                            ----------      ---------- 
 
Total assets (1)         $   2,218,661   $   1,354,894 
                            ==========      ========== 
 
Liabilities, 
Mezzanine Deficit, 
and Stockholders' 
Equity 
 
Current liabilities 
 Accounts payable and 
  accrued expenses       $     195,912   $     106,142 
 Fiduciary accounts 
  payable                        3,524           8,223 
 Medical liabilities           335,705         209,039 
 Operating lease 
  liabilities                    7,809           5,350 
 Current portion of 
  long-term debt                47,865           9,375 
 Other liabilities              24,458          27,479 
                            ----------      ---------- 
 
Total current 
 liabilities                   615,273         365,608 
                            ----------      ---------- 
 
Non-current 
liabilities 
 Deferred tax 
  liability                      5,491           4,555 
 Operating lease 
  liabilities, net of 
  current portion               31,552          30,654 
 Long-term debt, net 
  of current portion 
  and deferred 
  financing costs              990,904         425,299 
 Other long-term 
  liabilities                   17,107          14,610 
                            ----------      ---------- 
 
Total non-current 
 liabilities                 1,045,054         475,118 
                            ----------      ---------- 
 
Total liabilities (1)    $   1,660,327   $     840,726 
                            ==========      ========== 
 
Mezzanine deficit 
 Non-controlling 
  interest in Allied 
  Physicians of 
  California, a 
  Professional 
    Medical 
  Corporation ("APC")        (234,962)       (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 
 December 31, 2025 
 and December 31, 
 2024                               --              -- 
 Common stock, $0.001 
  par value per share; 
  100,000,000 shares 
  authorized, 
  48,885,358 and 
  47,929,872 shares 
  issued and 
  outstanding, 
  excluding 10,571,011 
  and 10,603,849 
  treasury shares, as 
  of December 31, 2025 
  and December 31, 
  2024, respectively                49              48 
 Additional paid-in 
  capital                      470,863         426,389 
 Retained earnings             308,379         286,283 
                            ----------      ---------- 
 Total stockholders' 
  equity                       779,291         712,720 
 
 Non-controlling 
  interest                      14,005           4,006 
                            ----------      ---------- 
 
   Total equity                793,296         716,726 
                            ----------      ---------- 
 
Total liabilities, 
 mezzanine deficit, 
 and stockholders' 
 equity                  $   2,218,661   $   1,354,894 
                            ==========      ========== 
 
 
 
(1)  The Company's consolidated balance sheets include the assets and 
     liabilities of its consolidated VIEs. The consolidated balance sheets 
     include total assets that can be used only to settle obligations of the 
     Company's consolidated VIEs totaling $1,276.5 million and $712.3 million 
     as of December 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 $376.0 
     million and $207.9 million as of December 31, 2025 and December 31, 2024, 
     respectively. These VIE balances do not include $152.2 million of 
     investment in affiliates and $58.3 million of amounts due from affiliates 
     as of December 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 
     consolidated balance sheets. 
 
 
                          ASTRANA HEALTH, INC. 
                    CONSOLIDATED STATEMENTS OF INCOME 
             (in thousands, except share and per share data) 
 
                        Three Months Ended           Years Ended 
                           December 31,              December 31, 
                     ------------------------  ------------------------ 
                        2025         2024         2025         2024 
                     -----------  -----------  -----------  ----------- 
Revenue 
 Capitation, net     $   862,814  $   616,900  $ 2,924,265  $ 1,856,785 
 Risk pool 
  settlements and 
  incentives              25,508       28,660       86,199       86,224 
 Management fee 
  income                  10,290        5,550       30,394       13,979 
 Fee-for-service, 
  net                     39,787        7,743      112,635       62,331 
 Other revenue            12,127        6,356       28,276       15,221 
                      ----------   ----------   ----------   ---------- 
 
Total revenue            950,526      665,209    3,181,769    2,034,540 
                      ----------   ----------   ----------   ---------- 
 
Operating expenses 
 Cost of services, 
  excluding 
  depreciation and 
  amortization           855,483      614,730    2,840,239    1,763,152 
 General and 
  administrative 
  expenses                60,247       41,633      217,256      154,111 
 Depreciation and 
  amortization            16,401        8,126       45,749       27,927 
                      ----------   ----------   ----------   ---------- 
 
Total expenses           932,131      664,489    3,103,244    1,945,190 
                      ----------   ----------   ----------   ---------- 
 
Income from 
 operations               18,395          720       78,525       89,350 
 
Other expense 
 Income from equity 
  method 
  investments              1,176        1,564        1,708        4,451 
 Interest expense       (17,520)      (8,069)     (49,928)     (33,097) 
 Interest income           3,987        3,221       12,157       14,508 
 Unrealized gain 
  (loss) on 
  investments                769          316         (68)          731 
 Other income 
  (loss)                     699          353      (2,788)        4,875 
                      ----------   ----------   ----------   ---------- 
 
