Astrana Health, Inc. Reports Third Quarter 2026 Results

New Medicare Advantage payer partnerships take effect January 1, 2027, while two added clients are expected to onboard in early 2027.

Rhea-AI Summary

Astrana Health (NASDAQ: ASTH) reported third-quarter 2026 revenue of $1,023.6 million, up 7% from the same quarter a year earlier. Net income was $20.3 million, while income attributable to Astrana rose to $13.0 million from $0.4 million. Diluted earnings per share increased to $0.26 from $0.01. Adjusted EBITDA, a non-GAAP earnings measure, rose 13% to $77.2 million.

Nine-month revenue increased 33% to $2,961.2 million. Operating cash flow was $117.1 million and free cash flow was $105.4 million. Astrana narrowed its full-year outlook to revenue of $3,900 million–$4,000 million, adjusted EBITDA of $261 million–$274 million and free cash flow of $107.5 million–$130 million. Fourth-quarter guidance calls for revenue of $939 million–$1,039 million and adjusted EBITDA of $48.5 million–$61.5 million. The company also completed a Georgia independent practice association acquisition on October 1, 2026.

29 points · 0 major

PositiveiHow this balance works

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0 major · 8 points

Hollow bars mark forward-looking points. How the balance works

Positive

• Moderate pointThird-quarter revenue increased 7% to $1,023.6 million from $956.0 million a year earlier.
• Moderate pointThird-quarter net income reached $20.3 million, up 1,782% year over year.
• Moderate pointThird-quarter adjusted EBITDA increased 13% to $77.2 million from $68.5 million a year earlier.
• Moderate pointNine-month revenue increased 33% to $2,961.2 million from $2,231.2 million a year earlier.
• Moderate pointNine-month income attributable to Astrana increased 186% to $47.1 million from $16.5 million a year earlier.
• Moderate pointNine-month adjusted EBITDA increased 39% to $212.4 million from $153.0 million a year earlier.
• Moderate pointNine-month operating cash flow totaled $117.1 million, with free cash flow of $105.4 million.
• Moderate point. Forward-looking: it has not happened yet and may not happen.Astrana forecasts full-year revenue of $3,900 million–$4,000 million under its narrowed guidance.
• Moderate point. Forward-looking: it has not happened yet and may not happen.New Medicare Advantage payer partnerships become effective January 1, 2027, including Southern California, Texas and Arizona.
• Moderate pointNoncurrent debt, net of financing costs, fell to $865.546 million from $990.904 million at December 31, 2025.

19 minor points

• Minor pointThird-quarter income attributable to Astrana rose to $13.0 million from $0.4 million a year earlier.
• Minor pointThird-quarter diluted earnings per share increased to $0.26 from $0.01 a year earlier.
• Minor pointThird-quarter adjusted diluted earnings per share rose 4% to $0.71 from $0.68 a year earlier.
• Minor pointThird-quarter operating income increased to $39.879 million from $19.210 million a year earlier.
• Minor pointCare Partners third-quarter revenue increased 8% to $968.8 million from $897.7 million a year earlier.
• Minor pointCare Partners third-quarter operating income increased 94% year over year to $49.093 million.
• Minor pointCare Delivery third-quarter revenue increased 5% year over year to $91.017 million.
• Minor pointCare Enablement third-quarter revenue increased 5% year over year to $92.001 million.
• Minor pointCare Enablement third-quarter operating income increased 4% year over year to $24.435 million.
• Minor pointCare Partners nine-month revenue increased 32% to $2,811.3 million from $2,130.1 million a year earlier.
• Minor pointNine-month diluted earnings per share increased 188% to $0.95 from $0.33 a year earlier.
• Minor pointNine-month adjusted diluted earnings per share increased 36% to $2.25 from $1.66 a year earlier.
• Minor pointNine-month operating income increased to $102.728 million from $60.130 million a year earlier.
• Minor point. Forward-looking: it has not happened yet and may not happen.Astrana forecasts full-year adjusted EBITDA of $261 million–$274 million under its narrowed guidance.
• Minor point. Forward-looking: it has not happened yet and may not happen.Astrana forecasts full-year free cash flow of $107.5 million–$130 million under its narrowed guidance.
• Minor point. Forward-looking: it has not happened yet and may not happen.Astrana forecasts fourth-quarter revenue of $939 million–$1,039 million.
• Minor point. Forward-looking: it has not happened yet and may not happen.Astrana forecasts fourth-quarter adjusted EBITDA of $48.5 million–$61.5 million.
• Minor pointGeorgia independent practice association acquisition closed October 1, 2026.
• Minor point. Forward-looking: it has not happened yet and may not happen.Care Enablement added two clients, both expected to onboard in early 2027.

