olivLaw · US equity research
Astrana Health, Inc. ASTH
Services-Management Consulting Services · SIC 8742 · Vertical: Services-Management Consulting Services (SIC 8742)
Astrana Health is a physician-centric, technology-powered, risk-bearing healthcare company that coordinates patient care under value-based arrangements, mainly in California. Revenue reached over 3,181.8 million USD in 2025, at a time when US healthcare spending keeps rising.
At the close of 04 Nov 2026, Astrana Health, Inc. (ASTH) stock was 39.67 USD (+8.00% on the day), with market capitalisation 2.2 bn USD, P/E 48.3 on diluted EPS of 0.82 USD over the last 12 months, dividend yield 0.08%, beta 0.60, 52-week range 18.16–49.81 USD. Latest reported quarter (Q2 2026): revenue of 972.5 m USD (+48.5% YoY), net income of 19.7 m USD (+109.5% YoY), diluted EPS 0.40 USD.
Data as of · AI analysis dated · Source: SEC filings and closing prices, computed by olivLaw.
Price history
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Technical reading
- RSI (14)
- 63.0
- strong (55–70)
- Bollinger (20, 2)
- 35.69 – 39.09
- above the upper band · %B 1.17 · band width 9.1%
- SMA 50 / 200
- 37.05 / 34.01
- uptrend (price > SMA50 > SMA200)
- MACD (12, 26, 9)
- 0.18 / 0.07
- MACD above signal
Indicators describe past prices; on their own they do not predict direction. On our history the RSI ≤ 40 filter added no return (see the signals methodology).
Performance
| Company | S&P 500 | vs S&P 500 | Vertical median | |
|---|---|---|---|---|
| 1 month | +7.8% | −1.1% | +8.9 pp | — |
| 3 months | +10.7% | −0.5% | +11.2 pp | — |
| 6 months | +12.5% | +4.4% | +8.1 pp | — |
| Year to date | +59.9% | +12.3% | +47.6 pp | — |
| 1 year | +19.8% | +13.5% | +6.3 pp | −28.1% |
| 3 years | +24.1% | +76.4% | −52.3 pp | −29.4% |
| 5 years | −53.9% | +63.7% | −117.5 pp | — |
Price returns, dividends excluded.
Quarterly results
Latest quarter: Q2 2026 · 30 Jun 2026
Quarterly margins
Quarterly statements · USD
| Fiscal year | Q3 '24 | Q4 '24 | Q1 '25 | Q2 '25 | Q3 '25 | Q4 '25 | Q1 '26 | Q2 '26 |
|---|---|---|---|---|---|---|---|---|
| Revenue | 478.7 m | 665.2 m | 620.4 m | 654.8 m | 956.0 m | 950.5 m | 965.1 m | 972.5 m |
| Cost of revenue | 405.2 m | 614.7 m | 549.1 m | 576.8 m | 858.9 m | 855.5 m | 859.4 m | 868.5 m |
| Operating income | 28.4 m | 720.0 k | 20.6 m | 20.3 m | 19.2 m | 18.4 m | 28.5 m | 34.3 m |
| Depreciation & amortisation | 7.3 m ≈ | 8.1 m | 6.8 m | 6.9 m ≈ | 15.6 m ≈ | 16.4 m | 15.5 m | 15.5 m ≈ |
| Interest expense | 8.9 m | 8.1 m | 7.3 m | 7.4 m | 17.7 m | 17.5 m | 16.1 m | 16.0 m |
| Pre-tax income | 26.8 m | -1.9 m | 9.6 m | 16.8 m | 5.7 m | 7.5 m | 19.7 m | 27.2 m |
| Income tax | 7.8 m | 5.9 m | 3.4 m | 6.6 m | 4.6 m | 944.0 k | 6.6 m | 8.8 m |
| Net income | 16.1 m | -7.0 m | 6.7 m | 9.4 m | 373.0 k | 6.0 m | 14.4 m | 19.7 m |
| Diluted EPS | 0.33 | -0.14 ≈ | 0.14 | 0.19 | 0.01 | 0.12 ≈ | 0.29 | 0.40 |
| Operating cash flow | 34.0 m ≈ | -10.9 m | 16.6 m | 90.9 m ≈ | 10.0 m ≈ | -2.9 m | 68.1 m | 32.7 m ≈ |
| Capex | 2.3 m ≈ | 2.5 m | 3.1 m | 1.4 m ≈ | 2.6 m ≈ | 3.1 m | 4.0 m | 3.9 m ≈ |
| Dividends paid | 218.0 k ≈ | 1.9 m | 5.5 m | 778.0 k ≈ | 96.0 k ≈ | 1.6 m | 104.0 k | 95.0 k ≈ |
| Share repurchases | 0 ≈ | 900.0 k | 10.6 m | 0 ≈ | 0 ≈ | 15.0 m | 2.8 m | 0 ≈ |
≈ derived quarter (cumulative difference / share-days average)
E/P over time
E/P = trailing-12-month diluted EPS / price at quarter end. E/P is the inverse of P/E and stays defined when earnings are negative.
