Astrana Health (NASDAQ: ASTH) grows Q1 profit and cash flow sharply
Rhea-AI Filing Summary
Astrana Health, Inc. reported strong first quarter 2026 results, with total revenue of $965,100 (thousands), up 56% from the prior-year quarter. Net income attributable to Astrana was $14,436 (thousands), and diluted EPS doubled to $0.29.
Non-GAAP performance also improved, as Adjusted EBITDA rose to $66,298 (thousands), a year-over-year increase of 82%, and Adjusted EPS – diluted reached $0.74. Free cash flow increased to $64,056 (thousands), up 372% year over year, while cash and cash equivalents grew to $478,383 (thousands).
The company reaffirmed 2026 guidance, targeting total revenue between $3,800,000 and $4,100,000 (thousands), Adjusted EBITDA between $250,000 and $280,000 (thousands), and free cash flow between $105,000 and $132,500 (thousands). Management highlighted growth in full-risk value-based arrangements and continued deployment of its AI-enabled care platform.
Positive
- Strong Q1 financial performance: Revenue rose 56% year over year to $965,100 (thousands), Adjusted EBITDA increased 82% to $66,298 (thousands), Adjusted EPS – diluted climbed 76% to $0.74, and free cash flow grew 372% to $64,056 (thousands), indicating robust growth and improved cash generation.
Negative
- None.
Insights
Astrana delivers strong Q1 growth and reaffirms ambitious 2026 targets.
Astrana Health posted Q1 2026 revenue of $965,100 (thousands), up 56% year over year, with Adjusted EBITDA of $66,298 (thousands), up 82%. Adjusted EPS – diluted rose to $0.74, a 76% increase, signaling solid operating momentum.
Free cash flow reached $64,056 (thousands), up 372%, helping lift cash and cash equivalents to $478,383 (thousands) against total debt of roughly $1,027,629 (thousands). Segment data show Care Partners remains the main profit driver, while Care Enablement and Care Delivery are scaling.
The company reaffirmed 2026 guidance for revenue of $3,800,000–$4,100,000 (thousands) and Adjusted EBITDA of $250,000–$280,000 (thousands), implying continued margin expansion if achieved. Management also reports that about 80% of Q1 2026 revenue came from full-risk arrangements, deepening exposure to value-based care performance.
8-K Event Classification
Key Figures
Key Terms
capitation financial
Adjusted EBITDA financial
free cash flow financial
variable interest entities financial
material weakness in internal control over financial reporting regulatory
Earnings Snapshot
For 2026, Astrana guides to total revenue of $3,800,000–$4,100,000 (thousands), Adjusted EBITDA of $250,000–$280,000 (thousands), and free cash flow of $105,000–$132,500 (thousands).
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM
CURRENT REPORT
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Item 2.02 Results of Operations and Financial Condition.
On May 7, 2026, Astrana Health, Inc. (the “Company”) issued a press release announcing its financial results for the three months ended March 31, 2026. A copy of the press release is furnished with this Current Report on Form 8-K as Exhibit 99.1 and incorporated herein by reference.
The information furnished pursuant to this Item 2.02 to this Current Report on Form 8-K, including the exhibit, is being “furnished” and, as such, shall not be deemed to be “filed” for the purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of that section, nor shall it be incorporated by reference into any filing under the Securities Act of 1933, as amended (the “Securities Act”), or the Exchange Act, except as shall be expressly set forth by specific reference in such filing.
Item 7.01 Regulation FD Disclosure.
The Company has scheduled a conference call and webcast at 2:30 p.m. Pacific Time/5:30 p.m. Eastern Time on May 7, 2026 to discuss the Company’s financial results for the three months ended March 31, 2026. In addition to the press release, an earnings presentation will be made available on the Company’s investor relations page at ir.astranahealth.com. A copy of the earnings presentation is furnished as Exhibit 99.2 to this Current Report on Form 8-K and incorporated herein by reference.
The information furnished pursuant to this Item 7.01 to this Current Report on Form 8-K, including the exhibit, is being “furnished” and, as such, shall not be deemed to be “filed” for the purposes of Section 18 of the Exchange Act, or otherwise subject to the liabilities of that section, nor shall it be incorporated by reference into any filing under the Securities Act or the Exchange Act, except as shall be expressly set forth by specific reference in such filing.
| Item 9.01 | Financial Statements and Exhibits. |
(d) Exhibits.
| Exhibit No. |
Description | |
| 99.1 | Press Release of Astrana Health, Inc. Regarding its Financial Results for the Three Months Ended March 31, 2026, dated May 7, 2026. | |
| 99.2 | Supplemental Data of Astrana Health, Inc., dated May 7, 2026. | |
| 104 | Cover Page Interactive Data File (the cover page XBRL tags are embedded within the inline XBRL document). |
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
| ASTRANA HEALTH, INC. | ||
| Date: May 7, 2026 | By: | /s/ Brandon K. Sim |
| Name: | Brandon K. Sim | |
| Title: | Chief Executive Officer and President | |
Exhibit 99.1
Astrana Health, Inc. Reports First Quarter 2026 Results
Company to Host Conference Call on Thursday, May 7, 2026, at 2:30 p.m. PT/5:30 p.m. ET
| · | Reports total revenue of $965.1 million, up 56% year over year |
| · | Reports adjusted EBITDA(1) of $66.3 million, up 82% year over year and free cash flow(2) of $64.1 million, up 372% year over year |
ALHAMBRA, Calif., May 7, 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 first quarter ended March 31, 2026.