Negative

• Moderate pointMedical liabilities increased to $418.181 million from $335.705 million at December 31, 2025.
• Moderate pointConsolidated variable-interest entities held $1,314.6 million in assets restricted to settling their own obligations at September 30, 2026.
• Minor pointCare Delivery recorded a third-quarter operating loss of $1.591 million.
• Minor pointThird-quarter total expenses rose to $983.737 million from $936.838 million a year earlier.
• Minor pointNine-month total expenses rose to $2,858.509 million from $2,171.113 million a year earlier.

3 minor points

• Minor pointCash and equivalents declined to $396.225 million from $429.474 million at December 31, 2025.
• Minor pointCurrent debt increased to $59.831 million from $47.865 million at December 31, 2025.
• Minor pointOutstanding common shares increased to 49,320,378 from 48,885,358 at December 31, 2025.

News Explained

At September 30, 2026, Astrana reported 49,320,378 common shares issued and outstanding, versus 48,885,358 at December 31, 2025. For a holder whose own share count did not change, the higher total means a smaller ownership percentage, consistent with the definition of dilution.

Key Figures

Third-quarter revenue: $1,023.6 million, up 7% year-over-year Net income attributable to Astrana: $13.0 million, up from $0.4 million Adjusted EBITDA: $77.2 million, up 13% +5 more

Third-quarter revenue

$1,023.6 million, up 7% year-over-year

Three months ended September 30, 2026

Net income attributable to Astrana

$13.0 million, up from $0.4 million

Three months ended September 30, 2026

Adjusted EBITDA

$77.2 million, up 13%

Three months ended September 30, 2026

Adjusted diluted EPS

$0.71, up 4%

Three months ended September 30, 2026

2026 revenue guidance

$3,900 million–$4,000 million

Year ending December 31, 2026

2026 adjusted EBITDA guidance

$261 million–$274 million

Year ending December 31, 2026

2026 free cash flow guidance

$107.5 million–$130 million

Year ending December 31, 2026

Free cash flow

$105.4 million

Nine months ended September 30, 2026

Previous Earnings Reports

1 past event · Latest: Aug 06

Same Type 1 event

1. Aug 06

   Q2 2026 earnings

   24h Move

   +4.8%

   Q2 results set Q3 revenue and adjusted EBITDA guidance later replaced by reported results.

24h Move is the share-price change in the day after each event; other market factors may also have contributed.

Key Terms

adjusted ebitda, capitation, variable interest entities, non-controlling interests

4 terms

adjusted ebitda financial

"record adjusted EBITDA of $77.2 million"

Adjusted EBITDA is a way companies measure how much money they make from their core operations, like running a business, by removing certain costs or income that aren’t part of regular business activities. It helps investors see how well a company is doing without distractions from unusual expenses or gains, making it easier to compare companies or track performance over time.

capitation financial

"Capitation and other revenue, net"

Capitation is a health-care payment method where a provider or health plan receives a fixed amount of money per enrolled person for a set period, regardless of how many services that person uses. For investors, capitation matters because it shifts revenue from fee-for-service unpredictability to a steady, per-member stream, rewarding cost control and preventive care but increasing risk if patient costs exceed the fixed payments—think of it as a subscription fee for healthcare.

variable interest entities financial

"variable interest entities ("VIEs") in which the Company is the primary beneficiary"

A variable interest entity (VIE) is a business that a company controls through contracts or special arrangements instead of owning a majority of its shares, like steering a puppet without holding its ticket. Investors care because these arrangements can hide who really bears the financial risks and rewards, affect how assets and liabilities appear on financial statements, and create extra legal or enforcement uncertainty that can change the value and risk of an investment.

non-controlling interests financial

"Non-controlling interests represent third party equity ownership interests"

An ownership stake in a subsidiary held by outside shareholders rather than the parent company, representing the portion of that subsidiary’s assets and profits the parent does not control. For investors, it shows what part of consolidated earnings and equity belongs to others — like a roommate who owns part of a house — which affects how much value and profit per share are truly attributable to the parent company’s shareholders.

AI-generated analysis. How Rhea-AI works. Not financial advice.

