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ASTH on Nasdaq

Astrana Health, Inc.

Astrana Health, Inc. is an American management consulting services company based in Alhambra.1 Its shares trade on Nasdaq under the symbol ASTH.1

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Last updated Oct 21, 2026.

Overview

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  • TickerASTH on Nasdaq1
  • IndustryServices-Management Consulting Services1
  • HeadquartersAlhambra, California1
  • Incorporated inDE2
  • Business address1668 S. Garfield Avenue, 2Nd Floor, Alhambra, Ca 918012
  • Filer categoryLarge accelerated filer2
  • Legal formCorporation

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The following abbreviations or acronyms that may be used in this document shall have the adjacent meanings set forth below:4 From its latest annual report

Financials

From the company’s reports to the SEC. Every number links to the filing it came from.

Key numbers, fiscal 2025

2.5%Operating margin5
0.7%Net margin5
56.4%Revenue growth, 20255
2.9%Return on equity5
1.27×Debt to equity5
$104.5MFree cash flow5

What sells

Revenue by product, business segment and region, as the company reports it to the SEC.

Products and services

Health Care Capitation Revenue brought in 92% of the revenue Astrana Health, Inc. broke down this way in fiscal 2025.

  1. Health Care Capitation Revenue$2.9B592%up 57% from 2024
  2. Health Care, Patient Service$112.6M54%up 81% from 2024
  3. Health Care, Other$86.2M53%down 0% from 2024
  4. Management Service$30.4M51%up 117% from 2024
  5. Product and Service, Other$28.3M51%up 86% from 2024
Products and services by year
Products and services202320242025
Health Care Capitation Revenue$1.2B$1.9B$2.9B
Health Care, Patient Service$59.7M$62.3M$112.6M
Health Care, Other$63.5M$86.2M$86.2M
Management Service$38.7M$14.0M$30.4M
Product and Service, Other$9.2M$15.2M$28.3M

Business segments

Care Partners brought in 86% of the revenue Astrana Health, Inc. broke down this way in fiscal 2025.

  1. Care Partners$3.0B586%up 55% from 2024
  2. Care Delivery$250.7M57%up 83% from 2024
  3. Care Enablement$246.7M57%up 59% from 2024
Business segments by year
Business segments202320242025
Care Partners$1.3B$1.9B$3.0B
Care Delivery$117.9M$136.7M$250.7M
Care Enablement$135.8M$155.4M$246.7M

Where the money goes

Where each dollar of revenue went, fiscal 2025

  • Other costs99¢$3.1B
  • Income tax0¢$15.5M
  • Profit1¢$22.5M

Out of $3.2B in revenue.5

Where each dollar of operating cash went, fiscal 2025

  • Capital spending9¢$10.1M
  • Dividends paid7¢$7.9M
  • Share buybacks22¢$25.6M
  • Kept or used elsewhere62¢$71.0M

Out of $114.6M of cash from operations.5

Financial statements

Revenue67895$3.2B in 2025+468% since 2019
0$1.0B$2.0B$3.0B$4.0B2019: $560.6M$560.6M20192020: $687.2M$687.2M2020+23%2021: $773.9M$773.9M2021+13%2022: $1.1B$1.1B2022+48%2023: $1.4B$1.4B2023+21%2024: $2.0B$2.0B2024+47%2025: $3.2B$3.2B2025+56%
Operating income67895$78.5M in 2025+142% since 2019
0$50.0M$100.0M$150.0M2019: $32.4M$32.4M20192020: $80.5M$80.5M2020+148%2021: $98.2M$98.2M2021+22%2022: $104.3M$104.3M2022+6%2023: $84.6M$84.6M2023−19%2024: $89.3M$89.3M2024+6%2025: $78.5M$78.5M2025−12%
Net income67895$22.5M in 2025+59% since 2019
0$20.0M$40.0M$60.0M$80.0M2019: $14.1M$14.1M20192020: $37.7M$37.7M2020+167%2021: $68.9M$68.9M2021+83%2022: $45.2M$45.2M2022−34%2023: $60.7M$60.7M2023+34%2024: $43.1M$43.1M2024−29%2025: $22.5M$22.5M2025−48%

Every line of the income statement as filed: the last 3 fiscal years, latest first.5

