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Business Combinations and Goodwill (Tables) | 9 Months Ended
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Sep. 30, 2025
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 at the acquisition date (in thousands):
|  | Prospect |
Purchase consideration: |  | $ | 674,901 |
Assets: |  |  |
Cash and cash equivalents |  | $ | 124,834 |
Receivables, net |  |  | 76,247 |
Other receivables |  |  | 310 |
Prepaid expenses and other current assets |  |  | 7,904 |
Loan receivable |  |  | 794 |
Property and equipment |  |  | 37,501 |
Intangible assets |  |  | 193,500 |
Goodwill |  |  | 442,190 |
Loans receivable, non-current |  |  | 278 |
Operating lease right-of-use assets |  |  | 4,406 |
Other assets |  |  | 6,117 |
Total assets acquired |  | $ | 894,081 |
Liabilities: |  |  |
Accounts payable and accrued expenses |  | $ | 85,388 |
Medical liabilities |  |  | 120,759 |
Operating lease liabilities |  |  | 1,733 |
Other liabilities |  |  | 823 |
Deferred tax liability |  |  | 4,903 |
Operating lease liabilities, net of current portion |  |  | 2,673 |
Other long-term liabilities |  |  | 2,901 |
Total liabilities assumed |  | $ | 219,180 |
Total net assets acquired |  | $ | 674,901 |
The following table summarizes the purchase price allocation of the fair value of assets acquired and liabilities assumed at the acquisition date (in thousands):
|  | CHS |  |  | AHMS |
Total purchase consideration: |  |  |  |  |  |
Cash paid |  | $ | 35,322 |  |  | $ | 63,935 |
Purchase price due to (from) seller |  |  | 6,944 |  |  |  | (2,995 | )
Contingent consideration |  |  | 5,154 |  |  |  | — |
Common stock issued and replacement awards |  |  | 118 |  |  |  | — |
|  | $ | 47,538 |  |  | $ | 60,940 |
Assets: |  |  |  |  |  |
Cash and cash equivalents |  | $ | 4,556 |  |  | $ | 33,950 |
Receivables |  |  | 102,447 |  |  |  | 11,007 |
Other receivables |  |  | 36,766 |  |  |  | — |
Prepaid expenses and other current assets |  |  | 356 |  |  |  | 36 |
Intangible assets |  |  | 14,200 |  |  |  | 23,600 |
Goodwill |  |  | 9,161 |  |  |  | 25,571 |
Investments in other entities – equity method |  |  | 3,121 |  |  |  | — |
Restricted cash |  |  | — |  |  |  | 300 |
Total assets acquired |  | $ | 170,607 |  |  | $ | 94,464 |
Liabilities: |  |  |  |  |  |
Accounts payable and accrued expenses |  | $ | 69,258 |  |  | $ | 13,001 |
Medical liabilities |  |  | 53,889 |  |  |  | 14,093 |
Non-controlling interest |  |  | (78 | ) |  |  | — |
Deferred tax liability |  |  | — |  |  |  | 6,430 |
Total liabilities assumed |  | $ | 123,069 |  |  | $ | 33,524 |
Total net assets acquired |  | $ | 47,538 |  |  | $ | 60,940 |
Unaudited Pro Forma Financial Information Operating results of the acquired businesses have been included in our condensed consolidated financial statements. For the period from the acquisition dates through September 30, 2025, the total revenue and net income of our acquisitions closed in 2025, in aggregate, were $308.0 million and $13.1 million, respectively. The pro forma financial information in the table below presents the combined results of the Company and the acquisitions that occurred during the three and nine months ended September 30, 2025 and 2024, as if the acquisitions had occurred on January 1, 2024. The pro forma financial information presented has been adjusted to exclude Prospect’s historical interest expense as all outstanding debt obligations were settled at closing and not assumed by the Company. The pro forma financial information presented has been adjusted to include the Company’s incremental interest expense, as if the borrowing from the delayed draw term loan credit facility had occurred on January 1, 2024 to finance the purchase of Prospect. The pro forma financial 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.
|  | Three Months Ended September 30, |  |  | Nine Months Ended September 30, |
(in thousands, except per share amounts) |  | 2025 |  |  | 2024 |  |  | 2025 |  |  | 2024 |
Total revenue |  | $ | 956,048 |  |  | $ | 965,839 |  |  | $ | 2,861,725 |  |  | $ | 2,939,243 |
Net income (loss) attributable to Astrana Health, Inc. |  | $ | 373 |  |  | $ | (8,975 | ) |  | $ | (4,780 | ) |  | $ | 27,577 |
Earnings (loss) per share – basic |  | $ | 0.01 |  |  | $ | (0.19 | ) |  | $ | (0.10 | ) |  | $ | 0.58 |
Earnings (loss) per share – diluted |  | $ | 0.01 |  |  | $ | (0.19 | ) |  | $ | (0.10 | ) |  | $ | 0.57 |
Summary of Intangible Assets Acquired | The table below represents intangible assets acquired for the Prospect (in thousands):
|  | Fair Value |  |  | Useful Life (Years)
License |  | $ | 1,900 |  |  | Indefinite
Member relationships |  |  | 123,500 |  |  | 12 years
Network relationships |  |  | 53,800 |  |  | 15 years
Other(1) |  |  | 14,300 |  |  | 3-10 years
Total intangible assets acquired |  | $ | 193,500 |  |  |
(1) Other consists of management contracts and a trade name.
Schedule of Change in Carrying Value of Goodwill | The change in the carrying value of goodwill for the nine months ended September 30, 2025, was as follows (in thousands):
|  | Amount |
Balance at January 1, 2025 |  | $ | 419,253 |
Acquisitions |  |  | 447,163 |
Adjustments |  |  | (3,150 | )
Balance at September 30, 2025 |  | $ | 863,266 |

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