Executive Summary

Q2 delivered strong top-line and profitability: revenue $486.3M (+40% YoY), net income attributable to Astrana $19.2M (+46% YoY), EPS diluted $0.40 (+43% YoY), and Adjusted EBITDA $47.9M (+34% YoY), driven by organic growth in Care Partners, integration of Community Family Care (CFC), and cost-of-care management across ~1.0M risk-bearing members .
Guidance update: revenue range raised at the low end to $1.75–$1.85B (from $1.65–$1.85B), Adjusted EBITDA reiterated at $165–$185M, while EPS diluted was lowered to $1.12–$1.36 (from $1.28–$1.52) and net income to $54–$66M (from $61–$73M), reflecting higher interest expense and below-the-line items despite operating strength .
Strategic catalysts: new state entries (Arizona, Hawai‘i), partnerships (Anthem Blue Cross, Elation Health), and a definitive agreement to acquire Collaborative Health Systems (CHS), expanding payer-agnostic care enablement; CHS expected to close in Q4 2024 (subject to customary approvals) .
Estimates context: S&P Global consensus was unavailable via our tool for AMEH; external sources indicate a significant revenue beat and an EPS miss in Q2, which may prompt estimate revisions to revenue upward and EPS downward near term .

What Went Well and What Went Wrong

What Went Well

Strong growth across key metrics: revenue +40% YoY to $486.3M; Adjusted EBITDA +34% YoY to $47.9M; EPS diluted +43% YoY to $0.40 .
Care Partners momentum: segment revenue +44% YoY to $463.3M on organic growth, CFC integration, and cost-of-care management for ~1M risk-bearing members .
Strategic expansion: entries into Arizona and Hawai‘i, plus partnerships with Anthem Blue Cross and Elation Health; announced CHS acquisition to broaden enablement at scale . Management tone: “Strong revenue and adjusted EBITDA growth… successful integration… continued success in managing total cost of care… anticipated to continue driving strong, sustainable, and profitable growth” — Brandon K. Sim, CEO .

What Went Wrong

EPS guidance lowered despite raised revenue outlook and steady Adjusted EBITDA guidance, implying higher interest expense and other below-the-line headwinds pressuring GAAP EPS (Q2 interest expense $8.6M vs. $3.6M prior-year) .
Care Enablement operating income declined YoY in Q2 (–9%), highlighting investment needs to scale the platform while integrating partners .
Consensus visibility: S&P Global estimates unavailable via our tool for AMEH, increasing reliance on third-party sources for consensus comparisons this quarter .

Financial Results

Income Statement Snapshot and Margins (oldest → newest)

Metric	Q4 2023	Q1 2024	Q2 2024
Revenue ($M)	$353.036	$404.356	$486.265
Net Income attributable to Astrana ($M)	$12.356	$14.835	$19.171
EPS diluted ($)	$0.26	$0.31	$0.40
Adjusted EBITDA ($M)	$29.014	$42.245	$47.917
Adjusted EBITDA Margin (%)	8%	10%	10%

Actual vs Estimates (Q2 2024)

S&P Global consensus was not available for AMEH via our tool. External source (Seeking Alpha) indicates: Revenue beat by $45.51M; EPS miss by $0.11 .

Metric	Actual (Q2 2024)	Consensus Source	Delta vs Consensus
Revenue ($M)	$486.265	Seeking Alpha	+$45.51M beat
EPS diluted ($)	$0.40	Seeking Alpha	–$0.11 miss

Note: S&P Global consensus was unavailable via our tool for AMEH. External consensus and deltas per Seeking Alpha.

Segment Revenue (Q1 → Q2 2024)

Segment Revenue ($M)	Q1 2024	Q2 2024
Care Partners	$397.095	$463.277
Care Delivery	$30.719	$34.857
Care Enablement	$33.274	$36.172
Intersegment Elimination	$(56.732)	$(48.041)
Consolidated Total	$404.356	$486.265

KPIs and Balance Sheet Highlights

KPI	Q1 2024	Q2 2024
Members in value-based, risk-bearing arrangements	~1.0M (company statement)	~1.0M (company statement)
Providers served	10,000+	10,000+
Cash & Equivalents ($M)	$334.796	$325.310
Total Debt ($M, LT + current)	~$389.198 ($368.448 + $20.750)	~$442.006 ($425.006 + $17.000)
Adjusted EBITDA Margin (%)	10%	10%

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Total revenue ($B)	FY 2024	$1.65–$1.85	$1.75–$1.85	Raised (low end)
Net income attributable to Astrana ($M)	FY 2024	$61–$73	$54–$66	Lowered
Adjusted EBITDA ($M)	FY 2024	$165–$185	$165–$185	Maintained
EPS diluted ($)	FY 2024	$1.28–$1.52	$1.12–$1.36	Lowered

Implications: Operating momentum supports revenue uplift while unchanged Adjusted EBITDA points to steady operating profitability; lower EPS and net income ranges reflect higher interest expense and other non-operating impacts, consistent with rising quarterly interest expense ($8.6M in Q2 vs $3.6M prior-year) .

