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Business Combinations, Asset Acquisitions, and Goodwill (Tables) | 12 Months Ended
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Dec. 31, 2024
Business Combination and Asset Acquisition [Abstract] |
Schedule of Business Acquisitions, by Acquisition | The following table summarizes the purchase price allocation of the fair value of assets acquired and liabilities assumed related to each acquisition at the acquisition date for acquisitions that closed during the year ended December 31, 2024 (in thousands):
|  | CHS |  |  | AHMS |  |  | CFC |  |  | Others* |  |  | Net Total |
Total purchase consideration: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Cash paid |  | $ | 35,322 |  |  | $ | 63,935 |  |  | $ | 90,998 |  |  | $ | 15,000 |  |  | $ | 205,255 |
Purchase price due to (from) seller |  |  | 6,944 |  |  |  | (2,995 | ) |  |  | — |  |  |  | — |  |  |  | 3,949 |
Contingent consideration |  |  | 5,154 |  |  |  | — |  |  |  | 8,026 |  |  |  | 6,161 |  |  |  | 19,341 |
Common stock issued and replacement awards |  |  | 118 |  |  |  | — |  |  |  | 21,952 |  |  |  | — |  |  |  | 22,070 |
Conversion of promissory note |  |  |  |  |  | — |  |  |  | — |  |  |  | 5,175 |  |  |  | 5,175 |
|  | $ | 47,538 |  |  | $ | 60,940 |  |  | $ | 120,976 |  |  | $ | 26,336 |  |  | $ | 255,790 |
Assets: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Cash and cash equivalents |  | $ | 4,556 |  |  | $ | 33,950 |  |  | $ | 16,674 |  |  | $ | 3,515 |  |  | $ | 58,695 |
Investment in marketable securities |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 30 |  |  |  | 30 |
Receivables |  |  | 87,416 |  |  |  | 11,007 |  |  |  | 6,530 |  |  |  | — |  |  |  | 104,953 |
Other receivables |  |  | 54,194 |  |  |  | — |  |  |  | 472 |  |  |  | — |  |  |  | 54,666 |
Prepaid expenses and other current assets |  |  | 357 |  |  |  | 36 |  |  |  | 2,902 |  |  |  | 11 |  |  |  | 3,306 |
Property and equipment, net |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 823 |  |  |  | 823 |
Intangible assets |  |  | 14,200 |  |  |  | 23,600 |  |  |  | 28,000 |  |  |  | 6,338 |  |  |  | 72,138 |
Goodwill |  |  | 12,151 |  |  |  | 25,731 |  |  |  | 83,571 |  |  |  | 16,357 |  |  |  | 137,810 |
Income tax receivable |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 1 |  |  |  | 1 |
Investments in other entities – equity method |  |  | 3,125 |  |  |  | — |  |  |  | — |  |  |  | — |  |  |  | 3,125 |
Restricted cash |  |  | — |  |  |  | 300 |  |  |  | — |  |  |  | — |  |  |  | 300 |
Total assets acquired |  | $ | 175,999 |  |  | $ | 94,624 |  |  | $ | 138,149 |  |  | $ | 27,075 |  |  | $ | 435,847 |
Liabilities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Accounts payable and accrued expenses |  | $ | 68,115 |  |  | $ | 13,001 |  |  | $ | 2,486 |  |  | $ | 303 |  |  | $ | 83,905 |
Medical liabilities |  |  | 60,424 |  |  |  | 14,253 |  |  |  | 14,663 |  |  |  | — |  |  |  | 89,340 |
Income taxes payable |  |  | — |  |  |  | — |  |  |  | 24 |  |  |  | — |  |  |  | 24 |
Deferred tax liability |  |  | — |  |  |  | 6,430 |  |  |  | — |  |  |  | 8 |  |  |  | 6,438 |
Non-controlling interest |  |  | (78 | ) |  |  | — |  |  |  | — |  |  |  | 428 |  |  |  | 350 |
Total liabilities assumed |  | $ | 128,461 |  |  | $ | 33,684 |  |  | $ | 17,173 |  |  | $ | 739 |  |  | $ | 180,057 |
Total net assets acquired |  | $ | 47,538 |  |  | $ | 60,940 |  |  | $ | 120,976 |  |  | $ | 26,336 |  |  | $ | 255,790 |
*Others consist of estimated fair values of the assets acquired, net of cash acquired, related to ADSC, PCCCV, Airline Complete, and DWGAS. Unaudited Pro Forma Financial Information The pro forma financial information in the table below presents the combined results of the Company and the acquisitions in 2024 as if the acquisitions had occurred on January 1, 2023. The pro forma information presented is shown for illustrative purposes only and is not necessarily indicative of future results of operations of the Company or results of operations of the Company that would have actually occurred had the transactions been in effect for the periods presented.
|  | For the Years Ended December 31, |
(in thousands, except per share amounts) |  | 2024 |  |  | 2023 |
Total revenue |  | $ | 2,732,932 |  |  | $ | 2,655,460 |
Net income attributable to Astrana Health, Inc. |  | $ | 20,885 |  |  | $ | 57,381 |
Net income per share – basic |  | $ | 0.44 |  |  | $ | 1.23 |
Net income per share – diluted |  | $ | 0.44 |  |  | $ | 1.22 |
Schedule of Change in Carrying Value of Goodwill | The change in the carrying value of goodwill for the years ended December 31, 2024 and 2023 was as follows (in thousands):
|  | Amount |
Balance at January 1, 2023 |  | $ | 269,053 |
Acquisitions |  |  | 7,866 |
Adjustments |  |  | 1,912 |
Balance at December 31, 2023 |  |  | 278,831 |
Acquisitions |  |  | 137,810 |
Adjustments |  |  | 2,612 |
Balance at December 31, 2024 |  | $ | 419,253 |

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