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      Astrana Health, Inc. Reports Second Quarter 2026 Results

      Astrana Health

      News provided by

      Astrana Health, Inc.

      Aug 06, 2026, 16:05 ET

      Share this article

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      Company to Host Conference Call on Thursday, August 6, 2026, at 2:30 p.m. PT/5:30 p.m. ET

      • Reports revenue of $972.5 million, up 49% year-over-year, net income of $18.5 million, up 81% year-over-year, and adjusted EBITDA (1) of $68.9 million, up 43% year-over-year for the three months ended June 30, 2026
      • Reports net cash provided by operating activities of $100.8 million and free cash flow (2) of $92.9 million for the six months ended June 30, 2026

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

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

      Financial Highlights for Second Quarter Ended June 30, 2026:

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

      • Total revenue of $972.5 million, up 49% from $654.8 million
      • Care Partners revenue of $932.8 million, up 48% from $631.4 million
      • Net income attributable to Astrana of $19.7 million, up 109% from $9.4 million
      • Earnings per share ("EPS") - diluted of $0.40, up 111% from $0.19
      • Adjusted EBITDA(1) of $68.9 million, up 43% from $48.1 million
      • Adjusted EPS - diluted(3) of $0.80, up 45% from $0.55

      Financial Highlights for Six Months Ended June 30, 2026:

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

      • Total revenue of $1,937.6 million, up 52% from $1,275.2 million
      • Care Partners revenue of $1,842.5 million, up 50% from $1,232.4 million
      • Net income attributable to Astrana of $34.2 million, up 112% from $16.1 million
      • EPS - diluted of $0.69, up 109% from $0.33
      • Adjusted EBITDA(1) of $135.2 million, up 60% from $84.5 million
      • Adjusted EPS - diluted(3) of $1.54, up 59% from $0.97
      • Net cash provided by operating activities of $100.8 million
      • Free cash flow(2) of $92.9 million

      (1)

      See "Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin" and "Use of Non-GAAP Financial Measures" below for additional information.

      (2)

      See reconciliation provided with the condensed consolidated statements of cash flow and "Use of Non-GAAP Financial Measures" below for additional information.

      (3)

      See "Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS - Diluted" and "Use of Non-GAAP Financial Measures" below for additional information.

      Recent Operating Highlights

      • Daniel Rothman joined as President of Physician Enterprise and Vishal Gupta joined as Senior Vice President of Enterprise Transformation, further strengthening the executive leadership team as the Company continues to scale its physician-centric, AI-native operating platform for value-based care.
      • Astrana's affiliated Accountable Care Organizations ("ACOs") generated $120.4 million in gross shared savings for the 2024 performance year, and Astrana Care Partners ACO ranked seventh nationwide in net shared savings per beneficiary in its first performance year.
      • Astrana continued to expand its Medicare Advantage footprint, including new agreements in Hawaii and Texas. The Texas agreement added approximately 3,000 new Medicare Advantage professional-risk lives.

      Segment Results for three months ended June 30, 2026:

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



      Three Months Ended June 30, 2026


      (in thousands)


      Care
      Partners



      Care
      Delivery



      Care
      Enablement



      Intersegment
      Elimination



      Corporate
      Costs



      Consolidated
      Total


      Total revenues


      $

      932,836



      $

      74,696



      $

      85,598



      $

      (120,610)



      $

      —



      $

      972,520


      % change vs. prior year quarter



      48

      %



      95

      %



      109

      %





























      Cost of services



      805,469




      61,923




      51,665




      (50,559)




      —




      868,498


      General and administrative expenses



      72,133




      14,552




      16,158




      (70,091)




      21,398




      54,150


      Depreciation and amortization



      12,362




      1,188




      1,378




      —




      622




      15,550


      Total expenses



      889,964




      77,663




      69,201




      (120,650)




      22,020




      938,198





















      Income (loss) from operations


      $

      42,872



      $

      (2,967)



      $

      16,397



      $

      40


      (1)

      $

      (22,020)



      $

      34,322


      % change vs. prior year quarter



      (14)

      %



      (238)

      %


      *











      * Percentage change of over 500%.