“We had a strong start to 2026, delivering disciplined growth, strong medical cost performance, continued operating leverage, and early performance from new full-risk contracts in line with our expectations,” said Brandon Sim, President and Chief Executive Officer of Astrana Health. “In an increasingly dynamic healthcare environment, we believe advantage will accrue to organizations that can integrate care delivery, data, and financial accountability into a single operating system. Astrana has built exactly that: a proprietary healthcare operating platform that enables us to embed AI and workflow orchestration directly into clinical and operational workflows across the enterprise. Combined with our longitudinal patient relationships and data continuity, our infrastructure allows us to translate AI into durable clinical and economic value while continuing to improve patient outcomes, operating efficiency, and scalability. We believe Astrana is well positioned to continue widening that advantage over time.”
Financial Highlights for First Quarter Ended March 31, 2026:
All comparisons are to the three months ended March 31, 2025 unless otherwise stated.
| · | Total revenue of $965.1 million, up 56% from $620.4 million |
| · | Care Partners revenue of $909.7 million, up 51% from $601.0 million |
| · | Net income attributable to Astrana of $14.4 million, up 116% from $6.7 million |
| · | Earnings per share (“EPS”) - diluted of $0.29, up 107% from $0.14 |
| · | Adjusted EBITDA(1) of $66.3 million, up 82% from $36.4 million |
| · | Adjusted EPS - diluted(3) of $0.74, up 76% from $0.42 |
| · | Net cash provided by operating activities of $68.1 million, up 309% from $16.6 million |
| · | Free cash flow(2) of $64.1 million, up 372% from $13.6 million |
(1) See “Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin” and “Use of Non-GAAP Financial Measures” below for additional information.
(2) See reconciliation provided with the condensed consolidated statements of cash flow and “Use of Non-GAAP Financial Measures” below for additional information.
(3) See “Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS - Diluted” and “Use of Non-GAAP Financial Measures” below for additional information.
Recent Operating Highlights
| · | Delivered on its commitment to convert key contracts to full-risk arrangements, with approximately 80% of Care Partners capitation revenue and approximately 40% of consolidated membership now in full-risk arrangements. |
| · | Launched Astrana’s delegated full-risk model with a payer partner in Texas, expanding Medicare Advantage membership in the market to more than 14,000 members. |
| · | Continued deleveraging ahead of schedule, with net leverage declining to approximately 2.3x on a pro forma trailing twelve-month basis and to 2.2x based on the midpoint of the Company’s full-year guidance. |
| · | Foothill Regional Medical Center (“FRMC”) received Healthgrades’ 2026 Patient Safety Excellence Award™ for the fourth consecutive year and was named among Healthgrades’ America’s 100 Best Hospitals for Joint Replacement in 2026. FRMC also received the Healthgrades Joint Replacement Excellence Award for the second consecutive year, reflecting continued strength in clinical quality and patient outcomes. |
Segment Results for three months ended March 31, 2026:
All comparisons are to the three months ended March 31, 2025 unless otherwise stated.
| Three Months Ended March 31, 2026 | ||||||||||||||||||||||||
| (in thousands) | Care Partners |
Care Delivery |
Care Enablement |
Intersegment Elimination |
Corporate Costs |
Consolidated Total |
||||||||||||||||||
| Total revenues | $ | 909,703 | $ | 85,077 | $ | 87,745 | $ | (117,425 | ) | $ | — | $ | 965,100 | |||||||||||
| % change vs. prior year quarter | 51 | % | 155 | % | 122 | % | ||||||||||||||||||
| Cost of services | 785,531 | 72,544 | 48,704 | (47,423 | ) | — | 859,356 | |||||||||||||||||
| General and administrative expenses | 72,546 | 14,374 | 17,259 | (69,974 | ) | 27,532 | 61,737 | |||||||||||||||||
| Depreciation and amortization | 12,170 | 1,122 | 1,629 | — | 558 | 15,479 | ||||||||||||||||||
| Total expenses | 870,247 | 88,040 | 67,592 | (117,397 | ) | 28,090 | 936,572 | |||||||||||||||||
| Income (loss) from operations | $ | 39,456 | $ | (2,963 | ) | $ | 20,153 | $ | (28 | )(1) | $ | (28,090 | ) | $ | 28,528 | |||||||||
| % change vs. prior year quarter | (11 | )% | (5 | )% | 470 | % | ||||||||||||||||||
(1) Loss from operations for the intersegment elimination represents sublease income between segments. Sublease income is presented within other income, which is not presented in the table.
2026 Guidance:
Astrana is providing the following guidance for total revenue and Adjusted EBITDA for the quarter ending June 30, 2026 and reiterating guidance for the year ending December 31, 2026 based on the Company’s existing business, current view of existing market conditions, and assumptions.
| Three Months Ending June 30, 2026 | Year Ending December 31, 2026 | |||||||||||||||
| Guidance Range | Guidance Range | |||||||||||||||
| ($ in millions) | Low | High | Low | High | ||||||||||||
| Total revenue | $ | 965 | $ | 1,000 | $ | 3,800 | $ | 4,100 | ||||||||
| Adjusted EBITDA | $ | 65 | $ | 70 | $ | 250 | $ | 280 | ||||||||
| Free cash flow | $ | 105 | $ | 132.5 | ||||||||||||
See “Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA,” “Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow,” and “Use of Non-GAAP Financial Measures” below for additional information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See “Forward-Looking Statements” below for additional information.
Conference Call and Webcast Information:
Astrana will host a conference call at 2:30 p.m. PT/5:30 p.m. ET today (Thursday, May 7, 2026), during which management will discuss the results of the first quarter ended March 31, 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=HHhCPjaF
An accompanying slide presentation will be available in PDF format on the “IR Calendar” page of the Company’s website (https://ir.astranahealth.com/news-events/ir-calendar) after issuance of the earnings release and will be furnished as an exhibit to Astrana’s current report on Form 8-K to be filed with the SEC, accessible at www.sec.gov.
Those who are unable to attend the live conference call may access the recording at the above webcast link, which will be made available shortly after the conclusion of the call.