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Company to Host Conference Call on Thursday, November 5, 2026, at 2:30 p.m. PT/5:30 p.m. ET

• Reports record revenue of $1,023.6 million, up 7% year-over-year, net income of $20.3 million, up 1,782% year-over-year, and record adjusted EBITDA⁽¹⁾ of $77.2 million, up 13% year-over-year for the three months ended September 30, 2026
• Reports net cash provided by operating activities of $117.1 million and free cash flow⁽²⁾ of $105.4 million for the nine months ended September 30, 2026

ALHAMBRA, Calif., Nov. 5, 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 third quarter ended September 30, 2026.

"Our third quarter results demonstrate the growing impact of Astrana's physician-centric, AI-native healthcare operating platform and our team's continued focus on execution," said Brandon Sim, President and Chief Executive Officer of Astrana Health. "We delivered record revenue, record adjusted EBITDA, and double-digit organic earnings growth while continuing to invest in the next phase of our growth. By combining proprietary technology, aligned physician partnerships, and integrated care delivery, we're building a scalable, repeatable model to improve patient outcomes and manage the total cost of care – a value proposition that extends across payer and reimbursement models and positions us to create sustainable long-term value for patients, physician partners, and shareholders."

Financial Highlights for Third Quarter Ended September 30, 2026:

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

• Total revenue of $1,023.6 million, up 7% from $956.0 million
• Care Partners revenue of $968.8 million, up 8% from $897.7 million
• Net income attributable to Astrana of $13.0 million, up from $0.4 million
• Earnings per share ("EPS") - diluted of $0.26, up from $0.01
• Adjusted EBITDA⁽¹⁾ of $77.2 million, up 13% from $68.5 million
• Adjusted EPS - diluted⁽³⁾ of $0.71, up 4% from $0.68

Financial Highlights for Nine Months Ended September 30, 2026:

All comparisons are to the nine months ended September 30, 2025 unless otherwise stated.

• Total revenue of $2,961.2 million, up 33% from $2,231.2 million
• Care Partners revenue of $2,811.3 million, up 32% from $2,130.1 million
• Net income attributable to Astrana of $47.1 million, up 186% from $16.5 million
• EPS - diluted of $0.95, up 188% from $0.33
• Adjusted EBITDA⁽¹⁾ of $212.4 million, up 39% from $153.0 million
• Adjusted EPS - diluted⁽³⁾ of $2.25, up 36% from $1.66
• Net cash provided by operating activities of $117.1 million
• Free cash flow⁽²⁾ of $105.4 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 flows and "Use of Non-GAAP Financial Measures" below for additional information.
(3)	See "Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS - Diluted" and "Use of Non-GAAP Financial Measures" below for additional information.

Recent Operating Highlights

• Closed the acquisition of an independent practice association in Georgia on October 1, 2026.
• Added two Care Enablement clients, a provider group in Connecticut and a hospital in California, with both expected to onboard onto Astrana's AI-powered technology and managed services platform in early 2027.
• Entered into several new Medicare Advantage payer partnerships effective January 1, 2027, with new health plan partners in markets including Southern California, Texas, and Arizona, supporting continued membership growth across the Astrana platform.

Segment Results for three months ended September 30, 2026:

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

		Three Months Ended September 30, 2026
(in thousands)		Care Partners				Care Delivery				Care Enablement				Intersegment Elimination				Corporate Costs				Consolidated Total
Total revenues		$	968,757			$	91,017			$	92,001			$	(128,159)			$	—			$	1,023,616
% change vs. prior year quarter			8	%			5	%			5	%
Cost of services			829,490				69,116				47,915				(46,453)				—				900,068
General and administrative expenses			77,694				22,229				18,425				(81,713)				31,412				68,047
Depreciation and amortization			12,480				1,263				1,226				—				653				15,622
Total expenses			919,664				92,608				67,566				(128,166)				32,065				983,737
Income (loss) from operations		$	49,093			$	(1,591)			$	24,435			$	7		(1)	$	(32,065)			$	39,879
% change vs. prior year quarter			94	%			56	%			4	%

(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.

2026 Guidance:

Based on the Company's existing business, current view of existing market conditions, and assumptions, the Company is providing guidance for total revenue and Adjusted EBITDA for the quarter ending December 31, 2026 and narrowing guidance for total revenue, Adjusted EBITDA, and free cash flow for the year ending December 31, 2026.

