false 0001083446 0001083446 2024-05-07 2024-05-07 iso4217:USD xbrli:shares iso4217:USD xbrli:shares

 

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549

 

FORM 8-K

 

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the

Securities Exchange Act of 1934

 

Date of report (Date of earliest event reported): May 7, 2024

 

ASTRANA HEALTH, INC.

(Exact Name of Registrant as Specified in Charter)

 

Delaware 001-37392 95-4472349
(State or Other Jurisdiction (Commission (I.R.S. Employer
of Incorporation) File Number) Identification No.)

 

1668 S. Garfield Avenue, 2nd Floor, Alhambra, California 91801

(Address of Principal Executive Offices) (Zip Code)

 

(626) 282-0288

Registrant’s Telephone Number, Including Area Code

 

 

(Former Name or Former Address, if Changed Since Last Report)

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

¨ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

¨ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

¨ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

¨ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

  

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class Trading symbol(s) Name of each exchange on which registered
Common Stock, $0.001 par value per share ASTH The Nasdaq Stock Market LLC

 

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

 

Emerging growth company ¨

 

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨

  

 

 

   

 

 

Item 2.02Results of Operations and Financial Condition.

 

On May 7, 2024, Astrana Health, Inc. (the “Company”) issued a press release announcing its financial results for the three months ended March 31, 2024. A copy of the press release and supplemental data is furnished with this Current Report on Form 8-K as Exhibit 99.1 and Exhibit 99.2, respectively, and incorporated herein by reference.

 

In accordance with General Instruction B.2 of Form 8-K, the information furnished pursuant to this Item 2.02, including Exhibit 99.1 and Exhibit 99.2 furnished herewith, shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as shall be expressly set forth by specific reference in such filing.

 

Item 9.01Financial Statements and Exhibits.

 

(d) Exhibits.

 

Exhibit No.   Description
99.1   Press Release of Astrana Health, Inc. Regarding its Financial Results for the Three Months Ended March 31, 2024, dated May 7, 2024.
99.2   Supplemental Data of Astrana Health, Inc., dated May 7, 2024.
104   Cover Page Interactive Data File (the cover page XBRL tags are embedded within the inline XBRL document).

 

 

 

 

SIGNATURES

 

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

  ASTRANA HEALTH, INC.
   
Date: May 7, 2024 By: /s/ Brandon Sim
  Name: Brandon Sim
  Title: Chief Executive Officer and President

 

 

 

 

Exhibit 99.1

 

 

Astrana Health, Inc. Reports First Quarter 2024 Results

Company to Host Conference Call on Tuesday, May 7, 2024, at 2:30 p.m. PT/5:30 p.m. ET

 

ALHAMBRA, Calif., May 7, 2024 /PRNewswire/ -- Astrana Health, Inc. (“Astrana,” and together with its subsidiaries and affiliated entities, the “Company”) (NASDAQ: ASTH), a leading provider-centric, technology-powered healthcare company enabling providers to deliver accessible, high-quality, and high-value care to all, today announced its consolidated financial results for the first quarter ended March 31, 2024.

 

“We believe our strong first quarter performance continues to demonstrate the uniqueness of our platform, care model, and technology. Revenue growth of 20%, net income attributable to Astrana growth of 13% and adjusted EBITDA growth of 42% relative to the prior year quarter were primarily driven by solid membership growth across all lines of business and successful management of total cost of care for our members. Additionally, organic membership growth of 10% year-to-date increased our total number of lives managed to approximately one million. We also made further progress transitioning our members into full-risk arrangements, which expect to account for approximately 60% of our total capitation revenue as of April 1, 2024. We believe our consistent execution against our strategic roadmap has set the stage for continued growth this year as we bring high-quality, high-value care to the communities we serve,” said Brandon K. Sim, President and Chief Executive Officer of Astrana Health.

 

Financial Highlights for First Quarter Ended March 31, 2024:

 

All comparisons are to the quarter ended March 31, 2023 unless otherwise stated.

·Total revenue of $404.4 million, up 20% from $337.2 million

 

·Care Partners revenue of $397.1 million, up 26% from $314.7 million

 

·Net income attributable to Astrana of $14.8 million, up 13% from $13.1 million

 

·Adjusted EBITDA of $42.2 million, up 42% from $29.8 million

 

·Earnings per share - diluted (“EPS - diluted”) of $0.31 per share, up 11% from $0.28 per share

 

Recent Operating Highlights

 

·We successfully closed the second and final part of our Community Family Care (“CFC”) acquisition on March 31, 2024. This acquisition marks the largest in Astrana’s history and allows the Company to take on greater responsibility for the outcomes of the patients we serve with CFC’s full-risk Medicaid Restricted Knox-Keene license.

 

·We also completed the acquisition of Prime Community Care of Central Valley (“PCCCV”) on March 29, 2024. PCCCV is a risk-bearing provider organization with over 150 primary care and multi-specialty care providers which serves around 26,000 primarily Medicaid members in the Central Valley of California.

 

·We opened two new de novo clinics in Nevada in April.