Earnings Call Themes & Trends

Topic	Previous Mentions (Q4’23, Q1’24)	Current Period (Q2’24)	Trend
Geographic expansion	Q4: New clinics; long-term partnership with BASS; MSSP participation . Q1: De novo clinics in Nevada; CFC and PCCCV acquisitions .	Entry into Arizona and Hawai‘i via partnerships; enablement expansion .	Accelerating footprint expansion
Payer/partner ecosystem	Q4: BASS partnership . Q1: Ongoing health plan relationships .	Anthem Blue Cross clinics partnership; Elation Health EHR partnership .	Deepening partnerships
Risk mix and cost-of-care	Q1: Full-risk ~60% of capitation as of Apr 1, 2024; strong cost-of-care management .	Continued focus on managing total cost of care for ~1M risk-bearing members .	Stable to improving accountability
M&A/Enablement scale	Q4: CFC IPA asset closing (part one) . Q1: CFC second closing completed; PCCCV acquired .	CHS acquisition announced (close expected Q4 2024) .	Scaling enablement nationally
Profitability/EBITDA	Q4: Adj. EBITDA $29.0M; 2024 guide $165–$185M . Q1: Adj. EBITDA $42.2M; 2024 guide reiterated .	Adj. EBITDA $47.9M; guide reiterated .	Consistent 10% margin
Capital structure/interest	Q4→Q1: Debt increased with growth/m&A .	Higher interest expense YoY in Q2 ($8.6M), guiding to lower EPS .	Interest headwind near term

Note: Q2 call transcript available via third party sources .

Management Commentary

“Strong revenue and adjusted EBITDA growth in the quarter were driven by continued organic growth in our Care Partners segment, the successful integration of the Community Family Care acquisition, and continued success in managing total cost of care for our one million members in value-based, risk-bearing arrangements… [our] entry into Arizona and Hawai‘i, partnerships with Anthem Blue Cross and Elation Health, and our agreement to acquire Collaborative Health Systems are anticipated to continue driving strong, sustainable, and profitable growth for the Astrana platform.” — Brandon K. Sim, CEO .
Segment profitability snapshot (Q2): Care Partners income from operations $40.3M (+45% YoY); Care Delivery $1.8M (+221% YoY); Care Enablement $6.9M (–9% YoY) .

Q&A Highlights

Themes addressed on the call included growth drivers (Care Partners momentum, state expansion), the CHS acquisition timing and integration path, utilization/cost trends, and reconciliation of guidance changes (revenue raised, EPS lowered), as reflected in the company’s press release and call materials .
Management reiterated confidence in operating execution (Adjusted EBITDA guide maintained) while acknowledging below-the-line pressures impacting EPS guidance .
Sell-side engagement included Truist, BofA, William Blair, BTIG, Lake Street, Jefferies, Baird, Stifel, and TD Cowen, indicating broad coverage and interest in CHS and growth trajectory .

Estimates Context

S&P Global consensus was unavailable via our tool for AMEH this quarter; we therefore cannot present S&P-anchored consensus levels. External source indicates Astrana beat revenue by ~$45.5M and missed EPS by ~$0.11 in Q2 2024, suggesting upward revisions to revenue and potential downward revisions to EPS near term .
Given raised revenue guidance and unchanged Adjusted EBITDA guidance, estimate models may shift mix toward higher revenue with stable operating margins but lower GAAP EPS due to higher interest and other below-the-line items (consistent with Q2 interest expense trends) .

Key Takeaways for Investors

Durable growth engine: Multi-pronged momentum (organic growth, enablement, geographic expansion) is lifting revenue and Adjusted EBITDA, with consistent ~10% Adjusted EBITDA margins .
Guidance quality: Revenue raised; EBITDA steady; EPS reduced—expect the market to parse cash earnings power (EBITDA) versus GAAP EPS sensitivity to financing costs .
CHS as a scale catalyst: If closed in Q4 2024, CHS broadens payer-agnostic enablement and cross-state scale; integration execution and profitability ramp are key watch items .
Risk-bearing leadership: ~1M members under value-based, risk-bearing arrangements with demonstrated cost-of-care management supports medium-term visibility .
Balance sheet/cost of capital: Rising debt and interest expense are near-term EPS headwinds; monitor leverage, interest run-rate, and cash generation (Q2 cash & equivalents $325.3M) .
Partnership flywheel: Anthem Blue Cross clinics initiative and Elation Health EHR collaboration can reinforce provider acquisition, enablement adoption, and network depth .
Near-term trading setup: Positive revenue surprise and raised top-line guide are offsets to EPS guide reduction; updates on CHS closing, utilization trends, and interest expense path may drive stock reaction .

Appendix: Additional Prior-Quarter Context

Q1 2024: Revenue $404.4M (+20% YoY), Adjusted EBITDA $42.2M (+42% YoY), EPS $0.31; reiterated FY24 guidance at that time; noted ~60% of capitation revenue in full-risk arrangements as of April 1, 2024 .
Q4 2023: Revenue $353.0M (+20% YoY), Adjusted EBITDA $29.0M (+23% YoY), EPS $0.26; introduced FY24 guidance .

Sources: Company 8-Ks and press releases and Q2 2024 exhibits as cited above ; external transcript/consensus context .

Astrana Health, Inc. (AMEH)·Q2 2024 Earnings Summary