		Three Months Ending December 31, 2026								Year Ending December 31, 2026
		Guidance Range								Guidance Range
($ in millions)		Low				High				Low				High
Total revenue		$	939			$	1,039			$	3,900			$	4,000
Adjusted EBITDA		$	48.5			$	61.5			$	261			$	274
Free cash flow										$	107.5			$	130

See "Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA," "Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow," and "Use of Non-GAAP Financial Measures" below for additional information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See "Forward-Looking Statements" below for additional information.

Conference Call and Webcast Information:

Astrana will host a conference call at 2:30 p.m. PT/5:30 p.m. ET today (Thursday, November 5, 2026), during which management will discuss the results of the third quarter ended September 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=PPgZy93u

An accompanying slide presentation will be available in PDF format on the "IR Calendar" page of the Company's website (https://ir.astranahealth.com/news-events/ir-calendar) after issuance of the earnings release and will be furnished as an exhibit to Astrana's current report on Form 8-K to be filed with the SEC, accessible at www.sec.gov.

Those who are unable to attend the live conference call may access the recording at the above webcast link, which will be made available shortly after the conclusion of the call.

Note About Consolidated Entities

The Company consolidates entities in which it has a controlling financial interest. The Company consolidates subsidiaries in which it holds, directly or indirectly, more than 50% of the voting rights, and variable interest entities ("VIEs") in which the Company is the primary beneficiary. Non-controlling interests represent third party equity ownership interests in the Company's consolidated entities (including certain VIEs). The amount of net income or loss attributable to non-controlling interests is disclosed in the Company's consolidated statements of income.

About Astrana Health, Inc.

Astrana Health is a physician-centric, AI-powered healthcare company committed to delivering high-quality, patient-centered care. Built from the physician's perspective, Astrana combines its scalable care delivery infrastructure, proprietary technology platform, and aligned provider networks to enable proactive, preventive care at scale - improving patient outcomes, enhancing patient experiences, supporting provider well-being, and driving greater value across the healthcare system.

Today, Astrana supports more than 20,000 providers and approximately 1.5 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.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, such as statements about the Company's guidance for the quarter ending 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.

FOR MORE INFORMATION, PLEASE CONTACT:

Investor Relations
investors@astranahealth.com

ASTRANA HEALTH, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)
		September 30, 2026				December 31, 2025
		(Unaudited)
Assets
Current assets
Cash and cash equivalents		$	396,225			$	429,474
Receivables, net (including amounts from related parties)			530,889				374,465
Income taxes receivable			—				1,799
Other receivables			20,384				26,385
Prepaid expenses and other current assets			29,348				26,264
Loans receivable			3,128				4,926
Total current assets			979,974				863,313
Non-current assets
Property and equipment, net			66,103				57,332
Intangible assets, net			229,533				270,968
Goodwill			889,390				865,305
Income taxes receivable, net of current portion			26,220				26,220
Loans receivable, net of current portion			49,374				48,724
Investments in other entities – equity method			27,015				25,637
Operating lease right-of-use assets			48,308				35,738
Other assets			27,515				25,424
Total non-current assets			1,363,458				1,355,348
Total assets (1)		$	2,343,432			$	2,218,661
Liabilities, Mezzanine Deficit, and Stockholders' Equity
Current liabilities
Accounts payable and accrued expenses		$	272,541			$	195,912
Fiduciary accounts payable			3,694				3,524
Income taxes payable			2,561				—
Medical liabilities			418,181				335,705
Operating lease liabilities			10,612				7,809
Current portion of long-term debt			59,831				47,865
Other liabilities			18,648				24,458
Total current liabilities			786,068				615,273
Non-current liabilities
Deferred tax liability			7,635				5,491
Operating lease liabilities, net of current portion			41,392				31,552
Long-term debt, net of current portion and deferred financing costs			865,546				990,904
Other long-term liabilities			11,290				17,107
Total non-current liabilities			925,863				1,045,054
Total liabilities (1)			1,711,931				1,660,327
Mezzanine deficit
Non-controlling interest in Allied Physicians of California, a Professional Medical Corporation ("APC")			(236,801)				(234,962)
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, 2026 and December 31, 2025			—				—
Common stock, $0.001 par value per share; 100,000,000 shares authorized, 49,320,378 and 48,885,358 shares issued and outstanding, excluding 10,724,258 and 10,571,011 treasury shares, as of September 30, 2026 and December 31, 2025, respectively			49				49
Additional paid-in capital			501,366				470,863
Retained earnings			355,204				308,379
Total stockholders' equity			856,619				779,291
Non-controlling interests			11,683				14,005
Total equity			868,302				793,296
Total liabilities, mezzanine deficit, and stockholders' equity		$	2,343,432			$	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  $1,314.6 million and $1,276.5 million as of September 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 $382.6 million and $376.0 million as of September 30, 2026 and December 31, 2025, respectively, for which creditors do not have recourse to the general credit of Astrana Health, Inc., the VIE's primary beneficiary. These VIE balances do not include $218.1 million of investment in affiliates and $8.6 million of amount due to affiliates as of September 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.