Note About Consolidated Entities
The Company consolidates entities in which it has a controlling financial interest. The Company consolidates subsidiaries in which it holds, directly or indirectly, more than 50% of the voting rights, and variable interest entities (“VIEs”) in which the Company is the primary beneficiary. Non-controlling interests represent third party equity ownership interests in the Company’s consolidated entities (including certain VIEs). The amount of net income or loss attributable to non-controlling interests is disclosed in the Company’s consolidated statements of income.
About Astrana Health, Inc.
Astrana Health is a physician-centric, AI-powered healthcare company committed to delivering high-quality, patient-centered care. Built from the physician's perspective, Astrana combines its scalable care delivery infrastructure, proprietary technology platform, and aligned provider networks to enable proactive, preventive care at scale - improving patient outcomes, enhancing patient experiences, supporting provider well-being, and driving greater value across the healthcare system.
Today, Astrana supports more than 20,000 providers and approximately 1.55 million patients in value-based care arrangements through its affiliated provider networks, management services organization, and integrated care delivery clinics spanning primary, specialty, and ancillary care. Together, Astrana is building the healthcare system we all deserve - one that delivers better care, better experiences, and better outcomes for all. For more information, visit www.astranahealth.com.
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, such as statements about the Company’s guidance for the quarter ending June 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 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:
Carolyne Sohn, Investor Relations
investors@astranahealth.com
ASTRANA HEALTH, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)
| March 31, 2026 | December 31, 2025 | |||||||
| (Unaudited) | ||||||||
| Assets | ||||||||
| Current assets | ||||||||
| Cash and cash equivalents | $ | 478,383 | $ | 429,474 | ||||
| Receivables, net (including amounts from related parties) | 467,395 | 374,465 | ||||||
| Income taxes receivable | — | 1,799 | ||||||
| Other receivables | 28,017 | 26,385 | ||||||
| Prepaid expenses and other current assets | 25,647 | 26,264 | ||||||
| Loans receivable | 4,658 | 4,926 | ||||||
| Total current assets | 1,004,100 | 863,313 | ||||||
| Non-current assets | ||||||||
| Property and equipment, net | 59,546 | 57,332 | ||||||
| Intangible assets, net | 257,118 | 270,968 | ||||||
| Goodwill | 874,799 | 865,305 | ||||||
| Income taxes receivable, net of current portion | 26,220 | 26,220 | ||||||
| Loans receivable, net of current portion | 49,068 | 48,724 | ||||||
| Investments in other entities – equity method | 27,257 | 25,637 | ||||||
| Operating lease right-of-use assets | 33,933 | 35,738 | ||||||
| Other assets | 26,786 | 25,424 | ||||||
| Total non-current assets | 1,354,727 | 1,355,348 | ||||||
| Total assets (1) | $ | 2,358,827 | $ | 2,218,661 | ||||
| Liabilities, Mezzanine Deficit, and Stockholders’ Equity | ||||||||
| Current liabilities | ||||||||
| Accounts payable and accrued expenses | $ | 221,389 | $ | 195,912 | ||||
| Fiduciary accounts payable | 3,706 | 3,524 | ||||||
| Income taxes payable | 2,507 | — | ||||||
| Medical liabilities | 439,259 | 335,705 | ||||||
| Operating lease liabilities | 7,557 | 7,809 | ||||||
| Current portion of long-term debt | 47,865 | 47,865 | ||||||
| Other liabilities | 23,086 | 24,458 | ||||||
| Total current liabilities | 745,369 | 615,273 | ||||||
| Non-current liabilities | ||||||||
| Deferred tax liability | 7,399 | 5,491 | ||||||
| Operating lease liabilities, net of current portion | 30,006 | 31,552 | ||||||
| Long-term debt, net of current portion and deferred financing costs | 979,764 | 990,904 | ||||||
| Other long-term liabilities | 18,833 | 17,107 | ||||||
| Total non-current liabilities | 1,036,002 | 1,045,054 | ||||||
| Total liabilities (1) | 1,781,371 | 1,660,327 | ||||||
| Mezzanine deficit | ||||||||
| Non-controlling interest in Allied Physicians of California, a Professional Medical Corporation (“APC”) | (237,739 | ) | (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 March 31, 2026 and December 31, 2025 | — | — | ||||||
| Common stock, $0.001 par value per share; 100,000,000 shares authorized, 48,946,399 and 48,885,358 shares issued and outstanding, excluding 10,695,758 and 10,571,011 treasury shares, as of March 31, 2026 and December 31, 2025, respectively | 49 | 49 | ||||||
| Additional paid-in capital | 477,508 | 470,863 | ||||||
| Retained earnings | 322,711 | 308,379 | ||||||
| Total stockholders’ equity | 800,268 | 779,291 | ||||||
| Non-controlling interests | 14,927 | 14,005 | ||||||
| Total equity | 815,195 | 793,296 | ||||||
| Total liabilities, mezzanine deficit, and stockholders’ equity | $ | 2,358,827 | $ | 2,218,661 | ||||
(1) The Company’s condensed consolidated balance sheets include the assets and liabilities of its consolidated VIEs. The condensed consolidated balance sheets include (a) total assets of $1,317.1 million and $1,276.5 million as of March 31, 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 $394.5 million and $376.0 million as of March 31, 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 $150.4 million of investment in affiliates and $24.4 million of amounts due from affiliates as of March 31, 2026, and $152.2 million of investment in affiliates and $58.3 million of amounts 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 March 31, | ||||||||
| 2026 | 2025 | |||||||
| Revenue | ||||||||
| Capitation, net | $ | 892,908 | $ | 583,963 | ||||
| Risk pool settlements and incentives | 12,486 | 14,491 | ||||||
| Management fee income | 15,685 | 2,310 | ||||||
| Fee-for-service, net | 37,831 | 14,890 | ||||||
