Revenue growth reached 55.6% in 2026Q1, yet structural margin compression persists as gross margins declined to 9.4% from 17.0% in 2024Q1.
| Sales/Revenue | 3.53B | 3.18B | 2.03B | 1.39B | 1.14B | 773.91M | 370.25M | 560.62M | 519.91M | 357.75M | 44.05M |
| Revenue Growth % | 56.69% | 56.39% | 46.72% | 21.19% | 47.84% | 109.03% | -33.96% | 7.83% | 45.33% | 712.16% | - |
| Cost of Goods Sold | 3.2B | 2.89B | 1.76B | 1.17B | 944.68M | 596.14M | 348.54M | 467.81M | 380.44M | 293.73M | 34.35M |
| COGS % of Revenue | - | 90.7% | 86.66% | 84.5% | 82.57% | 77.03% | 94.14% | 83.44% | 73.17% | 82.11% | 77.99% |
| Gross Profit | 328.47M | 295.78M | 271.39M | 214.96M | 199.48M | 177.77M | 21.7M | 92.81M | 139.47M | 64.02M | 9.7M |
| Gross Margin % | 9.31% | 9.3% | 13.34% | 15.5% | 17.43% | 22.97% | 5.86% | 16.56% | 26.83% | 17.89% | 22.01% |
| Gross Profit Growth % | - | 8.99% | 26.25% | 7.76% | 12.21% | 719.04% | -76.61% | -33.45% | 117.87% | 560.19% | - |
| Operating Expenses | 242M | 217.26M | 182.04M | 130.34M | 95.21M | 79.59M | 15.62M | 60.39M | 47.24M | 26.44M | 16.28M |
| OpEx % of Revenue | - | 6.83% | 8.95% | 9.4% | 8.32% | 10.28% | 4.22% | 10.77% | 9.09% | 7.39% | 36.96% |
| Selling, General & Admin | 235.1M | 217.26M | 154.11M | 112.6M | 77.67M | 62.08M | 15.59M | 41.48M | 47.24M | 26.44M | 16.28M |
| SG&A % of Revenue | - | 6.83% | 7.57% | 8.12% | 6.79% | 8.02% | 4.21% | 7.4% | 9.09% | 7.39% | 36.96% |
| Research & Development | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| R&D % of Revenue | - | - | - | - | - | - | - | - | - | - | - |
| Other Operating Expenses | 1000K | 0 | 27.93M | 17.75M | 17.54M | 17.52M | 26K | 18.91M | 0 | 0 | 0 |
| Operating Income | 86.47M | 78.53M | 89.35M | 84.61M | 104.27M | 98.18M | 6.09M | 32.42M | 92.23M | 37.58M | -6.58M |
| Operating Margin % | 2.45% | 2.47% | 4.39% | 6.1% | 9.11% | 12.69% | 1.64% | 5.78% | 17.74% | 10.5% | -14.94% |
| Operating Income Growth % | - | -12.12% | 5.6% | -18.85% | 6.2% | 1513.19% | -81.23% | -64.85% | 145.44% | 670.91% | - |
| EBITDA | 140.85M | 124.27M | 117.28M | 102.36M | 121.81M | 115.7M | 24.44M | 50.7M | 111.53M | 56.65M | -6.23M |
| EBITDA Margin % | 3.99% | 3.91% | 5.76% | 7.38% | 10.65% | 14.95% | 6.6% | 9.04% | 21.45% | 15.84% | -14.14% |
| EBITDA Growth % | 28.66% | 5.97% | 14.57% | -15.97% | 5.28% | 373.47% | -51.8% | -54.54% | 96.87% | 1009.26% | - |
| D&A (Non-Cash Add-back) | 54.38M | 45.75M | 27.93M | 17.75M | 17.54M | 17.52M | 18.35M | 18.28M | 19.3M | 19.08M | 351.4K |
| EBIT | 94.52M | 78.53M | 113.92M | 105.94M | 94.54M | 83.14M | 11.39M | 30.57M | 83.19M | 49.79M | -7.7M |
| Net Interest Income | -45.06M | -37.77M | -18.59M | -1.89M | -5.94M | -3.82M | -2.12M | -2.71M | 698K | 935.51K | -542.3K |
| Interest Income | 13.66M | 12.16M | 14.51M | 14.21M | 1.98M | 1.57M | 405K | 2.02M | 1.26M | 1.02M | 0 |
| Interest Expense | 58.72M | 49.93M | 33.1M | 16.1M | 7.92M | 5.39M | 2.53M | 4.73M | 560.51K | 79.69K | 542.3K |
| Other Income/Expense | -36.76M | -38.92M | -8.53M | 5.22M | -17.65M | -20.43M | 2.78M | -6.58M | -9.6M | 12.13M | -1.66M |
| Pretax Income | 49.71M | 39.61M | 80.82M | 89.84M | 86.62M | 77.75M | 8.87M | 25.84M | 82.63M | 49.71M | -8.24M |
| Pretax Margin % | 1.41% | 1.24% | 3.97% | 6.48% | 7.57% | 10.05% | 2.4% | 4.61% | 15.89% | 13.9% | -18.72% |
| Income Tax | 18.73M | 15.53M | 30.89M | 31.99M | 40.88M | 31.69M | 9.18M | 8.17M | 22.36M | 3.89M | -71.04K |
| Effective Tax Rate % | 37.67% | 39.21% | 38.22% | 35.61% | 47.19% | 40.76% | 103.54% | 31.61% | 27.06% | 7.82% | 0.86% |
| Net Income | 30.23M | 22.49M | 43.15M | 60.72M | 45.17M | 68.92M | -23.75M | 14.12M | 10.84M | 25.8M | -9.34M |
| Net Margin % | 0.86% | 0.71% | 2.12% | 4.38% | 3.95% | 8.91% | -6.42% | 2.52% | 2.08% | 7.21% | -21.21% |
| Net Income Growth % | -13.64% | -47.89% | -28.93% | 34.42% | -34.46% | 390.18% | -268.26% | 30.28% | -58.01% | 376.13% | - |
| Net Income (Continuing) | 30.99M | 24.08M | 49.93M | 57.85M | 45.74M | 46.05M | -314K | 17.67M | 60.27M | 45.82M | -8.17M |
| Discontinued Operations | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Minority Interest | -222.81M | -220.96M | -198.55M | -203.45M | 15.99M | 62.48M | 114.32M | 169.51M | 226.12M | 176.37M | 2.74M |