 

 

 

 

Segment Results for the First Quarter Ended March 31, 2024:

 

   Three Months Ended March 31, 2024 
(in thousands)  Care
Partners
   Care
Delivery
   Care
Enablement
   Other   Intersegment
Elimination
   Corporate
Costs
   Consolidated
Total
 
Total revenues  $397,095   $30,719   $33,274   $   $(56,732)  $   $404,356 
% change vs. prior year quarter   26%   21%   9%                  20%
                                    
Cost of services   314,966    24,794    17,373        (26,734)       330,399 
General and administrative(1)    38,933    6,163    12,397        (30,075)   16,400    43,818 
Total expenses   353,899    30,957    29,770        (56,809)   16,400    374,217 
                                    
Income (loss) from operations  $43,196   $(238)  $3,504   $   $77(2)   $(16,400)  $30,139 
% change vs. prior year quarter   94%   (75)%   (39)%                  35%

 

(1) Balance includes general and administrative expenses and depreciation and amortization.

 

(2) Income from operations for the intersegment elimination represents rental income from segments renting from other segments. Rental income is presented within other income which is not presented in the table.

 

2024 Guidance:

 

Astrana is reiterating the following guidance for total revenue, net income attributable to Astrana, Adjusted EBITDA, and EPS - diluted, based on the Company’s existing business, current view of existing market conditions and assumptions for the year ending December 31, 2024.

 

   2024 Guidance Range 
($ in millions)  Low   High 
Total revenue  $1,650.0   $1,850.0 
Net income attributable to Astrana Health, Inc.  $61.0   $73.0 
Adjusted EBITDA  $165.0   $185.0 
EPS – diluted  $1.28   $1.52 

 

See “Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non-GAAP Financial Measures” below for additional information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See “Forward-Looking Statements” below for additional information.

 

Conference Call and Webcast Information:

 

Astrana will host a conference call at 2:30 p.m. PT/5:30 p.m. ET today (Tuesday, May 7, 2024), during which management will discuss the results of the first quarter ended March 31, 2024. To participate in the conference call, please use the following dial-in numbers about 5 minutes prior to the scheduled conference call time:

 

U.S. & Canada (Toll-Free): +1 (888) 437-3179
International (Toll): +1 (862) 298-0702

 

The conference call can also be accessed via webcast at: https://event.choruscall.com/mediaframe/webcast.html?webcastid=y3Hig4E8.

 

 

 

 

An accompanying slide presentation will be available in PDF format on the “IR Calendar” page of the Company’s website (https://ir.astranahealth.com/news-events/ir-calendar) after issuance of the earnings release and will be furnished as an exhibit to Astrana’s current report on Form 8-K to be filed with the SEC, accessible at www.sec.gov.

 

Those who are unable to attend the live conference call may access the recording at the above webcast link, which will be made available shortly after the conclusion of the call.

 

Note About Consolidated Entities

 

The Company consolidates entities in which it has a controlling financial interest. The Company consolidates subsidiaries in which it holds, directly or indirectly, more than 50% of the voting rights, and variable interest entities (“VIEs”) in which the Company is the primary beneficiary. Noncontrolling interests represent third party equity ownership interests in the Company’s consolidated entities (including certain VIEs). The amount of net income attributable to noncontrolling interests is disclosed in the Company’s consolidated statements of income.

 

Note About StockholdersEquity, Certain Treasury Stock and Earnings Per Share

 

As of the date of this press release, 41,048 holdback shares have not been issued to certain former shareholders of the Company’s subsidiary, Astrana Health Management, Inc. (“AHM”), formerly known as Network Medical Management, Inc., who were AHM shareholders at the time of closing of the merger, as they have yet to submit properly completed letters of transmittal to Astrana in order to receive their pro rata portion of Astrana’s common stock as contemplated under that certain Agreement and Plan of Merger, dated December 21, 2016, among Astrana, AHM, Apollo Acquisition Corp. (“Merger Subsidiary”) and Kenneth Sim, M.D., as amended, pursuant to which Merger Subsidiary merged with and into AHM, with AHM as the surviving corporation. Pending such receipt, such former AHM shareholders have the right to receive, without interest, their pro rata share of dividends or distributions with a record date after the effectiveness of the merger. The Company’s consolidated financial statements have treated such shares of common stock as outstanding, given the receipt of the letter of transmittal is considered perfunctory and Astrana is legally obligated to issue these shares in connection with the merger.

 

Shares of Astrana’s common stock owned by Allied Physicians of California, a Professional Medical Corporation (“APC”), a VIE of the Company, are legally issued and outstanding but excluded from shares of common stock outstanding in the Company’s consolidated financial statements, as such shares are treated as treasury shares for accounting purposes. Such shares, therefore, are not included in the number of shares of common stock outstanding used to calculate the Company’s earnings per share.

 

About Astrana Health, Inc.

 

Astrana is a leading provider-centric, technology-powered healthcare company enabling providers to deliver accessible, high-quality, and high-value care to all. Leveraging its proprietary end-to-end technology solutions, Astrana operates an integrated healthcare delivery platform that enables providers to successfully participate in value-based care arrangements, thus empowering them to deliver high quality care to patients in a cost-effective manner.

