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Astrana Health
(NASDAQ:ASTH)
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Rating:68Neutral
Price Target:
$39.00
▲(2.12% Upside)
Action:Downgraded
Date:07/13/26
ASTH scores well on strong cash generation and a supportive technical uptrend, reinforced by a constructive earnings-call outlook with guidance reaffirmation and ongoing deleveraging. The main constraint on the score is valuation (high P/E) alongside compressed margins and modest returns, which increase sensitivity to execution and profitability improvement.
Positive Factors
Free cash flow generation
Sustained, high free cash flow (TTM FCF ~$155M; ~48% FCF growth) provides durable funding for deleveraging, M&A integration, and platform investment. Strong cash conversion reduces refinancing risk and underpins long‑term strategic optionality even if margins recover gradually.
Negative Factors
Compressed profitability
Very low gross and net margins despite revenue growth mean earnings are sensitive to adverse medical cost trends or integration missteps. Until margins sustainably improve, returns on invested capital remain muted, constraining reinvestment capacity and long‑term ROE expansion.
Read all positive and negative factors
Positive Factors
Negative Factors
Free cash flow generation
Sustained, high free cash flow (TTM FCF ~$155M; ~48% FCF growth) provides durable funding for deleveraging, M&A integration, and platform investment. Strong cash conversion reduces refinancing risk and underpins long‑term strategic optionality even if margins recover gradually.
Read all positive factors
Astrana Health (ASTH) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$1.76B
Dividend YieldN/A
Average Volume (3M)694.19K
Price to Earnings (P/E)57.6
Beta (1Y)1.10
Revenue Growth56.69%
EPS Growth-15.92%
CountryUS
Employees3,000
SectorHealthcare
Sector Strength45
IndustryMedical - Care Facilities
Share Statistics
EPS (TTM)0.62
Shares Outstanding49,583,420
10 Day Avg. Volume571,928
30 Day Avg. Volume694,191
Financial Highlights & Ratios
PEG Ratio-1.09
Price to Book (P/B)1.56
Price to Sales (P/S)0.38
P/FCF Ratio11.65
Enterprise Value/Market Cap<0.01
Enterprise Value/Revenue<0.01
Enterprise Value/Gross Profit<0.01
Enterprise Value/Ebitda<0.01
Forecast
1Y Price Target
$48.57Price Target Upside27.18% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering9
EPS Forecast (FY)1.27
Revenue Forecast (FY)$4.00B
Astrana Health Business Overview & Revenue Model
Company Description
Astrana Health, Inc., which rebranded from Apollo Medical Holdings, Inc. in February 2024, is a healthcare management firm based in Alhambra, California, founded in 1985. This company delivers medical services throughout the United States, operati...
How the Company Makes Money
Astrana Health makes money primarily by supporting and participating in value-based care and managed-care arrangements through a platform that delivers care-management and administrative services to provider networks.
Key revenue mechanics typica...
Astrana Health Earnings Call Summary
Earnings Call Date:May 07, 2026
(Q1-2026)
| % Change Since: |
Next Earnings Date:Aug 06, 2026
Earnings Call Sentiment Positive
The call presented a strong operational and financial quarter with outsized revenue and EBITDA growth, meaningful free cash flow, accelerated deleveraging, confirmed platform‑driven operating leverage from AI, and on‑track integration of the Prospect acquisition. Management remains deliberately conservative in full‑year guidance due to enrollment and HQAF timing uncertainties and highlighted working capital effects from full‑risk transitions. Overall, the positives (robust growth, margin expansion levers, rapid deleveraging, and platform advantages) outweigh the manageable execution and macro/regulatory uncertainties called out by management.Positive Updates
Strong Top-Line and Profitability Growth
Q1 revenue of $965.1M, up 56% year‑over‑year; adjusted EBITDA $66.3M, up 82% YoY; non‑GAAP adjusted EPS $0.74, up 76% YoY; net income attributable to Astrana $14.4M.
Negative Updates
Enrollment Uncertainty — Exchange and Medicaid Dynamics
Exchange and Medicaid trends showed variability year‑to‑date: management initially modeled 30%–40% ACA disenrollment but now expects a lower decline (~20%–30%) and said exchange attrition dynamics remain uncertain; company is conservatively assuming downside on Medicaid/exchange in guidance.
Read all updates
Q1-2026 Updates
Positive
Negative
Strong Top-Line and Profitability Growth
Q1 revenue of $965.1M, up 56% year‑over‑year; adjusted EBITDA $66.3M, up 82% YoY; non‑GAAP adjusted EPS $0.74, up 76% YoY; net income attributable to Astrana $14.4M.