 

ASTRANA HEALTH, INC.
CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE AMOUNTS)
(UNAUDITED)
		Three Months Ended September 30,								Nine Months Ended September 30,
		2026				2025				2026				2025
Revenue
Capitation and other revenue, net		$	1,023,616			$	956,048			$	2,961,237			$	2,231,243
Operating expenses
Cost of services, excluding depreciation and amortization			900,068				858,856				2,627,923				1,984,756
General and administrative expenses			68,047				62,387				183,935				157,009
Depreciation and amortization			15,622				15,595				46,651				29,348
Total expenses			983,737				936,838				2,858,509				2,171,113
Income from operations			39,879				19,210				102,728				60,130
Other expense
Income from equity method investments			860				1,019				3,128				532
Interest expense			(15,021)				(17,718)				(47,120)				(32,408)
Interest income			4,147				3,522				13,870				8,170
Unrealized gain (loss) on investments			1,126				(807)				6,942				(837)
Other income (loss)			1,231				445				(408)				(3,487)
Total other expense, net			(7,657)				(13,539)				(23,588)				(28,030)
Income before provision for income taxes			32,222				5,671				79,140				32,100
Provision for income taxes			11,953				4,594				27,288				14,586
Net income			20,269				1,077				51,852				17,514
Net income attributable to non-controlling interests			7,317				704				4,725				1,026
Net income attributable to Astrana Health, Inc.		$	12,952			$	373			$	47,127			$	16,488
Earnings per share – basic		$	0.26			$	0.01			$	0.96			$	0.34
Earnings per share – diluted		$	0.26			$	0.01			$	0.95			$	0.33
Weighted average shares of common stock outstanding – basic			49,230,686				49,217,134				49,070,359				49,005,363
Weighted average shares of common stock outstanding – diluted			49,915,989				49,473,417				49,586,343				49,311,384
Revenue consisted of the following (in thousands):
		Three Months Ended September 30,								Nine Months Ended September 30,
		2026				2025				2026				2025
Capitation, net		$	936,662			$	863,380			$	2,735,374			$	2,061,451
Risk pool settlements and incentives			24,324				30,798				58,627				60,691
Management fee income			14,105				15,217				43,001				20,104
Fee-for-service, net			35,122				40,080				95,935				72,848
Other revenue			13,403				6,573				28,300				16,149
Capitation and other revenue, net		$	1,023,616			$	956,048			$	2,961,237			$	2,231,243

 

ASTRANA HEALTH, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(IN THOUSANDS)
(UNAUDITED)
		Nine Months Ended September 30,
		2026				2025
Cash flows from operating activities
Net income		$	51,852			$	17,514
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization			46,651				29,348
Amortization of debt issuance cost			3,438				2,892
Stock-based compensation			37,245				27,219
Non-cash lease expense			6,865				4,348
Deferred tax			1,774				(4,924)
Change in fair value of contingent consideration liabilities			(4,212)				4,353
Change in fair value of financing obligation			(3,272)				—
Other			(4,415)				609
Changes in operating assets and liabilities, net of business combinations			(18,849)				36,125
Net cash provided by operating activities			117,077				117,484
Cash flows from investing activities
Payments for acquisitions, net of cash acquired			(6,825)				(548,553)
Proceeds from sale of equity method investment			—				15,100
Purchases of property and equipment			(11,711)				(7,042)
Other			3,666				2,553
Net cash used in investing activities			(14,870)				(537,942)
Cash flows from financing activities
Dividends paid			(1,127)				(6,329)
Borrowings on debt			—				1,119,300
Repayments of debt			(115,899)				(483,323)
Deferred financing cost			—				(19,205)
Payments of contingent liabilities			(2,864)				(8,284)
Taxes paid from net share settlement of restricted stock			(5,340)				(5,562)
Purchase of treasury shares			(3,893)				(955)
Other			(5,937)				41
Net cash (used in) provided by financing activities			(135,060)				595,683
Net (decrease) increase in cash, cash equivalents, and restricted cash			(32,853)				175,225
Cash, cash equivalents, and restricted cash, beginning of period			434,045				289,101
Cash, cash equivalents, and restricted cash, end of period		$	401,192			$	464,326
Supplemental disclosures of cash flow information
Cash paid for income taxes		(1)				$	4,728
Cash paid for interest		$	43,647			$	30,184
Supplemental disclosures of non-cash investing and financing activities
Right-of-use assets obtained in exchange for operating lease liabilities		$	13,969			$	7,780
Common stock issued for contingent consideration payment		$	—			$	2,600
Elimination of note payable upon consolidation		$	—			$	9,488
Dividend paid in the form of common stock		$	—			$	21,935

