Slides
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Second Quarter 2026 Earnings Supplement August 2026 Astrana Health
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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, our ability to successfully complete and realize the benefits of anticipated acquisitions, integration of acquired companies and any projections of earnings, revenue, EBITDA, Adjusted EBITDA, adjusted EPS – diluted, free cash flow or other financial items, such as the Company's projected capitation and future liquidity, as well as statements regarding the material weakness in internal control over financial reporting and the Company’s ability to remediate such material weakness in a timely manner 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 last Annual Report on Form 10-K and subsequent quarterly reports on Form 10-Q filed with the SEC. 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. This presentation may contain statistics and other data that in some cases has been obtained from or compiled from information made available by third-party service providers. The Company makes no representation or warranty, express or implied, with respect to the accuracy, reasonableness or completeness of such information. Use of Non-GAAP Financial Measures This presentation contains the non-GAAP financial measures EBITDA, Adjusted EBITDA, Adjusted EBITDA margin, adjusted net income attributable to Astrana, and adjusted EPS – diluted of which the most directly comparable financial measure presented in accordance with U.S. generally accepted accounting principles (“GAAP”) is net income. This presentation also contains the non-GAAP financial measure free cash flow, of which the most directly comparable financial measure presented in accordance with U.S GAAP is net cash provided by operating activities. 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, Adjusted EBITDA margin, adjusted EPS – diluted, and free cash flow as supplemental performance measures of our operations, for financial and operational decision-making, and as supplemental means of evaluating period-to-period comparisons on a consistent basis, and, for free cash flow, to reflect the cash flow trends in our business. Adjusted EBITDA is calculated as earnings before interest expense, interest income, income taxes, depreciation, and amortization, excluding income or loss from equity method investments, non-recurring and non-cash transactions, stock-based compensation, and, for periods on or prior to December 31, 2023, 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 defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue. Adjusted net income attributable to Astrana is calculated as net income, excluding income or loss from equity method investments, non-recurring and non-cash transactions, stock-based compensation, amortization of intangible assets attributable to acquisitions, certain tax adjustments, and amounts related to net income or loss attributable to non-controlling interests. The Company defines adjusted EPS - diluted as adjusted net income attributable to Astrana over weighted average shares of common stock outstanding - diluted. The Company defines free cash flow as net cash provided by operating activities minus cash used in purchases of property and equipment. 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 EBITDA, Adjusted EBITDA, Adjusted EBITDA margin, adjusted net income attributable to Astrana, adjusted EPS – diluted, and free cash flow 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 the projected adjusted EBITDA 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.
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3 Q2 2026 Financial Results Revenue $972.5 49%3 Adj. EPS – Diluted2 $0.80 45%3 YTD Free Cash Flow4 $92.95 10%5 Second Quarter 2026 Performance Highlights $ in millions, except for per share information 1. See “Reconciliation of Net Income to EBITDA and Adjusted EBITDA” and “Use of Non-GAAP Financial Measures” slides for more information. 2. See “Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS – Diluted” and “Use of Non-GAAP Financial Measures” slides for more information. 3. All comparisons are to the three months ended June 30, 2025 unless otherwise stated. 4. See “Reconciliation and Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow” and “Use of Non-GAAP Financial Measures” slides for more information. 5. Free cash flow is provided for the six months ended June 30, 2026 and compared to the six months ended June 30, 2025. Adj. EBITDA1 $68.9 43%3 NI attr. to ASTH $19.7 109%3
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4 Actual FY 2025 Results FY 2026 Guidance Range2,3,4 Total Revenue $3,181.8 $3,800 - $4,100 Adjusted EBITDA2 $205.4 $255 - $280 Free Cash Flow3 $104.5 $105 - $132.5 Q2 2026 Financial Results1 Revenue $972.5 Adjusted EBITDA2 $68.9 YTD Free Cash Flow3 $92.9 1. Q2 2026 Financial Results are provided for the three months ended June 30, 2026 except for free cash flow, which is provided for the six months ended June 30, 2026. 2. 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. 3. See “Reconciliation and Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow” 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. 4. Raised Adjusted EBITDA guidance to reflect broad-based outperformance across the business. $ in millions FY2026 Guidance