Today's P/E sits at the 65 percentile of its own 34-quarter history (min 18.1, median 39.1, max 163.6; quarters with earnings only).
Fiscal years
| Fiscal year | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|---|---|---|
| Revenue | 519.9 m | 560.6 m | 687.2 m | 773.9 m | 1.1 bn | 1.4 bn | 2.0 bn | 3.2 bn |
| Revenue YoY | +45.9% | +7.8% | +22.6% | +12.6% | +47.8% | +21.2% | +46.7% | +56.4% |
| Net income | 10.8 m | 14.1 m | 37.7 m | 68.9 m | 45.2 m | 60.7 m | 43.1 m | 22.5 m |
| Net income YoY | −58.0% | +30.3% | +167.0% | +82.9% | −34.5% | +34.4% | −28.9% | −47.9% |
| Diluted EPS | 0.29 | 0.39 | 1.01 | 1.52 | 0.99 | 1.29 | 0.90 | 0.46 |
| Diluted EPS YoY | −67.8% | +34.5% | +159.0% | +50.5% | −34.9% | +30.3% | −30.2% | −48.9% |
| net % | 2.1% | 2.5% | 5.5% | 8.9% | 3.9% | 4.4% | 2.1% | 0.7% |
| Free cash flow | 24.3 m | 12.6 m | 45.0 m | 51.1 m | 59.2 m | 39.7 m | 44.2 m | 104.5 m |
Reported results vs expectations
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Balance sheet & financial health
Fiscal year 2025 · 31 Dec 2025
- Cash
- 429.5 m USD
- Financial debt
- 1.0 bn USD
- Net debt
- 609.3 m USD
- Equity
- 793.3 m USD
- Total assets
- 2.2 bn USD
- Debt / equity
- 1.31x
- Current ratio
- 1.40x
- ROE
- 3.0%
- ROA
- 1.3%
- FCF margin
- 3.3%
Financial statements (source on every figure)
Revenue and net income (USD)
Margins
Income statement · USD
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Revenue | 687.2 m | 773.9 m | 1.1 bn | 1.4 bn | 2.0 bn | 3.2 bn | SEC (XBRL)· 12 Mar 2026verified |
| Cost of revenue | 539.2 m | 596.1 m | 944.7 m | 1.2 bn | 1.8 bn | 2.8 bn | SEC (XBRL)· 12 Mar 2026verified |
| Gross profit | 148.0 m ≈ | 177.8 m ≈ | 199.5 m ≈ | 215.0 m ≈ | 271.4 m ≈ | 341.5 m ≈ | SEC (XBRL)· 12 Mar 2026derived |
| Operating income | 80.5 m | 98.2 m | 104.3 m | 84.6 m | 89.4 m | 78.5 m | SEC (XBRL)· 12 Mar 2026verified |
| Depreciation & amortisation | 18.4 m | 17.5 m | 17.5 m | 17.7 m | 27.9 m | 45.7 m | SEC (XBRL)· 12 Mar 2026verified |
| EBITDA | 98.9 m ≈ | 115.7 m ≈ | 121.8 m ≈ | 102.4 m ≈ | 117.3 m ≈ | 124.3 m ≈ | SEC (XBRL)· 12 Mar 2026derived |
| Interest expense | 9.5 m | 5.4 m | 7.9 m | 16.1 m | 33.1 m | 49.9 m | SEC (XBRL)· 12 Mar 2026verified |
| Pre-tax income | 178.4 m | 77.7 m | 86.6 m | 89.8 m | 80.8 m | 39.6 m | SEC (XBRL)· 12 Mar 2026verified |
| Income tax | 56.3 m | 31.7 m | 40.9 m | 32.0 m | 30.9 m | 15.5 m | SEC (XBRL)· 12 Mar 2026verified |
| Net income | 37.7 m | 68.9 m | 45.2 m | 60.7 m | 43.1 m | 22.5 m | SEC (XBRL)· 12 Mar 2026verified |
| Diluted EPS | 1.01 | 1.52 | 0.99 | 1.29 | 0.90 | 0.46 | SEC (XBRL)· 12 Mar 2026verified |
| Weighted average diluted shares | 37.4 m | 45.4 m | 45.6 m | 46.9 m | 48.0 m | 49.4 m | SEC (XBRL)· 12 Mar 2026verified |
≈ computed by olivLaw from the reported lines of the same year: Revenue − Cost of revenue; Operating income + Depreciation & amortisation.
