Astrana Health

ASTH · Nasdaq · Health Care · Financials, fiscal 2017 to 2025

ASTH · Last close · October 26, 2026

$37.23

Astrana Health's revenue rose 56.4% to $3.2 billion in fiscal 2025. Its operating margin was 2.5%, down from 4.4% a year earlier. Free cash flow was $104 million, up 136.6%. It paid out $33 million in dividends and buybacks, 32% of free cash flow. The diluted share count rose 2.9%.

Astrana Health, Inc. Latest fiscal year ended December 31, 2025 10-K filed March 12, 2026 · 0001193125-26-103128 Updated October 22, 2026

Revenue

$3.2B

56.4%

Operating margin

2.5%

1.9 pts

Net income

$22M

47.9%

Free cash flow

$104M

136.6%

Return on capital

4.2%

3.3 pts

Market cap

$1.9B

Oct 26 close

P/E

44.9x

On $0.83 EPS, 4 qtrs

Operating margin is operating income as a share of revenue. Free cash flow is cash from operations minus capital spending. Return on capital is after-tax operating income as a share of the money invested in the business: debt plus equity, minus cash. Market cap is the last closing share price times the latest diluted share count, so it is approximate. P/E is the last close divided by diluted earnings per share over the last four quarters, or the latest fiscal year where the quarters aren't available; there is none when the company made a loss.

About these figures. Astrana's balance sheet shows a negative 'mezzanine' amount for the minority owners of Allied Physicians of California (US$235 million at the end of 2025). Total liabilities plus shareholders' equity therefore exceed total assets by that amount, as filed. In fiscal 2025 the SEC's structured data shows assets that differ from liabilities plus equity by more than 3%, so total liabilities may be incomplete.

Charts show fiscal years, from the 10-K filings.

Revenue and margins

Revenue

US$ billions, fiscal years

Margins

Percent of revenue

GrossOperatingNetFree cash flow

Net income and earnings per share

From fiscal 2017 to 2025, earnings per share fell 8.0% a year and net income 1.7% a year, as new shares raised the share count by 72% and diluted each share's earnings.

Net income

US$ billions, fiscal years; loss years in red.

Diluted earnings per share

US$ per share, fiscal years, restated for any stock splits; loss years in red.

Returns on capital

Return on capital and on equity

Percent. Return on capital is after-tax operating income over the money invested in the business (debt plus equity, minus cash); return on equity is net income over shareholders' equity. Both use the average of opening and closing balances.

Return on capitalReturn on equity

Cash flow

Free cash flow

US$ billions. Cash from operations minus capital expenditure; negative years in red.

Payouts and share count

Dividends and buybacks

US$ billions, cash paid in each fiscal year

DividendsShare buybacks

Diluted share count

Weighted-average diluted shares, millions

Valuation

Two ways to value Astrana Health yourself, both starting from its filings: a discounted cash flow model and the price-to-earnings method.

Discounted cash flow (DCF)

A discounted cash flow (DCF) model values a business as the cash it may generate in future, discounted back to today. The starting figures come from Astrana Health's 10-K (or, for net cash and shares, its latest 10-Q) and the assumptions are yours: start from one of three example scenarios, then change any figure to see what it implies for a share, and how that compares with the last share price.

Value per share on three example scenarios, from Astrana Health's fiscal 2025 free cash flow of $104M, net cash of −$609M at December 31, 2025 and 49 million diluted shares, from its filings. The scenarios are fitted to Astrana Health: the base scenario's growth in years 1 to 5 is its revenue growth over the last 3 years, 40.6% a year, kept between 0% and 20%; the cautious and optimistic ones are lower and higher, and growth in years 6 to 10 is halfway to the long-run rate. The base scenario's discount rate is 10%: 9% for a business of moderate risk (Health Care Facilities), plus 1 point as a smaller company, worth $1.9B; the cautious and optimistic ones use a point more and a point less. Select one to load it into the calculator. These are the model's arithmetic on those assumptions, not a forecast or a price target.

From the filings

Starting free cash flow, US$ millions

Cash from operations minus capital spending in fiscal 2025.

Net cash, US$ millions

Cash and short-term investments minus debt and finance leases at December 31, 2025. Negative means net debt.

Diluted shares, millions

Weighted-average diluted shares in fiscal 2025.

Your assumptions

Start from

Fitted to Astrana Health's own revenue growth, as above. Cautious: growth of 10% then 6% a year, 2% after year 10, a 11% discount rate. Base: growth of 20% then 11% a year, 2.5% after year 10, a 10% discount rate. Optimistic: growth of 25% then 14% a year, 3% after year 10, a 9% discount rate.

Free cash flow growth, years 1 to 5 (% a year)

Free cash flow growth, years 6 to 10 (% a year)

Growth after year 10 (% a year)Long-run growth forever after year 10. Usually close to inflation, and always below the discount rate.

Discount rate (% a year)The yearly return an investor wants for the risk. A higher rate gives a lower value.