Read all positive updates
Company Guidance
Astrana reaffirmed its full‑year 2026 guidance of $3.8–$4.1 billion of revenue, $250–$280 million of adjusted EBITDA and $105–$132.5 million of free cash flow, with a blended medical cost trend assumption of ~5.2%; Q2 guidance is $965 million–$1.0 billion of revenue and $65–$70 million of adjusted EBITDA. Management noted Q1 came in at the high end (Q1 revenue $965.1M, adjusted EBITDA $66.3M, adj. EPS $0.74, FCF $64.1M), pro forma net leverage has already declined to ~2.3x (2.2x vs. the guidance midpoint) and they expect to finish the year at or below ~2.0x; G&A was 6.4% of revenue (a 70 bps YoY improvement) and is expected to fall further. The guide assumes conservative Medicaid membership trends and zero HQAF contribution, treats the low end as a stacked‑downside case, and leaves room for upside from MA rate tailwinds, Prospect synergies (target $12M–$15M annual), cohort maturization, and AI/automation efficiencies.Astrana Health Financial Statement Overview
Summary
Income Statement
58
Neutral
Balance Sheet
66
Positive
Cash Flow
74
Positive
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 3.53B | 3.18B | 2.03B | 1.39B | 1.14B | 773.91M |
| Gross Profit | 328.47M | 295.78M | 271.39M | 214.96M | 199.48M | 177.77M |
| EBITDA | 162.81M | 135.28M | 141.84M | 123.69M | 112.08M | 100.66M |
| Net Income | 30.23M | 22.49M | 43.15M | 60.72M | 45.17M | 68.92M |
Balance Sheet | ||||||
| Total Assets | 2.36B | 2.22B | 1.35B | 933.36M | 966.21M | 867.36M |
| Cash, Cash Equivalents and Short-Term Investments | 478.38M | 429.47M | 290.83M | 296.31M | 293.59M | 286.51M |
| Total Debt | 1.07B | 1.08B | 471.84M | 321.01M | 229.36M | 200.98M |
| Total Liabilities | 1.78B | 1.66B | 840.73M | 522.59M | 407.67M | 356.72M |
| Stockholders Equity | 800.27M | 779.29M | 712.72M | 614.22M | 542.56M | 448.17M |
Cash Flow | ||||||
| Free Cash Flow | 154.99M | 104.49M | 44.17M | 39.70M | 59.19M | 51.11M |
| Operating Cash Flow | 166.03M | 114.60M | 52.20M | 68.23M | 82.13M | 70.33M |
| Investing Cash Flow | -539.42M | -539.00M | -192.40M | -65.52M | -7.11M | 16.54M |
| Financing Cash Flow | 597.53M | 569.35M | 135.15M | 3.42M | -20.09M | -47.75M |
Astrana Health Risk Analysis
Astrana Health disclosed 78 risk factors in its most recent earnings report. Astrana Health reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Astrana Health Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
76 Outperform | $1.60B | 13.47 | 24.12% | ― | 5.22% | 1109.87% | |
72 Outperform | $2.18B | 12.87 | 20.09% | ― | -2.25% | ― | |
69 Neutral | $2.04B | 7.41 | 241.47% | ― | 20.49% | 4335.46% | |
68 Neutral | $1.76B | 57.58 | 3.88% | ― | 56.69% | -15.92% | |
57 Neutral | $1.20B | 158.12 | 0.24% | 2.44% | 13.73% | -77.14% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% |
* Healthcare Sector Average
ASTH
Astrana Health
35.56
13.68
62.52%
HCSG
Healthcare Services
23.30
9.46
68.35%
MD
Pediatrix Medical Group
26.51
14.21
115.53%
USPH
US Physical Therapy
79.06
10.43
15.20%
AVAH
Aveanna Healthcare Holdings
9.39
5.57
145.81%
Astrana Health Corporate Events
Business Operations and StrategyFinancial Disclosures
Astrana Health Reports Strong Medicare ACO Shared Savings Performance
Positive
Jul 13, 2026
On July 13, 2026, Astrana Health reported that its eight affiliated accountable care organizations produced $120.4 million in gross shared savings in the 2024 performance year, with all of them achieving net shared savings while serving nearly 100...
Business Operations and StrategyExecutive/Board Changes
Astrana Health announces planned accounting leadership transition
Neutral
Jul 1, 2026
Astrana Health said Chief Accounting Officer and principal accounting officer Glenn Sobotka agreed on June 25, 2026, to retire from his roles effective August 7, 2026, noting the move is not due to any disagreement over the company’s operati...
Business Operations and StrategyExecutive/Board ChangesShareholder Meetings
Astrana Health Shareholders Expand Equity Plan, Back Leadership
Positive
Jun 10, 2026
At its 2026 Annual Meeting of Stockholders held on June 10, 2026, Astrana Health shareholders approved an amended and restated 2024 Equity Incentive Plan, increasing the pool of shares available for awards by 1,000,000 and extending the plan’...
Business Operations and StrategyRegulatory Filings and Compliance
Astrana Health Updates Investor Presentation via Regulation FD Disclosure
Neutral
May 12, 2026
On May 12, 2026, Astrana Health updated its corporate investor presentation, which it plans to use at upcoming conferences and meetings, and furnished the new slide deck via a Form 8-K. The company emphasized that the materials are furnished rathe...
Business Operations and StrategyExecutive/Board Changes
Astrana Health Announces Upcoming Chief Medical Officer Resignation
Negative
May 12, 2026
Astrana Health, Inc. said that on May 7, 2026, Chief Medical Officer Dinesh Kumar, M.D., notified the company of his intention to resign, with his departure effective June 1, 2026. The company emphasized that Kumar’s resignation was not due ...
Business Operations and StrategyFinancial Disclosures
Astrana Health Posts Strong Q1 Growth, Reaffirms 2026 Outlook
Positive
May 7, 2026
On May 7, 2026, Astrana Health reported first-quarter 2026 results showing total revenue of $965.1 million, a 56% year-on-year increase, driven largely by Care Partners revenue of $909.7 million, alongside a 116% rise in net income to $14.4 millio...
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.