Balance sheet · USD
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Cash | 193.5 m | 233.1 m | 288.0 m | 293.8 m | 288.5 m | 429.5 m | SEC (XBRL)· 12 Mar 2026verified |
| Receivables | 7.1 m | 10.6 m | 49.6 m | — | 276.0 m | 374.5 m | SEC (XBRL)· 12 Mar 2026verified |
| Current assets | 338.6 m | 404.5 m | 428.1 m | 461.5 m | 638.5 m | 863.3 m | SEC (XBRL)· 12 Mar 2026verified |
| Property, plant & equipment, net | — | — | — | — | 14.3 m | 57.3 m | SEC (XBRL)· 12 Mar 2026verified |
| Goodwill | 232.4 m | 246.4 m | 269.1 m | 278.8 m | 419.3 m | 865.3 m | SEC (XBRL)· 12 Mar 2026verified |
| Intangibles (excl. goodwill) | 87.0 m | 82.8 m | 76.9 m | 71.6 m | 118.2 m | 271.0 m | SEC (XBRL)· 12 Mar 2026verified |
| Total assets | 817.5 m | 867.4 m | 966.2 m | 933.4 m | 1.4 bn | 2.2 bn | SEC (XBRL)· 12 Mar 2026verified |
| Accounts payable | 9.6 m | 9.6 m | 49.6 m | 59.9 m | 106.1 m | 195.9 m | SEC (XBRL)· 12 Mar 2026verified |
| Short-term debt | 10.9 m | 780.0 k | 619.0 k | 19.5 m | 9.4 m | 47.9 m | SEC (XBRL)· 12 Mar 2026verified |
| Long-term debt | 230.2 m | 182.9 m | 203.4 m | 258.9 m | 425.3 m | 990.9 m | SEC (XBRL)· 12 Mar 2026verified |
| Current liabilities | 115.0 m | 114.7 m | 148.6 m | 218.7 m | 365.6 m | 615.3 m | SEC (XBRL)· 12 Mar 2026verified |
| Total liabilities | 372.3 m | 356.7 m | 407.7 m | 522.6 m | 840.7 m | 1.7 bn | SEC (XBRL)· 12 Mar 2026verified |
| Equity | 329.5 m | 454.1 m | 544.3 m | 616.7 m | 716.7 m | 793.3 m | SEC (XBRL)· 12 Mar 2026verified |
Cash flow · USD
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Operating cash flow | 46.2 m | 70.3 m | 82.1 m | 68.2 m | 52.2 m | 114.6 m | SEC (XBRL)· 12 Mar 2026verified |
| Capex | 1.2 m | 19.2 m | 22.9 m | 28.5 m | 8.0 m | 10.1 m | SEC (XBRL)· 12 Mar 2026verified |
| Free cash flow | 45.0 m ≈ | 51.1 m ≈ | 59.2 m ≈ | 39.7 m ≈ | 44.2 m ≈ | 104.5 m ≈ | SEC (XBRL)· 12 Mar 2026derived |
| Investing cash flow | 95.5 m | 16.5 m | -7.1 m | -65.5 m | -192.4 m | -539.0 m | SEC (XBRL)· 12 Mar 2026verified |
| Financing cash flow | -51.7 m | -47.7 m | -20.1 m | 3.4 m | 135.1 m | 569.3 m | SEC (XBRL)· 12 Mar 2026verified |
| Dividends paid | 51.3 m | 31.1 m | 14.0 m | 62.1 m | 4.0 m | 7.9 m | SEC (XBRL)· 12 Mar 2026verified |
| Share repurchases | 537.0 k | 5.7 m | 9.3 m | 10.2 m | 900.0 k | 25.6 m | SEC (XBRL)· 12 Mar 2026verified |
≈ computed by olivLaw from the reported lines of the same year: Operating cash flow − Capex.
