Astrana Health (ASTH) stock price is $36.90, up 0.24% on the day, as of Oct 19, 2026. It has a market cap of $1.81Bn and a P/E ratio of 44.66, and is classified in the Managed Care industry (Healthcare sector).
Enterprise Value
Margins
P/FCF
Key Stats
Market Cap1.81 Bn
P/E44.66
P/S0.47
Div. Yield0.00
Total Debt (Qtr)936.50 Mn
Revenue Growth (1y) (Qtr)48.52
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About
Astrana Health, Inc. is a provider centric technology powered risk bearing healthcare company that operates an integrated healthcare delivery platform enabling physicians to participate in value based care arrangements. The company leverages its proprietary end to end technology solutions to support coordinated outcomes based medical care for patients across multiple states. Together with its affiliated physician groups and consolidated entities it serves patients covered by…
Astrana Health, Inc. is a provider centric technology powered risk bearing healthcare company that operates an integrated healthcare delivery platform enabling physicians to participate in value based care arrangements. The company leverages its proprietary end to end technology solutions to support coordinated outcomes based medical care for patients across multiple states. Together with its affiliated physician groups and consolidated entities it serves patients covered by private or public insurance including Medicare Medicaid and health maintenance organizations with a small portion from non insured individuals. As of December 31 2024 the company managed care for approximately 1.1 million patients through a network of more than 10 000 contracted physicians. This positions Astrana to benefit from the industry shift toward value based and results oriented healthcare focused on patient satisfaction high quality care and cost efficiency.
Astrana generates revenue from four primary streams including capitation revenue risk pool settlements and incentives management fee income and fee for service revenue. Capitation revenue consists of fixed payments received from health maintenance organizations for assuming responsibility to provide medical services to enrolled members under capitated arrangements. Risk pool settlements and incentives are earned when the company shares in surpluses from risk sharing agreements with hospitals and health plans and receives payments for quality performance programs. Management fee income is derived from fees paid for administrative and non medical services provided to affiliated physician groups accountable care organizations hospitals and other healthcare providers. Fee for service revenue is generated when the company bills and collects payments for the professional component of medical services rendered by its contracted physicians.
The company operates through the following segments: Care Partners Care Delivery and Care Enablement.
The Care Partners segment focuses on building and managing high performance provider networks by partnering with independent physicians and enabling them to succeed in value based care arrangements while acting as a single payer for the network and organizing risk bearing entities such as independent practice associations accountable care organizations and state licensed health plans to coordinate care for patients.
The Care Delivery segment operates a patient centric data driven organization that provides high quality accessible care through more than 60 clinics located in three states offering primary care specialty care and ancillary services such as urgent care imaging ambulatory surgery and laboratory services.
The Care Enablement segment supplies a comprehensive technology platform that integrates clinical operational financial and administrative data to support value based care delivery for internal and external providers and includes management service organizations that provide non medical functions such as physician recruitment contracting claims processing and revenue cycle management.
Astrana holds a competitive position in the U. S. healthcare services sector by combining clinical expertise administrative support and proprietary technology to serve a large patient base under value based models. The company faces competition from large integrated health systems such as Optum UnitedHealth Group and from regional physician groups and management service organizations like Conifer Health Solutions. Its advantages stem from a combined offering of clinical care management technology and data analytics that enables it to reduce costs while improving quality for health plans and providers. Additionally the company’s long standing relationships with health plans hospitals and independent physician groups provide a stable source of recurring revenue and barrier to entry for new entrants.
The company serves a diverse customer base that includes individual patients receiving medical care through its clinics and provider networks as well as health maintenance organizations hospitals and accountable care organizations that contract for capitation management and other services. These customers are located primarily in California Nevada Texas Maryland Connecticut Georgia and Hawaii where the company maintains its provider and facility footprint.