 

Headquartered in Alhambra, California, Astrana serves over 10,000 providers and 1.0 million patients in value-based care arrangements. Its subsidiaries and affiliates include management services organizations (MSOs), affiliated independent practice associations (IPAs), accountable care organizations (ACOs), and care delivery entities across primary, multi-specialty, and ancillary care. For more information, please visit www.astranahealth.com.

 

Forward-Looking Statements

 

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, such as statements about the Company’s guidance for the year ending December 31, 2024, ability to meet operational goals, ability to meet expectations in deployment of care coordination and management capabilities, ability to decrease cost of care while improving quality and outcomes, ability to deliver sustainable revenue and EBITDA growth as well as long-term value, ability to respond to the changing environment, and successful implementation of strategic growth plans, acquisition strategy, and merger integration efforts. Forward-looking statements reflect current views with respect to future events and financial performance and therefore cannot be guaranteed. Such statements are based on the current expectations and certain assumptions of the Company’s management, and some or all of such expectations and assumptions may not materialize or may vary significantly from actual results. Actual results may also vary materially from forward-looking statements due to risks, uncertainties and other factors, known and unknown, including the risk factors described from time to time in the Company’s reports to the SEC, including, without limitation the risk factors discussed in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023, and any subsequent quarterly reports on Form 10-Q.

 

 

FOR MORE INFORMATION, PLEASE CONTACT:

 

Investor Relations
(626) 943-6491
investors@astranahealth.com

 

 

 

 

ASTRANA HEALTH, INC.

CONSOLIDATED BALANCE SHEETS

(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)

 

   March 31,
2024
   December 31,
2023
 
    (Unaudited)      
Assets          
           
Current assets          
Cash and cash equivalents  $334,796   $293,807 
Investment in marketable securities   2,490    2,498 
Receivables, net   120,106    76,780 
Receivables, net – related parties   62,354    58,980 
Income taxes receivable       10,657 
Other receivables   1,783    1,335 
Prepaid expenses and other current assets   17,281    17,450 
           
Total current assets   538,810    461,507 
           
Non-current assets          
Land, property and equipment, net   7,985    7,171 
Intangible assets, net   119,707    71,648 
Goodwill   410,267    278,831 
Income taxes receivable   15,943    15,943 
Loans receivable, non-current   47,412    26,473 
Investments in other entities – equity method   35,893    25,774 
Investments in privately held entities   6,396    6,396 
Restricted cash   645    345 
Operating lease right-of-use assets   39,152    37,396 
Other assets   4,067    1,877 
           
Total non-current assets   687,467    471,854 
           
Total assets(1)  $1,226,277   $933,361 
           
Liabilities, mezzanine equity and equity          
           
Current liabilities          
Accounts payable and accrued expenses  $146,473   $59,949 
Fiduciary accounts payable   7,792    7,737 
Medical liabilities   136,494    106,657 
Income taxes payable   5,522     
Dividend payable   638    638 
Finance lease liabilities   636    646 
Operating lease liabilities   5,007    4,607 
Current portion of long-term debt   20,750    19,500 
Other liabilities   31,960    18,940 
           
Total current liabilities   355,272    218,674 

 

 

 

 

   March 31,
2024
   December 31,
2023
 
Non-current liabilities          
Deferred tax liability   3,756    4,072 
Finance lease liabilities, net of current portion   1,015    1,033 
Operating lease liabilities, net of current portion   37,716    36,289 
Long-term debt, net of current portion and deferred financing costs   368,448    258,939 
Other long-term liabilities   7,652    3,586 
           
Total non-current liabilities   418,587    303,919 
           
Total liabilities(1)   773,859    522,593 
           
Mezzanine equity          
Noncontrolling interest in Allied Physicians of California, a Professional Medical Corporation ("APC")   (205,557)   (205,883)
           
Stockholders’ equity          
Series A Preferred stock, par value $0.001; 5,000,000 shares authorized (inclusive of Series B Preferred stock); 1,111,111 issued and zero outstanding        
Series B Preferred stock, par value $0.001; 5,000,000 shares authorized (inclusive of Series A Preferred stock); 555,555 issued and zero outstanding        
Common stock, par value $0.001; 100,000,000 shares authorized, 47,458,264 and 46,843,743 shares outstanding, excluding 10,584,340 and 10,584,340  Treasury shares, at March 31, 2024 and December 31, 2023, respectively   48    47 
Additional paid-in capital   395,473    371,037 
Retained earnings   257,969    243,134 
Total Stockholders' equity   653,490    614,218 
           
Non-controlling interest   4,485    2,433 
           
Total equity   657,975    616,651 
           
Total liabilities, mezzanine equity, and stockholders’ equity  $1,226,277   $933,361 

 

(1) The Company’s consolidated balance sheets include the assets and liabilities of its consolidated VIEs. The consolidated balance sheets include total assets that can be used only to settle obligations of the Company’s consolidated VIEs totaling $717.5 million and $540.8 million as of March 31, 2024 and December 31, 2023, respectively, and total liabilities of the Company’s consolidated VIEs for which creditors do not have recourse to the general credit of the primary beneficiary of $179.6 million and $146.0 million as of March 31, 2024 and December 31, 2023, respectively. The VIE balances do not include $299.5 million of investment in affiliates and $110.1 million of amounts due to affiliates as of March 31, 2024 and $273.2 million of investment in affiliates and $107.3 million of amounts due to affiliates as of December 31, 2023 as these are eliminated upon consolidation and not presented within the consolidated balance sheets.

