Astrana Health Reports 47% Revenue Growth to $2,034.5 Million in 2024

Astrana Health, Inc. (ASTH) reported total revenue of $2,034.5 million for the year ended December 31, 2024, a 47% increase compared to $1,386.6 million in 2023. This significant increase was primarily driven by acquisitions within the Care Partners segment and increased patient enrollment in full-risk Restricted Knox-Keene plans. Net income attributable to Astrana Health, Inc. decreased to $43.1 million in 2024 from $60.7 million in 2023, a 29% decline primarily due to increased interest expense and income attributable to non-controlling interests, partially offset by an increase in unrealized gains on investments. Adjusted EBITDA, a non-GAAP measure, increased by 16% to $170.4 million in 2024.

The company's operating expenses also increased significantly in 2024, reaching $1,945.2 million compared to $1,302.1 million in 2023, a 49% rise. This increase reflects higher costs of services, general and administrative expenses, and depreciation and amortization, largely due to increased participation in value-based care models, higher patient visits, and increased headcount to support operational growth and acquisitions. The cost of services, excluding depreciation and amortization, increased by 50% to $1,763.2 million. General and administrative expenses rose by 37% to $154.1 million.

During 2024, Astrana Health completed several acquisitions, including Collaborative Health Systems, LLC (CHS) for $37.5 million plus potential earn-out payments, and acquired assets from a subsidiary of DWGAS, Inc. The company also entered into an agreement to acquire certain assets and businesses of Prospect Medical Holdings, Inc. for $745 million, subject to customary closing conditions and regulatory approvals; this acquisition is anticipated to close in mid-2025. Other strategic developments included partnerships with Anthem Blue Cross and BASS Medical Group, and a convertible loan to Elation Health which was subsequently converted to an asset acquisition.

As of December 31, 2024, Astrana Health managed care for approximately 1.1 million patients through its network of over 10,000 contracted physicians across seven states. The company employed approximately 1,900 employees. The company's revenue streams are diversified across capitation, risk pool settlements and incentives, management fees, and fee-for-service revenue. A limited number of payers accounted for a significant portion of the company's net revenue, with four payers representing 66.2% of total net revenue in 2024.

The company's 10-K filing includes numerous risk factors, including those related to the Prospect acquisition, the company's complex legal structure, dependence on a limited number of key payers, intense competition in the healthcare industry, and the risks associated with participation in value-based care models like ACO REACH and MSSP. The filing also details the company's compliance with extensive healthcare regulations and the potential impact of changes in healthcare legislation and government regulation. The company's outlook is contingent upon the successful completion of the Prospect acquisition and its ability to manage the associated risks and integrate the acquired operations.