Sector:HealthcareSector rationaleAstrana Health operates as a risk-bearing healthcare company that provides medical services through its own clinics and a network of contracted physicians. Its revenue is primarily derived from capitation payments, fee-for-service medical billing, and risk pool settlements for patient care, which aligns directly with the Healthcare sector's scope of delivering patient care and healthcare services.Industries:Managed CareManaged CarePrimaryAstrana Health is a risk-bearing healthcare company that generates significant revenue from capitation payments and risk pool settlements, assuming financial responsibility for patient care. It organizes risk-bearing entities such as state-licensed health plans and acts as a single payer for its network, which aligns with the managed care and insurance risk-bearing model.Healthcare ServicesHealthcare ServicesSecondaryThe company's Care Delivery segment operates more than 60 clinics providing primary care, specialty care, urgent care, imaging, and ambulatory surgery. These are outpatient services delivered in a clinic setting, generating fee-for-service revenue.Classified using BQ-MICSCIK: 0001083446
Bull & bear
Investment Thesis
▲ Bull case
Astrana’s AI enabled platform is not a collection of point solutions but a fully integrated operating system that ties together claims processing prior authorization care management and clinical decision support within a single data ontology. This architecture allows the company to capture longitudinal patient data across payer lines and settings which continuously refines its risk prediction models and next best action recommendations. As more members flow through the platform the models become sharper leading to lower medical cost trends and higher gap closure rates without proportional increases in administrative expense. The result is a self reinforcing cycle where better clinical outcomes generate more predictable financial performance and the platform’s value compounds over time.
The company has moved approximately 40% of its membership and 80% of its care partners revenue into full risk arrangements well ahead of the original conversion timeline. This shift translates into a higher percentage of premium captured per member while creating strong incentives to manage inpatient utilization and overall cost of care. Early performance of the new full risk cohorts shows medical cost trends tracking at or below the 5.2% blended assumption indicating disciplined underwriting. As these cohorts mature the margin profile is expected to converge with that of partial risk businesses unlocking additional operating leverage and free cash flow generation.
Integration of the Prospect acquisition is progressing faster than expected with gross provider retention above 99% and the company tracking toward the high end of its twelve to fifteen million dollar annual synergy target. Beyond cost synergies the combined network offers denser provider coverage and improved access to care which can generate revenue synergies that have not yet been quantified. The ability to onboard Prospect onto the Astrana operating system demonstrates the platform’s scalability and its capacity to assimilate acquired assets without disruption. As the integration continues the company expects to realize additional medical cost improvements and expanded market presence in its expansion geographies.
The care enablement business which sells Astrana’s AI powered workflow tools to external provider groups is growing rapidly and carries strong gross and EBITDA margins. This segment not only creates a recurring revenue stream but also serves as a validation of the platform’s utility outside the company’s owned networks. Management has highlighted that the Quality Adjustment Fund (HQAF) contribution remains excluded from guidance due to timing uncertainty but could provide a meaningful uplift to earnings once realized. The combination of internal margin expansion from AI driven efficiencies and external monetization of the platform creates multiple levers for earnings growth that are not fully reflected in current consensus estimates.
Net leverage has fallen to approximately 2.3 times on a pro forma trailing twelve month basis and is projected to reach or fall below 2.0 times by year end well ahead of the original 24 month target set after the Prospect transaction. This rapid deleveraging improves the company’s financial flexibility and reduces interest expense pressure on future earnings. Strong free cash flow generation in the first quarter of over sixty four million dollars underscores the durability of the operating model even as integration costs decline. With a healthier balance sheet Astrana can consider opportunistic share repurchases or selective tuck in acquisitions without compromising its deleveraging goals.
Astrana’s AI enabled platform is not a collection of point solutions but a fully integrated operating system that ties together claims processing prior authorization care management and clinical decision support within a single data ontology. This architecture allows the company to capture longitudinal patient data across payer lines and settings which continuously refines its risk prediction models and next best action recommendations. As more members flow through the platform the models become sharper leading to lower medical cost trends and higher gap closure rates without proportional increases in administrative expense. The result is a self reinforcing cycle where better clinical outcomes generate more predictable financial performance and the platform’s value compounds over time.