Period ending2025-12-312024-12-312023-12-31
Total revenue$3.2B$2.0B$1.4B
Cost of services, excluding depreciation and amortization$2.8B$1.8B$1.2B
General and administrative expenses$217.3M$154.1M$112.6M
Depreciation and amortization$45.7M$27.9M$17.7M
Total expenses$3.1B$1.9B$1.3B
Income from operations$78.5M$89.3M$84.6M
Income from equity method investments$1.7M$4.5M$5.6M
Interest expense-$49.9M-$33.1M-$16.1M
Interest income$12.2M$14.5M$14.2M
Unrealized (loss) gain on investments-$68.0K$731.0K-$4.6M
Other (loss) income-$2.8M$4.9M$6.1M
Total other (expense) income, net-$38.9M-$8.5M$5.2M
Income before provision for income taxes$39.6M$80.8M$89.8M
Provision for income taxes$15.5M$30.9M$32.0M
Net income$24.1M$49.9M$57.8M
Net income (loss) attributable to noncontrolling interests$1.6M$6.8M-$2.9M
Net income attributable to Astrana Health, Inc.$22.5M$43.1M$60.7M
Earnings per share - basic (in dollars per share)$0.46$0.91$1.30
Earnings per share diluted (in dollars per share)$0.46$0.90$1.29

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Corporate structure

Astrana Health, Inc. sits at the top of its group. 10 entities, 1 country on record. Switch between the flow chart and the network, and select any entity to see its details.

Major holders of Astrana Health, Inc.

  • Astrana Health, Inc. Alhambra, California
    • Allied Physicians of California, A Professional Medical Corporation Subsidiary · California, United States
    • Astrana Care Partners Medical Corporation Subsidiary · California, United States
    • Astrana Health Management, Inc. Subsidiary · California, United States
    • Astrana Health Medical Corporation Subsidiary · California, United States
    • Astrana Health Technologies, Inc. Subsidiary · Delaware, United States
    • Community Family Care Health Plan Subsidiary · California, United States
    • Foothill Regional Medical Center Subsidiary · California, United States
    • For your Benefit, Inc. Subsidiary · California, United States
    • Prospect Health Plan, Inc. Subsidiary · Delaware, United States

Built from subsidiaries listed in Exhibit 21 of annual reports filed with the SEC; major holders from Schedules 13D and 13G. Each entity in the chart links to its source.

What it owns

What Astrana Health, Inc. reports owning in its annual reports to the SEC: buildings, land and equipment, real estate and locations, investments, intangible assets and inventory, at the end of its latest fiscal year and a year before.

Property and equipment

ItemLatestA year beforeChange
Property and equipment, before depreciation$87.0M5 Dec 31, 2025$39.0M5 Dec 31, 2024+123.3%
Accumulated depreciation$29.7M5 Dec 31, 2025$24.7M5 Dec 31, 2024+20.2%
Property and equipment, net$57.3M5 Dec 31, 2025$14.3M5 Dec 31, 2024+301.7%
Finance-lease assets$1.3M9 Dec 31, 2024$1.7M9 Dec 31, 2023−23.5%
Operating-lease assets (leased space)$35.7M5 Dec 31, 2025$32.6M5 Dec 31, 2024+9.6%

Investments

ItemLatestA year beforeChange
Cash and cash equivalents$429.5M5 Dec 31, 2025$288.5M5 Dec 31, 2024+48.9%
Marketable securities, current$2.4M9 Dec 31, 2024$2.5M9 Dec 31, 2023−4.8%
Debt securities available for sale$115.0K5 Dec 31, 2025$2.4M5 Dec 31, 2024−95.2%
Equity securities at fair value$89.0K9 Dec 31, 2024$348.0K9 Dec 31, 2023−74.4%
Stakes in other companies (equity method)$25.6M5 Dec 31, 2025$39.3M5 Dec 31, 2024−34.8%

Intangibles and goodwill

ItemLatestA year beforeChange
Goodwill$865.3M5 Dec 31, 2025$419.3M5 Dec 31, 2024+106.4%
Intangible assets, net (excluding goodwill)$271.0M5 Dec 31, 2025$118.2M5 Dec 31, 2024+129.3%
Accumulated amortization$197.6M5 Dec 31, 2025$156.9M5 Dec 31, 2024+26.0%
Finite-lived intangibles, net$265.0M5 Dec 31, 2025$114.1M9 Dec 31, 2024+132.2%

Properties, in its own words

Our corporate headquarters are located in Alhambra, California, where we lease approximately 35,000 square feet of office space in two adjacent buildings from a related party. We also lease approximately 47,500 square feet of office space in Monterey Park, California, from a related party and approximately 13,000 square feet of office space in Las Vegas, Nevada.