Computed indicators
Growth
Profitability
Returns
Balance sheet
Liquidity
Cash
Efficiency
Market and valuation
1 indicators that do not apply to the sector.
Valuation
olivLaw classification
Score: 43 / 100
A scoring methodology on indicators and valuation, not investment advice.
Closing price
04 Nov 2026Source: olivLaw, closing series
Market cap: 2.2 bn USD
Key indicators
Coverage and freshness
Score by group
- Valuation35
- Balance sheet21
- Quality66
- Growth50
- Returns48
Estimated value range
The combined range = the median of the valid methods' low, central and high values; it is not a probability interval and does not cover every result. Envelope of all methods: 11.02 – 79.99 USD.
Valuation assumptions are editorial choices, not measured; beta is not measured.
Method ranges (USD per share)
— — Mid · ▏ Price
Valuation methods
- DCF (discounted cash flow)41.25 – 79.99 (Mid 55.05)WACC 7.7% · starting FCFF 138.3 m USD · terminal value share of EV 79%The WACC × g sensitivity gives the method's bounds; these are not probabilities.Reverse DCF: starting growth implied by the price (fading linearly to terminal growth, everything else fixed): 2.8%
- Peers: EV/EBITDA25.47 – 36.09 (Mid 34.23)9 companies used · median multiple 14.9x · quartiles 12.0x – 15.6xACCS, BAH, BWMN, FCN, HCKT, HURN, ICFI, III, ONT
- Peers: P/E11.02 – 20.39 (Mid 16.03)12 companies used · median multiple 19.5x · quartiles 13.4x – 24.8xAERT, BAH, EXPO, FCN, G, HCKT, HURN, ICFI, III, RMR, TSSI, ZTG
- Dividend discount (DDM)unavailable · input data missing
Classification (SIC) comparables group by industry code, not by economic activity; the direct group is an editorial selection by activity. Members' multiples are on their own trailing twelve months, at their own latest close.
Assumptions (illustrative, editorial)
- Risk-free rate
- 4.3%
- Equity risk premium
- 5.0%
- Beta (default)
- 1.00
- Cost of equity
- 9.3%
- Terminal growth
- 2.5%
Factor scorecard
Neutral profile · Score 43/100
| Factor | Value | Score | Weight used |
|---|---|---|---|
| ROIC · Quality | 5.9% | 56 (vs peers) | 10% |
| Net margin · Quality | 1.1% | 48 (vs peers) | 6% |
| FCF conversion · Quality | 232.8% | 100 (on a fixed band) | 6% |
| Revenue CAGR 3Y · Growth | 40.6% | 100 (on a fixed band) | 8% |
| EPS CAGR 3Y · Growth | -22.5% | 0 (on a fixed band) | 8% |
| Net debt / EBITDA · Balance sheet | 3.3x | 27 (vs peers) | 10% |
| Interest coverage · Balance sheet | 1.5x | 0 (on a fixed band) | 6% |
| Current ratio · Balance sheet | 1.2x | 36 (on a fixed band) | 4% |
| P/E (TTM) · Valuation | 48.3x | 29 (vs peers) | 10% |
| EV/EBITDA · Valuation | 16.8x | 27 (vs peers) | 10% |
| FCF yield · Valuation | 4.3% | 53 (on a fixed band) | 8% |
| Shareholder yield (distributions) · Returns | 0.9% | 13 (on a fixed band) | 6% |
| Payout ratio (FCF) · Returns | 2.0% | 100 (on a fixed band) | 4% |
Score groups
- Balance sheet21/100 · 3/3 factors with a value
- Growth50/100 · 2/2 factors with a value
- Quality66/100 · 3/3 factors with a value
- Returns48/100 · 2/2 factors with a value
- Valuation35/100 · 3/3 factors with a value
Memo
Astrana Health, Inc. (ASTH). Latest full fiscal year: 2025; data up to 2026-06-30.
Figures computed from the financial statements: revenue 3.2 bn USD in 2025; YoY growth 56.4%; net margin 1.1%; ROE 5.1%; net debt/EBITDA 3.3x.