Total other 
 expense, net           (10,889)      (2,615)     (38,919)      (8,532) 
                      ----------   ----------   ----------   ---------- 
 
Income (loss) 
 before provision 
 for income taxes          7,506      (1,895)       39,606       80,818 
 
Provision for 
 income taxes                944        5,882       15,530       30,886 
                      ----------   ----------   ----------   ---------- 
 
Net income (loss)          6,562      (7,777)       24,076       49,932 
                      ----------   ----------   ----------   ---------- 
 
Net income (loss) 
 attributable to 
 noncontrolling 
 interests                   563        (826)        1,589        6,783 
                      ----------   ----------   ----------   ---------- 
 
Net income (loss) 
 attributable to 
 Astrana Health, 
 Inc.                $     5,999  $   (6,951)  $    22,487  $    43,149 
                      ==========   ==========   ==========   ========== 
 
Earnings (loss) per 
 share -- basic      $      0.12  $    (0.15)  $      0.46  $      0.91 
 
Earnings (loss) per 
 share -- diluted    $      0.12  $    (0.15)  $      0.46  $      0.90 
 
Weighted average 
 shares of common 
 stock outstanding 
 -- basic             49,230,904   47,823,360   49,075,727   47,597,295 
 
Weighted average 
 shares of common 
 stock outstanding 
 -- diluted           49,527,521   47,823,360   49,369,685   47,974,334 
 
 
                 ASTRANA HEALTH, INC. 
   CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS 
                    (in thousands) 
 
                          Years ended December 31, 
                        ---------------------------- 
                             2025           2024 
                        ---------------  ----------- 
Cash flows from 
operating activities 
 Net income              $       24,076  $    49,932 
 Adjustments to 
 reconcile net income 
 to net cash provided 
 by operating 
 activities: 
   Depreciation and 
    amortization                 45,749       27,927 
   Amortization of 
    debt issuance 
    cost                          4,050        1,828 
   Share-based 
    compensation                 38,601       34,536 
   Non-cash lease 
    expense                       6,647        5,278 
   Deferred tax                 (4,287)      (4,249) 
   Change in fair 
    value of 
    contingent 
    consideration 
    liabilities                   5,166        3,526 
   Other                        (2,307)      (2,967) 
   Changes in 
    operating assets 
    and liabilities, 
    net of business 
    combinations                (3,098)     (63,613) 
                            -----------   ---------- 
Net cash provided by 
 operating activities           114,597       52,198 
                            -----------   ---------- 
 
Cash flows from 
investing activities 
 Payments for business 
  and asset 
  acquisition, net of 
  cash acquired               (548,604)    (146,260) 
 Purchases of 
  investments -- 
  equity method                      --      (5,968) 
 Purchase of call 
  option issued in 
  conjunction with 
  equity method 
  investment                         --      (3,907) 
 Issuance of loans 
  receivable                    (1,708)     (26,000) 
 Purchases of property 
  and equipment                (10,106)      (8,031) 
 Proceeds from sale 
 of equity method 
 investment                      15,100           -- 
 Other                            6,319      (2,229) 
                            -----------   ---------- 
Net cash used in 
 investing activities         (538,999)    (192,395) 
                            -----------   ---------- 
 
Cash flows from 
financing activities 
 Dividends paid                 (7,885)      (4,036) 
 Repayments on debt           (495,289)     (18,500) 
 Borrowings on debt           1,119,300      171,875 
 Taxes paid from net 
  share settlement of 
  restricted stock              (6,169)      (4,662) 
 Repurchase of 
  treasury shares              (15,429)        (937) 
 Deferred financing 
 cost                          (19,205)           -- 
 Payment of financing 
  obligation                         --      (8,542) 
 Payment of contingent 
  consideration 
  liabilities                   (8,284)        (518) 
 Other                            2,307          466 
                            -----------   ---------- 
Net cash provided by 
 financing activities           569,346      135,146 
                            -----------   ---------- 
 
Net increase 
 (decrease) in cash, 
 cash equivalents, and 
 restricted cash                144,944      (5,051) 
 
Cash, cash 
 equivalents, and 
 restricted cash, 
 beginning of year              289,101      294,152 
                            -----------   ---------- 
 
Cash, cash 
 equivalents, and 
 restricted cash, end 
 of year                 $      434,045  $   289,101 
                            ===========   ========== 
 
Supplemental 
disclosures of cash 
flow information 
 Cash paid for income 
  taxes                             (1)  $    43,936 
 Cash paid for 
  interest               $       45,767  $    30,419 
 
