Astrana Health (ASTH) Q4 2023 earnings summary

Executive summary

• FY 2023 revenue rose 21% to $1,386.7M; net income attributable to ASTH was $60.7M, up 34%, and Adjusted EBITDA was $146.6M.

• Value-based care scale reached ~900K members; Medicare Advantage hospital admissions and ER visits were 46% and 40% below benchmarks.

• Strategic priorities include expanding membership and geographies, taking on greater value-based care accountability, supporting provider outcomes, and pursuing acquisitions.

Financial highlights

• Q4 2023 revenue was $353.0M, up 20% YoY; net income attributable to ASTH was $12.4M versus a $3.7M loss, and diluted EPS was $0.26 versus $(0.08).

• Q4 Adjusted EBITDA increased 23% to $29.0M from $23.7M.

• FY 2023 operating income was $84.6M versus $104.3M; attributable net income was $60.7M versus $45.2M.

• FY 2023 Adjusted EBITDA increased 5% to $146.6M from $140.0M; margin was 11% versus 12% in FY 2022.

• FY 2023 total expenses rose to $1,302.0M from $1,039.9M.

Outlook and guidance

• FY 2024 guidance: revenue $1.65B–$1.85B; net income attributable to ASTH $61M–$73M; diluted EPS $1.28–$1.52; Adjusted EBITDA $165M–$185M.

• Adjusted EBITDA guidance reconciles to GAAP net income of $71.5M–$85.5M before attribution to noncontrolling interests.

• Medium-term outlook cited 25%+ growth visibility; historical five-year revenue and Adjusted EBITDA CAGRs were each 26%, based on estimates through FY 2023.