(1)	Following the adoption of Accounting Standards Codification ("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 September 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):

		September 30, 2026				December 31, 2025				September 30, 2025
Cash and cash equivalents		$	396,225			$	429,474			$	462,227
Restricted cash (1)			4,967				4,571				2,099
Total cash, cash equivalents, and restricted cash, end of period shown in the statement of cash flows		$	401,192			$	434,045			$	464,326

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

 

Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow
		Nine Months Ended September 30,
(in thousands)		2026				2025
Net cash provided by operating activities		$	117,077			$	117,484
Purchases of property and equipment			(11,711)				(7,042)
Free cash flow		$	105,366			$	110,442

Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin

Set forth below are reconciliations of Net Income to EBITDA and Adjusted EBITDA, as well as the reconciliations to Adjusted EBITDA margin for the three and nine months ended September 30, 2026 and 2025. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.

		Three Months Ended September 30,									Nine Months Ended September 30,
(in thousands)		2026				2025					2026				2025
Net income		$	20,269			$	1,077				$	51,852			$	17,514
Interest expense			15,021				17,718					47,120				32,408
Interest income			(4,147)				(3,522)					(13,870)				(8,170)
Provision for income taxes			11,953				4,594					27,288				14,586
Depreciation and amortization			15,622				15,595					46,651				29,348
EBITDA			58,718				35,462					159,041				85,686
Income from equity method investments			(860)				(1,019)					(3,128)				(532)
Other, net			3,784		(1)		26,340		(2)			19,234		(3)		40,597		(4)
Stock-based compensation			15,563				7,699					37,245				27,219
Adjusted EBITDA		$	77,205			$	68,482				$	212,392			$	152,970
Total revenue		$	1,023,616			$	956,048				$	2,961,237			$	2,231,243
Adjusted EBITDA margin			8	%			7	%				7	%			7	%

(1)	Other, net, for the three months ended September 30, 2026, relates to post-acquisition integration costs and a fair value remeasurement of a previously held equity method investments that is now fully acquired, partially offset by non-cash changes to the fair value of our interest rate swap.
(2)	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"), transaction and other costs related to our acquisitions, including $12.7 million related to our completed acquisition of certain businesses and assets of Prospect Medical Holdings, Inc, ("Prospect"), non-cash changes in the fair value of our call option and collar agreement, and severance.
(3)	Other, net, for the nine months ended September 30, 2026, relates to post-acquisition integration costs, an allowance on receivables that the Company plans to recover from the payer, non-routine legal matters, severance, and a fair value remeasurement of a previously held equity method investment that is now fully acquired, partially offset by non-cash changes to the fair value of an equity purchase financing obligation and our interest rate swap.
(4)	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, transaction and other costs related to our acquisitions, including $23.6 million related to Prospect, debt issuance costs incurred in connection with our Second Amended and Restated Credit Facility, non-cash changes in the fair value of our call option and collar agreement, and severance.

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

Set forth below are reconciliations of net income to adjusted net income attributable to Astrana as well as the reconciliation to adjusted EPS - diluted for the three and nine months ended September 30, 2026 and 2025.

