Astrana Health Q3 Revenue Tops $1 Billion as Profit Surges

Astrana Health (ASTH ) reported on November 5, 2026 that third-quarter revenue rose 7% to $1.02 billion from $956.0 million a year earlier, while income from operations increased to $39.9 million from $19.2 million for the quarter ended September 30, 2026.

The bottom line improved even faster. Consolidated net income reached $20.3 million, compared with $1.1 million, although $7.3 million was attributable to non-controlling interests, representing third-party equity ownership in entities Astrana consolidates. Net income attributable to Astrana was $13.0 million, up from $0.4 million, and diluted earnings per share rose to $0.26 from $0.01.

A smaller other-expense burden helped carry the operating improvement into earnings. Total other expense, net, narrowed to $7.7 million from $13.5 million, including interest expense of $15.0 million versus $17.7 million. Adjusted EBITDA, which Astrana defines as earnings before interest, income taxes, depreciation and amortization, excluding equity-method investment results, non-recurring and non-cash transactions and stock-based compensation, increased 13% to $77.2 million.

President and Chief Executive Officer Brandon Sim said, “We delivered record revenue, record adjusted EBITDA, and double-digit organic earnings growth while continuing to invest in the next phase of our growth.”

Care Partners Drives the Earnings Increase

Care Partners generated $968.8 million of revenue, up 8%, and $49.1 million of operating income, up 94%. Care Enablement produced $92.0 million of revenue and $24.4 million of operating income, increases of 5% and 4%, respectively. Care Delivery’s revenue also rose 5%, to $91.0 million, but that segment recorded a $1.6 million operating loss.

The segment revenue figures are presented before $128.2 million of intersegment eliminations, while consolidated operating income also reflects $32.1 million of corporate costs. Those deductions explain why the individual businesses’ revenue and profit totals cannot simply be added together to reproduce the consolidated results.

Capitation remained the principal source of growth. Capitation revenue, net, increased to $936.7 million from $863.4 million, while risk pool settlements and incentives declined to $24.3 million from $30.8 million. Fee-for-service revenue also fell, to $35.1 million from $40.1 million. The revenue mix therefore shows growth anchored in capitation rather than in those two declining revenue lines.

Cash Generation Trails Profit Growth

Nine-month cash generation presented a more restrained picture. Net income for the period rose to $51.9 million from $17.5 million, yet operating cash flow was nearly unchanged at $117.1 million, compared with $117.5 million a year earlier. Changes in operating assets and liabilities, net of business combinations, reduced operating cash flow by $18.8 million after contributing $36.1 million in the prior-year period.

Free cash flow, which Astrana defines as operating cash flow minus purchases of property and equipment, declined to $105.4 million from $110.4 million as those purchases increased to $11.7 million from $7.0 million. Astrana also repaid $115.9 million of debt during the nine months. Cash and cash equivalents stood at $396.2 million on September 30, 2026, compared with $429.5 million at December 31, 2025.

Guidance and Post-Quarter Developments

Astrana’s guidance projects fourth-quarter revenue of $939 million to $1.039 billion and adjusted EBITDA of $48.5 million to $61.5 million, with GAAP net income of $3.1 million to $9.1 million. Both profit ranges sit below the corresponding third-quarter results. For the year ending December 31, 2026, the company narrowed revenue guidance to $3.9 billion to $4.0 billion, adjusted EBITDA guidance to $261 million to $274 million, and free cash flow guidance to $107.5 million to $130 million.

After the quarter closed, Astrana completed its acquisition of an independent practice association in Georgia on October 1, 2026. Separately, two new Care Enablement clients, a provider group in Connecticut and a hospital in California, are expected to onboard onto its technology and managed-services platform in early 2027. Several new Medicare Advantage payer partnerships are scheduled to take effect on January 1, 2027 in markets including Southern California, Texas and Arizona.

Those client onboardings and payer partnerships remain future developments rather than contributors to the reported quarter. The central question for subsequent results is whether Astrana can broaden profitability beyond Care Partners, reverse Care Delivery’s operating loss and bring cash generation closer to its faster earnings growth as the new relationships come online.