Open the filing on EDGARAstrana Health, Inc. Reports Third Quarter 2026 Results
Company to Host Conference Call on Thursday, November 5, 2026, at 2:30 p.m. PT/5:30 p.m. ET
- Reports record revenue of $1,023.6 million, up 7% year-over-year, net income of $20.3 million, up 1,782% year-over-year, and record adjusted EBITDA of $77.2 million, up 13% year-over-year for the three months ended September 30, 2026
- Reports net cash provided by operating activities of $117.1 million and free cash flow of $105.4 million for the nine months ended September 30, 2026
ALHAMBRA, Calif., November 5, 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 third quarter ended September 30, 2026.
“Our third quarter results demonstrate the growing impact of Astrana’s physician-centric, AI-native healthcare operating platform and our team’s continued focus on execution,” said Brandon Sim, President and Chief Executive Officer of Astrana Health. “We delivered record revenue, record adjusted EBITDA, and double-digit organic earnings growth while continuing to invest in the next phase of our growth. By combining proprietary technology, aligned physician partnerships, and integrated care delivery, we’re building a scalable, repeatable model to improve patient outcomes and manage the total cost of care - a value proposition that extends across payer and reimbursement models and positions us to create sustainable long-term value for patients, physician partners, and shareholders.”
Financial Highlights for Third Quarter Ended September 30, 2026:
All comparisons are to the three months ended September 30, 2025 unless otherwise stated.
- Total revenue of $1,023.6 million, up 7% from $956.0 million
- Care Partners revenue of $968.8 million, up 8% from $897.7 million
- Net income attributable to Astrana of $13.0 million, up from $0.4 million
- Earnings per share (“EPS”) - diluted of $0.26, up from $0.01
- Adjusted EBITDA of $77.2 million, up 13% from $68.5 million
- Adjusted EPS - diluted of $0.71, up 4% from $0.68
Financial Highlights for Nine Months Ended September 30, 2026:
All comparisons are to the nine months ended September 30, 2025 unless otherwise stated.
- Total revenue of $2,961.2 million, up 33% from $2,231.2 million
- Care Partners revenue of $2,811.3 million, up 32% from $2,130.1 million
- Net income attributable to Astrana of $47.1 million, up 186% from $16.5 million
- EPS - diluted of $0.95, up 188% from $0.33
- Adjusted EBITDA of $212.4 million, up 39% from $153.0 million
- Adjusted EPS - diluted of $2.25, up 36% from $1.66
- Net cash provided by operating activities of $117.1 million
- Free cash flow of $105.4 million
See “Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin” and “Use of Non-GAAP Financial Measures” below for additional information.
See reconciliation provided with the condensed consolidated statements of cash flows and “Use of Non-GAAP Financial Measures” below for additional information.
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
- Closed the acquisition of an independent practice association in Georgia on October 1, 2026.
- Added two Care Enablement clients, a provider group in Connecticut and a hospital in California, with both expected to onboard onto Astrana's AI-powered technology and managed services platform in early 2027.
- Entered into several new Medicare Advantage payer partnerships effective January 1, 2027, with new health plan partners in markets including Southern California, Texas, and Arizona, supporting continued membership growth across the Astrana platform.
Segment Results for three months ended September 30, 2026:
All comparisons are to the three months ended September 30, 2025 unless otherwise stated.
| Three Months Ended September 30, 2026 |
|---|
| (in thousands) | Care Partners | Care Delivery | Care Enablement | Intersegment Elimination | Corporate Costs | Consolidated Total |
| Total revenues | $968,757 | $91,017 | $92,001 | $(128,159) | $ - | $1,023,616 |
| % change vs. prior year quarter | 8% | 5% | 5% | | | |
| Cost of services | 829,490 | 69,116 | 47,915 | (46,453) | - | 900,068 |
| General and administrative expenses | 77,694 | 22,229 | 18,425 | (81,713) | 31,412 | 68,047 |
| Depreciation and amortization | 12,480 | 1,263 | 1,226 | - | 653 | 15,622 |
| Total expenses | 919,664 | 92,608 | 67,566 | (128,166) | 32,065 | 983,737 |
| Income (loss) from operations | $49,093 | $(1,591) | $24,435 | $7 | $(32,065) | $39,879 |
| % change vs. prior year quarter | 94% | 56% | 4% | | | |
Income from operations for the intersegment elimination represents sublease income between segments. Sublease income is presented within other income, which is not presented in the table.