We lease other offices and medical spaces located in the following counties in California: Los Angeles, Riverside, Orange, and San Mateo. We also maintain offices and medical spaces in Nevada, Texas, and New York. Monthly rental payments range from approximately $1,000 to $0.1 million and have terms that expire between April 30, 2026 and, subject to options to extend provided thereunder, December 31, 2045. We own and operate approximately 109,000 square feet of an acute care hospital based in Tustin, California.

The rest of Item 2

We believe our existing facilities are in good condition, suitable, and adequate for our current requirements. Based on current information and subject to future events and circumstances, we anticipate extending leases on our various facilities as necessary, as they expire, and leasing additional facilities to accommodate possible future growth.

Item 2 of the 10-K filed Mar 12, 2026.4

Leadership

Who has led Astrana Health, Inc., and when. Pick a name to see everywhere that person has worked.

Chief executive

  1. Warren Hosseinion2008–2018
  2. Thomas S. Lam2017–2023
  3. Brandon Sim2021–now

Chair

  1. Gary Augusta2016–2017
  2. Thomas S. Lam2022

President

  1. Thomas S. Lam2019–2023
  2. Brandon Sim2024–now

Chief financial officer

  1. A. Noel Dewinter2010
  2. Kyle Francis2013–2014
  3. Mitchell Creem2014–2015
  4. Mihir Shah2016–2018
  5. Eric Chin2018–2022
  6. Chandan Basho2024–now

Chief operating officer

  1. Hing Ang2017–2020
  2. Brandon Sim2020–2021
  3. Chandan Basho2024–now
2010201520202025
Board members and other officers (28)

Named in SEC Form D filings

People the company listed in its private-offering notices.

  • Executive ChairmanKenneth Sim named Nov 21, 202555
  • DirectorDavid G. Schmidt named Nov 21, 202555
  • DirectorWeili S. Dai named Nov 21, 202555

Subsidiaries and ownership

Subsidiaries (Exhibit 21)

  • Allied Physicians of California, A Professional Medical Corporation California3
  • Astrana Care Partners Medical Corporation California3
  • Astrana Health Management, Inc. California3
  • Astrana Health Medical Corporation California3
  • Astrana Health Technologies, Inc. Delaware3
  • Community Family Care Health Plan California3
  • Foothill Regional Medical Center California3
  • For your Benefit, Inc. California3
  • Prospect Health Plan, Inc. Delaware3

The subsidiaries the company lists in Exhibit 21 of its annual report, as filed.

Former names

  • Apollo Medical Holdings, Inc.Jun 25, 2008 to Feb 13, 20242
  • SICLONE INDUSTRIES INCApr 19, 1999 to Jul 15, 20082

Timeline

  1. Sep 23, 20268-K Cybersecurity incident56
  2. Sep 23, 20268-K Regulation FD disclosure57
  3. Sep 15, 20268-K Regulation FD disclosure58
  4. Aug 6, 20268-K Results of operations; Regulation FD disclosure59
  5. Jul 13, 20268-K Regulation FD disclosure60
  6. Jul 1, 20268-K Executive or director change61
  7. Jun 10, 20268-K Executive or director change; Shareholder vote62
  8. May 12, 20268-K Regulation FD disclosure63
  9. May 12, 20268-K Executive or director change64
  10. May 7, 20268-K Results of operations; Regulation FD disclosure65
  11. Mar 30, 20268-K Other events66
  12. Mar 4, 20268-K Regulation FD disclosure67
  13. Nov 4, 2021New chief executive Brandon Sim becomes CEO14
  14. Dec 12, 2017New chief executive Thomas S. Lam becomes CEO15
  15. Jun 24, 2008New chief executive Warren Hosseinion becomes CEO16