The company has moved approximately 40% of its membership and 80% of its care partners revenue into full risk arrangements well ahead of the original conversion timeline. This shift translates into a higher percentage of premium captured per member while creating strong incentives to manage inpatient utilization and overall cost of care. Early performance of the new full risk cohorts shows medical cost trends tracking at or below the 5.2% blended assumption indicating disciplined underwriting. As these cohorts mature the margin profile is expected to converge with that of partial risk businesses unlocking additional operating leverage and free cash flow generation.
Integration of the Prospect acquisition is progressing faster than expected with gross provider retention above 99% and the company tracking toward the high end of its twelve to fifteen million dollar annual synergy target. Beyond cost synergies the combined network offers denser provider coverage and improved access to care which can generate revenue synergies that have not yet been quantified. The ability to onboard Prospect onto the Astrana operating system demonstrates the platform’s scalability and its capacity to assimilate acquired assets without disruption. As the integration continues the company expects to realize additional medical cost improvements and expanded market presence in its expansion geographies.
The care enablement business which sells Astrana’s AI powered workflow tools to external provider groups is growing rapidly and carries strong gross and EBITDA margins. This segment not only creates a recurring revenue stream but also serves as a validation of the platform’s utility outside the company’s owned networks. Management has highlighted that the Quality Adjustment Fund (HQAF) contribution remains excluded from guidance due to timing uncertainty but could provide a meaningful uplift to earnings once realized. The combination of internal margin expansion from AI driven efficiencies and external monetization of the platform creates multiple levers for earnings growth that are not fully reflected in current consensus estimates.
Net leverage has fallen to approximately 2.3 times on a pro forma trailing twelve month basis and is projected to reach or fall below 2.0 times by year end well ahead of the original 24 month target set after the Prospect transaction. This rapid deleveraging improves the company’s financial flexibility and reduces interest expense pressure on future earnings. Strong free cash flow generation in the first quarter of over sixty four million dollars underscores the durability of the operating model even as integration costs decline. With a healthier balance sheet Astrana can consider opportunistic share repurchases or selective tuck in acquisitions without compromising its deleveraging goals.
Medicaid membership trends remain a source of uncertainty with disenrollment tracking slightly ahead of the midpoint of the company’s range and acuity benefiting from lower than expected adverse selection which may not persist if enrollment patterns shift. The exchange business experienced attrition ahead of expectations earlier in the year although recent trends show improvement but the sustainability of this reversal is unproven. A sudden increase in adverse selection driven by macroeconomic pressures or changes in subsidy design could erode medical cost performance and increase volatility in earnings. Because the company’s guidance assumes a conservative outlook for these lines any better than expected outcome would be a positive surprise but the downside risk remains material to the overall forecast.
While the company reports that approximately 40% of members and 80% of care partners revenue are now in full risk arrangements the transition carries execution risk as the shift to full risk requires changes in provider behavior utilization management and financial oversight. Early cohorts have shown medical cost trends at or below assumptions but there is limited history of how these margins will evolve as the risk base expands and as newer contracts with different payer mixes are added. If the anticipated margin maturation does not occur as expected the company could experience lower than projected EBITDA margins despite higher premium percentages. Furthermore any missteps in care coordination or authorization processes under full risk could lead to increased medical costs and provider dissatisfaction.
Integration of Prospect is progressing quickly but the complexity of aligning disparate IT systems provider contracts and clinical workflows across a larger geographic footprint could uncover unforeseen costs or operational friction. The company has disclosed only cost synergies in the twelve to fifteen million dollar range and has not quantified potential revenue synergies leaving upside uncertain. If the integration process encounters delays or requires additional investments the anticipated synergies may be delayed or reduced impacting the earnings outlook. Moreover retaining provider loyalty at the reported above 99% rate may become challenging as the combined entity scales and faces competitive pressures in local markets.
