Astrana Health (ASTH) Q2 2026 earnings summary

Executive summary

• Q2 2026 revenue reached $973 million, up 49% year-over-year, with adjusted EBITDA of $69 million, up 43% year-over-year, and adjusted EPS at $0.80, up 45% year-over-year.

• Net income attributable to shareholders was $19.7 million, more than doubling year-over-year.

• Free cash flow for the first half of 2026 totaled $92.9 million, with a 69% conversion of adjusted EBITDA.

• Growth was driven by organic expansion, the Prospect Health acquisition, and ramp-up of full risk contracts.

• Membership in value-based arrangements grew to 1.5 million, with 81% of capitation revenue from full-risk contracts.

Financial highlights

• Q2 2026 revenue: $973 million (+49% YoY); adjusted EBITDA: $69 million (+43% YoY); adjusted EPS: $0.80 (+45% YoY).

• Free cash flow for H1 2026: $92.9 million; net income: $19.7 million.

• Adjusted EBITDA margin was 7% for Q2 and the first half of 2026.

• Cash and cash equivalents stood at $400.8 million as of June 30, 2026.

• G&A as a percentage of revenue improved by 210 bps YoY; expected to be ~6% for the full year.

Outlook and guidance

• Full-year 2026 revenue guidance reaffirmed at $3.8–$4.1 billion; adjusted EBITDA guidance raised to $255–$280 million.

• Free cash flow guidance for 2026: $105–$132.5 million.

• Q3 2026 revenue expected at $1.0–$1.03 billion; adjusted EBITDA at $72.5–$77.5 million.

• Guidance reflects broad-based outperformance and confidence in continued growth.

• Mid to high teens EBITDA growth expected for 2027 and medium term, with Medicaid headwinds and investments factored in.