      (1)

      Income from operations for the intersegment elimination represents sublease income between segments. Sublease  income is presented within other income, which is not presented in the table.

      2026 Guidance:

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



      Three Months Ending
      September 30, 2026



      Year Ending
      December 31, 2026




      Guidance Range



      Guidance Range


      ($ in millions)


      Low



      High



      Low



      High


      Total revenue


      $

      1,000



      $

      1,030



      $

      3,800



      $

      4,100


      Adjusted EBITDA


      $

      72.5



      $

      77.5



      $

      255



      $

      280


      Free cash flow








      $

      105



      $

      132.5


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

      Conference Call and Webcast Information:

      Astrana will host a conference call at 2:30 p.m. PT/5:30 p.m. ET today (Thursday, August 6, 2026), during which management will discuss the results of the second quarter ended June 30, 2026. To participate in the conference call, please use the following dial-in numbers about 5 minutes prior to the scheduled conference call time:

      U.S. & Canada (Toll-Free):     +1 (877) 858-9810
      International (Toll):                  +1 (201) 689-8517

      The conference call can also be accessed via webcast at:
      https://event.choruscall.com/mediaframe/webcast.html?webcastid=w7Ip0KQB

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

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

      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 September 30, 2026 and the year ending  December 31, 2026, ability to meet operational goals, ability to meet expectations in deployment of care coordination and management capabilities, ability to decrease cost of care while improving quality and outcomes, ability to deliver sustainable revenue and EBITDA growth as well as long-term value, ability to respond to the changing environment, statements about the Company's liquidity, and successful completion and implementation of strategic growth plans, acquisition strategy, and merger integration efforts, as well as statements regarding the material weakness in internal control over financial reporting and the Company's ability to remediate such material weakness in a timely manner. Forward-looking statements reflect current views with respect to future events and financial performance and therefore cannot be guaranteed. Such statements are based on the current expectations and certain assumptions of the Company's management, and some or all of such expectations and assumptions may not materialize or may vary significantly from actual results. Actual results may also vary materially from forward-looking statements due to risks, uncertainties and other factors, known and unknown, including the risk factors described from time to time in the Company's reports to the SEC, including, without limitation the risk factors discussed in the Company's Annual Report on Form 10-K for the year ended December 31, 2025, and subsequent quarterly reports on Form 10-Q. Any forward-looking statement made by the Company in this release speaks only as of the date on which it is made. The Company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future developments or otherwise, except as may be required by any applicable securities laws.

      FOR MORE INFORMATION, PLEASE CONTACT:

      Investor Relations
      [email protected]

      ASTRANA HEALTH, INC.

      CONDENSED CONSOLIDATED BALANCE SHEETS

      (IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)




      June 30,
      2026



      December 31,
      2025




      (Unaudited)





      Assets














      Current assets







      Cash and cash equivalents


      $

      400,792



      $

      429,474


      Receivables, net (including amounts from related parties)



      465,080




      374,465


      Income taxes receivable



      —




      1,799


      Other receivables



      24,113




      26,385


      Prepaid expenses and other current assets



      25,857




      26,264


      Loans receivable



      3,318




      4,926









      Total current assets



      919,160




      863,313









      Non-current assets







      Property and equipment, net



      62,567




      57,332


      Intangible assets, net



      243,312




      270,968


      Goodwill



      886,995




      865,305


      Income taxes receivable, net of current portion



      26,220




      26,220


      Loans receivable, net of current portion



      49,273




      48,724


      Investments in other entities – equity method



      27,805




      25,637


      Operating lease right-of-use assets



      39,194




      35,738


      Other assets



      27,554




      25,424









      Total non-current assets



      1,362,920




      1,355,348









      Total assets (1)