		Three Months Ended September 30,									Nine Months Ended September 30,
(in thousands, except for share and per share data)		2026				2025					2026				2025
Net income		$	20,269			$	1,077				$	51,852			$	17,514
Income from equity method investments			(860)				(1,019)					(3,128)				(532)
Other, net (1)			3,784				26,340					19,234				40,597
Stock-based compensation			15,563				7,699					37,245				27,219
Amortization of intangible assets attributable to acquisitions			13,779				14,177					41,435				26,619
Tax adjustments			(5,562)		(2)		(10,614)		(3)			(19,052)		(2)		(19,852)		(3)
Adjusted net income attributable to non-controlling interests			(11,747)		(4)		(3,871)		(5)			(16,235)		(4)		(9,902)		(5)
Adjusted net income attributable to Astrana Health, Inc.		$	35,226			$	33,789				$	111,351			$	81,663
Weighted average shares of common stock outstanding – diluted			49,915,989				49,473,417					49,586,343				49,311,384
Adjusted earnings per share - diluted		$	0.71			$	0.68				$	2.25			$	1.66

(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 nine months ended September 30, 2026, include the tax effect for, at a 27.4% statutory blended tax rate, the adjustments made to net income of $8.8 million and $25.9 million, respectively, partially offset by 162(m) impact of $3.3 million and $6.7 million, respectively.
(3)	Tax adjustments for the three and nine months ended September 30, 2025, include the tax effect for, at a 27.1% statutory blended tax rate, the adjustments made to net income of $12.8 million and $25.4 million, respectively, partially offset by 162(m) impact of $1.7 million and $5.1 million, respectively.
(4)	Adjusted net income attributable to non-controlling interests ("NCI") for the three and nine months ended September 30, 2026, includes net income attributable to NCI of $7.3 million and $4.7 million, respectively, as well as adjustments attributable to NCI of $4.4 million and $11.5 million, respectively.
(5)	Adjusted net income attributable to NCI for the three and nine months ended September 30, 2025 includes net income attributable to NCI of $0.7 million and $1.0 million, respectively, as well as adjustments attributable to NCI of $3.2 million and $8.9 million, respectively.

 

Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA
		Three Months Ending December 31, 2026								Year Ending December 31, 2026
		Guidance Range								Guidance Range
(in thousands)		Low				High				Low				High
Net income		$	3,100			$	9,100			$	55,000			$	61,000
Interest expense			9,800				10,800				43,000				44,000
Provision for income taxes			4,700				5,700				32,000				33,000
Depreciation and amortization			15,300				17,300				62,000				64,000
EBITDA			32,900				42,900				192,000				202,000
Income from equity method investments			(900)				(900)				(4,000)				(4,000)
Other, net			3,700				5,700				23,000				25,000
Stock-based compensation			12,800				13,800				50,000				51,000
Adjusted EBITDA		$	48,500			$	61,500			$	261,000			$	274,000

 

Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow
		Year Ending December 31, 2026
		Guidance Range
(in thousands)		Low				High
Net cash provided by operating activities		$	127,500			$	142,500
Cash used in purchases of property and equipment			(20,000)				(12,500)
Free cash flow		$	107,500			$	130,000

Use of Non-GAAP Financial Measures

This press release contains the non-GAAP financial measures EBITDA, Adjusted EBITDA, Adjusted EBITDA margin, adjusted net income attributable to Astrana, and adjusted EPS – diluted, of which the most directly comparable financial measure presented in accordance with 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 the Company, adjusted EPS – diluted, and free cash flow differently, limiting the usefulness of these measures for comparative purposes. To the extent this press release contains historical or future non-GAAP financial measures, we have provided corresponding GAAP financial measures for comparative purposes. The reconciliations between certain GAAP and non-GAAP measures are provided above.

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SOURCE Astrana Health, Inc.

FAQ

AI-generated questions and answers. How Rhea-AI works. Not financial advice.

What were Astrana Health's third-quarter 2026 earnings results?

Astrana reported revenue of $1,023.6 million and diluted earnings per share of $0.26 for the quarter ended September 30, 2026. Revenue rose 7% year over year, while diluted earnings per share increased from $0.01. Net income attributable to Astrana rose to $13.0 million from $0.4 million.

What is Astrana Health's full-year 2026 guidance?

Astrana forecasts $3,900 million–$4,000 million in revenue, $261 million–$274 million in adjusted EBITDA and $107.5 million–$130 million in free cash flow for 2026. These narrowed ranges reflect the company's existing business, current view of market conditions and assumptions.

Which new Care Enablement clients did Astrana Health add?

Astrana added a provider group in Connecticut and a hospital in California as Care Enablement clients. The company expects both to onboard onto its AI-powered technology and managed services platform in early 2027.