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5 Growth Sustainably growing membership to bring better care to more Americans Astrana now serves approximately 1.5 million patients in value-based arrangements Approximately 1.2 million members in our Care Partners segment Growth Second Quarter 2026 Highlights and Recent Updates Operating Leverage Driving operating leverage across our business through our Care Enablement suite On track to achieve high end of $12-15M synergy range related to Prospect Continued development and deployment of proprietary AI-enabled tools across clinical workflows and administrative processes, leading to 210 bps improvement in G&A as a percentage of revenue year over year (5.6% in Q2 2026, 7.7% in Q2 2025) Risk Progression Increasing alignment through total cost of care responsibility in value-based arrangements 81% of Q2 2026 capitation revenue from full-risk arrangements Continued prudent shift toward full-risk, accountable care contracts Outcomes and Cost Achieving superior patient outcomes while managing cost Medical cost trends across both Prospect and core Astrana remained firmly within expectations for the quarter Strong engagement in Annual Wellness Visits, supporting earlier intervention and improved care coordination; >500k automated member interactions per month
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6 Projected Full-risk Partial-risk Members by Risk Arrangement2 35% 47% 73% 76% 81% 81% 100% 65% 53% 27% 24% 19% 19% 2021 2022 2023 2024 2025 Q2 2026 2026 E 42% 43% 58% 57% Q2 2026 2026 E Capitated Revenue by Risk Arrangement1 Our partial-risk membership presents an embedded opportunity for increased platform value and risk alignment. We succeed in these contracts by continuing to drive positive patient outcomes. 1. Revenue by risk arrangement represents capitation revenue only. 2. Members by risk arrangement represent Care Partners membership only. 3. Revenue for the quarter ended June 30, 2026. 4. 2026 E based on June 2026 forecast. 5. Members by risk arrangement as of June 30, 2026. Prudently transitioning to full-risk contracts to better align incentives around patient outcomes and improve unit economics 2026 E4 2026 E4Q2 20263 Q2 20265
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7 93% 2% 1% 3% Capitation, net Risk Pool Settlements & Incentives Management Fee Income Fee-for-service, net Other Income Revenue by Type1 61% 27% 9% 3% Medicare Medicaid Commercial Other Third Parties Revenue By Payer Type1 81% 19% Full-risk Partial-risk Revenue by Risk Arrangement1,2 42% 58% Full-risk Partial-risk Members by Risk Arrangement3 Our Value-Based Care Business is Diverse 1% 1. Revenue for the quarter ended June 30, 2026. 2. Revenue by risk arrangement represents capitation revenue only. 3. Members by risk arrangement represent Care Partners membership only as of June 30, 2026.
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8 Revenue ($ in millions) Adj. EBITDA ($ in millions) $561 $687 $774 $1,144 $1,387 $2,035 $3,182 2019 2020 2021 2022 2023 ~32% CAGR 2024 $54.2 $102.8 $133.5 $140.0 $146.6 $170.4 $205.4 2019 2020 2021 2022 2023 2024 ~26% CAGR 2025 $3,800- $4,100 $255- $280 2026E2026E 2025 Astrana grows profitably across all market conditions Note: For more information, 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.
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9 Quarter over Quarter Segment Revenue Revenue $ in millions Q2 2025 Q3 2025 Q4 2025 Q1 2026 Care Partners High-performing network of aligned providers $897.7 $892.5 Care Delivery High-quality system of employed providers $38.4 $86.9 $92.1 Care Enablement Full-stack tech, clinical, and operations platform $40.9 $87.3 $78.9 Inter- company $(55.9) $(115.9) $(112.9) Total $654.8 $956.0 $950.5 $909.7 $85.1 $87.7 $(117.4) $965.1 $631.4 Note: Numbers may not total due to rounding. Certain amounts disclosed in the prior periods have been recast to conform to the current period presentation. Specifically, segments are presented net of intrasegment eliminations. Q2 2026 $932.8 $74.7 $85.6 $(120.6) $972.5
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10 Selected Financial Results
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11 Three Months Ended June 30, $ in thousands, except per share data 2026 2025 Revenue Capitation, net $ 905,804 $ 614,108 Risk pool settlements and incentives 21,816 15,402 Management fee income 13,211 2,577 Fee-for-service, net 22,982 17,878 Other revenue 8,707 4,843 Total revenue 972,520 654,808 Total expenses 938,198 634,468 Income from operations 34,322 20,340 Net income $ 18,452 $ 10,216 Net (loss) income attributable to non-controlling interests (1,287) 793 Net income attributable to Astrana Health, Inc. $ 19,739 $ 9,423 Earnings per share – diluted $ 0.40 $ 0.19 EBITDA1 $ 52,850 $ 28,775 Adjusted EBITDA1 $ 68,889 $ 48,101 Adjusted EPS – Diluted2 $ 0.80 $ 0.55 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. 2. See “Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS – Diluted” and “Use of Non-GAAP Financial Measures” slides for more information.