Value per share on these assumptions

—

Last close, October 26, 2026: $37.23
Value on these assumptions, against the last close: —

Cash flows in years 1 to 10, valued today: —
Everything after year 10, valued today: —
Plus net cash: —
Share of value from after year 10: —

Projected free cash flow

US$ billions. Each column is one year's projected free cash flow, split into what it is worth today and the part removed by discounting.

Value todayRemoved by discounting

How the value changes with two assumptions

Value per share in US$, with the growth rates above. The highlighted cell matches the current assumptions.

How the model works. Free cash flow grows at the first rate for five years and the second rate for five more, and each year is discounted at the discount rate. Everything after year 10 is valued as year-10 cash flow × (1 + growth after year 10) ÷ (discount rate − growth after year 10), discounted back ten years. Net cash is added and the total is divided by diluted shares. The result depends entirely on the assumptions. It is not a forecast, a price target or a recommendation. The last close is the consolidated US closing price, from Databento.

Price-to-earnings (P/E) method

Another common way to value a company is to multiply its earnings per share by a price-to-earnings (P/E) multiple: the number of years of today's earnings an investor pays for a share. A higher multiple usually means investors expect earnings to grow. Choose a multiple, for example from similar companies, to see the value it gives.

Value per share on three example scenarios, from Astrana Health's earnings per share of $0.83 (over the last four quarters). Each grows earnings for a year at the cash flow scenarios' rates and applies a multiple to next year's earnings: 27.8×, the middle of Astrana Health's own P/E today, its peers' median and its sector's median (the Health Care median) for the base scenario, 20% less and more for the cautious and optimistic ones. The price is brought back a year at 11%, 10% and 9%. Select one to load it into the calculator. These are the model's arithmetic on those assumptions, not a forecast or a price target.

Earnings per share, US$

Diluted earnings per share over the four quarters to June 30, 2026, from the 10-Qs and 10-K.

P/E multiple

P/E today is the last close divided by the latest earnings per share, the four quarters' where available. Peers: Ensign Group, Option Care Health, Encompass Health.

Earnings growth in the years ahead (% a year) Starts at Astrana Health's revenue growth over the last 3 years, 40.6% a year, kept between 0% and 20%, as the base scenario does.

Earnings per share in the years ahead, US$

Year 1Year 2Year 3Year 4Year 5

Type your own estimate for any year; the years after it carry on at the growth rate.

Apply the multiple to earnings

A multiple on a future year's earnings gives the price then, brought back to today at the discount rate below.

Discount rate (% a year) The yearly return an investor wants for the risk, as in the cash flow model.

Value per share today at this multiple

—

Last close, October 26, 2026: $37.23
Value at this multiple, against the last close: —
Astrana Health's P/E at the last close: 44.9×

Company	Last close	Earnings per share	P/E today
Astrana HealthASTH	$37.23	$0.83	44.9×
Ensign GroupENSG	$176.92	$6.38	27.7×
Option Care HealthOPCH	$31.23	$1.28	24.4×
Encompass HealthEHC	$124.10	$6.14	20.2×

How the P/E method works. Value per share is earnings per share times the multiple. On a future year's earnings, that gives the price in that year, which is brought back to today at the discount rate: price ÷ (1 + discount rate) for each year ahead. It is quick and easy to compare across companies, but it ignores debt and cash, and earnings can swing with one-off gains and charges, so a multiple says most about steady, profitable businesses. Like the cash flow model, the result depends entirely on the assumptions you choose. It is not a forecast, a price target or a recommendation.

Balance sheet

Fiscal year end	FY21	FY22	FY23	FY24	FY25
Cash and short-term investments	286	294	296	291	430
Debt incl. finance leases	185	206	280	436	1,039
Net debt (negative means net cash)	−101	−88	−16	145	609
Net debt to EBITDA	−0.9x	−0.7x	−0.2x	1.2x	4.9x
Debt to equity	0.4x	0.4x	0.5x	0.6x	1.3x
Interest coverage	18.2x	13.2x	5.2x	2.7x	1.6x
Current ratio	3.5x	2.9x	2.1x	1.8x	1.4x
Quick ratio	3.5x	2.9x	2.1x	1.8x	1.4x

US$ millions unless stated, at each fiscal year end. Net debt to EBITDA is debt minus cash, divided by operating income before depreciation and amortization: roughly how many years of those earnings the net debt equals. Debt to equity is debt as a multiple of shareholders' equity. Interest coverage is operating income divided by interest expense. The current ratio is current assets over current liabilities; the quick ratio leaves out inventory.

Insider trades

No officer, director or 10% owner of Astrana Health reported buying or selling its shares on the open market between October 27, 2025 and October 26, 2026.

From Form 4 filings with the SEC. Grants, option exercises and shares withheld for tax aren't counted. Insider trades at all companies

Piotroski F-score

The F-score counts how many of nine simple tests of profitability, funding and efficiency a company passed in a year (Piotroski, 2000). The more tests passed, the stronger the year: 8 or 9 is strong, 0 to 2 weak. Companies that report no gross profit are scored on the other eight.