2026 Guidance:
Based on the Company’s existing business, current view of existing market conditions, and assumptions, the Company is providing guidance for total revenue and Adjusted EBITDA for the quarter ending December 31, 2026 and narrowing guidance for total revenue, Adjusted EBITDA, and free cash flow for the year ending December 31, 2026.
| Three Months Ending December 31, 2026 | Year Ending December 31, 2026 |
|---|
| Guidance Range | Guidance Range |
|---|
| ($ in millions) | Low | High | Low | High |
| Total revenue | $939 | $1,039 | $3,900 | $4,000 |
| Adjusted EBITDA | $48.5 | $61.5 | $261 | $274 |
| Free cash flow | | | $107.5 | $130 |
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, November 5, 2026), during which management will discuss the results of the third quarter ended September 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:
The conference call can also be accessed via webcast at: https://event.choruscall.com/mediaframe/webcast.html?webcastid=PPgZy93u
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
Forward-looking statements notice
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 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 investors@astranahealth.com
CONDENSED CONSOLIDATED BALANCE SHEETS
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)
| September 30, 2026 | December 31, 2025 |
|---|
| (Unaudited) | |
|---|
| Assets | | |
| Current assets | | |
| Cash and cash equivalents | $396,225 | $429,474 |
| Receivables, net (including amounts from related parties) | 530,889 | 374,465 |
| Income taxes receivable | - | 1,799 |
| Other receivables | 20,384 | 26,385 |
| Prepaid expenses and other current assets | 29,348 | 26,264 |
| Loans receivable | 3,128 | 4,926 |
| Total current assets | 979,974 | 863,313 |
| Non-current assets | | |
| Property and equipment, net | 66,103 | 57,332 |
| Intangible assets, net | 229,533 | 270,968 |
| Goodwill | 889,390 | 865,305 |
| Income taxes receivable, net of current portion | 26,220 | 26,220 |
| Loans receivable, net of current portion | 49,374 | 48,724 |
| Investments in other entities - equity method | 27,015 | 25,637 |
| Operating lease right-of-use assets | 48,308 | 35,738 |
| Other assets | 27,515 | 25,424 |
| Total non-current assets | 1,363,458 | 1,355,348 |
| Total assets | $2,343,432 | $2,218,661 |
| Liabilities, Mezzanine Deficit, and Stockholders’ Equity | | |
| Current liabilities | | |
| Accounts payable and accrued expenses | $272,541 | $195,912 |
| Fiduciary accounts payable | 3,694 | 3,524 |
| Income taxes payable | 2,561 | - |
| Medical liabilities | 418,181 | 335,705 |
| Operating lease liabilities | 10,612 | 7,809 |
| Current portion of long-term debt | 59,831 | 47,865 |
| Other liabilities | 18,648 | 24,458 |
| Total current liabilities | 786,068 | 615,273 |
| Non-current liabilities | | |
| Deferred tax liability | 7,635 | 5,491 |
| Operating lease liabilities, net of current portion | 41,392 | 31,552 |
| Long-term debt, net of current portion and deferred financing costs | 865,546 | 990,904 |
| Other long-term liabilities | 11,290 | 17,107 |
| Total non-current liabilities | 925,863 | 1,045,054 |
| Total liabilities | 1,711,931 | 1,660,327 |
| Mezzanine deficit | | |
| Non-controlling interest in Allied Physicians of California, a Professional Medical Corporation (“APC”) | (236,801) | (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 September 30, 2026 and December 31, 2025 | - | - |
| Common stock, $0.001 par value per share; 100,000,000 shares authorized, 49,320,378 and 48,885,358 shares issued and outstanding, excluding 10,724,258 and 10,571,011 treasury shares, as of September 30, 2026 and December 31, 2025, respectively | 49 | 49 |
| Additional paid-in capital | 501,366 | 470,863 |
| Retained earnings | 355,204 | 308,379 |
| Total stockholders’ equity | 856,619 | 779,291 |
| Non-controlling interests | 11,683 | 14,005 |
| Total equity | 868,302 | 793,296 |
| Total liabilities, mezzanine deficit, and stockholders’ equity | $2,343,432 | $2,218,661 |
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 $1,314.6 million and $1,276.5 million as of September 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 $382.6 million and $376.0 million as of September 30, 2026 and December 31, 2025, respectively, for which creditors do not have recourse to the general credit of Astrana Health, Inc., the VIE’s primary beneficiary. These VIE balances do not include $218.1 million of investment in affiliates and $8.6 million of amount due to affiliates as of September 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.
CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE AMOUNTS)
(UNAUDITED)
| Three Months Ended September 30, | Nine Months Ended September 30, |
|---|
| 2026 | 2025 | 2026 | 2025 |
|---|
| Revenue | | | | |
| Capitation and other revenue, net | $1,023,616 | $956,048 | $2,961,237 | $2,231,243 |
| Operating expenses | | | | |
| Cost of services, excluding depreciation and amortization | 900,068 | 858,856 | 2,627,923 | 1,984,756 |
| General and administrative expenses | 68,047 | 62,387 | 183,935 | 157,009 |
| Depreciation and amortization | 15,622 | 15,595 | 46,651 | 29,348 |
| Total expenses | 983,737 | 936,838 | 2,858,509 | 2,171,113 |
| Income from operations | 39,879 | 19,210 | 102,728 | 60,130 |
| Other expense | | | | |
| Income from equity method investments | 860 | 1,019 | 3,128 | 532 |
| Interest expense | (15,021) | (17,718) | (47,120) | (32,408) |
| Interest income | 4,147 | 3,522 | 13,870 | 8,170 |
| Unrealized gain (loss) on investments | 1,126 | (807) | 6,942 | (837) |
| Other income (loss) | 1,231 | 445 | (408) | (3,487) |
| Total other expense, net | (7,657) | (13,539) | (23,588) | (28,030) |
| Income before provision for income taxes | 32,222 | 5,671 | 79,140 | 32,100 |
| Provision for income taxes | 11,953 | 4,594 | 27,288 | 14,586 |
| Net income | 20,269 | 1,077 | 51,852 | 17,514 |
| Net income attributable to non-controlling interests | 7,317 | 704 | 4,725 | 1,026 |
| Net income attributable to Astrana Health, Inc. | $12,952 | $373 | $47,127 | $16,488 |
| Earnings per share - basic | $0.26 | $0.01 | $0.96 | $0.34 |
| Earnings per share - diluted | $0.26 | $0.01 | $0.95 | $0.33 |
| Weighted average shares of common stock outstanding - basic | 49,230,686 | 49,217,134 | 49,070,359 | 49,005,363 |
| Weighted average shares of common stock outstanding - diluted | 49,915,989 | 49,473,417 | 49,586,343 | 49,311,384 |
Revenue consisted of the following (in thousands):
| Three Months Ended September 30, | Nine Months Ended September 30, |
|---|
| 2026 | 2025 | 2026 | 2025 |
|---|
| Capitation, net | $936,662 | $863,380 | $2,735,374 | $2,061,451 |
| Risk pool settlements and incentives | 24,324 | 30,798 | 58,627 | 60,691 |
| Management fee income | 14,105 | 15,217 | 43,001 | 20,104 |
| Fee-for-service, net | 35,122 | 40,080 | 95,935 | 72,848 |
| Other revenue | 13,403 | 6,573 | 28,300 | 16,149 |
| Capitation and other revenue, net | $1,023,616 | $956,048 | $2,961,237 | $2,231,243 |
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(IN THOUSANDS)
(UNAUDITED)
| Nine Months Ended September 30, |
|---|
| 2026 | 2025 |
|---|
| Cash flows from operating activities | | |
| Net income | $51,852 | $17,514 |
| Adjustments to reconcile net income to net cash provided by operating activities: | | |
| Depreciation and amortization | 46,651 | 29,348 |
| Amortization of debt issuance cost | 3,438 | 2,892 |
| Stock-based compensation | 37,245 | 27,219 |
| Non-cash lease expense | 6,865 | 4,348 |
| Deferred tax | 1,774 | (4,924) |
| Change in fair value of contingent consideration liabilities | (4,212) | 4,353 |
| Change in fair value of financing obligation | (3,272) | - |
| Other | (4,415) | 609 |
| Changes in operating assets and liabilities, net of business combinations | (18,849) | 36,125 |
| Net cash provided by operating activities | 117,077 | 117,484 |
| Cash flows from investing activities | | |
| Payments for acquisitions, net of cash acquired | (6,825) | (548,553) |
| Proceeds from sale of equity method investment | - | 15,100 |
| Purchases of property and equipment | (11,711) | (7,042) |
| Other | 3,666 | 2,553 |
| Net cash used in investing activities | (14,870) | (537,942) |
| Cash flows from financing activities | | |
| Dividends paid | (1,127) | (6,329) |