      $

      2,282,080



      $

      2,218,661









      Liabilities, Mezzanine Deficit, and Stockholders' Equity














      Current liabilities







      Accounts payable and accrued expenses


      $

      245,860



      $

      195,912


      Fiduciary accounts payable



      3,771




      3,524


      Income taxes payable



      2,082




      —


      Medical liabilities



      415,765




      335,705


      Operating lease liabilities



      8,938




      7,809


      Current portion of long-term debt



      53,848




      47,865


      Other liabilities



      17,375




      24,458









      Total current liabilities



      747,639




      615,273









      Non-current liabilities







      Deferred tax liability



      8,795




      5,491


      Operating lease liabilities, net of current portion



      33,975




      31,552


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



      882,650




      990,904


      Other long-term liabilities



      10,442




      17,107









      Total non-current liabilities



      935,862




      1,045,054









      Total liabilities (1)



      1,683,501




      1,660,327









      Mezzanine deficit







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



      (242,261)




      (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 June 30, 2026 and December 31, 2025



      —




      —


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



      49




      49


      Additional paid-in capital



      487,820




      470,863


      Retained earnings



      342,355




      308,379


      Total stockholders' equity



      830,224




      779,291









      Non-controlling interests



      10,616




      14,005









      Total equity



      840,840




      793,296









      Total liabilities, mezzanine deficit, and stockholders' equity


      $

      2,282,080



      $

      2,218,661



      (1)

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

      ASTRANA HEALTH, INC.

      CONDENSED CONSOLIDATED STATEMENTS OF INCOME

      (IN THOUSANDS, EXCEPT SHARE AND PER SHARE AMOUNTS)

      (UNAUDITED)




      Three Months Ended
      June 30,



      Six Months Ended
      June 30,




      2026



      2025



      2026



      2025


      Revenue













      Capitation and other revenue, net


      $

      972,520



      $

      654,808



      $

      1,937,620



      $

      1,275,196















      Operating expenses













      Cost of services, excluding depreciation and
      amortization



      868,498




      576,839




      1,727,855




      1,125,900


      General and administrative expenses



      54,150




      50,725




      115,888




      94,623


      Depreciation and amortization



      15,550




      6,904




      31,028




      13,752















      Total expenses



      938,198




      634,468




      1,874,771




      1,234,275















      Income from operations



      34,322




      20,340




      62,849




      40,921















      Other (expense) income













      Income (loss) from equity method investments



      548




      381




      2,268




      (486)


      Interest expense



      (15,997)




      (7,382)




      (32,098)




      (14,690)


      Interest income



      5,907




      2,336




      9,723




      4,647


      Unrealized gain (loss) on investments



      4,732




      14




      5,816




      (30)


      Other (loss) income



      (2,302)




      1,136




      (1,640)




      (3,934)















      Total other expense, net



      (7,112)




      (3,515)




      (15,931)




      (14,493)















      Income before provision for income taxes



      27,210




      16,825




      46,918




      26,428















      Provision for income taxes



      8,758




      6,609




      15,335




      9,991















      Net income



      18,452




      10,216




      31,583




      16,437















      Net (loss) income attributable to non-controlling
      interests



      (1,287)




      793




      (2,592)




      322















      Net income attributable to Astrana Health, Inc.


      $

      19,739



      $

      9,423



      $

      34,175



      $

      16,115















      Earnings per share – basic


      $

      0.40



      $

      0.19



      $

      0.70



      $

      0.33















      Earnings per share – diluted


      $

      0.40



      $

      0.19



      $

      0.69



      $

      0.33















      Weighted average shares of common stock
      outstanding – basic



      49,115,835




      49,187,885




      48,986,953




      48,831,265















      Weighted average shares of common stock
      outstanding – diluted



      49,778,028




      49,470,677




      49,418,278




      49,162,653




























      Revenue consisted of the following (in thousands):