 

 

 

 

ASTRANA HEALTH, INC.

CONSOLIDATED STATEMENTS OF INCOME

(IN THOUSANDS, EXCEPT SHARE AND PER SHARE AMOUNTS)

(UNAUDITED)

 

    Three Months Ended
March 31,
 
    2024     2023  
Revenue                
Capitation, net   $ 365,910     $ 300,204  
Risk pool settlements and incentives     17,377       13,462  
Management fee income     4,078       9,896  
Fee-for-service, net     15,937       12,062  
Other revenue     1,054       1,620  
                 
Total revenue     404,356       337,244  
                 
Operating expenses                
Cost of services, excluding depreciation and amortization     330,399       289,397  
General and administrative expenses     38,722       21,182  
Depreciation and amortization     5,096       4,292  
                 
Total expenses     374,217       314,871  
                 
Income from operations     30,139       22,373  
                 
Other income (expense)                
Income from equity method investments     632       2,484  
Interest expense     (7,585 )     (3,269 )
Interest income     3,996       3,009  
Unrealized gain (loss) on investments     1,099       (6,392 )
Other (loss) income     (4,277 )     1,204  
                 
Total other expense, net     (6,135 )     (2,964 )
                 
Income before provision for income taxes     24,004       19,409  
                 
Provision for income taxes     7,142       6,921  
                 
Net income     16,862       12,488  
                 
Net income (loss) attributable to non-controlling interest     2,027       (644 )
                 
Net income attributable to Astrana Health, Inc.   $ 14,835     $ 13,132  
                 
Earnings per share – basic   $ 0.31     $ 0.28  
                 
Earnings per share – diluted   $ 0.31     $ 0.28  

 

 

 

 

EBITDA

 

Set forth below are reconciliations of Net Income to EBITDA and Adjusted EBITDA as well as the reconciliation to Adjusted EBITDA margin for the three months ended March 31, 2024 and 2023. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.

 

    Three Months Ended
March 31,
 
(in thousands)   2024     2023  
Net income   $ 16,862     $ 12,488  
Interest expense     7,585       3,269  
Interest income     (3,996 )     (3,009 )
Provision for income taxes     7,142       6,921  
Depreciation and amortization     5,096       4,292  
EBITDA     32,689       23,961  
                 
Income from equity method investments     (632 )     (249 )
Other, net     4,440 (1)      1,402 (2) 
Stock-based compensation     5,748       3,445  
APC excluded asset costs           1,266  
Adjusted EBITDA   $ 42,245     $ 29,825  
                 
Total revenue   $ 404,356     $ 337,244  
                 
Adjusted EBITDA margin     10 %     9 %

 

(1) Other, net for the three months ended March 31, 2024 relates to a financial guarantee via a letter of credit that we provided almost three years ago in support of two local provider-led ACOs, non-cash changes related to change in the fair value of our financing obligation to purchase the remaining equity interests in one of our investments, non-cash changes related to change in the fair value of the Company’s Collar Agreement, and transaction costs incurred for our investments and tax restructuring fees.

 

(2) Other, net for the three months ended March 31, 2023 relates to changes in the fair value of our financing obligation to purchase the remaining equity interest in one of our investments.

 

Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA

 

   2024 Guidance Range 
(in thousands)  Low   High 
Net income  $71,500   $85,500 
Interest expense   14,500    12,500 
Provision for income taxes   36,500    44,500 
Depreciation and amortization   14,500    14,500 
EBITDA   137,000    157,000 
           
Income from equity method investments   (5,000)   (5,000)
Other, net   6,000    6,000 
Stock-based compensation   27,000    27,000 
Adjusted EBITDA  $165,000   $185,000 

 

 

 

 

Use of Non-GAAP Financial Measures

 

This press release contains the non-GAAP financial measures EBITDA, Adjusted EBITDA and Adjusted EBITDA margin, of which the most directly comparable financial measure presented in accordance with U.S. generally accepted accounting principles (“GAAP”) is net income. These measures are not in accordance with, or alternatives to GAAP, and may be calculated differently from similar non-GAAP financial measures used by other companies. The Company uses Adjusted EBITDA as a supplemental performance measure of our operations, for financial and operational decision-making, and as a supplemental means of evaluating period-to-period comparisons on a consistent basis. Adjusted EBITDA is calculated as earnings before interest, taxes, depreciation, and amortization, excluding income or loss from equity method investments, non-recurring and non-cash transactions, stock-based compensation, and APC excluded assets costs. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.