| Other revenue | 6,190 | 4,736 | ||||||
| Total revenue | 965,100 | 620,390 | ||||||
| Operating expenses | ||||||||
| Cost of services, excluding depreciation and amortization | 859,356 | 549,061 | ||||||
| General and administrative expenses | 61,737 | 43,897 | ||||||
| Depreciation and amortization | 15,479 | 6,849 | ||||||
| Total expenses | 936,572 | 599,807 | ||||||
| Income from operations | 28,528 | 20,583 | ||||||
| Other (expense) income | ||||||||
| Income (loss) from equity method investments | 1,720 | (867 | ) | |||||
| Interest expense | (16,101 | ) | (7,308 | ) | ||||
| Interest income | 3,816 | 2,312 | ||||||
| Unrealized gain (loss) on investments | 1,084 | (44 | ) | |||||
| Other income (loss) | 662 | (5,072 | ) | |||||
| Total other expense, net | (8,819 | ) | (10,979 | ) | ||||
| Income before provision for income taxes | 19,709 | 9,604 | ||||||
| Provision for income taxes | 6,578 | 3,383 | ||||||
| Net income | 13,131 | 6,221 | ||||||
| Net loss attributable to non-controlling interests | (1,305 | ) | (471 | ) | ||||
| Net income attributable to Astrana Health, Inc. | $ | 14,436 | $ | 6,692 | ||||
| Earnings per share – basic | $ | 0.30 | $ | 0.14 | ||||
| Earnings per share – diluted | $ | 0.29 | $ | 0.14 | ||||
| Weighted average shares of common stock outstanding – basic | 48,853,678 | 48,470,682 | ||||||
| Weighted average shares of common stock outstanding – diluted | 49,054,135 | 48,850,666 | ||||||
ASTRANA HEALTH, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(IN THOUSANDS)
(UNAUDITED)
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Cash flows from operating activities | ||||||||
| Net income | $ | 13,131 | $ | 6,221 | ||||
| Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||
| Depreciation and amortization | 15,479 | 6,849 | ||||||
| Amortization of debt issuance cost | 1,134 | 691 | ||||||
| Share-based compensation | 9,895 | 7,811 | ||||||
| Non-cash lease expense | 2,005 | 1,287 | ||||||
| Deferred tax | 1,907 | (358 | ) | |||||
| Change in fair value of contingent consideration liabilities | 581 | 1,407 | ||||||
| Other | (2,564 | ) | 729 | |||||
| Changes in operating assets and liabilities, net of business combinations | 26,488 | (8,010 | ) | |||||
| Net cash provided by operating activities | 68,056 | 16,627 | ||||||
| Cash flows from investing activities | ||||||||
| Purchases of property and equipment | (4,000 | ) | (3,070 | ) | ||||
| Other | 1,156 | 676 | ||||||
| Net cash used in investing activities | (2,844 | ) | (2,394 | ) | ||||
| Cash flows from financing activities | ||||||||
| Dividends paid | (104 | ) | (5,455 | ) | ||||
| Borrowings on debt | — | 412,000 | ||||||
| Repayment of debt | (11,967 | ) | (428,232 | ) | ||||
| Deferred financing cost | — | (17,241 | ) | |||||
| Taxes paid from net share settlement of restricted stock | (1,172 | ) | (4,052 | ) | ||||
| Repurchase of treasury shares | (2,906 | ) | — | |||||
| Other | 189 | (1,190 | ) | |||||
| Net cash used in financing activities | (15,960 | ) | (44,170 | ) | ||||
| Net increase (decrease) in cash, cash equivalents, and restricted cash | 49,252 | (29,937 | ) | |||||
| Cash, cash equivalents, and restricted cash, beginning of period | 434,045 | 289,101 | ||||||
| Cash, cash equivalents, and restricted cash, end of period | $ | 483,297 | $ | 259,164 | ||||
| Supplemental disclosures of cash flow information | ||||||||
| Cash paid for income taxes | (1) | $ | 4,338 | |||||
| Cash paid for interest | $ | 14,723 | $ | 7,360 | ||||
| Supplemental disclosures of non-cash investing and financing activities | ||||||||
| Right-of-use assets obtained in exchange for operating lease liabilities | $ | 350 | $ | 5,729 | ||||
| Dividend paid in the form of common stock | $ | — | $ | 21,935 | ||||
(1) Following the adoption of ASC 2023-09 "Income Taxes (Topics 740): Improvements to Income Tax Disclosures", cash paid for income taxes is presented net of tax refunds, for the quarter ended March 31, 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):
| March 31, | ||||||||
| 2026 | 2025 | |||||||
| Cash and cash equivalents | $ | 478,383 | $ | 258,517 | ||||
| Restricted cash (1) | 4,914 | 647 | ||||||
| Total cash, cash equivalents, and restricted cash shown in the statement of cash flows | $ | 483,297 | $ | 259,164 | ||||
(1) Restricted cash is included in other assets on the condensed consolidated balance sheets.
Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow
| Three Months Ended March 31, | ||||||||
| (in thousands) | 2026 | 2025 | ||||||
| Net cash provided by operating activities | $ | 68,056 | $ | 16,627 | ||||
| Purchases of property and equipment | (4,000 | ) | (3,070 | ) | ||||
| Free cash flow | $ | 64,056 | $ | 13,557 | ||||
Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin
Set forth below are reconciliations of Net Income to EBITDA and Adjusted EBITDA, as well as the reconciliations to Adjusted EBITDA margin for the three months ended March 31, 2026 and 2025. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.
| Three Months Ended March 31, | ||||||||
| (in thousands) | 2026 | 2025 | ||||||
| Net income | $ | 13,131 | $ | 6,221 | ||||
| Interest expense | 16,101 | 7,308 | ||||||
| Interest income | (3,816 | ) | (2,312 | ) | ||||
| Provision for income taxes | 6,578 | 3,383 | ||||||
| Depreciation and amortization | 15,479 | 6,849 | ||||||
| EBITDA | 47,473 | 21,449 | ||||||
| (Income) loss from equity method investments | (1,720 | ) | 867 | |||||
| Other, net | 10,650 | (1) | 6,259 | (2) | ||||
| Stock-based compensation | 9,895 | 7,811 | ||||||
| Adjusted EBITDA | $ | 66,298 | $ | 36,386 | ||||
| Total revenue | $ | 965,100 | $ | 620,390 | ||||
| Adjusted EBITDA margin | 7 | % | 6 | % | ||||
(1) Other, net, for the three months ended March 31, 2026, relates to an allowance on receivables that the Company plans to recover from the payer, post-acquisition integration costs, and severance fees incurred.