      Three Months Ended
      June 30,



      Six Months Ended
      June 30,




      2026



      2025



      2026



      2025


      Capitation, net


      $

      905,804



      $

      614,108



      $

      1,798,712



      $

      1,198,071


      Risk pool settlements and incentives



      21,816




      15,402




      34,302




      29,893


      Management fee income



      13,211




      2,577




      28,896




      4,887


      Fee-for-service, net



      22,982




      17,878




      60,813




      32,769


      Other revenue



      8,707




      4,843




      14,897




      9,576















      Capitation and other revenue, net


      $

      972,520



      $

      654,808



      $

      1,937,620



      $

      1,275,196


      ASTRANA HEALTH, INC.

      CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

      (IN THOUSANDS)

      (UNAUDITED)



      Six Months Ended
      June 30,




      2026



      2025


      Cash flows from operating activities







      Net income


      $

      31,583



      $

      16,437


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







      Depreciation and amortization



      31,028




      13,752


      Amortization of debt issuance cost



      2,280




      1,740


      Share-based compensation



      21,682




      19,519


      Non-cash lease expense



      4,131




      2,559


      Deferred tax



      2,734




      (1,961)


      Change in fair value of contingent consideration liabilities



      (4,820)




      3,351


      Other



      (6,735)




      560


      Changes in operating assets and liabilities, net of business combinations



      18,921




      51,571


      Net cash provided by operating activities



      100,804




      107,528









      Cash flows from investing activities







      Payments for business and assets acquisition, net of cash acquired



      (3,739)




      —


      Purchases of property and equipment



      (7,878)




      (4,490)


      Other



      2,545




      1,019


      Net cash used in investing activities



      (9,072)




      (3,471)









      Cash flows from financing activities







      Dividends paid



      (199)




      (6,233)


      Borrowings on debt



      —




      412,000


      Repayment of debt



      (103,933)




      (431,357)


      Deferred financing cost



      —




      (17,241)


      Payment of contingent liabilities



      (2,864)




      (3,631)


      Taxes paid from net share settlement of restricted stock



      (3,834)




      (5,053)


      Repurchase of treasury shares



      (4,364)




      (1,316)


      Other



      (4,840)




      23


      Net cash used in financing activities



      (120,034)




      (52,808)









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



      (28,302)




      51,249









      Cash, cash equivalents, and restricted cash, beginning of period



      434,045




      289,101









      Cash, cash equivalents, and restricted cash, end of period


      $

      405,743



      $

      340,350









      Supplemental disclosures of cash flow information







       Cash paid for income taxes


      (1)



      $

      4,728


       Cash paid for interest


      $

      29,348



      $

      13,535









      Supplemental disclosures of non-cash investing and financing activities







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


      $

      2,795



      $

      7,110


       Dividend paid in the form of common stock


      $

      —



      $

      21,935



      (1)

      Following the adoption of ASC 2023-09 "Income Taxes (Topics 740): Improvements to Income Tax Disclosures", cash
      paid for income taxes is presented net of tax refunds, for the quarterly period ended June 30, 2026, under Item 1 of the
      Company's Quarterly Report on Form 10-Q.

      The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total amounts of cash, cash equivalents, and restricted cash shown in the condensed consolidated statements of cash flows (in thousands):



      June 30,
      2026



      December 31,
      2025



      June 30,
      2025


      Cash and cash equivalents


      $

      400,792



      $

      429,474



      $

      339,703


      Restricted cash (1)



      4,951




      4,571




      647


      Total cash, cash equivalents, and restricted cash, end of period
      shown in the statement of cash flows


      $

      405,743



      $

      434,045



      $

      340,350



      (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




      Six Months Ended
      June 30,



      (in thousands)


      2026



      2025



      Net cash provided by operating activities


      $

      100,804



      $

      107,528



      Purchases of property and equipment



      (7,878)




      (4,490)



      Free cash flow


      $

      92,926



      $

      103,038



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



      Three Months Ended
      June 30,



      Six Months Ended
      June 30,



      (in thousands)