 

The Company believes the presentation of these non-GAAP financial measures provides investors with relevant and useful information, as it allows investors to evaluate the operating performance of the business activities without having to account for differences recognized because of non-core or non-recurring financial information. When GAAP financial measures are viewed in conjunction with non-GAAP financial measures, investors are provided with a more meaningful understanding of the Company’s ongoing operating performance. In addition, these non-GAAP financial measures are among those indicators the Company uses as a basis for evaluating operational performance, allocating resources, and planning and forecasting future periods. Non-GAAP financial measures are not intended to be considered in isolation, or as a substitute for, GAAP financial measures. Other companies may calculate both EBITDA and Adjusted EBITDA differently, limiting the usefulness of these measures for comparative purposes. To the extent this release contains historical or future non-GAAP financial measures, the Company has provided corresponding GAAP financial measures for comparative purposes. The reconciliation between certain GAAP and non-GAAP measures is provided above.

 

 

 

Exhibit 99.2
 

GRAPHIC

May 2024 Q1 2024 Update Q1 2024 Earnings Supplement

GRAPHIC

2 Forward Looking Statements This presentation contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act and Section 21E of the Exchange Act. Forward-looking statements include any statements about the Company's business, financial condition, operating results, plans, objectives, expectations and intentions, expansion plans, estimates of our total addressable market, integration of acquired companies and any projections of earnings, revenue, EBITDA, Adjusted EBITDA or other financial items, such as the Company's projected capitation and future liquidity, and may be identified by the use of forward-looking terms such as “anticipate,” “could,” “can,” “may,” “might,” “potential,” “predict,” “should,” “estimate,” “expect,” “project,” “believe,” “plan,” “envision,” “intend,” “continue,” “target,” “seek,” “will,” “would,” and the negative of such terms, other variations on such terms or other similar or comparable words, phrases or terminology. Forward-looking statements reflect current views with respect to future events and financial performance and therefore cannot be guaranteed. Such statements are based on the current expectations and certain assumptions of the Company’s management, and some or all of such expectations and assumptions may not materialize or may vary significantly from actual results. Actual results may also vary materially from forward-looking statements due to risks, uncertainties and other factors, known and unknown, including the risk factors described from time to time in the Company’s reports to the U.S. Securities and Exchange Commission (the “SEC”), including without limitation the risk factors discussed in the Company's Annual Report on Form 10-K for the year ended December 31, 2023, and subsequent Quarterly Reports on Form 10-Q. Because the factors referred to above could cause actual results or outcomes to differ materially from those expressed or implied in any forward-looking statements, you should not place undue reliance on any such forward-looking statements. Any forward-looking statements speak only as of the date of this presentation and, unless legally required, the Company does not undertake any obligation to update any forward-looking statement, as a result of new information, future events or otherwise. Use of Non-GAAP Financial Measures This presentation contains the non-GAAP financial measures EBITDA and Adjusted EBITDA, of which the most directly comparable financial measure presented in accordance with U.S. generally accepted accounting principles (“GAAP”) is net income. These measures are not in accordance with, or alternatives to, GAAP, and may be calculated differently from similar non-GAAP financial measures used by other companies. The Company uses Adjusted EBITDA as a supplemental performance measure of our operations, for financial and operational decision-making, and as a supplemental means of evaluating period-to-period comparisons on a consistent basis. Adjusted EBITDA is calculated as earnings before interest, taxes, depreciation, and amortization, excluding income or loss from equity method investments, non-recurring and non-cash transactions, stock-based compensation, and APC excluded assets costs. Beginning in the third quarter ended September 30, 2022, the Company has revised the calculation for Adjusted EBITDA to exclude provider bonus payments and losses from recently acquired IPAs, which it believes to be more reflective of its business. The Company believes the presentation of these non-GAAP financial measures provides investors with relevant and useful information, as it allows investors to evaluate the operating performance of the business activities without having to account for differences recognized because of non-core or non-recurring financial information. When GAAP financial measures are viewed in conjunction with non-GAAP financial measures, investors are provided with a more meaningful understanding of the Company’s ongoing operating performance. In addition, these non-GAAP financial measures are among those indicators the Company uses as a basis for evaluating operational performance, allocating resources, and planning and forecasting future periods. Non-GAAP financial measures are not intended to be considered in isolation, or as a substitute for, GAAP financial measures. Other companies may calculate both EBITDA and Adjusted EBITDA differently, limiting the usefulness of these measures for comparative purposes. To the extent this Presentation contains historical or future non-GAAP financial measures, the Company has provided corresponding GAAP financial measures for comparative purposes. The reconciliation between certain GAAP and non-GAAP measures is provided in the Appendix. The Company has not provided a quantitative reconciliation of applicable non-GAAP measures, such as EBITDA margin targets, to the most comparable GAAP measure, such as net income, on a forward-looking basis within this presentation because the Company is unable, without unreasonable efforts, to provide reconciling information with respect to certain line items that cannot be calculated. These items, which could materially affect the computation of forward-looking GAAP net income, are inherently uncertain and depend on various factors, some of which are outside of the Company’s control.