Calendar

Coming up

  1. Nov 5, 2026 · After the closeReports results for the quarter ending Sep/2026 A year earlier it reported $0.01 a share, on Nov 6, 2025.68

When it reported results

  1. Aug 6, 2026Reported quarterly or annual results59
  2. May 7, 2026Reported quarterly or annual results65
  3. Mar 2, 2026Reported quarterly or annual results69
  4. Nov 6, 2025Reported quarterly or annual results70
  5. Aug 7, 2025Reported quarterly or annual results71
  6. Jul 2, 2025Reported quarterly or annual results72
  7. May 8, 2025Reported quarterly or annual results73
  8. Mar 14, 2025Reported quarterly or annual results74

Upcoming dates from Nasdaq's calendar; past results from the company's 8-K filings (Item 2.02). The full markets calendar

Filings

328 filings to the SEC since October 2021: 6 annual reports, 16 quarterly reports, 101 major events, 158 insider forms, 17 large holders, 1 private raises, 29 other. The latest 20:

  1. Oct 13, 20264 OWNERSHIP DOCUMENT EDGAR
  2. Oct 8, 20264 OWNERSHIP DOCUMENT EDGAR
  3. Oct 8, 20264 OWNERSHIP DOCUMENT EDGAR
  4. Oct 6, 20264 OWNERSHIP DOCUMENT EDGAR
  5. Sep 23, 20268-K EDGAR
  6. Sep 23, 20268-K EDGAR
  7. Sep 17, 20264 OWNERSHIP DOCUMENT EDGAR
  8. Sep 15, 20268-K EDGAR
  9. Sep 9, 20264 OWNERSHIP DOCUMENT EDGAR
  10. Sep 8, 20264 OWNERSHIP DOCUMENT EDGAR
  11. Sep 1, 20264 OWNERSHIP DOCUMENT EDGAR
  12. Aug 18, 20264 OWNERSHIP DOCUMENT EDGAR
  13. Aug 11, 20263 OWNERSHIP DOCUMENT EDGAR
  14. Aug 11, 20264 OWNERSHIP DOCUMENT EDGAR
  15. Aug 10, 202610-Q EDGAR
  16. Aug 6, 20268-K EDGAR
  17. Jul 31, 2026SCHEDULE 13G EDGAR
  18. Jul 13, 20268-K EDGAR
  19. Jul 1, 20268-K EDGAR
  20. Jun 30, 20264 OWNERSHIP DOCUMENT EDGAR

The 328 filings since October 2021 can be filtered by form type and year here when JavaScript is on.

Every filing from the last five years, summarized. The full record is on SEC EDGAR.

Insider trades

2 open-market trades by officers, directors and large owners since October 2021: 1 buys and 1 sales. Grants, option exercises and gifts are left out.

DateWhoTradeSharesPriceValueFiling
Jun 17, 2022Marsh LindaDirectorSale250,000$37.00$9.2MForm 4
Jun 17, 2022ALLIED PHYSICIANS OF CALIFORNIA, A PROFESSION MEDICAL Corp10% ownerBuy250,000$37.00$9.2MForm 4

From Forms 4 filed with the SEC.

Major holders

Investors who own more than 5% of the shares must tell the SEC: a 13D if they may seek to influence the company, a 13G if they hold passively.

Executive pay

What the company paid its top executives, from the summary compensation table in its proxy statement. Total pay includes salary, bonus, stock and option awards and other pay, as the company valued them.

YearExecutiveAgeSalaryTotal pay
2025Brandon K. Sim, M.S.Chief Executive Officer$850.0K$14.9M79
2025Dinesh Kumar, M.D.Chief Medical Officer$700.0K$4.3M79
2025Chandan Basho, M.B.A.Chief Financial Officer and Chief Operating Officer$678.1K$3.9M79
2025Kenneth Sim, M.D.Executive Chairman72$950.0K$1.1M79
2024Brandon K. Sim, M.S.Chief Executive Officer$813.5K$18.2M79
2024Dinesh Kumar, M.D.Chief Medical Officer$678.0K$10.4M79
2024Kenneth Sim, M.D.Executive Chairman72$950.0K$10.4M79
2024Chandan Basho, M.B.A.Chief Financial Officer and Chief Operating Officer$556.2K$5.5M79
2023Brandon K. Sim, M.S.Chief Executive Officer$712.3K$14.3M79
2023Chandan Basho, M.B.A.Chief Financial Officer and Chief Operating Officer$415.4K$5.7M79
2023Kenneth Sim, M.D.Executive Chairman72$950.0K$5.2M79

Money raised

Private offerings the company reported to the SEC on Form D.