The estimated value range is 25.47–36.09 USD per share (median of 3 methods, agreement: low); assumptions are illustrative. Against the central value of 34.23 USD, the price of 39.67 USD leaves a potential of -13.7% (value / price − 1) and a margin of safety of -15.9% (1 − price / value). The range is the median of the methods' low, central and high values, not a probability interval.
olivLaw score 43/100, methodological classification: neutral profile (score, margin of safety and method agreement together; not a judgement of the right price). Not investment advice.
Text generated deterministically from the figures shown; no language model. Not investment advice.
What supports the thesis
- FCF conversion: 232.8%
- Revenue CAGR 3Y: 40.6%
- Payout ratio (FCF): 2.0%
What contradicts it
- EPS CAGR 3Y: -22.5%
- Net debt / EBITDA: 3.3x
- Interest coverage: 1.5x
- P/E (TTM): 48.3x
- EV/EBITDA: 16.8x
- Shareholder yield (distributions): 0.9%
- The price is above the estimated value range
- The valuation methods diverge
Versus the vertical median
Services-Management Consulting Services (SIC 8742) · same industry (4-digit SIC) · compared with 33 companies
Multiples and returns vs the median
Price rebased to 100 (monthly, 5 years)
Companies in the vertical
| Market cap | P/E | ROE | Net margin | Revenue YoY | 1A / 3A | |
|---|---|---|---|---|---|---|
| BAHBooz Allen Hamilton Holding Corporation | 10.5 bn | 13.7 | 70.0% | 7.1% | −6.4% | +6% / −29% |
| GGenpact Limited | 6.9 bn | 12.1 | 22.4% | 11.1% | +6.6% | −7% / +20% |
| FCNFti Consulting, Inc | 5.4 bn | 24.7 | 15.2% | 5.9% | +2.4% | +22% / −10% |
| EXPOExponent, Inc. | 4.2 bn | 39.2 | 31.2% | 17.7% | +4.2% | +21% / +14% |
| HURNHuron Consulting Group Inc. | 2.7 bn | 25.8 | 25.5% | 6.1% | +11.7% | +5% / +66% |
| ASTHAstrana Health, Inc. | 2.2 bn | 48.3 | 5.1% | 1.1% | +56.4% | +20% / +24% |
| ICFIICF International, Inc. | 1.7 bn | 20.1 | 8.6% | 4.9% | −7.3% | +24% / −31% |
| BWMNBowman Consulting Group Ltd. | 744.2 m | 105.3 | 2.9% | 1.4% | +14.9% | +19% / +39% |
| ONTOnterris, Inc. | 566.4 m | — | -2.5% | -1.4% | +19.3% | −37% / −48% |
| PPHCPublic Policy Holding Company, Inc. | 381.3 m | — | -39.5% | -18.9% | +24.7% | unavailable / unavailable |
| HCKTHackett Group, Inc. | 329.4 m | 19.0 | 20.7% | 6.3% | −2.6% | −28% / −40% |
| IIIInformation Services Group Inc. | 289.5 m | 25.2 | 12.7% | 4.7% | −1.2% | +13% / +46% |
| AERTAeries Technology, Inc. | 282.0 m | 20.9 | — | 3.6% | −0.3% | +35% / −68% |
| RMRRmr Group Inc. | 250.5 m | 12.6 | 8.7% | 3.1% | −22.0% | +10% / −30% |
| SUPXSuperx Ai Technology Limited | 209.8 m | — | -101.8% | -527.7% | +1,878.6% | −84% / unavailable |
| TSSITss, Inc. | 193.3 m | 14.1 | 32.0% | 7.4% | +65.9% | −29% / +1,976% |
| GRNQGreenpro Capital Corp. | 122.4 m | — | -26.8% | -169.6% | −40.7% | −57% / −19% |
| AUCAtif Holdings Limited | 109.4 m | — | -90.5% | -723.7% | −74.7% | −12% / −70% |
| ROMARoma Green Finance Limited | 101.0 m | — | -44.2% | -287.8% | −22.2% | +138% / unavailable |
| RTBRTB Digital, INC. | 92.6 m | — | -141.9% | -198.5% | −38.7% | −49% / −94% |
| MHHMastech Digital, Inc. | 74.9 m | 71.0 | 1.3% | 0.7% | −3.8% | −21% / −27% |
| EGGEnigmatig Ltd | 64.8 m | 268.0 | 6.3% | 12.6% | +12.2% | +40% / unavailable |
| CTMCastellum, Inc. | 46.4 m | — | -6.8% | -4.1% | +18.1% | −53% / +123% |
| ACCLAcco Group Holdings Limited | 34.9 m | 119.0 | 7.0% | 5.6% | +5.8% | −38% / unavailable |
| INTJIntelligent Group Limited | 33.5 m | — | -23.5% | -98.3% | −9.0% | −72% / unavailable |
1- and 3-year price returns: for ASTH from daily closes (the same as the performance table), for the other companies from month-end closes.