GRAPHIC

3 Q1 2024 Earnings Supplement May 2024 ApolloMed is now Astrana Health

GRAPHIC

4 ApolloMed is now Astrana Health ApolloMed became Astrana Health and trades under the ticker ASTH on the NASDAQ, effective February 26, 2024 Astrana Health represents a unifying brand that reflects our rapidly expanding national footprint and our deep commitment to providing high-quality care to local communities across the country New name pays homage to our founding physicians and represents our star providers and teammates, who work together to create a constellation of quality care We are excited to unite our entire team under the new brand and further accelerate our mission to deliver exceptional patient experiences and to provide quality care to all

GRAPHIC

5 Q1 2024 Performance Highlights ($ in millions, except for per share information) Q1 2024 financial results Revenue $404.4 Net Incomeattr. to ASTH $14.8 Adjusted EBITDA1 $42.2 EPS – Diluted $0.31 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA,” “Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non-GAAP Financial Measures” slides for more information. $337.2 $404.4 Q1 2023 Q1 2024 $13.1 $14.8 Q1 2023 Q1 2024 $29.8 $42.2 Q1 2023 Q1 2024 $0.28 $0.31 Q1 2023 Q1 2024 Revenue Net Income attr. To ASTH Adjusted EBITDA EPS - Diluted 20% 13% 42% 11%

GRAPHIC

6 Q1 2024 Highlights Opened 2 new de novo clinics in Nevada in April Closed acquisition of Advanced Diagnostic Surgical Center on Jan 1, 2024 Care Delivery Community Family Care Health Plan acquisition closed March 31, 2024 Prime Community Care of Central Valley joins our Care Partners segment Started full risk delegated contract in Nevada 60% revenue in full risk arrangements1 Care Partners 1. Percentage of total capitation revenue calculated expected as of April 1, 2024

GRAPHIC

7 Financial Profile Note: For more information, see “Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non-GAAP Financial Measures“ slides for more information 1. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue 2. 2020-2021 Adj. EBITDA benefitted from tailwinds of lower utilization during the COVID-19 pandemic. Return to pre-pandemic utilization in 2022 and 2023 % Adjusted EBITDA Margin1 Revenue ($ in millions) Adj. EBITDA ($ in millions) $561 $687 $774 $1,144 $1,387 $1,650- $1,850 2019 2020 2021 2022 2023 ~26% CAGR 2024E 10% 15% 17% 12% 11% 10% $54.2 $102.8 $133.5 $140.0 $146.6 $165.0- $185.0 2019 20202 20212 20222 20232 2024E ~26% CAGR

GRAPHIC

8 Care Partners Care Delivery Care Enablement Quarter over Quarter Segment Revenue Revenue $ in millions High-performing network of aligned providers High-quality system of employed providers Full-stack tech, clinical, and operations platform Other Intercompany Total Q2 2023 $325.2 $26.7 $35.0 $0.2 $(38.9) $348.2 Q3 2023 $326.5 $29.3 $36.9 $0.3 $(44.8) $348.2 Q1 2023 $314.7 $25.4 $30.6 $0.2 $(33.6) $337.2 Q4 2023 $333.7 $38.5 $33.4 $0.2 $(52.8) $353.0 Q1 2024 $397.1 $30.7 $33.3 $0.0 $(56.7) $404.4

GRAPHIC

9 Astrana Reiterates Guidance for 2024 Q1 2024 financial results Revenue $404.4 Net Incomeattr. to ASTH $14.8 Adjusted EBITDA1 $42.2 EPS – Diluted $0.31 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA,” “Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non-GAAP Financial Measures” slides for more information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See “Forward-Looking Statements” on slide 2. Actual FY 2023 Results 2024 Guidance Range Total Revenue $1,386.7 $1,650 - $1,850 Net Incomeattr. to ASTH $60.7 $61 - $73 Adjusted EBITDA1 $146.6 $165 - $185 EPS – Diluted $1.29 $1.28 - $1.52 ($ in millions, except for per share information)

GRAPHIC

10 Selected Financial Results

GRAPHIC

11 Three Months Ended March 31, $ in 000s except per share data 2024 2023 Revenue Capitation, net $ 365,910 $ 300,204 $ Risk pool settlements and incentives 17,377 13,462 Management fee income 4,078 9,896 Fee-for-service, net 15,937 12,062 Other revenue 1,054 1,620 Total revenue 404,356 337,244 Total expenses 374,217 314,871 Income from operations 30,139 22,373 Net income $ 16,862 $ 12,488 $ Net income (loss) attributable to noncontrolling interests 2,027 (644) Net income attributable to Astrana Health $ 14,835 $ 13,132 $ Earnings per share – diluted $ 0.31 $ 0.28 $ EBITDA1 $ 32,689 $ 23,961 $ Adjusted EBITDA1 $ 42,245 $ 29,825 $ Summary of Selected Financial Results 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA and “Use of Non-GAAP Financial Measures” slides for more information.