| EPS (Diluted) | 0.62 | 0.46 | 0.90 | 1.29 | 0.99 | 1.52 | 1.01 | 0.39 | 0.29 | 0.90 | -1.79 |
| EPS Growth % | -16.78% | -48.89% | -30.23% | 30.3% | -34.87% | 50.5% | 158.97% | 34.48% | -67.78% | 150.28% | - |
| EPS (Basic) | - | 0.46 | 0.91 | 1.30 | 1.00 | 1.57 | 1.04 | 0.41 | 0.33 | 1.01 | 0.00 |
| Diluted Shares Outstanding | 49.05M | 49.37M | 48.22M | 47.07M | 45.6M | 45.4M | 37.45M | 36.4M | 37.91M | 28.66M | 5.21M |
| Basic Shares Outstanding | 48.85M | 49.08M | 47.69M | 46.71M | 44.97M | 43.83M | 36.53M | 34.71M | 32.89M | 25.53M | 1 |
| Dividend Payout Ratio | - | 35.06% | 9.35% | 102.24% | 31.06% | 45.11% | - | 437.21% | 163.9% | 40.49% | - |
Margin compression from scaling
As reported in recent financial filings, Astrana Health achieved a significant 55.6% year-over-year revenue growth in 2026Q1, reaching $965.1 million, which highlights the company's aggressive pursuit of market share within its capitated risk-bearing model despite the inherent challenges of maintaining consistent bottom-line performance during rapid scaling.
The rapid top-line expansion suggests that the company is successfully capturing new member lives, yet the lack of corresponding margin stability warrants caution. Investors should monitor whether this growth is driven by high-quality, sustainable contracts or if it reflects a capital-intensive strategy that may struggle to achieve long-term operating leverage.
Based on the provided income statement data, Astrana Health's gross margin has compressed from 17.0% in 2024Q1 to 9.4% in 2026Q1, indicating that the company's cost of medical claims is rising faster than its ability to optimize revenue per member within its current risk-bearing framework.
The decline in gross margins suggests that the company's pass-through cost structure is highly sensitive to medical utilization trends. This trend implies that the current business model may face difficulty in achieving meaningful profitability unless the company can successfully shift its revenue mix toward higher-margin care enablement services.
According to the company's quarterly income statements, operating income has failed to scale proportionally with revenue, as evidenced by an operating margin that fluctuated between 7.5% in 2024Q1 and 3.0% in 2026Q1, suggesting that SG&A expenses remain a significant drag on the company's overall operational efficiency.
The inability to expand operating margins during a period of 56% revenue growth indicates that the company is incurring substantial overhead to support its expanding network. This may suggest that the integrated MSO model requires significant administrative investment, which could continue to pressure earnings until the platform reaches a more mature scale.
Analysis of the historical income statements reveals that net margins have remained consistently thin, hovering near 0.71% on average, which suggests that the company's profitability is highly vulnerable to minor fluctuations in medical loss ratios or unexpected increases in clinical delivery costs across its California-heavy footprint.
Short-term volatility in net income, such as the dip into negative territory in 2024Q4, highlights the fragility of the current earnings profile. Investors should consider whether the company's reliance on bonus-heavy revenue streams provides a reliable foundation for future earnings growth or if it introduces unnecessary lumpiness that obscures underlying operational performance.
Quick answers to the most common questions about buying ASTH stock.
For fiscal year 2025, Astrana Health, Inc. (ASTH) reported total revenue of $3.18B. This represents a 7123.3% increase compared to $44.0M in 2015.
Astrana Health, Inc. (ASTH) is profitable, generating $22.5M in net income for the fiscal year ending 2025 with a net profit margin of 0.7%.
Astrana Health, Inc. (ASTH) reported an operating income of $78.5M, resulting in an operating profit margin of 2.5%. This margin reflects the operational efficiency of the business before interest and taxes.
Astrana Health, Inc. (ASTH) generated $295.8M in gross profit for the year, representing a gross profit margin of 9.3%. This demonstrates the company's core pricing power and production efficiency.