  1. Nov 6, 2025Raised $1.4 million in a private offering of equity Form D: 6 investors so far Form D

Held by these funds

The largest holders among investment managers' 13F reports for the quarter ending Jun 30, 2026, the top 25 of 100. Change is in shares since the quarter before.

FundSharesValueShare of the fundChange
BlackRock, Inc.6,899,990$320.2M0.0%+736,263
Vanguard Portfolio Management LLC2,605,775$120.9M0.0%+328,969
Vanguard Capital Management LLC1,946,431$90.3M0.0%+236,169
State Street Corp1,738,930$80.7M0.0%+88,440
325 Capital LLC1,613,843$74.9M17.9%−225,233
Dimensional Fund Advisors LP1,468,508$68.1M0.0%+100,429
Wellington Management Group Llp1,292,573$60.0M0.0%−49,251
Geode Capital Management, LLC1,167,974$54.2M0.0%+129,889
Bank Of America Corp /de/852,145$39.5M0.0%+277,416
Fmr LLC685,922$31.8M0.0%+269,797
Wells Fargo & Company/mn664,940$30.9M0.0%+561,941
Charles Schwab Investment Management Inc652,669$30.3M0.0%+8,498
Ameriprise Financial Inc512,110$23.8M0.0%−39,489
Northern Trust Corp505,044$23.4M0.0%+66,881
Diamond Hill Capital Management, LLC (Investment Advisor)475,941$22.1M0.2%−68,093
Royce & Associates LP472,480$21.9M0.2%+75,519
SteelPeak Wealth, LLC464,937$21.6M0.6%−95,000
Morgan Stanley433,508$20.1M0.0%+94,705
Invesco Ltd.381,830$17.7M0.0%+30,718
Vanguard Fiduciary Trust Co307,022$14.2M0.0%+14,019
Goldman Sachs Group Inc271,798$12.6M0.0%−23,531
Principal Financial Group Inc267,706$12.4M0.0%+1,758
Earnest Partners LLC258,991$12.0M0.0%+38,996
Hotchkis & Wiley Capital Management LLC249,410$11.6M0.0%−232,110
Bank of New York Mellon Corp234,896$10.9M0.0%+13,054

13F reports cover disclosed long positions in U.S. stocks only.

Members of Congress who traded it

2 trades disclosed by members of Congress. “Vs S&P since” is the stock’s change since the trade minus the S&P 500’s.

DateMemberTradeAmountVs S&P sinceFiling
Aug 19, 2025Judy ChuDemocratic, HouseBuy$100,001 - $250,000+3.3%Report
Aug 19, 2025Judy ChuDemocratic, HouseSale$100,001 - $250,000−3.3%Report

Members report amounts as ranges, not exact figures. Returns are price-only (no dividends).

SEC filer profile

How Astrana Health, Inc. is registered with the Securities and Exchange Commission, from its EDGAR record and the cover page of its latest annual report.

  • Name on EDGARAstrana Health, Inc.1
  • CIK0001083446
  • Employer ID (EIN)95-44723494
  • Filer statusLarge accelerated filer not an emerging growth company; not a smaller reporting company; not a shell company4
  • Incorporated inDelaware4
  • Fiscal year endsDecember 311
  • Industry code (SIC)8742 Services-Management Consulting Services1
  • SEC reviewing officeOffice of Trade & Services, Division of Corporation Finance1
  • Business address1668 S. Garfield Avenue, 2Nd Floor, Alhambra, CA 918011
  • Phone(626) 282-02881
  • Shares outstanding55,737,168 as of Aug 3, 202611
  • Public float$1.1B as of Jun 30, 20254
  • AuditorErnst & Young LLP, Los Angeles, California PCAOB ID 42; it also attests to the company’s internal control over financial reporting4
  • On EDGAR sinceApr 19, 19991
  • Filings1,032 in all: 4 (366), 8-K (228), 10-Q (56), 4/A (47), 3 (39), 10QSB (25), SC 13D/A (21), UPLOAD (19)1
    All 50 form types