Supplemental 
disclosures of 
non-cash investing 
and financing 
  activities 
 Right-of-use assets 
  obtained in exchange 
  for operating lease 
  liabilities            $       11,875  $    14,117 
 Common stock issued 
  in business 
  combination            $           --  $    21,952 
 Common stock issued 
  for contingent 
  consideration 
  payment                $        2,600  $     4,023 
 Acquisition of 
  business through 
  loan conversion        $           --  $     5,175 
 Draw on letter of 
  credit through 
  Revolver Loan          $           --  $     4,732 
 Elimination of note 
  payable upon 
  consolidation          $        9,488  $        -- 
 Reclass of investment 
  -- Third Way Health    $        6,000  $        -- 
 Repurchase of 
  treasury shares 
  outstanding payable    $          922  $        -- 
 Dividend paid in form 
  of 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 year ended December 31, 2025 and 
     prospectively, under Item 8 of the Company's Annual Report on Form 10-K. 
 

The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the 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):

 
                                                   December 31, 
                                                ------------------ 
                                                  2025      2024 
                                                --------  -------- 
Cash and cash equivalents                       $429,474  $288,455 
Restricted cash (1)                                4,571       646 
Total cash, cash equivalents and restricted 
 cash shown in the statement of cash flows      $434,045  $289,101 
                                                 =======   ======= 
 
 
 
(1)  Restricted cash is included in other assets on the consolidated balance 
     sheets. 
 

The following table provides a reconciliation of net cash provided by operating activities to free cash flow for the years ended December 31, 2025 and 2024 (in thousands):

 
Reconciliation of Net Cash Provided by 
Operating Activities to Free Cash Flow            December 31, 
                                               ------------------- 
                                                 2025       2024 
                                               ---------  -------- 
Net cash provided by operating activities      $ 114,597  $ 52,198 
Cash used in purchases of property and 
 equipment                                      (10,106)   (8,031) 
Free cash flow                                 $ 104,491  $ 44,167 
                                                ========   ======= 
 

Reconciliation of Net Income (Loss) to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin

Set forth below are reconciliations of net income (loss) to EBITDA and Adjusted EBITDA as well as the reconciliation to Adjusted EBITDA margin for the three months and years ended December 31, 2025 and 2024. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.

 
                      Three Months Ended                          Years Ended 
                          December 31,                            December 31, 
                  ---------------------------           ------------------------------- 
(in thousands)      2025               2024                2025                 2024 
                  --------           --------           ----------           ---------- 
Net income 
 (loss)           $  6,562           $(7,777)           $   24,076           $   49,932 
 Interest 
  expense           17,520              8,069               49,928               33,097 
 Interest income   (3,987)            (3,221)             (12,157)             (14,508) 
 Provision for 
  income taxes         944              5,882               15,530               30,886 
 Depreciation 
  and 
  amortization      16,401              8,126               45,749               27,927 
                   -------            -------            ---------            --------- 
EBITDA              37,440             11,079              123,126              127,334 
 
 Income from 
  equity method 
  investments      (1,176)            (1,564)              (1,708)              (4,451) 
 Other, net          4,808      (1)    10,288      (2)      45,405      (3)      12,951      (4) 
 Stock-based 
  compensation      11,382             15,235               38,601               34,536 
                   -------            -------            ---------            --------- 
Adjusted EBITDA   $ 52,454           $ 35,038           $  205,424           $  170,370 
                   =======            =======            =========            ========= 
 
Total revenue     $950,526           $665,209           $3,181,769           $2,034,540 
 
Adjusted EBITDA 
 margin                  6%                 5%                   6%                   8% 
                   =======            =======            =========            ========= 
 
 
 
(1)  Other, net, for the three months ended December 31, 2025 relates to $2.3 
     million for transaction and integration costs primarily for the 
     acquisition of Prospect, certain costs and final settlement for some of 
     our acquisitions, and severance fees incurred, partially offset by 
     employer retention tax credits related to COVID-19 relief. 
(2)  Other, net for the three months ended December 31, 2024 relates to 
     transaction costs incurred for our investments, to anticipated recoveries 
     from one time losses relating to third party payer payments associated 
     with the Collaborative Health Systems, LLC ("CHS") transaction, and 
     non-cash change in the fair value of our call option. 
(3)  Other, net, for the year ended December 31, 2025, relates to $13.0 
     million for a legal matter with a provider associated with CFC HP, $25.9 
     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 and final 
     settlement for some of our acquisitions, and severance fees incurred, 
     partially offset by employer retention tax credits related to COVID-19 
     relief. 
(4)  Other, net for the year ended December 31, 2024 relates to transaction 
     costs incurred for our investments and tax restructuring fees, 
     anticipated recoveries from one-time losses relating to third party payor 
     payments associated with the CHS transaction, a financial guarantee via a 
     letter of credit that we provided in support of two local provider-led 
     ACOs, non-cash gain on debt extinguishment related to one of our 
     promissory note payables, non-cash realized loss from the sale of one of 
     our marketable equity securities, non-cash changes related to change in 
     the fair value of our call option, non-cash change in the fair value of 
     our financing obligation to purchase the remaining equity interests in 
     one our investments, non-cash changes in the fair value of our contingent 
     liabilities, non-cash changes in the fair value of the Company's Collar 
     Agreement, and reimbursement from a related party of the Company for 
     taxes associated with the Excluded Assets spin-off 
 