Test	FY23	FY24	FY25
Net income is positive	Pass	Pass	Pass
Cash from operations is positive	Pass	Pass	Pass
Return on assets rose	Pass	Fail	Fail
Cash from operations exceeds net income	Pass	Pass	Pass
Debt fell relative to assets	Fail	Fail	Fail
Current ratio rose	Fail	Fail	Fail
Share count didn't rise	Fail	Fail	Fail
Gross margin rose	—	—	—
Revenue rose relative to assets	Pass	Pass	Pass
F-score	5 of 8	4 of 8	4 of 8
Accruals ratio	−0.8%	−0.8%	−5.2%

The accruals ratio is net income minus cash from operations, over average total assets.

Compare

Put Astrana Health side by side with any other company we cover: revenue, growth, margins, cash flow and returns, with ten years of charts.

Similar companies

Company	Year	Revenue growth	Operating margin	Free cash flow margin	Return on capital	Net debt to EBITDA	F-score	Compare
Astrana Health	FY25	56.4%	2.5%	3.3%	4.2%	4.9x	4
Acadia Healthcare	FY25	5.0%	—	−13.3%	−16.0%	—	4	Compare
Ensign Group	FY25	18.7%	8.4%	—	19.7%	−0.8x	6	Compare
Option Care Health	FY25	13.0%	6.0%	3.8%	11.4%	2.3x	5	Compare
Encompass Health	FY25	10.5%	—	7.4%	15.8%	1.7x	8	Compare

Each company's latest fiscal year. Fiscal years end in different months, so the periods don't line up exactly. Free cash flow margin is free cash flow as a share of revenue. Net debt to EBITDA is explained under the balance sheet, and the F-score above.

10 years of figures

Fiscal year	FY17	FY17	FY18	FY19	FY20	FY21	FY22	FY23	FY24	FY25
Income statement
Revenue	356	356	520	561	687	774	1,144	1,387	2,034	3,182
Revenue growth	709.0%	709.0%	45.9%	7.8%	22.6%	12.6%	47.8%	21.2%	46.7%	56.4%
Gross profit	83	83	159	93	148	178	—	—	—	—
Research and development	—	—	—	—	—	—	—	—	—	—
Operating income	35	35	88	32	80	98	104	85	89	78
Net income	26	26	11	14	38	69	45	61	43	22
Diluted EPS (US$)	0.90	0.90	0.29	0.39	1.01	1.52	0.99	1.29	0.90	0.46
Diluted shares (millions)	29	29	38	36	37	45	46	47	48	49
Cash flow
Cash from operations	52	52	26	14	46	70	82	68	52	115
Capital expenditure	2	2	1	1	1	19	23	28	8	10
Free cash flow	50	50	24	13	45	51	59	40	44	104
Dividends paid	10	10	18	62	51	31	14	62	4	8
Share buybacks	3	3	5	8	0	6	9	10	1	26
Acquisitions	0	0	0	49	11	3	16	6	146	549
Stock-based compensation	3	3	1	2	3	7	16	22	34	39
Balance sheet at fiscal year end
Cash and short-term investments	101	101	108	220	261	286	294	296	291	430
Debt incl. finance leases	—	—	0	233	242	185	206	280	436	1,039
Total assets	491	491	513	729	818	867	966	933	1,355	2,219
Total liabilities	154	154	106	368	372	357	408	523	841	1,660
Shareholders' equity	160	160	180	192	331	448	543	614	713	779
Margins and ratios
Gross margin	23.3%	23.3%	30.5%	16.6%	21.5%	23.0%	—	—	—	—
Operating margin	9.9%	9.9%	17.0%	5.8%	11.7%	12.7%	9.1%	6.1%	4.4%	2.5%
Net margin	7.2%	7.2%	2.1%	2.5%	5.5%	8.9%	4.0%	4.4%	2.1%	0.7%
Free cash flow margin	14.0%	14.0%	4.7%	2.2%	6.5%	6.6%	5.2%	2.9%	2.2%	3.3%
Return on capital	—	—	—	15.9%	21.4%	17.6%	13.6%	10.3%	7.5%	4.2%
Return on equity	32.5%	32.5%	6.4%	7.6%	14.4%	17.7%	9.1%	10.5%	6.5%	3.0%
Return on assets	10.1%	10.1%	2.2%	2.3%	4.9%	8.2%	4.9%	6.4%	3.8%	1.3%
Net debt to EBITDA	—	—	−1.0x	0.3x	−0.2x	−0.9x	−0.7x	−0.2x	1.2x	4.9x

US$ millions unless stated. Where a later 10-K restated a year, the latest filed figure is shown. Download all figures (CSV, US$ millions)

Source: Astrana Health's Form 10-K filings, from SEC EDGAR. For information only, not investment advice. The Filing Desk is not affiliated with Astrana Health.