GRAPHIC

12 $ in 000s Care Partners Care Delivery Care Enablement Other Intersegment Elimination Corporate Costs Consolidated Total Total revenues $ 397,095 30,719 33,274 - (56,732) - 404,356 % change vs prior year 26% 21% 9% 20% Cost of services 314,966 24,794 17,373 - (26,734) - 330,399 General and administrative expenses1 38,933 6,163 12,397 - (30,075) 16,400 43,818 Total expenses 353,899 30,957 29,770 - (56,809) 16,400 374,217 Income (loss) from operations $ 43,196 (238) 3,504 - 772 (16,400) 30,139 % change vs prior year 94% (75%) (39%) 35% For the three months ended March 31, 2024 1. Balance includes general and administrative expenses and depreciation and amortization. 2. Income from operations for the intersegment elimination represents rental income from segments renting from other segments. Rental income is presented within other income, which is not presented in the table. Segment Results

GRAPHIC

13 $ in millions 3/31/2024 12/31/2023 $ Change Cash and cash equivalents and investments in marketable securities1 $337.29 $296.31 $40.98 Working capital $183.54 $242.83 $(59.29) Total stockholders’ equity $657.98 $616.65 $41.33 1. Excluding restricted cash Balance Sheet Highlights

GRAPHIC

14 Three Months Ended March 31, $ in 000s 2024 2023 Net Income $ 16,862 $ 12,488 Interest Expense 7,585 3,269 Interest income (3,996) (3,009) Provision for income taxes 7,142 6,921 Depreciation and amortization 5,096 4,292 EBITDA 32,689 23,961 Income from equity method investments (632) (249) Other, net 4,440 2 1,402 Stock-based compensation 5,748 3,445 APC excluded assets costs - 1,266 Adjusted EBITDA $ 42,245 $ 29,825 Adjusted EBITDA margin1 10% 9% 1. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue. 2. Other, net for the three months ended March 31, 2024 relates to a financial guarantee via a letter of credit that we provided almost three years ago in support of two local provider-led ACOs, non-cash changes related to change in the fair value of our financing obligation to purchase the remaining equity interests in one of our investments, non-cash changes related to change in the fair value of the Company’s Collar Agreement, and transaction costs incurred for our investments and tax restructuring fees. Reconciliation of Net Income to EBITDA & Adjusted EBITDA

GRAPHIC

15 For the twelve months ended TTM Ended Year Ended $ in millions March,31, 2024 2023 2022 2021 2020 2019 Net Income $ 62.2 $ 57.8 $ 45.7 $ 46.1 $ 122.1 $ 15.8 Interest expense 20.4 16.1 7.9 5.4 9.5 4.7 Interest income (15.2) (14.2) (2.0) (1.6) (2.8) (2.0) Provision for income taxes 32.2 32.0 40.9 31.7 56.3 10.0 Depreciation and amortization 18.6 17.7 17.5 17.5 18.4 18.3 EBITDA1 118.2 109.5 110.1 99.1 203.5 46.8 Goodwill impairment - - - - - 2.0 Income (loss) from equity method investments (0.9) (5.1) (5.7)6 5.36 (0.3) 6 2.9 Gain on sale of equity method investment - - - (2.2) - - Other, net 9.37 6.22 3.33 (1.7) 4 (0.5) 4 - Stock-based compensation 24.3 22.0 16.1 6.7 3.4 0.9 APC excluded assets costs 8.1 14.0 16.26 26.46 (103.3)6 1.5 Adjusted EBITDA1 $ 159.0 $ 146.6 $ 140.0 $ 133.5 $ 102.8 $ 54.2 Net Revenue $ 1,453.8 $ 1,386.7 $ 1,144.2 $ 773.9 $ 687.2 $ 560.6 Adjusted EBITDA Margin5 11% 11% 12% 17% 15% 10% 1. See “Use of Non-GAAP Financial Measures” slide for more information; 2. Other, net for the year ended December 31, 2023 consists of nonrecurring transaction costs and tax restructuring fees incurred, non-cash gains and losses related to the changes in the fair value of our financing obligation to purchase the remaining equity interests, contingent liabilities, and the Company's Collar Agreement, and excise tax related to a nonrecurring buyback of the Company’s stock from APC.; 3. Other, net for the year ended December 31, 2022 consists of one-time transaction costs incurred and non-cash gains and losses related to the changes in the fair value of our financing obligation to purchase the remaining equity interests and contingent considerations.; 4. Other, net for the years ended December 31, 2021 and 2020 relate to COVID-19 relief payments recognized in 2021 and 2020; 5. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue; 6. Certain APC minority interests where APC owns the asset but not the right to the dividends is reclassified from APC excluded asset costs to income from equity method investments; 7. Other, net for TTM ended March 31, 2024 consists of a financial guarantee via a letter of credit that we provided almost three years ago in support of two local provider-led ACOs, nonrecurring transaction costs and tax restructuring fees incurred, non-cash gains and losses related to the changes in the fair value of our financing obligation to purchase the remaining equity interests, contingent liabilities, and the Company's Collar Agreement, and excise tax related to a nonrecurring buyback of the Company’s stock from APC Reconciliation of Net Income to EBITDA & Adjusted EBITDA (continued)

