Astrana Health (ASTH) Q1 2025 earnings summary

Executive summary

• Q1 2025 revenue grew 53% year-over-year to $620.4 million, driven by Care Partners segment growth and acquisitions, with adjusted EBITDA of $36.4 million and net income of $6.7 million; diluted EPS was $0.14.

• Membership in Care Partners reached 910,000, with 38% in full-risk contracts, now 75% of capitation revenue; Collaborative Health Systems integration completed, yielding over $10 million in G&A efficiencies.

• Prospect Health acquisition expected to close in summer 2025, adding 600,000 members and $81 million adjusted EBITDA; HSR approval received.

• Leadership team expanded with new Chief Data & Analytics Officer, Chief Accounting Officer, and Chief People Officer.

• Investments in automation and AI are expected to yield at least $10 million in annual operating efficiencies by early 2026.

Financial highlights

• Q1 2025 revenue: $620.4 million, up 53% year-over-year; adjusted EBITDA: $36.4 million, down from $42.2 million in Q1 2024; net income: $6.7 million; EPS: $0.14.

• Care Partners segment revenue grew 57% year-over-year to $601.0 million.

• Adjusted EBITDA margin declined to 6% from 10% in Q1 2024.

• Cash and short-term investments at quarter-end were $258.5–$260.9 million.

• Free cash flow was $13.6 million (or $18.6 million excluding $5 million non-recurring debt issuance cost); net cash from operations was $16.6 million.

Outlook and guidance

• Full-year 2025 revenue guidance: $2.5–$2.7 billion; adjusted EBITDA: $170–$190 million.

• Q2 2025 revenue expected between $615–$665 million; adjusted EBITDA $45–$50 million.

• Guidance includes ~$15 million in planned investments for integration, growth, and AI, but excludes contributions from pending acquisitions.

• Medium-term (2027) adjusted EBITDA guidance of at least $350 million.

• Prospect acquisition expected to increase pro forma net leverage to 3.4x, with a goal to delever below 3x within 12 months post-close.