    10-K (18), CORRESP (18), 8-K/A (17), 5 (13), DEF 14A (13), NT 10-Q (12), SC 13D (11), D (10), NT 10-K (10), 10-Q/A (9), 10KSB (9), S-8 (9), 3/A (7), SC 13G/A (6), DEFA14A (5), EFFECT (5), 10-K/A (4), ARS (4), PRE 14A (4), S-3ASR (4), SCHEDULE 13G/A (4), 424B3 (3), 425 (3), 5/A (3), S-1/A (3), S-3 (3), S-4/A (3), 8-A12B (2), DEF 14C (2), NTN 10Q (2), SC 13G (2), SCHEDULE 13D/A (2), SCHEDULE 13G (2), 10-QT (1), 10SB12G (1), 424B7 (1), CERT (1), PRE 14C (1), RW (1), S-1 (1), S-4 (1), SC 14F1 (1)

  • Latest filingsAnnual report (10-K) Mar 12, 2026
    Quarterly report (10-Q) Aug 10, 2026
    Proxy statement (DEF 14A) Apr 17, 2026
    Latest 8-K (8-K) Sep 23, 2026

Securities registered for trading

ClassSymbolExchange
Common Stock, $0.001 par value per shareASTHThe Nasdaq Stock Market LLC

From the cover page of the 10-K filed Mar 12, 2026 (Section 12(b) of the Exchange Act).4

Risk factors and legal proceedings

The risks Astrana Health, Inc. names in Item 1A of its 10-K filed Mar 12, 2026: 80 risks under these headings, as written.4