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12 $ in thousands Care Partners Care Delivery Care Enablement Intersegment Elimination Corporate Costs Consolidated Total Total revenues $ 932,836 74,696 85,598 (120,610) - 972,520 % change vs prior year quarter 48% 95% 109% Cost of services 805,469 61,923 51,665 (50,559) - 868,498 General and administrative expenses 72,133 14,552 16,158 (70,091) 21,398 54,150 Depreciation and amortization 12,362 1,188 1,378 - 622 15,550 Total expenses 889,964 77,663 69,201 (120,650) 22,020 938,198 Income (loss) from operations $ 42,872 (2,967) 16,397 401 (22,020) 34,322 % change vs prior year quarter (14)% (238)% *2 For the three months ended June 30, 2026 Segment Results 1. Income from operations for the intersegment elimination represents sublease income between segments. Sublease income is presented within other income which is not presented in the table. 2. Percentage change of over 500%
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13 $ in millions 6/30/2026 12/31/2025 $ Change Cash and cash equivalents1 $400.8 $429.5 $(28.7) Working capital $171.5 $248.0 $(76.5) Total stockholders’ equity $840.8 $793.3 $47.5 Balance Sheet Highlights 1. Excluding restricted cash and marketable securities.
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14 1. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.; 2. Other, net, for the three months ended June 30, 2026 relates to post-acquisition integration costs, non-cash update to the fair value of an equity purchase financing obligation, accrual for non-routine legal matters, and severance.; 3. Other, net for the three months ended June 30, 2025 relates to transaction and other costs related to our acquisitions including Prospect, non-cash changes in the fair value of our call option and collar agreement, and severance. Three Months Ended June 30, $ in thousands 2026 2025 Net Income $ 18,452 $ 10,216 Interest expense 15,997 7,382 Interest income (5,907) (2,336) Provision for income taxes 8,758 6,609 Depreciation and amortization 15,550 6,904 EBITDA 52,850 28,775 Income from equity method investments (548) (381) Other, net 4,8002 7,9983 Stock-based compensation 11,787 11,709 Adjusted EBITDA Adjusted EBITDA margin1 $ 68,889 7% $ 48,101 7% Reconciliation of Net Income to EBITDA & Adjusted EBITDA
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15 For the twelve months ended TTM Ended Year Ended $ in millions June 30, 2026 2025 2024 2023 2022 2021 2020 2019 Net Income $ 39.2 $ 24.1 $ 49.9 $ 57.8 $ 45.7 $ 46.1 $ 122.1 $ 15.8 Interest expense 67.3 50.0 33.1 16.1 7.9 5.4 9.5 4.7 Interest income (17.2) (12.2) (14.5) (14.2) (2.0) (1.6) (2.8) (2.0) Provision for income taxes 20.9 15.5 30.9 32.0 40.9 31.7 56.3 10.0 Depreciation and amortization 63.0 45.7 27.9 17.7 17.5 17.5 18.4 18.3 EBITDA1 173.2 123.1 127.3 109.5 110.1 99.1 203.5 46.8 (Income) loss from equity method investments (4.5) (1.7) (4.5) (5.1) (5.7)9 5.39 (0.3)9 2.9 Gain on sale of equity method investment - - - - - (2.2) - - Other, net 46.62 45.43 13.04 6.25 3.36 (1.7)7 (0.5)7 2.010 Stock-based compensation 40.8 38.6 34.5 22.0 16.1 6.7 3.4 0.9 APC excluded assets costs - - - 14.0 16.29 26.49 (103.3)9 1.5 Adjusted EBITDA1 $ 256.1 $ 205.4 $ 170.4 $ 146.6 $ 140.0 $ 133.5 $ 102.8 $ 54.2 Net Revenue $ 3,844.2 $ 3,181.8 $ 2,034.5 $ 1,386.7 $ 1,144.2 $ 773.9 $ 687.2 $ 560.6 Adjusted EBITDA Margin8 7% 6% 8% 11% 12% 17% 15% 10% Reconciliation of Net Income to EBITDA & Adjusted EBITDA (continued) 1. See “Use of Non-GAAP Financial Measures” slide for more information.; 2. Other, net, for TTM ended June 30, 2026, relates to an allowance on receivables that the Company plans to recover from the payer, post-acquisition integration costs, accruals for non-routine legal matters including $13.0 million for a legal matter with a provider associated with CFC HP, transaction and other costs related to our acquisitions including Prospect, non-cash changes related to the change in the fair value of an equity purchase finance obligation, our call option and collar agreement, and severance fees incurred.; 3. Other, net, for the year ended December 31, 2025, relates to $13.0 million for a legal matter with a provider associated with CFC HP, transaction and other costs related to our acquisitions including $25.9 million for Prospect, debt issuance costs incurred in connection with our Second Amended and Restated Credit Facility, and severance fees incurred, partially offset by employer retention tax credits related to COVID-19 relief.; 4. Other, net for the year ended December 31, 2024 relates to transaction costs incurred for our investments and tax restructuring fees, anticipated recoveries from one time losses relating