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- **Revenue Growth**: Q3 2025 revenue up 100% YoY to $956 million, driven by Prospect integration and organic growth.
- **AI Innovation**: AI tools for risk prediction, claims analytics, and clinical documentation enhance care efficiency and margins.
- **Guidance Update**: 2025 EBITDA revised to $200 million-$210 million due to delayed full-risk contracts, with 2026 growth driven by Medicare Advantage rates.
- **Financial Strength**: Net leverage reduced to 2.5x, with plans to deleverage to below 2.0x through free cash flow.
- **Partnerships**: New deals with Intermountain Health and a Southern California provider group expand market reach and EBITDA contribution.

**【CEO Summary Section】**
- Astrana Health reported Q3 2025 revenue of $956 million, up 100% year-over-year and 46% sequentially, driven by the integration of Prospect Health and organic growth.
- Adjusted EBITDA was $68.5 million, up 52% year-over-year, with medical cost trends stable across both legacy Astrana and Prospect businesses.
- AI initiatives include predictive risk models, claims analytics tools, and a large language model for clinical documentation, enhancing care coordination and efficiency.
- New partnerships with Intermountain Health in Nevada and a Southern California provider group (40,000+ members) expand market reach.
- 2025 guidance updated to $3.1 billion-$3.18 billion in revenue and $200 million-$210 million in EBITDA, reflecting delayed full-risk contract transitions to Q1 2026.
- 2026 outlook includes Medicare Advantage rate tailwinds and Medicaid headwinds due to regulatory changes.

**【CFO Financial Commentary】**
- Total revenue growth of 100% YoY and 46% QoQ, with Care Enablement segment doubling in Q3.
- Operating expenses as a percentage of revenue declined, with $12 million-$15 million synergy targets on track.
- Cash flow from operations was $10 million for the quarter, with full-year free cash flow conversion expected at 40%-45% of EBITDA.
- Net leverage ratio improved to 2.5x on a pro forma basis, with plans to reduce leverage through EBITDA growth and free cash flow.

**【Q&A Key Highlights】**
- **Full-Risk Contract Delays**: 50% of delayed contracts expected to go live on 1/1/2026, others in Q1 2026, impacting Q4 2025 revenue by $60 million and EBITDA by $15 million.
- **Medicaid Trends**: Year-to-date disenrollment rates in mid-single digits, better than industry averages, with plans to stabilize trends in 2026.
- **AI Synergies**: Prospect integration on track for mid-2026, with AI tools expected to drive operating leverage and margin expansion.
- **Leverage Reduction**: Target to reduce net leverage below 2.0x within 12 months through EBITDA growth and cash flow generation.
- **2026 Growth Drivers**: Medicare Advantage rate increases,Prospect synergies, and full-risk contract expansion offset by Medicaid regulatory headwinds.

Astrana Health, Inc. (ASTH) Q3 2025 Earnings Call Transcript

- **Revenue Growth**: Q2 2025 revenue up 35% YoY to $654.8 million, driven by full-risk contracts (78% of revenue).
- **EBITDA Guidance**: FY2025 EBITDA updated to $215-225 million, with 2027 target of $350 million unchanged.
- **Prospect Synergies**: $12-15 million over 18 months, with potential upside; M&A paused until leverage <2.5x.
- **Medicaid Risk Management**: 28% of pro forma revenue, cautious on HR1 but California exposure reduces fraud risk.
- **Financial Health**: Free cash flow conversion target 40-45%, Q3 guidance reflects stable performance.

**【CEO Opening Remarks】**
- Q2 2025 revenue: $654.8 million (+35% YoY), adjusted EBITDA: $48.1 million, both at top of guidance range.
- 78% of revenue from full-risk contracts (vs. 60% YoY, 75% Q1).
- Medical cost trends: 4.5% weighted average (MA/commercial below 4.5%, Medicaid sequential improvement).
- Prospect acquisition closed at $708 million (vs. $745M originally), reducing leverage to 2.7x (target <2.5x in 12-18 months).
- Updated FY2025 guidance: $3.1-3.3B revenue, $215-225M EBITDA.
- Medicaid exposure: 28% of pro forma revenue ($1B), cautious on HR1 implementation but manageable.
- Medicare Advantage RAF stable at 1.02, minimal Part D risk (<2% members).

**【CFO Financial Commentary】**
- Q2 net income: $9.4 million, EPS: $0.19.
- Cash: $342 million, pro forma debt: $700 million.
- Free cash flow: $20 million (40% of EBITDA), FY2025 target: $90-100 million.
- Q3 guidance: $925-965M revenue, $65-70M EBITDA.
- 2027 EBITDA target: $350 million (unchanged).

**【Q&A Highlights】**
- **Prospect Integration**: $12-15M synergies over 18 months, optimistic on upside; no large M&A until deleveraging.
- **Medicaid Risks**: 20-25% enrollment drop possible, but 78% of business in California with less fraud exposure.
- **Cost Trends**: Blended 4.5% for FY2025, Prospect business trend baked into higher Q2/Q3 guidance.
- ** Pharmacy/Hospital**: Pharmacy a strategic asset for Part B optimization; hospital focused on value-based care.
- **RAF Scores**: Stable at 1.02, gap widening vs. peers using reimbursement mechanics.
- **Exchange Exposure**: <5% of membership, minimal impact expected from subsidy changes.