(2) Other, net, for the three months ended March 31, 2025, relates to debt issuance costs expensed in connection with our Second Amended and Restated Credit Facility, transaction costs for our acquisition of Prospect, certain costs for some of our acquisitions, non-cash changes related to change in the fair value of our call option and collar agreement, and severance fees incurred.
Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS - Diluted
Set forth below are reconciliations of net income to adjusted net income attributable to Astrana as well as the reconciliation to adjusted EPS - diluted for the three months ended March 31, 2026 and 2025.
| Three Months Ended March 31, | ||||||||
| (in thousands, except for share and per share data) | 2026 | 2025 | ||||||
| Net income | $ | 13,131 | $ | 6,221 | ||||
| (Income) loss from equity method investments | (1,720 | ) | 867 | |||||
| Other, net (1) | 10,650 | 6,259 | ||||||
| Stock-based compensation | 9,895 | 7,811 | ||||||
| Amortization of intangible assets attributable to acquisitions | 13,850 | 6,263 | ||||||
| Tax adjustments | (7,525 | )(2) | (4,602 | )(3) | ||||
| Adjusted net income attributable to non-controlling interests | (1,928 | )(4) | (2,317 | )(5) | ||||
| Adjusted net income attributable to Astrana Health, Inc. | $ | 36,353 | $ | 20,502 | ||||
| Weighted average shares of common stock outstanding – diluted | 49,054,135 | 48,850,666 | ||||||
| Adjusted earnings per share - diluted | $ | 0.74 | $ | 0.42 | ||||
(1) The components of other, net, as set forth in the table above, are described in the footnotes to the table under “Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin”. Please see the footnotes to such table for additional information.
(2) Tax adjustments for the three months ended March 31, 2026, includes the tax effect for, at a 27.1% statutory blended tax rate, the adjustments made to net income of $8.9 million, partially offset by 162(m) impact of $1.3 million.
(3) Tax adjustments for the three months ended March 31, 2025, includes the tax effect for, at a 27.1% statutory blended tax rate, the adjustments made to net income of $5.7 million, partially offset by 162(m) impact of $1.1 million.
(4) Includes net loss attributable to non-controlling interests ("NCI") of $1.3 million, offset by adjustments attributable to NCI of $3.2 million, for the three months ended March 31, 2026.
(5) Includes net loss attributable to NCI of $0.5 million, offset by adjustments attributable to NCI of $2.8 million, for the three months ended March 31, 2025.
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 quarter ending June 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.
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 | $ | 125,000 | $ | 145,000 | ||||
| Cash used in purchases of property and equipment | (20,000 | ) | (12,500 | ) | ||||
| Free cash flow | $ | 105,000 | $ | 132,500 | ||||
Use of Non-GAAP Financial Measures
This press release contains the non-GAAP financial measures EBITDA, Adjusted EBITDA, Adjusted EBITDA margin, adjusted net income attributable to Astrana, and adjusted EPS - diluted, of which the most directly comparable financial measure presented in accordance with 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 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.
Exhibit 99.2
May 2026 First Quarter 2026 Earnings Supplement
2 Forward Looking Statements This presentation contains forward - looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 , Section 27A of the Securities Act and Section 21E of the Exchange Act. Forward - looking statements include any statements about the Company's business, financial condition, operating results, plans, objectives, expectations and intentions, expansion plans, est imates of our total addressable market, our ability to successfully complete and realize the benefits of anticipated acquisit ion s, integration of acquired companies and any projections of earnings, revenue, EBITDA, Adjusted EBITDA, adjusted EPS - diluted or o ther financial items, such as the Company's projected capitation and future liquidity, as well as statements regarding the ma ter ial weakness in internal control over financial reporting and the Company’s ability to remediate such material weakness in a time ly manner and may be identified by the use of forward - looking terms such as “anticipate,” “could,” “can,” “may,” “might,” “potentia l,” “predict,” “should,” “estimate,” “expect,” “project,” “believe,” “plan,” “envision,” “intend,” “continue,” “target,” “seek,” “wi ll,” “would,” and the negative of such terms, other variations on such terms or other similar or comparable words, phrases or te rminology. 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 re sul ts 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 U.S. Securities and Exchange Commissio n ( the “SEC”), including without limitation the risk factors discussed in the Company’s last Annual Report on Form 10 - K and subsequ ent quarterly reports on Form 10 - Q filed with the SEC. Because the factors referred to above could cause actual results or outcomes to differ materially from those expressed or imp lie d in any forward - looking statements, you should not place undue reliance on any such forward - looking statements. Any forward - looking statements speak only as of the date of this presentation and, unless legally required, the Company does not undertak e a ny obligation to update any forward - looking statement, as a result of new information, future events or otherwise. This presentation may contain statistics and other data that in some cases has been obtained from or compiled from informatio n m ade available by third - party service providers. The Company makes no representation or warranty, express or implied, with respec t to the accuracy, reasonableness or completeness of such information. Use of Non - GAAP Financial Measures This presentation 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 presentation also contains the non - GA AP 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 m ay be calculated differently from similar non - GAAP financial measures used by other companies. The Company uses Adjusted EBITDA, Adjusted EBITDA margin, adjusted EPS – diluted, and free cash flow as supplemental performance measures of our operations, for f inancial 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 be for e interest expense, interest income, income taxes, depreciation, and amortization, excluding income or loss from equity metho d investments, non - recurring and non - cash transactions, stock - based compensation, and, for periods on or prior to December 31, 202 3, APC excluded assets costs. Beginning in the third quarter ended September 30, 2022, the Company has revised the calculati on for Adjusted EBITDA to exclude provider bonus payments and losses from recently acquired IPAs, which it believes to be more r efl ective of its business. The Company defines 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 . 