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what it is
Astrana runs coordinated medical groups that manage patient care and take on insurance risk across California, Nevada, and Texas.
how it gets paid
Last year Astrana Health made $3.2B in revenue. Value-based care arrangements was the main engine at $1.44B, or 45% of sales.
why it's growing
Revenue grew 56.4% last year. Revenue came in at $2.2B and EPS reached $0.33 in the latest quarter.
what just happened
Astrana posted $2.2B in quarterly revenue and $0.33 EPS, while margins stayed lean.
At a glance
B balance sheet — gets the job done, barely
40/100 earnings predictability — expect surprises
98.8x trailing p/e — you're paying up for this one
5.2% return on capital — nothing to write home about
$0.90 fy2024 eps est
xvary composite: 40/100 — below average
What they do
Astrana runs coordinated medical groups that manage patient care and take on insurance risk across California, Nevada, and Texas.
Value-based care → doctors get paid for outcomes, not just visits → Astrana keeps more when care costs less than the insurer pays. You feel that in the network. Leaving is painful because 1,900 employees, multiple payers, and three states are already wired into one system. It is clinic logic with spreadsheet consequences.
How they make money
$3.2B
annual revenue · their business grew +56.4% last year
Value-based care arrangements
$1.44B
Care coordination services
$0.80B
Provider services
$0.64B
Technology and admin services
$0.32B
The products that matter
value-based care for medicare and medicaid
care partners platform
$3.2B revenue · 56% growth
it is the operating business. Astrana takes risk on patient populations and gets paid to manage care efficiently. The $3.2B top-line is real. The 0.7% net margin is the part still asking for patience.
revenue driver · margin pressure
acquired medical group and lives expansion
prospect medical holdings
$745M acquisition · 165,000+ lives
this is the swing factor. Prospect adds more than 165,000 risk-bearing lives, but it also raises the integration stakes. If this lifts margins, the multiple makes more sense. If it does not, 52.7x earnings starts to look unserious.
integration risk · thesis lever
Key numbers
$3.2B
annual revenue
That is the scale of the business. You are not buying a tiny clinic chain. You are buying a $3.2B healthcare operator with small-cap valuation.
5.8%
operating margin
This shows how much profit is left after the bills. A 5.8% margin means every $100 of revenue leaves $5.80 before interest and taxes.
$1.0B
long-term debt
Debt of $1.0B is not background noise. It is the part of the capital stack that gets paid first.
1.35
beta
A beta of 1.35 means the stock tends to move about 35% more than the market. Your nerves pay for that.
Financial health
B
strength
- balance sheet grade B — adequate — nothing special
- risk rank 4 — safer than 20% of stocks
- price stability 5 / 100
- long-term debt $1.0B (46% of capital)
B — functional but not a standout on the balance sheet.
Total return vs. market
Return history isn't available for ASTH right now.
source: institutional data · return history unavailable
What just happened
beat estimates
Astrana posted $2.2B in quarterly revenue and $0.33 EPS, while margins stayed lean.
Revenue came in at $2.2B and EPS reached $0.33 in the latest quarter. The business is still scaling fast, but 5.8% operating margin says profit is not keeping pace with size.
$2.2B
revenue
$0.33
eps
5.8%
operating margin
the number that mattered
Revenue at $2.2B mattered most. It shows Astrana can grow fast, but the 5.8% margin says scale still has to do the heavy lifting.
source: company earnings report, 2026
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What could go wrong
Astrana's risk picture is unusually specific right now. This is not about vague healthcare uncertainty. It is about whether a debt-backed acquisition, thin margins, and a control issue can all be managed at the same time.
med
prospect integration misses the margin fix
The $745M Prospect deal is supposed to improve the earnings profile of a business that currently runs at a 0.7% net margin. If the acquired lives add complexity faster than they add profit, the thesis breaks where it matters most.
Impact: the stock is trading at 52.7x earnings today because investors are paying for a better future margin structure, not the current one.
med
material weakness in internal controls
A delayed filing tied to a material weakness is not cosmetic. When a company is digesting an acquisition and carrying $1.0B in debt, weak controls raise the odds of unpleasant surprises in reported numbers.
Impact: this does not need to hit revenue to matter. It can pressure credibility, valuation, and financing flexibility all by itself.
med
debt has less forgiveness in a 0.7% margin business
Long-term debt sits at $1.0B, or 46% of capital. That is workable if operations are stable. It is far less comfortable when earnings are thin and the stock scores 5 / 100 on price stability.
Impact: leverage turns small operating misses into larger equity problems. Thin margins do not absorb shocks. They transmit them.
If debt stays at $1.0B and margins stay at 5.8%, the multiple is the story, not the business.
source: institutional data · regulatory filings · risk analysis
Pay attention to
earnings date
may 13 is the first real post-deal report card
Consensus EPS is $0.28. You are not just looking for a beat or miss. You are looking for evidence that a much larger company can report cleanly and keep the 2026 guide intact.
filing risk
the delayed filing matters more than the market may want to admit
The company said the filing would arrive within a 15-day extension period after March 2, 2026 and would detail the material weakness in internal controls. That is a trust issue, not just an admin issue.
guidance trend
$3.8B–$4.1B revenue only helps if EBITDA scales with it
Management's 2026 guide includes $250M–$280M in adjusted EBITDA. Revenue growth without margin follow-through would mean the business got bigger, not better.
core metric
net margin has to move off 0.7%
This is the number that decides whether 52.7x earnings is justified or detached. A platform doing $3.2B in revenue should not live forever on less than a penny of profit per dollar.
Analyst rankings
xvary composite
40 / 100
below average overall. in human-speak, the market sees real growth but does not trust the quality of it yet.
earnings predictability
40 / 100
earnings can be harder to predict here. expect more variance than you would from a cleaner operator.
source: institutional data
Institutional activity
institutional ownership data for ASTH is being compiled.
source: institutional data
Price targets
3-5 year target range
n/a
n/a
$19
current price
n/a
target midpoint · n/a from current
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