GRAPHIC

16 Note: See “Use of Non-GAAP Financial Measures” slide for more information. 2024 Guidance Range ($ in 000s except per share data) Low High Net Income 71,500 85,500 Interest expense 14,500 12,500 Provision for income taxes 36,500 44,500 Depreciation and amortization 14,500 14,500 EBITDA 137,000 157,000 Loss (income) from equity method investments (5,000) (5,000) Other, net 6,000 6,000 Stock-based compensation 27,000 27,000 Adj. EBITDA 165,000 185,000 Guidance Reconciliation of Net Income to EBITDA & Adjusted EBITDA

GRAPHIC

17 Care Enablement Full-stack technology and solutions platform, empowering providers to deliver the best possible care to all patients in their communities Care Delivery Flexible footprint of owned primary care and multi-specialty clinics with employed providers who deliver personalized care Care Partners Affiliated and employed provider network, empowered to take risk across all health plan lines of business to deliver integrated care Astrana Health at-a-glance AstranaHealth is a healthcare platform that organizes and empowers providers to drive accessible, high-quality, and high-value care for all patientsthrough a provider-centric, technology-driven approach via its three business segments: 10k+ Astrana Health providers1 ~1M Members in value-based care 32+ Markets 20+ Payer partners $159.0M TTM Adj. EBITDA $1.45B TTM Revenue Note: For more information, see “Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non-GAAP Financial Measures“ slides for more information 1. Includes contracted and employed providers in our provider network, across all specialties, and including both Consolidated and Managed providers 2. Astrana Health figures based on analysis of Jan-Dec 2023 internal data from all consolidated IPAs (Medicare Advantage) and compared against relevant benchmark 3. As of March 31st, 2024 Financial Strength A platform with… Demonstrable Clinical Outcomes Scale 46% Fewer hospital admissions2 40% Fewer ER visits2

GRAPHIC

18 Care Partners Care Delivery Care Enablement Astrana flexibly supports patients and providers Quarter ended 3/31/2024 $ in 000s High-performing network of aligned providers High-quality system of employed providers Full-stack tech, clinical, and operations platform Total revenues, $ $397,095 $30,719 $33,274 Income (loss) from operations, $ $43,196 $(238) $3,504 % Margin 11% (1)% 11% Total VBC members1 , K ~880K ~800K ~1M Degree of Risk Partial & full-risk Partial & full-risk N/A Percent of premium opp. 80-90% 80-90% 10-15% LT profitability target 10-20% 10-20% 20-30% Primary Revenue Model Partial & full-risk PMPM2 Partial & full-risk PMPM2 Fee-for-service Percent of collections/revenue 1. Members in value-based care arrangements for Care Partners or Care Enablement; unique visits over LTM for Care Delivery, both as of March 31, 2024 2. PMPM: Per member per month

GRAPHIC

19 Key Takeaways Admits/K 48% below benchmark; ER visits 43% below benchmark3 Tech-powered, integrated care delivery model results in industry-leading clinical outcomes 26% 5-year adj. EBITDA CAGR2; Proven ability to consistently scale business at 10-15% EBITDA margins Proven track record of consistent profitability ~975K members in VBC arrangements across Medicare, Medicaid, and Commercial4 Strongly positioned to create a future where all can get access to high quality healthcare 26% 5-year revenue CAGR1 ; Clear visibility into continued 25%+ growth in medium term and beyond Clear levers and a repeatable growth playbook to drive further nationwide expansion Predictable adj. EBITDA margins, with 10%-17% adj. EBITDA margins in each of the last 5 years2 Flexible, capital efficient model with predictable unit economics 1. Growth figures are based on historical revenue and estimates through FY 2023 2. See the “Reconciliation of Net Income to EBITDA and Adjusted EBITDA” slide for additional information 3. Astrana Health figures based on analysis of Jan-Dec 2023 internal data from all consolidated IPAs (Medicare Advantage) and compared against relevant risk adjusted benchmark 4. As of March 31, 2024

GRAPHIC

Investor Relations Asher Dewhurst (626) 943-6491 investors@astranahealth.com

v3.24.1.u1
Cover
May 07, 2024
Cover [Abstract]  
Document Type 8-K
Amendment Flag false
Document Period End Date May 07, 2024
Entity File Number 001-37392
Entity Registrant Name ASTRANA HEALTH, INC.
Entity Central Index Key 0001083446
Entity Tax Identification Number 95-4472349
Entity Incorporation, State or Country Code DE
Entity Address, Address Line One 1668 S. Garfield Avenue
Entity Address, Address Line Two 2nd Floor
Entity Address, City or Town Alhambra
Entity Address, State or Province CA
Entity Address, Postal Zip Code 91801
City Area Code 626
Local Phone Number 282-0288
Written Communications false
Soliciting Material false
Pre-commencement Tender Offer false
Pre-commencement Issuer Tender Offer false
Title of 12(b) Security Common Stock, $0.001 par value per share
Trading Symbol ASTH
Security Exchange Name NASDAQ
Entity Emerging Growth Company false

Astrana Health (NASDAQ:ASTH)
Historical Stock Chart
Von Apr 2024 bis Mai 2024 Click Here for more Astrana Health Charts.
Astrana Health (NASDAQ:ASTH)
Historical Stock Chart
Von Mai 2023 bis Mai 2024 Click Here for more Astrana Health Charts.