| Borrowings on debt | - | 1,119,300 |
| Repayments of debt | (115,899) | (483,323) |
| Deferred financing cost | - | (19,205) |
| Payments of contingent liabilities | (2,864) | (8,284) |
| Taxes paid from net share settlement of restricted stock | (5,340) | (5,562) |
| Purchase of treasury shares | (3,893) | (955) |
| Other | (5,937) | 41 |
| Net cash (used in) provided by financing activities | (135,060) | 595,683 |
| Net (decrease) increase in cash, cash equivalents, and restricted cash | (32,853) | 175,225 |
| Cash, cash equivalents, and restricted cash, beginning of period | 434,045 | 289,101 |
| Cash, cash equivalents, and restricted cash, end of period | $401,192 | $464,326 |
| Supplemental disclosures of cash flow information | | |
| Cash paid for income taxes | | $4,728 |
| Cash paid for interest | $43,647 | $30,184 |
| Supplemental disclosures of non-cash investing and financing activities | | |
| Right-of-use assets obtained in exchange for operating lease liabilities | $13,969 | $7,780 |
| Common stock issued for contingent consideration payment | $ - | $2,600 |
| Elimination of note payable upon consolidation | $ - | $9,488 |
| Dividend paid in the form of common stock | $ - | $21,935 |
Following the adoption of Accounting Standards Codification (“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 September 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):
| September 30, 2026 | December 31, 2025 | September 30, 2025 |
|---|
| Cash and cash equivalents | $396,225 | $429,474 | $462,227 |
| Restricted cash | 4,967 | 4,571 | 2,099 |
| Total cash, cash equivalents, and restricted cash, end of period shown in the statement of cash flows | $401,192 | $434,045 | $464,326 |
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
| Nine Months Ended September 30, |
|---|
| (in thousands) | 2026 | 2025 |
| Net cash provided by operating activities | $117,077 | $117,484 |
| Purchases of property and equipment | (11,711) | (7,042) |
| Free cash flow | $105,366 | $110,442 |
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 nine months ended September 30, 2026 and 2025. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.
| Three Months Ended September 30, | Nine Months Ended September 30, |
|---|
| (in thousands) | 2026 | 2025 | 2026 | 2025 |
| Net income | $20,269 | $1,077 | $51,852 | $17,514 |
| Interest expense | 15,021 | 17,718 | 47,120 | 32,408 |
| Interest income | (4,147) | (3,522) | (13,870) | (8,170) |
| Provision for income taxes | 11,953 | 4,594 | 27,288 | 14,586 |
| Depreciation and amortization | 15,622 | 15,595 | 46,651 | 29,348 |
| EBITDA | 58,718 | 35,462 | 159,041 | 85,686 |
| Income from equity method investments | (860) | (1,019) | (3,128) | (532) |
| Other, net | 3,784 | 26,340 | 19,234 | 40,597 |
| Stock-based compensation | 15,563 | 7,699 | 37,245 | 27,219 |
| Adjusted EBITDA | $77,205 | $68,482 | $212,392 | $152,970 |
| Total revenue | $1,023,616 | $956,048 | $2,961,237 | $2,231,243 |
| Adjusted EBITDA margin | 8% | 7% | 7% | 7% |
Other, net, for the three months ended September 30, 2026, relates to post-acquisition integration costs and a fair value remeasurement of a previously held equity method investments that is now fully acquired, partially offset by non-cash changes to the fair value of our interest rate swap.
Other, net, for the three months ended September 30, 2025, relates to $13.0 million for a legal matter with a provider associated with CFC Health Plan, Inc. (“CFC HP”), transaction and other costs related to our acquisitions, including $12.7 million related to our completed acquisition of certain businesses and assets of Prospect Medical Holdings, Inc, (“Prospect”), non-cash changes in the fair value of our call option and collar agreement, and severance.
