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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 2.02 | Results 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 9.01 | Financial Statements and Exhibits. |
(d) Exhibits.
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 Stockholders’ Equity,
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
| May 2024
Q1 2024 Update
Q1 2024 Earnings Supplement |
| 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. |
| 3
Q1 2024 Earnings Supplement
May 2024
ApolloMed is now Astrana Health |
| 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 |
| 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
$0.31
Q1 2023 Q1 2024
Revenue Net Income attr. To ASTH
Adjusted EBITDA EPS - Diluted
20% 13%
42%
11% |
| 6
Q1 2024 Highlights
Opened 2 new de novo clinics in Nevada in April
Closed acquisition of Advanced Diagnostic Surgical Center on Jan 1, 2024
Care Delivery
Community Family Care Health Plan acquisition closed March 31, 2024
Prime Community Care of Central Valley joins our Care Partners segment
Started full risk delegated contract in Nevada
60% revenue in full risk arrangements1
Care Partners
1. Percentage of total capitation revenue calculated expected as of April 1, 2024 |
| 7
Financial Profile
Note: For more information, see “Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non-GAAP Financial Measures“ slides for more information
1. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue
2. 2020-2021 Adj. EBITDA benefitted from tailwinds of lower utilization during the COVID-19 pandemic. Return to pre-pandemic utilization in 2022 and 2023
% Adjusted EBITDA Margin1
Revenue ($ 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 |
| 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 |
| 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) |
| 10
Selected Financial Results |
| 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. |
| 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 |
| 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 |
| 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 |
| 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) |
| 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 |
| 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 |
| 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 |
| 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 |
| Investor Relations
Asher Dewhurst
(626) 943-6491
investors@astranahealth.com |
v3.24.1.u1
Cover
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May 07, 2024 |
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