Astrana

Overview

Astrana (Nasdaq: ASTH) is a physician-centric, technology-powered, risk-bearing healthcare company. Its integrated health network and technology platform enables providers to participate in value-based care arrangements, with the goal of delivering accessible, high-quality care at lower cost.

As of December 31, 2025:

• More than 20,000 contracted physicians in the network
• Coordinated value-based care for approximately 1.6 million patients
• About 3,000 employees
• Care Delivery network spanning over 60 locations, including clinics and one wholly owned acute care hospital
• Care Partners and Care Enablement platforms that support a broad ecosystem of providers and payers

In July 2025 Astrana completed the acquisition of Prospect Medical Holdings, Inc. for $674.9 million, expanding its provider network, payer relationships, and strategic assets. Prospect operates over 11,000 providers, a California Knox-Keene licensed health plan, an MSO, a specialty pharmacy, and an accredited acute care hospital.

Segment structure

Astrana reports results in three segments:

1. Care Partners

• Builds and manages high-performance provider networks by partnering with and investing in independent providers aligned on value-based care.
• Operates networks that include IPAs, ACOs, and California Restricted Knox-Keene licensed health plans (RKKs).
• Can assume various levels of financial risk across Medicare, Medicaid, Commercial, and Exchange lines; California RKKs allow assumption of full professional and institutional risk in some plans.
• Participates in CMS models through ACOs (MSSP and ACO REACH) with shared savings or losses determined by CMS benchmarks and a defined risk-sharing corridor.
• Revenue types: capitation revenue; risk pool settlements and incentives; management fee income; pay-for-performance incentives.

2. Care Delivery

• Provides patient-centric, data-driven care across clinics and inpatient/outpatient services.
• Footprint includes 60+ locations: primary care, specialty clinics, inpatient services, post-acute care, urgent care, imaging centers, ambulatory surgery centers, full-service labs, and a specialty pharmacy.
• Includes hospital-based care and outpatient services.
• Serves approximately 1.6 million patients annually.
• Strategy includes evaluating, building, and acquiring practices to fill geographic or specialty gaps and to scale into new markets.

3. Care Enablement

• A technology and services platform that integrates clinical, operational, financial, and administrative data.
• Comprises a proprietary technology suite used across Care Partners and Care Delivery, and by third-party providers.
• Services include population health management (PHM), non-medical management services, and MSO operations providing administrative, risk management, contracting, credentialing, revenue cycle, and related services under MSAs.
• Provides solutions to payers and providers to manage total cost of care and support both fee-for-service and risk-based arrangements.

Business and operating model

• End-to-end value-based care platform combining clinical delivery, physician network management, and technology-enabled administrative services to coordinate care among patients, families, physicians, hospitals, and payers.
• Population health management tools aggregate and analyze patient data to improve outcomes, guide care coordination, and support risk adjustment factor (RAF) optimization and quality metrics.
• MSOs provide non-medical management services under long-term MSAs to affiliated IPAs and medical groups. Where corporate practice of medicine laws apply, Astrana uses nominee shareholder arrangements and physician-owned MSOs to comply while consolidating non-medical activities.

Revenue streams

Primary revenue sources include:

• Capitation revenue: fixed per-member-per-month payments under capitated arrangements with HMOs, IPAs, and a California Knox-Keene health plan, including global capitation covering professional and institutional costs in some plans.
• Risk pool settlements and incentives: revenue tied to hospital- and health-plan risk-sharing arrangements and pay-for-performance programs; MSSP-related revenue recognized on a net basis due to shared-risk characteristics.
• Management fee income: fees for MSO and related administrative services to IPAs, ACOs, hospitals, health plans, and other providers; contract terms typically range from 1 to 30 years and may be linked to volumes, staffing, or performance.
• Fee-for-service (FFS) revenue: professional fees billed to third-party payers and patients for services delivered by clinics, hospitals, and employed physicians.
• Other revenue: maternity care and HQAF-related revenue recognized as services are rendered or over the period of obligation.

Payor concentration and regulatory context

• Four payers accounted for a substantial portion of net revenue: 59.8% in 2025; 66.2% in 2024; 61.7% in 2023.
• Operations are subject to federal and state healthcare laws and regulations, including HIPAA, the Anti-Kickback Statute, the Stark Law, the False Claims Act, and state corporate practice of medicine restrictions, which influence structuring of MSAs, physician ownership arrangements, and risk-sharing activities.

Notable transaction

• Prospect Medical Holdings acquisition
  • Completed: July 1, 2025
  • Purchase price: $674.9 million
  • Strategic impact: expanded provider network (over 11,000 Prospect providers), added a California Knox-Keene health plan, an MSO, specialty pharmacy, and an acute care hospital, broadening Astrana’s access, quality, and value opportunities.

Key metrics (as of December 31, 2025)

• Patients under care: ~1.6 million
• Contracted physicians: >20,000
• Employees: ~3,000
• Care Delivery footprint: 60+ locations and one wholly owned hospital
• Four payers comprised about 59.8% of net revenue in 2025

One-sentence description

Astrana operates an integrated, physician-centric healthcare platform that combines a large provider network, data-driven care delivery, and a technology-enabled MSO ecosystem to coordinate and manage value-based care programs and capitation-based arrangements for a broad mix of patients, payers, and health plans.