Other, net, for the nine months ended September 30, 2026, relates to post-acquisition integration costs, an allowance on receivables that the Company plans to recover from the payer, non-routine legal matters, severance, and a fair value remeasurement of a previously held equity method investment that is now fully acquired, partially offset by non-cash changes to the fair value of an equity purchase financing obligation and our interest rate swap.
Other, net, for the nine months ended September 30, 2025, relates to $13.0 million for a legal matter with a provider associated with CFC HP, transaction and other costs related to our acquisitions, including $23.6 million related to Prospect, debt issuance costs incurred in connection with our Second Amended and Restated Credit Facility, non-cash changes in the fair value 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 nine months ended September 30, 2026 and 2025.
| Three Months Ended September 30, | Nine Months Ended September 30, |
|---|
| (in thousands, except for share and per share data) | 2026 | 2025 | 2026 | 2025 |
| Net income | $20,269 | $1,077 | $51,852 | $17,514 |
| Income from equity method investments | (860) | (1,019) | (3,128) | (532) |
| Other, net | 3,784 | 26,340 | 19,234 | 40,597 |
| Stock-based compensation | 15,563 | 7,699 | 37,245 | 27,219 |
| Amortization of intangible assets attributable to acquisitions | 13,779 | 14,177 | 41,435 | 26,619 |
| Tax adjustments | (5,562) | (10,614) | (19,052) | (19,852) |
| Adjusted net income attributable to non-controlling interests | (11,747) | (3,871) | (16,235) | (9,902) |
| Adjusted net income attributable to Astrana Health, Inc. | $35,226 | $33,789 | $111,351 | $81,663 |
| Weighted average shares of common stock outstanding - diluted | 49,915,989 | 49,473,417 | 49,586,343 | 49,311,384 |
| Adjusted earnings per share - diluted | $0.71 | $0.68 | $2.25 | $1.66 |
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.
Tax adjustments for the three and nine months ended September 30, 2026, include the tax effect for, at a 27.4% statutory blended tax rate, the adjustments made to net income of $8.8 million and $25.9 million, respectively, partially offset by 162(m) impact of $3.3 million and $6.7 million, respectively.
Tax adjustments for the three and nine months ended September 30, 2025, include the tax effect for, at a 27.1% statutory blended tax rate, the adjustments made to net income of $12.8 million and $25.4 million, respectively, partially offset by 162(m) impact of $1.7 million and $5.1 million, respectively.
Adjusted net income attributable to non-controlling interests (“NCI”) for the three and nine months ended September 30, 2026, includes net income attributable to NCI of $7.3 million and $4.7 million, respectively, as well as adjustments attributable to NCI of $4.4 million and $11.5 million, respectively.
Adjusted net income attributable to NCI for the three and nine months ended September 30, 2025 includes net income attributable to NCI of $0.7 million and $1.0 million, respectively, as well as adjustments attributable to NCI of $3.2 million and $8.9 million, respectively.
Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA
| Three Months Ending December 31, 2026 | Year Ending December 31, 2026 |
|---|
| Guidance Range | Guidance Range |
|---|
| (in thousands) | Low | High | Low | High |
| Net income | $3,100 | $9,100 | $55,000 | $61,000 |
| Interest expense | 9,800 | 10,800 | 43,000 | 44,000 |
| Provision for income taxes | 4,700 | 5,700 | 32,000 | 33,000 |
| Depreciation and amortization | 15,300 | 17,300 | 62,000 | 64,000 |
| EBITDA | 32,900 | 42,900 | 192,000 | 202,000 |
| Income from equity method investments | (900) | (900) | (4,000) | (4,000) |
| Other, net | 3,700 | 5,700 | 23,000 | 25,000 |
| Stock-based compensation | 12,800 | 13,800 | 50,000 | 51,000 |
| Adjusted EBITDA | $48,500 | $61,500 | $261,000 | $274,000 |
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 | $127,500 | $142,500 |
| Cash used in purchases of property and equipment | (20,000) | (12,500) |
| Free cash flow | $107,500 | $130,000 |
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 the Company, 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.
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