Astrana Health (ASTH) Q4 2024 earnings summary

Executive summary

• Achieved 47% year-over-year revenue growth to $2.03B in 2024, with Q4 revenue up 88% to $665.2M and Adjusted EBITDA rising 16% to $170.4M; Q4 Adjusted EBITDA was $35.0M.

• Membership in Care Partners segment grew 55%, with significant expansion into new markets and completion of the Collaborative Health Systems acquisition.

• Net income for 2024 was $43.1M, with a Q4 net loss of $7.0M; EPS-diluted for 2024 was $0.90, down from $1.29.

• Announced intended acquisition of Prospect Health, expanding pro-forma footprint to 13 states and estimated 2024 pro-forma revenue at $3.3B.

• Significant investments in automation, AI, and integration to support scalability and future M&A activity.

Financial highlights

• FY 2024 revenue: $2,034.5M, up from $1,386.7M in 2023; Q4 2024 revenue: $665.2M, up from $353.0M in Q4 2023.

• Adjusted EBITDA for FY 2024: $170.4M (margin 8%), up from $146.6M (margin 11%) in 2023.

• Care Partners segment revenue grew 52% to $1,949.0M; membership in this segment grew 55%.

• Cash and investments at year-end: $290.8M; total debt $471.8M; total assets $1,356.5M.

• EPS (diluted) for FY 2024: $0.90, down from $1.29 in 2023; Q4 EPS was $(0.15) compared to $0.26.

Outlook and guidance

• 2025 revenue guidance: $2.5B–$2.7B; Adjusted EBITDA: $170M–$190M, including $15M in strategic investment costs.

• Q1 2025 revenue: $600M–$650M; Adjusted EBITDA: $32M–$37M.

• Medium-term (2027) Adjusted EBITDA target: at least $350M.

• Guidance excludes contributions from pending acquisitions and assumes mid-single-digit cost trend, $15M in integration/AI investments, and 75–85% of revenue from full-risk arrangements.