Approximately eighty% of Astrana’s revenue continues to originate from California making the company highly exposed to state specific regulatory changes reimbursement rate adjustments and local market dynamics. Any adverse shift in California Medicaid policy or a deterioration in the state’s fiscal health could disproportionately affect earnings compared to a more geographically diversified peer group. While expansion into Texas and Southern Nevada is underway these markets still represent a small fraction of total membership and may take years to reach scale sufficient to meaningfully dilute California concentration. The company’s growth strategy remains dependent on successfully replicating its model outside of its home state which carries execution and market acceptance risks.
Management attributes a portion of the seventy basis point year over year improvement in G&A as a percentage of revenue to AI enabled tools but has not provided a precise quantification making it difficult to assess the true incremental benefit of these investments. Competitors with larger scale and deeper pockets are accelerating their own AI initiatives and may eventually narrow the technological gap that Astrana currently enjoys. If the AI driven efficiencies prove to be less durable or easier to replicate than suggested the company’s operating leverage assumptions could be overly optimistic. Additionally the focus on administrative automation may yield diminishing returns once low hanging fruit is captured leaving less room for further G&A compression.
Medicaid membership trends remain a source of uncertainty with disenrollment tracking slightly ahead of the midpoint of the company’s range and acuity benefiting from lower than expected adverse selection which may not persist if enrollment patterns shift. The exchange business experienced attrition ahead of expectations earlier in the year although recent trends show improvement but the sustainability of this reversal is unproven. A sudden increase in adverse selection driven by macroeconomic pressures or changes in subsidy design could erode medical cost performance and increase volatility in earnings. Because the company’s guidance assumes a conservative outlook for these lines any better than expected outcome would be a positive surprise but the downside risk remains material to the overall forecast.
While the company reports that approximately 40% of members and 80% of care partners revenue are now in full risk arrangements the transition carries execution risk as the shift to full risk requires changes in provider behavior utilization management and financial oversight. Early cohorts have shown medical cost trends at or below assumptions but there is limited history of how these margins will evolve as the risk base expands and as newer contracts with different payer mixes are added. If the anticipated margin maturation does not occur as expected the company could experience lower than projected EBITDA margins despite higher premium percentages. Furthermore any missteps in care coordination or authorization processes under full risk could lead to increased medical costs and provider dissatisfaction.
Integration of Prospect is progressing quickly but the complexity of aligning disparate IT systems provider contracts and clinical workflows across a larger geographic footprint could uncover unforeseen costs or operational friction. The company has disclosed only cost synergies in the twelve to fifteen million dollar range and has not quantified potential revenue synergies leaving upside uncertain. If the integration process encounters delays or requires additional investments the anticipated synergies may be delayed or reduced impacting the earnings outlook. Moreover retaining provider loyalty at the reported above 99% rate may become challenging as the combined entity scales and faces competitive pressures in local markets.
Approximately eighty% of Astrana’s revenue continues to originate from California making the company highly exposed to state specific regulatory changes reimbursement rate adjustments and local market dynamics. Any adverse shift in California Medicaid policy or a deterioration in the state’s fiscal health could disproportionately affect earnings compared to a more geographically diversified peer group. While expansion into Texas and Southern Nevada is underway these markets still represent a small fraction of total membership and may take years to reach scale sufficient to meaningfully dilute California concentration. The company’s growth strategy remains dependent on successfully replicating its model outside of its home state which carries execution and market acceptance risks.
Management attributes a portion of the seventy basis point year over year improvement in G&A as a percentage of revenue to AI enabled tools but has not provided a precise quantification making it difficult to assess the true incremental benefit of these investments. Competitors with larger scale and deeper pockets are accelerating their own AI initiatives and may eventually narrow the technological gap that Astrana currently enjoys. If the AI driven efficiencies prove to be less durable or easier to replicate than suggested the company’s operating leverage assumptions could be overly optimistic. Additionally the focus on administrative automation may yield diminishing returns once low hanging fruit is captured leaving less room for further G&A compression.