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 minus cash used in purchases of property and equ ipment. The Company believes the presentation of these non - GAAP financial measures provides investors with relevant and useful informati on, 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 co njunction 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 b asis 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 com pan ies 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 th is Presentation 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 in the Appendix. The Company has not provided a quantitative reconciliation of applicable non - GAAP measures, such as the projected adjusted EBITD A to the most comparable GAAP measure, such as net income, on a forward - looking basis within this presentation because the Company is unable, without unreasonable efforts, to provide reconciling information with respect to certain line items that c ann ot be calculated. 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. 1 2 3
3 Q1 2026 Financial Results 56% 3 $965.1 Revenue 76% 3 $0.74 Adj. EPS – Diluted 2 372% 3 $64.1 Free Cash Flow 4 First Quarter 2026 Performance Highlights $ in millions, except for per share information 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non - GAAP Financial Measures” slides for more info rmation. 2. See “Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS – Diluted” and “Use of Non - GAAP Financial Measures” slides for more information. 3. All comparisons are to the three months ended March ௗ 31, 2025 unless otherwise stated. 4. See “Reconciliation and Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow” and “Use of N on - GAAP Financial Measures” slides for more information. 82% 3 $66.3 Adj. EBITDA 1 116% 3 $14.4 NI attr. to ASTH AS1JZ2JZ3AS4AS5 AH6 AH7 TB8
4 FY 2026 Guidance Range 1,2 Actual FY 2025 Results $3,800 - $4,100 $3,181.8 Total Revenue $250 - $280 $205.4 Adjusted EBITDA 1 $105 - $132.5 $104.5 Free Cash Flow 2 Q1 2026 Financial Results $965.1 Revenue $66.3 Adjusted EBITDA 1 $64.1 Free Cash Flow 2 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA,” “Guidance Reconciliation of Net Income to EBITDA and Adjust ed EBITDA” and “Use of Non - GAAP Financial Measures” slides for more information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See “Forward - Looking Stateme nts” on slide 2. 2. See “ Reconciliation and Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow ” and “Use of Non - GAAP Financial Measures” slides for more information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See “Forward - Looking Statements” on slide 2. $ in millions Reaffirms FY2026 GuidanceAS1
5 Growth Sustainably growing membership to bring better care to more Americans Astrana now serves 1.55 million patients in value - based arrangements Approximately 1.3 million m embers in our Care Partners segment Growth First Quarter 2026 Highlights and Recent Updates Operating Leverage Driving operating leverage across our business through our Care Enablement suite On track to achieve high end of $12 - 15M synergy range related to Prospect Continued development and deployment of proprietary AI - enabled tools across clinical workflows and administrative processes, leading to 70 bps G&A improvement year over year (6.4% in Q1 2026, 7.1% in Q1 2025) Risk Progression Increasing alignment through total cost of care responsibility in value - based arrangements 80 % of Q1 2026 revenue from full - risk arrangements Anticipate ~ 81% of revenue from full - risk arrangements by the end of 2026 Continued prudent shift toward full - risk , accountable care contracts Outcomes and Cost Achieving superior patient outcomes while managing cost Medical cost trends across both Prospect and core Astrana remained firmly within expectations for the quarter Strong engagement in Annual Wellness Visits, supporting earlier intervention and improved care coordination AS1 AS2 AS3 AS4
6 Projected Full - risk Partial - risk Members by Risk Arrangement 2 35% 47% 73% 76% 80% 81% 100% 65% 53% 27% 24% 20% 19% 2021 2022 2023 2024 2025 Q1 2026 2026 E 40% 43% 60% 57% Q1 2026 2026 E Capitated Revenue by Risk Arrangement 1 Our partial - risk membership presents an embedded opportunity for increased platform value and risk alignment. We succeed in these contracts by continuing to drive positive patient outcomes. 1. Revenue by risk arrangement represents capitation revenue only. 2. Members by risk arrangement represent Care Partners membership only. 3. 2026 E based on April 2026 forecast. Prudently transitioning to full - risk contracts to better align incentives around patient outcomes and improve unit economics 2026 E 3 2026 E 3AS1 JZ2 AS3CB4
7 92% 1% 2% 4% Capitation, net Risk Pool Settlements & Incentives Management Fee Income Fee-for-service, net Other Income Revenue by Type 1 63% 24% 9% 4% Medicare Medicaid Commercial Other Third Parties Revenue By Payer Type 1 80% 20% Full-risk Partial-risk Revenue by Risk Arrangement 1,2 40% 60% Full-risk Partial-risk Members by Risk Arrangement 3 Our Value - Based Care Business is Diverse 1% 1. Revenue for the quarter ended March 31, 2026. 2. Revenue by risk arrangement represents capitation revenue only. 3. Members by risk arrangement represent Care Partners membership only as of March 31, 2026.AS1 JZ2 DH3 AS4
8 Revenue ($ in millions) Adj. EBITDA ($ in millions) $561 $687 $774 $1,144 $1,387 $2,035 $3,182 2019 2020 2021 2022 2023 ~32% CAGR 2024 $54.2 $102.8 $133.5 $140.0 $146.6 $170.4 $205.4 2019 2020 2021 2022 2023 2024 ~25% CAGR 2025 $3,800 - $4,100 $250 - $280 2026E 2026E 2025 Astrana grows profitably across all market conditions Note: For more information, see “Reconciliation of Net Income to EBITDA and Adjusted EBITDA”, “Guidance Reconciliation of Net In come to EBITDA and Adjusted EBITDA”, and “Use of Non - GAAP Financial Measures“ slides for more information.
