Astrana Health Q3 Revenue Rises 7% as Adjusted EBITDA Grows 13%

Astrana Health Inc. (NASDAQ: ASTH) reported higher third-quarter revenue and adjusted EBITDA as growth in its Care Partners business and a larger share of full-risk arrangements supported operating results. The value-based care company also narrowed its 2026 guidance ranges for revenue, adjusted EBITDA and free cash flow.

Revenue for the three months ended September 30 rose 7% year over year to $1.02 billion. Adjusted EBITDA increased 13% to $77.2 million, while adjusted EBITDA margin expanded to 8% from 7%.

GAAP net income was $20.3 million, compared with $1.1 million a year earlier. Net income attributable to Astrana reached $13.0 million, or $0.26 per diluted share, up from $373,000, or $0.01 per share. Adjusted diluted earnings per share increased 4% to $0.71.

Operating income more than doubled to $39.9 million from $19.2 million, as total expenses increased at a slower pace than revenue. Stock-based compensation rose to $15.6 million from $7.7 million and was among the items excluded from adjusted EBITDA.

Capitation and Care Partners drive growth

Net capitation revenue increased to $936.7 million from $863.4 million and accounted for 92% of quarterly revenue. That gain more than offset declines in risk-pool settlements and incentives, management fees, and fee-for-service revenue.

Care Partners, Astrana’s network of aligned providers, generated $968.8 million in segment revenue, an 8% year-over-year increase, and $49.1 million in operating income. Care Delivery revenue rose 5% to $91.0 million, though the segment recorded a $1.6 million operating loss. Care Enablement revenue increased 5% to $92.0 million and produced operating income of $24.4 million.

Astrana said it now serves approximately 1.5 million patients in value-based arrangements, including about 1.2 million Care Partners members. The company completed a tuck-in acquisition of an independent physician association in Georgia on October 1 and added two Care Enablement clients: a primary and multispecialty care group in Connecticut and a California hospital.

The company continued to shift its capitation business toward full-risk contracts, under which it assumes greater responsibility for total healthcare costs. Full-risk arrangements represented 85% of third-quarter capitation revenue, while 46% of Care Partners members were in full-risk arrangements as of September 30.

For the full year, Astrana expects 82% of capitation revenue to come from full-risk arrangements and 43% of Care Partners membership to be covered by those contracts at year-end. Management described the remaining partial-risk population as an opportunity for additional risk alignment and platform value.

Year-to-date general and administrative expenses were approximately 6.2% of revenue, an improvement of about 80 basis points from the prior-year period. Astrana also said its consolidated medical cost trend was tracking below its full-year assumption of approximately 5.2%. Its Annual Wellness Visit program had reached nearly 65% of eligible members through September.

Full-year guidance narrowed

Astrana expects 2026 revenue of $3.90 billion to $4.00 billion, representing 24.1% growth from 2025 at the midpoint. Adjusted EBITDA is projected at $261 million to $274 million, with the midpoint implying 30.2% growth. The company’s GAAP net income forecast is $55 million to $61 million.

Full-year free cash flow is expected to range from $107.5 million to $130 million. Astrana generated $105.4 million of free cash flow during the first nine months of 2026, down about 5% from $110.4 million in the corresponding 2025 period. Net cash provided by operating activities was $117.1 million, while capital expenditures totaled $11.7 million.

At September 30, the company had $396.2 million in cash and cash equivalents, excluding restricted cash and marketable securities, compared with $429.5 million at the end of 2025. Working capital declined to $193.9 million from $248.0 million, while total stockholders’ equity increased to $868.3 million from $793.3 million.

Astrana cautioned that its outlook remains subject to uncertainties involving acquisitions and integration, Medicare Advantage rate changes, cybersecurity remediation, medical costs and the remediation of a material weakness in internal control over financial reporting. The company also noted that forward-looking non-GAAP measures may be affected by items that cannot be estimated without unreasonable effort.