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 of $0.80, up 45% year-over-year; net income attributable to shareholders was $19.7 million, up 109%.

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

• Growth was driven by organic expansion in Care Partners, the Prospect Health acquisition, and ramp-up of full risk contracts, with strong demand from payer and provider partners.

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

• The AI-native healthcare operating system enabled over 500,000 automated member encounters per month, supporting scalability and care delivery.

Financial highlights

• Q2 2026 revenue: $973 million (+49% YoY); adjusted EBITDA: $69 million (+43% YoY); adjusted EPS: $0.80 (+45% YoY); net income: $19.7 million (up 109% YoY).

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

• G&A as a percentage of revenue improved by 210 basis points YoY in Q2; expected to be ~6% for the full year.

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

• One-time $15 million revenue reduction due to CMS ACO REACH billing adjustment, with immaterial EBITDA impact.

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 outlook: revenue $1.0–$1.03 billion; adjusted EBITDA $72.5–$77.5 million.

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

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