9 Quarter over Quarter Segment Revenue Revenue $ in millions Q1 2025 Q2 2025 Q3 2025 Q4 2025 Care Partners High - performing network of aligned providers $631.4 $897.7 Care Delivery High - quality system of employed providers $33.4 $38.4 $86.9 Care Enablement Full - stack tech, clinical, and operations platform $39.6 $40.9 $87.3 Inter - company $(53.5) $(55.9) $(115.9) Total $620.4 $654.8 $956.0 $892.5 $92.1 $78.9 $(112.9) $950.5 $601.0 Note: Numbers may not total due to rounding. Certain amounts disclosed in the prior periods have been recast to conform to th e c urrent period presentation. Specifically, segments are presented net of intrasegment eliminations. Q1 2026 $909.7 $85.1 $87.7 $(117.4) $965.1AS1AS2
10 Selected Financial Results
11 Three Months Ended March 31, 2025 2026 $ in thousands, except per share data Revenue 583,963 $ 892,908 $ Capitation, net 14,491 12,486 Risk pool settlements and incentives 2,310 15,685 Management fee income 14,890 37,831 Fee - for - service, net 4,736 6,190 Other revenue 620,390 965,100 Total revenue 599,807 936,572 Total expenses 20,583 28,528 Income from operations 6,221 $ 13,131 $ Net income (471) (1,305) Net loss attributable to non - controlling interests 6,692 $ 14,436 $ Net income attributable to Astrana Health 0.14 $ 0.29 $ Earnings per share – diluted 21,449 $ 47,473 $ EBITDA 1 36,386 $ 66,298 $ Adjusted EBITDA 1 0.42 $ 0.74 $ Adjusted EPS – Diluted 2 Summary of Selected Financial Results 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non - GAAP Financial Measures” slides for more inform ation. 2. See “Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS – Diluted” and “Use of Non - GAA P Financial Measures” slides for more information.AS1 JZ2
12 Consolidated Total Corporate Costs Intersegment Elimination Care Enablement Care Delivery Care Partners $ in thousands 965,100 - (117,425) 87,745 85,077 909,703 $ Total revenues 122% 155% 51% % change vs prior year quarter 859,356 - (47,423) 48,704 72,544 785,531 Cost of services 61,737 27,532 (69,974) 17,259 14,374 72,546 General and administrative expenses 15,479 558 - 1,629 1,122 12,170 Depreciation and amortization 936,572 28,090 (117,397) 67,592 88,040 870,247 Total expenses 28,528 (28,090) (28) 1 20,153 (2,963) 39,456 $ Income (loss) from operations 470% (5)% (11)% % change vs prior year quarter For the three months ended March 31, 2026 Segment Results 1. Loss from operations for the intersegment elimination represents sublease income from segments renting from other segments. S ubl ease income is presented within other income which is not presented in the table.AS1JZ2DH3AS4
13 $ Change 12/31/2025 3/31/2026 $ in millions $48.9 $429.5 $478.4 Cash and cash equivalents 1 $10.7 $248.0 $258.7 Working capital $21.9 $793.3 $815.2 Total stockholders’ equity Balance Sheet Highlights 1. Excluding restricted cash and marketable securities.AS1 JZ2
14 1 . The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue .; 2 . Other, net, for the three months ended March 31 , 2026 , relates to an allowance on receivables that the Company plans to recover from the payer, post - acquisition integration costs, and severance fees incurred .; 3 . Other, net for the three months ended March 31 , 2025 , relates to debt issuance costs expensed in connection with our Second Amended and Restated Credit Facility, transaction costs for our acquisition of Prospect, certain costs for some of our acquisitions, non - cash changes related to change in the fair value of our call option and collar agreement, and severance fees incurred . Three Months Ended March 31, 2025 2026 $ in thousands 6,221 $ 13,131 $ Net Income 7,308 16,101 Interest expense (2,312) (3,816) Interest income 3,383 6,578 Provision for income taxes 6,849 15,479 Depreciation and amortization 21,449 47,473 EBITDA 867 (1,720) (Income) loss from equity method investments 6,259 3 10,650 2 Other, net 7,811 9,895 Stock - based compensation 36,386 $ 66,298 $ Adjusted EBITDA 6% 7% Adjusted EBITDA margin 1 Reconciliation of Net Income to EBITDA & Adjusted EBITDAAS1JZ2 JZ3 4
15 Year Ended TTM Ended For the twelve months ended 2019 2020 2021 2022 2023 2024 2025 March 31, 2026 $ in millions 15.8 122.1 $ 46.1 $ 45.7 $ 57.8 $ 49.9 $ 24.1 $ 31.0 $ Net Income 4.7 9.5 5.4 7.9 16.1 33.1 50.0 58.7 Interest expense (2.0) (2.8) (1.6) (2.0) (14.2) (14.5) (12.2) (13.7) Interest income 10.0 56.3 31.7 40.9 32.0 30.9 15.5 18.7 Provision for income taxes 18.3 18.4 17.5 17.5 17.7 27.9 45.7 54.4 Depreciation and amortization 46.8 203.5 99.1 110.1 109.5 127.3 123.1 149.1 EBITDA 1 2.9 (0.3) 9 5.3 9 (5.7) 9 (5.1) (4.5) (1.7) (4.3) (Income) loss from equity method investments - - (2.2) - - - - - Gain on sale of equity method investment 2.0 10 (0.5) 7 (1.7) 7 3.3 6 6.2 5 13.0 4 45.4 3 49.8 2 Other, net 0.9 3.4 6.7 16.1 22.0 34.5 38.6 40.7 Stock - based compensation 1.5 (103.3) 9 26.4 9 16.2 9 14.0 - - - APC excluded assets costs 54.2 102.8 $ 133.5 $ 140.0 $ 146.6 $ 170.4 $ 205.4 $ 235.3 $ Adjusted EBITDA 1 560.6 687.2 $ 773.9 $ 1,144.2 $ 1,386.7 $ 2,034.5 $ 3,181.8 $ 3,526.5 $ Net Revenue 10% 15% 17% 12% 11% 8% 6% 7% Adjusted EBITDA Margin 8 Reconciliation of Net Income to EBITDA & Adjusted EBITDA (continued) 1 . See “Use of Non - GAAP Financial Measures” slide for more information .; 2 . Other, net, for TTM ended March 31 , 2026 , relates to an allowance on receivables that the Company plans to recover from the payer, post - acquisition integration costs, $ 13 . 