Astrana Health, Inc. (NASDAQ: ASTH)

Sector: Healthcare Industry: Medical Care Facilities CIK: 0001083446
Market Cap 916.51 Mn
P/B 1.18
P/E 96.10
P/S 0.32
ROIC (Qtr) 0.30
Div Yield % 0.00
Rev 1y % (Qtr) 99.71
Total Debt (Qtr) 1.09 Bn
Debt/Equity (Qtr) 1.40
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About

Investment thesis

Bull case

  • Healthy cash reserves of 462.23M provide 8.40x coverage of short-term debt 55.05M, demonstrating strong liquidity position and minimal refinancing risk.
  • Operating cash flow of 106.53M provides exceptional 532.67x coverage of minority interest expenses 200000, showing strong core operations.
  • Robust free cash flow of 96.96M exceeds capital expenditure of 9.57M by 10.13x, indicating strong organic growth funding capability.
  • Cash position of 462.23M provides exceptional 2311.14x coverage of minority interest expenses 200000, indicating strong liquidity.
  • Operating cash flow of 106.53M fully covers other non-current liabilities 20.34M by 5.24x, showing strong long-term stability.

Bear case

  • Operating cash flow of 106.53M barely covers its investment activities of (571.27M), with a coverage ratio of -0.19, indicating heavy reliance on external financing for growth which may not be sustainable in a tighter credit environment.
  • Operating cash flow of 106.53M provides thin coverage of dividend payments of (8.25M) with a -12.91 ratio, suggesting potential dividend sustainability issues if operational performance deteriorates.
  • Cash reserves of 462.23M provide limited coverage of acquisition spending of (579.32M), which is -0.80x, suggesting aggressive expansion might strain liquidity if market conditions deteriorate.
  • The company's operating cash flow of 106.53M shows concerning coverage of stock compensation expenses of 42.45M, with a 2.51 ratio indicating potential earnings quality issues.
  • Operating earnings of 70.48M show weak coverage of depreciation charges of 43.15M, with a 1.63 ratio indicating high capital intensity and potential reinvestment needs.

Subsegments Breakdown of Revenue (2024)

Customer Breakdown of Revenue (2024)

Peer comparison

Companies in the Medical Care Facilities
S.No. Ticker Company Market Cap P/E P/S Total Debt (Qtr)
1 HCA HCA Healthcare, Inc. 126.41 Bn 18.63 1.67 48.35 Bn
2 UHS Universal Health Services Inc 23.26 Bn 34.22 2.61 5.11 Bn
3 THC Tenet Healthcare Corp 21.11 Bn 15.01 0.99 13.17 Bn
4 FMS Fresenius Medical Care AG 14.42 Bn 17.06 0.62 14.98 Bn
5 EHC Encompass Health Corp 13.38 Bn 30.01 2.91 2.66 Bn
6 ENSG Ensign Group, Inc 12.18 Bn 35.41 2.41 2.21 Bn
7 DVA Davita Inc. 11.17 Bn 14.95 0.82 12.87 Bn
8 CHE Chemed Corp 8.11 Bn 81.70 5.57 0.14 Bn

Industry comparisons

Current Valuation Value Ind Avg Percentile
EV to Assets EV to Assets 0.46 1.24
EV to Cash from Ops. EV/CFO 9.62 15.08
EV to Debt EV to Debt 0.94 11.01
EV to EBIT EV/EBIT 14.53 15.96
EV to EBITDA EV/EBITDA 9.85 11.44
EV to Free Cash Flow [EV/FCF] EV/FCF 10.56 21.76
EV to Market Cap EV to Market Cap 1.12 619.57
EV to Revenue EV/Rev 0.35 2.71
Price to Book Value [P/B] P/B 1.18 -6.00
Price to Earnings [P/E] P/E 96.10 12.61
Dividend Metrics Value Ind Avg Percentile
Dividend Coverage Ratio Div Coverage (Qtr) 1.16 0.14
Dividend Payout Ratio % Div Payout % (Qtr) 0.00 -13.46
Dividend per Basic Share Div per Share (Qtr) 0.00 0.27
FCF Dividend Payout Ratio % FCF Div Payout % (Qtr) 0.00 5.42
Interest Coverage Int. cover (Qtr) 1.74 -94.29
Growth Metrics Value Ind Avg Percentile
Capex Growth (1y) % Capex 1y % (Qtr) 23.76 -116.62
Cash and Equivalents Growth (1y) % Cash & Equiv 1y % (Qtr) 32.83 46.03
Dividend Growth (1y) % Dividend Growth (1y) % 0.00 0.98
EBIAT Growth (1y) % EBIAT 1y % (Qtr) -73.31 -42.57
EBITDA Growth (1y) % EBITDA 1y % (Qtr) -9.85 91.55
EBIT Growth (1y) % EBIT 1y % (Qtr) -40.74 -56.79
EBT Growth (1y) % EBT 1y % (Qtr) -66.09 -111.80
EPS Growth (1y) % EPS 1y % (Qtr) -84.73 -19.28
FCF Growth (1y) % FCF 1y % (Qtr) 38.74 188.37
Gross Profit Growth (1y) % Gross Profit 1y % (Qtr) 14.27 20.14
Liquidity Ratios Value Ind Avg Percentile
Asset Utilization Ratio Asset Util Ratio (Qtr) 1.29 1.02
Cash Payout Ratio Cash Payout (Qtr) 0.07 0.04
Cash Ratio Cash Ratio (Qtr) 0.73 0.40
Current Ratio Curr Ratio (Qtr) 1.40 1.36
Debt to Equity Ratio Debt/Equity (Qtr) 1.40 -13.23
Interest Cover Ratio Int Coverage (Qtr) 1.74 -94.29
Times Interest Earned Times Interest Earned (Qtr) 1.74 -94.29
Profitability Value Ind Avg Percentile
EBITDA Margin % EBITDA Margin % (Qtr) 3.90 -75.46
EBIT Margin % EBIT Margin % (Qtr) 2.43 -74.60
EBT Margin % EBT Margin % (Qtr) 1.04 -85.12
Gross Margin % Gross Margin % (Qtr) 10.30 23.17
Net Profit Margin % Net Margin % (Qtr) 0.30 -85.79