Astrana Health (ASTH) investor relations material

Executive summary

• Q3 revenue reached a record $1,023.6M, up 7% YoY; adjusted EBITDA was a record $77.2M, up 13%, and adjusted diluted EPS was $0.71.

• GAAP net income was $20.3M versus $1.1M; net income attributable to the business was $13.0M versus $0.4M.

• Managed care covered ~1.5 million patients across 29 IPAs and a network of more than 20,000 contracted physicians at September 30, 2026.

• Growth reflected organic Medicare Advantage expansion, members transitioning to full-risk arrangements, and Prospect acquisition contributions to nine-month results.

Financial highlights

• Total revenue rose to $1,023.6M from $956.0M; capitation revenue was $936.7M versus $863.4M, with Q3 capitation growth of 8.5%.

• Operating income increased to $39.9M from $19.2M; EBITDA was $58.7M versus $35.5M, and adjusted EBITDA margin was 8% versus 7%.

• Nine-month revenue increased 33% to $2,961.2M; adjusted EBITDA rose 39% to $212.4M, and adjusted diluted EPS was $2.25 versus $1.66.

• Nine-month free cash flow was $105.4M versus $110.4M YoY; operating cash flow was $117.1M.

• Q3 included $5M–$10M of Medicare Advantage risk-adjustment sweep revenue and 2026 MSSP shared-savings accruals, not expected to recur in Q4.

Outlook and guidance

• FY26 guidance was narrowed while retaining midpoints: revenue $3.9B–$4.0B, adjusted EBITDA $261M–$274M, and free cash flow $107.5M–$130M.

• Q4 guidance is revenue $939M–$1,039M and adjusted EBITDA $48.5M–$61.5M; Q4 is expected to be the year's lowest-profitability quarter.

• Management expects at least mid-teens annual adjusted EBITDA growth over the medium term, supported by cohort maturation, risk conversions, new MA partnerships, and operating leverage.

• FY27 planning assumes 10%–15% Medicaid membership decline; MA margins are expected to remain stable, with formal FY27 guidance expected alongside Q4 results.