0 million for a legal matter with a provider associated with CFC HP, transaction costs primarily for the acquisition of Prospect, certain costs associated with the CHS transaction, non - cash changes related to the change in the fair value of our call option and collar agreement, and severance fees incurred .; 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 payer payments associated with the CHS transaction, financial guarantee via a letter of credit that we provided in support of two local provider - led ACOs, reimbursement from a related party of the Company for taxes associated with the December 2023 Excluded Assets Spin - off, non - cash gain on debt extinguishment related to one of our promissory note payables, non - cash realized loss from sale of one of our marketable equity securities, non - cash changes related to change in the fair value of our call option, our financing obligation to purchase the remaining equity interests in one of our investments, our contingent liabilities, and the Company's Collar Agreement .; 5 . Other, net for the year ended December 31 , 2023 consists of nonrecurring transaction costs and tax restructuring fees incurred, non - cash changes in the fair value of our financing obligation to purchase the remaining equity interests, contingent liabilities, and the Company's Collar Agreement, and excise tax related to a nonrecurring buyback of the Company’s stock from APC .; 6 . Other, net for the year ended December 31 , 2022 consists of one - time transaction costs incurred and non - cash changes in the fair value of our financing obligation to purchase the remaining equity interests and contingent considerations .; 7 . Other, net for the years ended December 31 , 2021 and 2020 relate to COVID - 19 relief payments recognized in 2021 and 2020 .; 8 . The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue .; 9 . Certain APC minority interests where APC owns the asset but not the right to the dividends is reclassified from APC excluded asset costs to income from equity method investments .; 10 . Other, net for the year ended December 31 , 2019 is related to goodwill impairment .AS1 RM2 RM3 JZ4 5
16 Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS - Diluted Three Months Ended March 31, 2025 2026 $ in thousands, except for share and per share data 6,221 $ 13,131 $ Net income 867 (1,720) (Income) loss from equity method investments 6,259 10,650 Other, net 1 7,811 9,895 Stock - based compensation 6,263 13,850 Amortization of intangible assets attributable to acquisitions (4,602) 3 (7,525) 2 Tax adjustments (2,317) 5 (1,928) 4 Adjusted net income attributable to non - controlling interests 20,502 $ 36,353 $ Adjusted net income attributable to Astrana Health, Inc. 48,850,666 49,054,135 Weighted average shares of common stock outstanding – diluted 0.42 $ 0.74 $ Adjusted earnings per share - diluted 1 . The components of other, net, as set forth in the table above, are described in the footnotes to the table under “Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin” . Please see the footnotes to such table for additional information .; 2 . Tax adjustments for the three months ended March 31 , 202 6 , includes the tax effect for, at a 27 . 1 % statutory blended tax rate, the adjustments made to net income of $ 8 . 9 million, partially offset by 162 (m) impact of $ 1 . 3 million .; 3 . Tax adjustments for the three months ended March 31 , 2025 , includes the tax effect for, at a 27 . 1 % statutory blended tax rate, the adjustments made to net income of $ 5 . 7 million, partially offset by 162 (m) impact of $ 1 . 1 million .; 4 . Includes net loss attributable to non - controlling interests ("NCI") of $ 1 . 3 million, offset by adjustments attributable to NCI of $ 3 . 2 million, for the three months ended March 31 , 2026 .; 5 . Includes net loss attributable to NCI of $ 0 . 5 million, offset by adjustments attributable to NCI of $ 2 . 8 million, for the three months ended March 31 , 2025 .AS1 JZ2 3 4
17 Guidance 1 Actual Results Actual Results Year Ending December 31, 2026 Year Ended December 31, 2025 Three Months Ended March 31, 2026 High Low $ in thousands 145,000 $ 125,000 $ 114,597 $ 68,056 $ Net cash provided by operating activities (12,500) (20,000) (10,106) (4,000) Cash used in purchases of property and equipment 132,500 $ 105,000 $ 104,491 $ 64,056 $ Free cash flow 2 1. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See “Forward - Looki ng Statements” on slide 2. 2. See “Use of Non - GAAP Financial Measures” slide for more information. Reconciliation and Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash FlowAS1
18 . Guidance Reconciliation of Net Income to EBITDA & Adjusted EBITDA 1. Note: See “Use of Non - GAAP Financial Measures” slide for more information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See “Forward - Looki ng Statements” on slide 2. 2026 Guidance Range High Low $ in thousands 74,000 $ 54,000 $ Net Income 55,000 51,000 Interest expense 44,000 38,000 Provision for income taxes 65,000 65,000 Depreciation and amortization 238,000 208,000 EBITDA (4,000) (4,000) Income from equity method investments 7,000 7,000 Other, net 39,000 39,000 Stock - based compensation 280,000 $ 250,000 $ Adjusted EBITDAAS1
Investor Relations Carolyne Sohn investors@astranahealth.com