Reconciliation of Net Income (Loss) to Adjusted Net Income Attributable to Astrana and Adjusted EPS - Diluted

Set forth below are reconciliations of net income (loss) to adjusted net income attributable to Astrana as well as the reconciliation to adjusted EPS - diluted for the three months and years ended December 31, 2025 and 2024.

 
                         Three Months Ended                      Years Ended 
                             December 31,                        December 31, 
                    -----------------------------       ----------------------------- 
(in thousands, 
except for share 
and per share 
data)                  2025              2024              2025              2024 
                    -----------       -----------       -----------       ----------- 
Net income (loss)   $     6,562       $   (7,777)       $    24,076       $    49,932 
 Income from 
  equity method 
  investments           (1,176)           (1,564)           (1,708)           (4,451) 
 Other, net (1)           4,808            10,288            45,405            12,951 
 Stock-based 
  compensation           11,382            15,235            38,601            34,536 
 Amortization of 
  intangibles            14,128             7,567            40,747            25,608 
 Tax adjustments        (5,485)  (2)      (5,411)  (3)     (25,337)  (2)     (13,902)  (3) 
 Adjusted 
  non-controlling 
  interest              (3,300)  (4)      (2,186)  (5)     (13,203)  (4)     (11,629)  (5) 
                     ----------        ----------        ----------        ---------- 
Adjusted net 
 income 
 attributable to 
 Astrana Health, 
 Inc.               $    26,919       $    16,152       $   108,581       $    93,045 
                     ==========        ==========        ==========        ========== 
 
Weighted average 
 shares of common 
 stock outstanding 
 -- diluted          49,527,521        47,823,360        49,369,685        47,974,334 
 
Adjusted earnings 
 per share - 
 diluted            $      0.54       $      0.34       $      2.20       $      1.94 
                     ==========        ==========        ==========        ========== 
 
 
 
(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 (Loss) to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin". 
     Please see the footnotes for additional information. 
(2)  Tax adjustments for the three months and year ended December 31, 2025, 
     includes the tax effect for, at a 27.1% statutory blended tax rate, the 
     adjustments made to net income of $7.9 million and $33.3 million, 
     respectively, partially offset by 162(m) impact of $2.4 million and $7.5 
     million, respectively. 
(3)  Tax adjustments for the three months and year ended December 31, 2024, 
     includes the tax effect for, at a 28.0% statutory blended tax rate, the 
     adjustments made to net (loss) income of $8.8 million and $19.2 million, 
     respectively, partially offset by 162(m) impact of $3.4 million and $5.3 
     million, respectively. 
(4)  Includes net income attributable to non-controlling interests ("NCI") of 
     $0.6 million and $1.6 million, respectively, and adjustments attributable 
     to NCI of $2.7 million and $11.6 million, respectively, for the three 
     months and year ended December 31, 2025. 
(5)  Includes net loss and income, respectively, attributable to NCI of $0.8 
     million and $6.8 million, respectively, and adjustments attributable to 
     NCI of $3.0 million and $4.8 million, respectively, for the three months 
     and year ended December 31, 2024. 
 

Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA

 
                                               Year Ending 
                                             December 31, 2026 
                                              Guidance Range 
                                          ---------------------- 
(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 three months ending March 31, 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.

Use of Non-GAAP Financial Measures

This press release contains the non-GAAP financial measures EBITDA, Adjusted EBITDA, 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 (loss). 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. generally accepted accounting principles ("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. The Company uses Adjusted EBITDA, 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. 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. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue. Adjusted net income attributable to Astrana is calculated as net income (loss), excluding income or loss from equity method investments, non-recurring and non-cash transactions, stock-based compensation, amortization of intangibles, certain tax adjustments, and amounts related to non-controlling interest. The Company defines adjusted EPS - diluted as adjusted net income attributable to Astrana over weighted average shares of common stock outstanding - diluted. The Company defines free cash flow as net cash provided by operating activities and cash used in purchases of property and equipment.

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 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 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.

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SOURCE Astrana Health, Inc.

 

(END) Dow Jones Newswires

March 02, 2026 07:00 ET (12:00 GMT)

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