  • Risks Relating to the Prospect Acquisition.
  • Financing the Prospect Acquisition resulted in an increase in our indebtedness, which could adversely affect us, including by decreasing our business flexibility and increasing our interest expense.
  • Any difficulties integrating Prospect’s operations could disrupt or have a material adverse effect on our current plans, business, or results of operations.
  • We acquired a hospital as part of the Prospect Acquisition, which is a new business for us and could subject us to additional risks and challenges. Our failure to effectively manage such related risks and challenges could adversely affect our business, operating results, and financial condition.
  • We could incur additional costs and expenses resulting from the July 7, 2025, bankruptcy of certain Prospect asset-seller entities and from the effect of the Prospect letter agreement dated July 1, 2025.
  • Risks Relating to Our General Business and Operations.
  • In 2019, the Company, Astrana Medical, and APC consummated a series of interrelated transactions that may expose the Company and its subsidiaries and VIEs to additional risks, including the inability to repay a significant loan in connection with such transactions.
  • Our failure to raise additional capital or generate cash flows necessary to expand our operations and invest in new technologies in the future could reduce our ability to compete successfully and harm our results of operations.
  • The Company has a complex legal structure, and tax regulatory authorities may disagree with our positions and conclusions regarding certain tax positions, resulting in unanticipated costs or non-realization of expected benefits.
  • Our net operating loss carryforwards and certain other tax attributes will be subject to limitations.
  • The “One Big Beautiful Bill Act” could adversely affect our business and results of operations.
  • Uncertain or adverse economic conditions could adversely impact us.
The other 68 risks
  • We may be required to take write-downs or write-offs, restructuring, impairment, or other charges that could have a significant negative effect on our financial condition, results of operations, and stock price.
  • A prolonged disruption of or any actual or perceived difficulties in the capital and credit markets may adversely affect our future access to capital, our cost of capital, and our ability to continue operations.
  • If there is a change in accounting principles or the interpretation thereof affecting the consolidation of VIEs, it could impact our consolidation of total revenues derived from our affiliated physician groups.
  • Breaches or compromises of our information security systems or our information technology systems or infrastructure could result in exposure of private information, disruption of our business, and damage to our reputation, which could harm our business, results of operation, and financial condition.
  • We rely on complex software systems and hosted applications to operate our business, and our business may be disrupted if we are unable to successfully or efficiently update these systems or convert to new systems.
  • We may face risks associated with our use of certain AI and machine learning models.
  • If our internal control over financial reporting is not considered effective or material weaknesses are not remediated on a timely basis, our business and stock price could be adversely affected.
  • We may be unable to renew our leases on favorable terms or at all as our leases expire, or our businesses could be negatively impacted by natural disasters and other catastrophic events, which could adversely affect our business, financial condition, and results of operations.
  • We currently derive a substantial portion of our revenues in California and are vulnerable to changes in that state.
  • Our success depends, to a significant degree, upon our ability to adapt to the ever-changing healthcare industry and the continued development of additional services.
  • Our reputation could be adversely impacted by sustainability and social policies and practices.
  • Risks Relating to Our Growth Strategy and Business Model.
  • Our growth strategy may not prove viable, and we may not realize expected results.
  • Obligations in our credit or loan documents could restrict our operations, particularly our ability to respond to changes in our business or to take specified actions. An event of default could harm our business, and creditors holding security interests in our assets could foreclose on them.
  • We may encounter difficulties in managing our growth, and the nature of our business and rapid changes in the healthcare industry make it difficult to reliably predict future growth and operating results.
  • We could experience significant losses under capitation contracts if our expenses exceed revenues.
  • If our agreements with affiliated physician groups are deemed invalid or terminated under applicable law, our results of operations and financial condition will be materially impaired.
  • The arrangements we have with our VIEs are not as secure as direct ownership of such entities.
  • Any failure by our affiliated entities or their owners to perform their obligations under their agreements with us or with other parties could have a material adverse effect on our business, results of operations, and financial condition.
  • Our revenues and operations are dependent on a limited number of key payers.
  • An exodus of our patients could materially adversely affect our results of operations. We may also be impacted by a shift in payer mix, including eligibility changes to government and private insurance programs.
  • Our business and growth strategy depends on our ability to maintain and expand a network of qualified physicians. If we are unable to do so, our future growth would be limited, and our business, financial condition, and results of operations would be harmed.
  • Our future growth could be harmed if we lose the services of our key management personnel.
  • If having our key personnel serving as nominee equity holders of our VIEs is deemed invalid under applicable laws, or if we lose the services of key personnel for any reason, it could have a material adverse impact on our results of operations and financial condition.
  • We are partly dependent on referrals from third parties and preferred provider status with payers.
  • Partner facilities may terminate agreements with our affiliated physician groups or reduce their fees.
  • Many of our agreements with hospitals and medical groups have limited durations, may be terminated by them without cause, and prohibit us from acquiring physicians or patients from or competing with them.
  • Our business model depends on numerous complex management information systems, and any failure to maintain or implement these systems successfully could undermine our ability to receive payments, and materially harm our operations, and may result in violations of healthcare laws and regulations.
  • We currently, and may in the future, have assets held at financial institutions that exceed the insurance coverage offered by the Federal Deposit Insurance Corporation (“FDIC”); the loss of such assets would have a severe negative impact on our operations and liquidity.
  • Risks Relating to the Healthcare Industry.
  • The healthcare industry is highly competitive.
  • Hospitals where our affiliated physicians provide services may deny privileges to our physicians.
  • Changes associated with reimbursements by third-party payers or decreases in payer rates may adversely affect our operations.
  • We may have difficulty collecting payments from third-party payers in a timely manner.
  • Federal and state laws may limit our ability to collect monies owed by patients.
  • We have established reserves for our potential medical claim losses, which are subject to inherent uncertainties, and a deficiency in the established reserves may lead to a reduction in our assets or net income.
  • Competition for qualified physicians, employees, and management personnel is intense in the healthcare industry, and we may not be able to hire and retain or contract with qualified physicians and other personnel.
  • If we are unable to adapt effectively to changes in the healthcare industry, including changes to laws and regulations affecting U.S. healthcare reform, our business may be harmed.
  • Consolidation in the healthcare industry could have a material adverse effect on our business, financial condition, and results of operations.
  • Risks Relating to ACO REACH.
  • There are uncertainties regarding the design and administration of the ACO REACH Model and CMS’s financial reports to ACO REACH participants, which could negatively impact our results of operations.
  • We chose to participate in the Total Care Capitation mechanism, the Primary Care Capitation mechanism, and the Global risk tracks of ACO REACH, which entail certain special risks.
  • Shared savings retained by our ACO are impacted by the amount of the Quality Withhold earned back.
  • We may suffer losses and may not generate savings through our participation in the ACO REACH Model.
  • We do not control, but are responsible for savings and losses related to care received by assigned patients at out-of-network providers, which could negatively impact our ability to control claim costs.
  • Our continued participation in CMS Advanced Alternative Payment Models, such as the ACO REACH, cannot be guaranteed.
  • Risks Relating to CMS Model Participation.
  • We may be unable to generate revenue under the CMS Sponsored Models.
  • We may suffer losses and may not generate savings through our participation in the CMS Sponsored Models.
  • We do not control, but are responsible for savings and losses related to, care received by assigned patients at out-of-network providers, which could negatively impact our ability to control claim costs.
  • Risks Relating to Regulatory Compliance and Legal Proceedings.
  • Laws regulating the corporate practice of medicine could restrict how we conduct our business, and failure to comply could subject us to penalties and restructuring.
  • The healthcare industry is intensely regulated at the federal, state, and local levels, and government authorities may determine that we fail to comply with applicable laws or regulations and take action against us.
  • Changes in healthcare laws could create an uncertain environment and materially impact us. We cannot predict the effect that the ACA (also known as Obamacare) and its implementation, amendment, or repeal and replacement, may have on our business, results of operations, or financial condition.
  • Changes to the Medicare and Medicaid programs or other government healthcare programs, including reductions in scale and scope, could have a material adverse effect on our business.
  • Healthcare providers could be subject to federal and state investigations and payer audits.
  • Controls imposed by Medicare, Medicaid, and private payers designed to reduce inpatient services and associated costs may reduce our revenues.
  • We do not have a Knox-Keene license covering all of our lines of business.
  • If our affiliated physician groups and Restricted Knox-Keene licensed health plans are not able to satisfy California regulations related to financial solvency and operational performance, they could become subject to sanctions, and their ability to do business in California could be limited or terminated.
  • Our revenue will be negatively impacted if our physicians fail to document their services appropriately.
  • Primary care physicians may seek to affiliate with our competitors’ IPAs.
  • If we inadvertently employ or contract with an excluded person, we may face government sanctions.
  • Compliance with federal and state privacy and data security laws is expensive, and we may be subject to government or private actions due to privacy and security breaches.
  • We may be subject to liability for failure to fully comply with applicable corporate and securities laws.
  • We may face lawsuits not covered by insurance, and related expenses may be material. Our failure to avoid, defend, and accrue for claims and litigation could negatively impact our results of operations or cash flows.
  • We are also subject to laws and regulations not specifically targeting the healthcare industry, compliance with which could require significant expenditures, and failing to comply with such laws could result in sanctions and penalties.
  • Risks Relating to the Ownership of Astrana’s Common Stock.
  • We are required to meet certain requirements in order to remain a Nasdaq-listed public company.