      2026



      2025



      2026



      2025



      Net income


      $

      18,452



      $

      10,216



      $

      31,583



      $

      16,437



      Interest expense



      15,997




      7,382




      32,098




      14,690



      Interest income



      (5,907)




      (2,336)




      (9,723)




      (4,647)



      Provision for income taxes



      8,758




      6,609




      15,335




      9,991



      Depreciation and amortization



      15,550




      6,904




      31,028




      13,752



      EBITDA



      52,850




      28,775




      100,321




      50,223

















      (Income) loss from equity method investments



      (548)




      (381)




      (2,268)




      486



      Other, net



      4,800


      (1)


      7,998


      (2)


      15,450


      (3)


      14,257


      (4)

      Stock-based compensation



      11,787




      11,709




      21,682




      19,519



      Adjusted EBITDA


      $

      68,889



      $

      48,101



      $

      135,185



      $

      84,485

















      Total revenue


      $

      972,520



      $

      654,808



      $

      1,937,620



      $

      1,275,196

















      Adjusted EBITDA margin



      7

      %



      7

      %



      7

      %



      7

      %




      (1)

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

      (2)

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

      (3)

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

      (4)

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

      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 six months ended June 30, 2026 and 2025.



      Three Months Ended
      June 30,



      Six Months Ended
      June 30,



      (in thousands, except for share and per share data)


      2026



      2025



      2026



      2025



      Net income


      $

      18,452



      $

      10,216



      $

      31,583



      $

      16,437



      (Income) loss from equity method investments



      (548)




      (381)




      (2,268)




      486



      Other, net (1)



      4,800




      7,998




      15,450




      14,257



      Stock-based compensation



      11,787




      11,709




      21,682




      19,519



      Amortization of intangible assets attributable to
      acquisitions



      13,806




      6,179




      27,656




      12,442



      Tax adjustments



      (5,965)


      (2)


      (4,637)


      (3)


      (13,490)


      (2)


      (9,238)


      (3)

      Adjusted net income attributable to non-controlling
      interests



      (2,561)


      (4)


      (3,715)


      (5)


      (4,489)


      (4)


      (6,032)


      (5)

      Adjusted net income attributable to Astrana Health, Inc.


      $

      39,771



      $

      27,369



      $

      76,124



      $

      47,871

















      Weighted average shares of common stock outstanding –
      diluted



      49,778,028




      49,470,677




      49,418,278




      49,162,653

















      Adjusted earnings per share - diluted


      $

      0.80



      $

      0.55



      $

      1.54



      $

      0.97




      (1)

      The components of other, net, as set forth in the table above, are described in the footnotes to the table under
      "Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin". Please see the footnotes to
      such table for additional information.

      (2)

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

      (3)

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

      (4)

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

      (5)

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

      Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA




      Year Ending
      December 31, 2026




      Guidance Range


      (in thousands)


      Low



      High


      Net income


      $

      59,000



      $

      74,000


      Interest expense



      49,000




      53,000


      Provision for income taxes



      38,000




      44,000


      Depreciation and amortization



      65,000




      65,000


      EBITDA



      211,000




      236,000









      Income from equity method investments



      (4,000)




      (4,000)


      Other, net



      9,000




      9,000


      Stock-based compensation



      39,000




      39,000


      Adjusted EBITDA


      $

      255,000



      $

      280,000


      The Company has not provided a quantitative reconciliation of EBITDA and Adjusted EBITDA for the three months ending September 30, 2026 to the most comparable GAAP measure on a forward-looking basis within this press release because the Company is unable, without unreasonable efforts, to provide reconciling information with respect to certain line items that cannot be calculated for the three month period. These items, which could materially affect the computation of forward-looking GAAP net income, are inherently uncertain and depend on various factors, some of which are outside of the Company's control.

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

      SOURCE Astrana Health, Inc.

      Modal title

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