olivLaw engine forecast
The world engine ran after the company's latest material disclosure. Probabilities are of TOUCHING a level within the horizon (not closing there) and sit next to the random walk (p_rw), the no-information benchmark.
The engine has no published run for this company yet.
Valuation scenarios (editable assumptions)
Illustrative scenarios
Illustrative: not forecasts and without probabilities. Each case is one coherent set of assumptions, computed on today's figures.
Estimated price (USD)
| Estimated price | Bear | Base | Bull |
|---|---|---|---|
| 1 years | 22.97 Total return -42% · Per year -42% | 40.42 Total return 2% · Per year 2% | 60.63 Total return 53% · Per year 53% |
| 3 years | 27.24 Total return -31% · Per year -12% | 53.45 Total return 35% · Per year 10% | 87.30 Total return 120% · Per year 30% |
| 5 years | 32.31 Total return -19% · Per year -4% | 70.69 Total return 78% · Per year 12% | 125.72 Total return 217% · Per year 26% |
- Exit P/E± 13.36
- Net margin± 9.35
- Annual revenue growth± 6.98
- Annual dilution± 0.79
AI analysis
AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.
In brief
Astrana Health is a physician-centric, technology-powered, risk-bearing healthcare company that coordinates patient care under value-based arrangements, mainly in California. Revenue reached over 3,181.8 million USD in 2025, at a time when US healthcare spending keeps rising.
SWOT
Strengths
- A large provider network and a physician-centric model give a solid base for value-based care 1.
- A proprietary technology platform and management services entities allow centralised handling of non-medical services 1.
- Operating cash flow improved in the first half of 2026, supporting funding of growth 3.
Weaknesses
- Reliance on a limited number of payers and on the California market makes the company vulnerable to local shifts 1.
- Higher borrowing after the Prospect acquisition increased interest costs and reduced financial flexibility 1.
- The Care Delivery segment posted an operating loss in the second quarter of 2026 3.
Opportunities
Threats
- Regulatory changes to Medicaid and Medicare could reduce rates or patient volumes 1.
- Rising medical costs can exceed the fixed amounts received under capitation contracts, which could produce losses 1.
- The company reported a material weakness in internal control, and timely remediation is not assured 3.
Risks
- Debt after the Prospect acquisitionhigh
Financing the acquisition substantially increased debt, which could limit flexibility and add pressure on cash flow 1.
- Integration of Prospecthigh
Difficulties integrating the acquired operations could prevent the expected synergies from being realised 1.
- Geographic concentrationmedium
Revenue is generated mainly in California, so regulatory changes in that state could affect results 1.
- Capitation contract riskmedium
If expenses exceed capitation revenue, the company could record significant losses 1.
- Internal control weaknessmedium
The company identified a material weakness in financial reporting controls, and remediation could take time 3.
Investment thesis
What would need to be true (bull case)
- If revenue and adjusted EBITDA growth holds, the company could turn recent acquisitions into durable earnings 13.
- Raising 2026 adjusted EBITDA guidance signals management's confidence in the company's earnings power 3.
- Solid free cash flow provides a base for reinvestment and gradual debt reduction 3.
What would break the thesis
What to watch
- Results for the quarter ending September 30, 2026 against revenue and EBITDA guidanceQ3 2026
- Final CMS decision on 2027 Medicare Advantage rates and impact on the Medicare line2027
- Debt level and interest expense after the Prospect acquisitionQ4 2026
Products, market & competition
AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.