Astrana Health, Inc. (ASTH) Q2 2025 Earnings Call Transcript

- **Revenue Growth**: Q1 2025 up 53% YoY to $620.4M, driven by Care Partners (57% YoY) and CHS integration.
- **EBITDA Expansion**: $36.4M in Q1, with 2027 target of $350M+.
- **Strategic Acquisitions**: CHS integration complete; Prospect Health acquisition (~1.7M members) on track for Q3 2025 close.
- **Market Expansion**: Nevada risk-bearing network breakeven; Texas on track for 2025 profitability.
- **Financial Discipline**: Q1 free cash flow $13.6M; 2025 revenue guidance $2.5B-$2.7B.
- **Risk Management**: <2% Part D exposure; V28 compliance minimal impact.


**【CEO Opening Remarks】**
- Astrana Health reported Q1 2025 revenue of $620.4 million, up 53% YoY, driven by Care Partners segment growth (57% YoY) and CHS acquisition integration.
- Adjusted EBITDA was $36.4 million, reflecting disciplined execution of value-based care models and strategic investments in AI and care infrastructure.
- Key strategic pillars: membership growth, risk alignment, cost management, and operational excellence via the Care Enablement platform.

**【CEO Strategic Updates】**
- **Care Partners Segment**: 910,000 members (38% in full-risk contracts) with 75% capitated revenue from full-risk cohorts.
- **Emerging Markets**: Nevada achieved breakeven in risk-bearing network and clinics; Texas on track for 2025 profitability.
- **Acquisitions**: CHS integration complete, with $10M+ G&A efficiencies; Prospect Health acquisition (~1.7M members) expected to close in Q3 2025.
- **Leadership Additions**: New Chief Data Officer, Chief Accounting Officer, and Chief People Officer to support scalability.

**【CFO Financial Commentary】**
- Q1 2025: 
  - Revenue: $620.4M (53% YoY), driven by organic growth and acquisitions.
  - Adjusted EBITDA: $36.4M.
  - Free Cash Flow: $13.6M (excluding one-time debt costs).
  - Cash Position: $260.9M.
- Full Year 2025 Guidance: 
  - Revenue: $2.5B-$2.7B.
  - Adjusted EBITDA: $170M-$190M.
  - 2027 EBITDA Target: At least $350M.
- Q2 2025 Outlook: 
  - Revenue: $615M-$665M.
  - Adjusted EBITDA: $45M-$50M.

**【Q&A Highlights】**
- **CHS Integration**: Complete with $10M+ G&A savings; breakeven expected in 2025, profitability in 2026.
- **Prospect Health**: 60% of combined revenue to be Medicare-focused; $81M EBITDA contribution post-close.
- **Medical Cost Trend**: Q1 2025 at mid-single digits (flu-driven Medicaid spike); full-year 4.5% trend guidance maintained.
- **Prop 35 Impact**: Neutral to EBITDA once resolved; no material impact on 2025 guidance.
- **V28 Compliance**: Minimal exposure; focus on outcomes-driven care model.
- **Debt Position**: Post-Prospect close, net leverage ~3.4x; target <3x within 12 months.


Astrana Health, Inc. (ASTH) Q1 2025 Earnings Call Transcript

- **Record Growth**: 2024 revenue up 47% to $2.03 billion, EBITDA up 16% to $170.4 million.
- **Strategic Wins**: 73% full-risk contracts, 75% seniors with wellness visits, $10M+ AI savings by 2026.
- **Acquisition Momentum**: CHS to add $350-400M in 2025, Prospect on track for Q2 close with $1.2B revenue.
- **Disciplined Execution**: 5.3% utilization trend vs. industry 8-10%, $15M integration costs in 2025.
- **Long-Term Vision**: 2027 EBITDA target of $350M, 15% non-CA revenue in 2025, sub-3x leverage post-Prospect.

**【CEO Summary Section】**
- **2024 Financial Highlights**: Total revenue of $2.03 billion (47% YoY growth), adjusted EBITDA of $170.4 million (16.2% YoY growth). Care Partners segment drove 52% YoY growth to $1.95 billion.
- **Strategic Pillars**: 
  1. **Membership Growth**: 55% membership expansion in Care Partners, including CHS acquisition and organic growth.
  2. **Risk Progression**: 73% of capitation revenue from full-risk contracts, targeting 75-85% in 2025.
  3. **Quality Outcomes**: 75% of seniors received annual wellness visits, with improved closure rates for chronic conditions.
  4. **Operational Excellence**: $10 million+ savings from AI/automation investments by 2026.
- **Acquisition Updates**: CHS to contribute $350-400 million in 2025, nearing break-even by late 2025. Prospect Health acquisition expected to close Q2 2025, with $1.2 billion revenue and $94 million EBITDA in 2024.
- **Utilization Trends**: 5.3% overall trend (vs. industry 8-10%), with disciplined cost management in full-risk business.

**【CFO Financial Commentary】**
- **2024 Liquidity**: $288.5 million cash, $471.8 million debt (including lease liabilities). Secured $1.3 billion credit facility for Prospect integration.
- **2025 Guidance**: 
  - Revenue: $2.5-2.7 billion
  - Adjusted EBITDA: $170-190 million
  - Assumptions: 4.5% trend, $15 million integration/AI costs, 75-85% full-risk revenue mix.
  - Free Cash Flow: ~45% of EBITDA, with one-time $10 million CHS benefit in 2025.
- **Debt Management**: Target net leverage below 3x within 9 months post-Prospect close.

**【Q&A Key Themes】**
- **Medicaid Challenges**: 8-9% trend driven by Prop 35 and redeterminations; no rate relief baked into guidance.
- **CHS Integration**: $10 million annual drag in 2025, targeting break-even in 2026.
- **Prospect Synergies**: Similar delegated model to Astrana, with potential for 7-8% margin at scale.
- **Market Expansion**: Nevada and Texas markets on track for 2025 break-even, targeting 15% non-CA revenue in 2025.
- **AI Savings**: $10 million+ annual savings from automation investments, materializing in 2026+.


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