to third party payer payments associated with the CHS transaction, financial guarantee via a letter of credit that we provided in support of two local provider-led ACOs, reimbursement from a related party of the Company for taxes associated with the December 2023 Excluded Assets Spin-off, non-cash gain on debt extinguishment related to one of our promissory note payables, non-cash realized loss from sale of one of our marketable equity securities, non-cash changes related to change in the fair value of our call option, our financing obligation to purchase the remaining equity interests in one of our investments, our contingent liabilities, and the Company’s collar agreement.; 5. Other, net for the year ended December 31, 2023 consists of nonrecurring transaction costs and tax restructuring fees incurred, non-cash 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.; 6. Other, net for the year ended December 31, 2022 consists of one-time transaction costs incurred and non-cash changes in the fair value of our financing obligation to purchase the remaining equity interests and contingent considerations.; 7. Other, net for the years ended December 31, 2021 and 2020 relate to COVID-19 relief payments recognized in 2021 and 2020.; 8. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.; 9. 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.; 10. Other, net for the year ended December 31, 2019 is related to goodwill impairment.
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16 Reconciliation of Net Income to Adjusted Net Income Attributable to Astrana and Adjusted EPS - Diluted Three Months Ended June 30, $ in thousands, except for share and per share data 2026 2025 Net income $ 18,452 $ 10,216 Income from equity method investments (548) (381) Other, net1 4,800 7,998 Stock-based compensation 11,787 11,709 Amortization of intangible assets attributable to acquisitions 13,806 6,179 Tax adjustments (5,965)2 (4,637)3 Adjusted net income attributable to non-controlling interests (2,561)4 (3,715)5 Adjusted net income attributable to Astrana Health, Inc.6 $ 39,771 $ 27,369 Weighted average shares of common stock outstanding – diluted 49,778,028 49,470,677 Adjusted earnings per share – diluted6 $ 0.80 $ 0.55 1. The components of other, net, as set forth in the table above, are described in the footnotes to the table under “Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin”. Please see the footnotes to such table for additional information.; 2. Tax adjustments for the three months ended June 30, 2026, includes the tax effect for, at a 27.4% statutory blended tax rate, the adjustments made to net income of $8.2 million, partially offset by 162(m) impact of $2.2 million.; 3. Tax adjustments for the three months ended June 30, 2025, includes the tax effect for, at a 27.1% statutory blended tax rate, the adjustments made to net income of $6.9 million, partially offset by 162(m) impact of $2.3 million.; 4. Includes net loss attributable to non-controlling interests ("NCI") of $1.3 million, offset by adjustments attributable to NCI of $3.8 million, for the three months ended June 30, 2026.; 5. Includes net income attributable to NCI of $0.8 million, as well as adjustments attributable to NCI of $2.9 million, for the three months ended June 30, 2025.; 6. See “Use of Non-GAAP Financial Measures” slide for more information.
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17 $ in thousands Actual Results Guidance1 Six Months Ended June 30, 2026 Year Ended December 31, 2025 Six Months Ended June 30, 2025 Year Ending December 31, 2026 Low High Net cash provided by operating activities $ 100,804 $ 114,597 $ 107,528 $ 125,000 $ 145,000 Cash used in purchases of property and equipment (7,878) (10,106) (4,490) (20,000) (12,500) Free cash flow2 $ 92,926 $ 104,491 $ 103,038 $ 105,000 $ 132,500 1. 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. 2. See “Use of Non-GAAP Financial Measures” slide for more information. Reconciliation and Guidance Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow
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18 . Guidance Reconciliation of Net Income to EBITDA & Adjusted EBITDA 1. Note: See “Use of Non-GAAP Financial Measures” slide 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. 2026 Guidance Range $ in thousands Low High Net Income $ 59,000 $ 74,000 Interest expense 49,000 53,000 Provision for income taxes 38,000 44,000 Depreciation and amortization 65,000 65,000 EBITDA 211,000 236,000 Income from equity method investments (4,000) (4,000) Other, net 9,000 9,000 Stock-based compensation 39,000 39,000 Adjusted EBITDA $ 255,000 $ 280,000
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