The business
Astrana Health, Inc. (ASTH, Nasdaq) describes itself as a physician-centric, technology-powered, risk-bearing healthcare company operating an integrated healthcare delivery platform. Through its risk-bearing organizations and affiliated physician groups, it was coordinating care for approximately 1.6 million patients as of December 31, 2025, with a network of more than 20,000 contracted physicians 1. The company says it helps independent providers remain independent while succeeding in value-based care 1.
Its model relies on capitation contracts, under which affiliated IPAs receive a fixed amount per member per month and assume the financial risk of costs above that amount 1. To comply with corporate practice of medicine laws, Astrana works through long-term management services agreements with physician-owned affiliated IPAs and medical groups 1. Revenue growth in 2025 was largely driven by the Prospect acquisition, completed July 1, 2025 for a purchase price of 674.9 million USD 1.
Recent results show growth continuing into 2026. In the second quarter, revenue was 972.5 million USD, up 49% year over year, and adjusted EBITDA was 68.9 million USD 3. For fiscal 2026, management raised adjusted EBITDA guidance to a range of 255 to 280 million USD 3.
Market context
Trends
- Shift to value-based caretailwind
The US healthcare system is moving toward models that pay providers for outcomes and efficiency, which favours coordinated networks such as Astrana's 1.
- Medicaid reform under OBBBAheadwind
The One Big Beautiful Bill Act introduces Medicaid work requirements and tighter provider tax rules starting in 2026, which management considers manageable 1.
- Medicare Advantage rate changesmixed
CMS's proposed 2027 payment rates could affect the Medicare line of business, though the company expects a smaller impact than for the broader Medicare Advantage market 1.
- Integration of acquisitionsmixed
The Prospect acquisition added substantial revenue but also brings integration risks and higher debt that could weigh on results if not managed well 1.
Competitive position
Astrana competes with other companies building risk-bearing provider networks and physician management services, both nationally and in California. The analysed sources do not explicitly name competitors, so the list below reflects only the companies and groups mentioned in the available documents.
The company's stated advantages are the scale of its provider network, its proprietary technology infrastructure and its contracts with health plans, elements it considers difficult to replicate 1. Competitive pressure can also come from payers who manage risk directly 1.
- Intermountain Health
Non-profit health system with which Astrana collaborated in southern Nevada, so it is more a partner than a direct rival.
- Other ACO and IPA operators in California
Organisations running similar risk-bearing provider networks in the same market, not named individually in the source.
- Health plans and payers managing risk in-house
Payers could try to bring care coordination functions in-house, which could reduce demand for the company's services.
Links, dependencies and risks
Who the company is tied to, from its own SEC filings (customers, suppliers, production, partners, competitors, countries, regulation), from the 5 %+ holders' statements (13D/13G) and from what other companies say about it. Click a node for its evidence; on a listed company the graph moves to it.
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News & filings
In the press
- Astrana latest healthcare tech firm to report data breach to SECThe Record (Recorded Future) · 24 Sept 2026 · EN
- Astrana Health Data Breach Impacts Private, Confidential InformationSecurityWeek · 24 Sept 2026 · EN
- Here’s What Boosted Astrana Health (ASTH) in Q2Yahoo Finance — News · 03 Sept 2026 · EN
SEC filings
- Current report23 Sept 2026Regulation FD disclosure · Financial statements and exhibits
- Current report23 Sept 2026Material cybersecurity incident
- Current report15 Sept 2026Regulation FD disclosure · Financial statements and exhibits
- Quarterly report10 Aug 2026
- Current report06 Aug 2026Results of operations · Regulation FD disclosure · Financial statements and exhibits
- Current report13 Jul 2026Regulation FD disclosure · Financial statements and exhibits
- Current report01 Jul 2026Departure or appointment of officers
- Current report10 Jun 2026Departure or appointment of officers · Shareholder vote · Financial statements and exhibits
- Current report12 May 2026Departure or appointment of officers
- Current report12 May 2026Regulation FD disclosure · Financial statements and exhibits
Sources
- [1] Form 10-K, fiscal year ended 2025-12-31 · SEC / Astrana Health, Inc. · 12 Mar 2026
- [2] Form 10-Q, quarter ended 2026-06-30 · SEC / Astrana Health, Inc. · 10 Aug 2026
- [3] Form 8-K, results release (exhibit 99.1) · SEC / Astrana Health, Inc. · 06 Aug 2026
Figures computed by olivLaw from SEC filings and closing prices; the qualitative analysis is AI-generated from cited sources. Not investment advice.