Legal proceedings

We are, from time to time, party to lawsuits, threatened lawsuits, disputes and other claims arising in the normal course of business. We assess our liabilities and contingencies in connection with outstanding legal proceedings utilizing the latest information available. Where it is probable that we will incur a loss and the amount of the loss can be reasonably estimated, we record a liability in our consolidated financial statements. These legal accruals may be increased or decreased to reflect any relevant developments on a quarterly basis. Where a loss is not probable or the amount of the loss is not estimable, we do not record an accrual, in accordance with applicable accounting guidance. In the opinion of management, while the outcome of such claims and disputes cannot be predicted with certainty, our ultimate liability in connection with these matters is not expected to have a material adverse effect on our results of operations, financial position or cash flows, and, except as described under “Litigation” in Note 14 — “Commitments and Contingencies,” to our consolidated financial statements under Item 8 in this Annual Report on Form 10-K, the amounts accrued for any individual matter are not material. However, legal proceedings are inherently uncertain. As a result, the outcome of a particular matter or a combination of matters may be material to our results of operations for a particular period, depending upon the size of the loss or our income for that particular period.

Certain of the pending or threatened legal proceedings or claims in which we are involved are discussed under Note 14 — “Commitments and Contingencies,” to our consolidated financial statements under Item 8 in this Annual Report on Form 10-K, which disclosure is incorporated by reference herein.

The opening of Item 3, Legal Proceedings.4

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