Form: 10-Q

Quarterly report pursuant to Section 13 or 15(d)

August 9, 2024

FalseQ220240001083446--12-310001083446asth:SecondAndThirdMetricMemberus-gaap:OtherNoncurrentLiabilitiesMemberasth:CommunityFamilyCareMedicalGroupIPAInc.Member2024-06-300001083446us-gaap:FairValueInputsLevel1Memberasth:VOMGMember2023-12-310001083446asth:PatientManagementPlatformMember2023-12-310001083446us-gaap:SeriesAPreferredStockMember2024-06-300001083446asth:ApcStockOptionMember2023-01-012023-06-300001083446us-gaap:RevolvingCreditFacilityMemberasth:AmendedCreditAgreementMember2024-06-300001083446srt:MaximumMember2024-06-300001083446asth:AHMCMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2023-04-012023-06-300001083446us-gaap:TrademarksAndTradeNamesMember2023-12-310001083446us-gaap:HealthCarePatientServiceMemberus-gaap:CorporateNonSegmentMember2023-01-012023-06-300001083446us-gaap:NoncontrollingInterestMember2023-04-012023-06-3000010834462023-06-300001083446us-gaap:OtherInvesteesMember2023-04-012023-06-300001083446us-gaap:HealthCareOtherMember2024-04-012024-06-300001083446asth:CommunityFamilyCareMedicalGroupIPAInc.Member2024-01-310001083446us-gaap:PrivateEquityFundsMemberasth:ThirdWayHealthIncMember2024-06-300001083446asth:MezzanineMemberus-gaap:NoncontrollingInterestMember2024-03-310001083446asth:MemberRelationshipsMembersrt:MinimumMember2024-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:IntersegmentEliminationMember2023-01-012023-06-300001083446us-gaap:FairValueInputsLevel3Memberasth:CFCMember2024-06-300001083446asth:ProfessionalMedicalCorporationMemberasth:OfficeLeaseMemberasth:FirstCommonwealthPropertyLLCMember2024-04-012024-06-300001083446asth:RelatedPartyTransactionRevenueRecognizedMemberasth:HSMSOMember2024-04-012024-06-300001083446us-gaap:PrivatePlacementMember2015-10-310001083446asth:AlliedPacificOfCaliforniaIPAMember2023-01-012023-12-310001083446asth:MemberRelationshipsMembersrt:MaximumMember2024-06-300001083446us-gaap:RestrictedStockMember2024-01-012024-06-300001083446us-gaap:FairValueInputsLevel1Memberasth:InterestRateCollarMember2024-06-300001083446asth:TotalAcquisitionsMember2024-01-310001083446asth:OneMSOLLCMember2022-12-310001083446us-gaap:OperatingSegmentsMemberus-gaap:ProductAndServiceOtherMemberus-gaap:AllOtherSegmentsMember2023-01-012023-06-300001083446asth:TotalAcquisitionsMember2024-01-312024-01-310001083446asth:LasalleMedicalAssociatesIpaMember2024-01-012024-06-300001083446asth:HSMSOMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2023-01-012023-06-300001083446us-gaap:CommonStockMember2023-01-012023-03-3100010834462023-12-310001083446asth:PacificMedicalImagingAndOncologyCenterIncMember2024-03-310001083446us-gaap:CertificatesOfDepositMember2024-01-012024-06-300001083446us-gaap:DevelopedTechnologyRightsMember2024-06-300001083446us-gaap:RestrictedStockMember2024-01-012024-06-300001083446asth:DmgMember2023-12-310001083446asth:ProviderServicesMemberasth:PmiocMember2023-01-012023-06-300001083446asth:ManagementContractsMember2023-12-310001083446asth:VOMGMember2024-06-300001083446us-gaap:FairValueInputsLevel2Memberasth:CFCMember2024-06-300001083446asth:CommercialMember2023-04-012023-06-300001083446asth:NetworkRelationshipsMembersrt:MinimumMember2024-06-300001083446us-gaap:AdditionalPaidInCapitalMember2023-04-012023-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:SunnyVillageCareCenterMember2023-04-012023-06-300001083446asth:ApolloSunLabsManagementLLCMember2023-01-012023-06-300001083446asth:PatientManagementPlatformMember2024-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberasth:CareDeliveryMember2023-04-012023-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ApcBusinessLoanAgreementMemberasth:PreferredBankMemberus-gaap:LineOfCreditMember2019-09-100001083446us-gaap:FairValueInputsLevel3Memberasth:PrimeCommunityCareMember2024-06-300001083446us-gaap:FairValueInputsLevel2Memberasth:VOMGMember2023-12-310001083446asth:NetworkRelationshipsMember2023-12-310001083446us-gaap:SalesRevenueNetMemberus-gaap:CustomerConcentrationRiskMemberasth:PayorBMember2024-04-012024-06-300001083446us-gaap:NotesPayableToBanksMember2024-06-300001083446us-gaap:OperatingSegmentsMemberus-gaap:AllOtherSegmentsMember2023-04-012023-06-300001083446asth:MemberRelationshipsMember2024-06-300001083446asth:DmgMember2024-06-300001083446asth:AlliedPacificHoldingsInvestmentManagementLLCMembersrt:ChiefExecutiveOfficerMember2023-12-310001083446us-gaap:AccountsReceivableMemberus-gaap:CustomerConcentrationRiskMemberasth:PayerCMember2024-01-012024-06-300001083446us-gaap:RelatedPartyMemberasth:ArroyoVistaMemberasth:AHMCMember2024-04-012024-06-300001083446us-gaap:CertificatesOfDepositMember2023-12-310001083446asth:CareEnablementMemberus-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMember2023-04-012023-06-300001083446us-gaap:FairValueInputsLevel1Member2023-12-310001083446asth:HealthCareCapitationRevenueMember2024-04-012024-06-300001083446asth:CFCMember2024-06-300001083446asth:ProviderServicesMemberasth:PmiocMember2024-04-012024-06-300001083446us-gaap:EmployeeStockOptionMember2024-04-012024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CareDeliveryMemberus-gaap:ProductAndServiceOtherMember2023-04-012023-06-300001083446asth:AAMGMemberasth:A2024MetricMember2024-01-012024-06-300001083446asth:MezzanineMemberus-gaap:NoncontrollingInterestMember2023-03-310001083446us-gaap:IntersegmentEliminationMemberus-gaap:ProductAndServiceOtherMember2023-04-012023-06-300001083446us-gaap:EmployeeStockOptionMember2023-04-012023-06-300001083446us-gaap:RelatedPartyMemberasth:ArroyoVistaMemberasth:AHMCMember2023-01-012023-06-300001083446us-gaap:FairValueInputsLevel3Memberasth:VOMGMember2024-06-300001083446asth:HealthCareCapitationRevenueMember2023-01-012023-06-300001083446srt:MinimumMember2024-06-300001083446us-gaap:RetainedEarningsMember2023-12-310001083446us-gaap:ManagementServiceMember2023-01-012023-06-300001083446us-gaap:VariableInterestEntityNotPrimaryBeneficiaryMember2023-12-310001083446us-gaap:FairValueInputsLevel1Memberasth:VOMGMember2024-06-300001083446asth:CompanyAndAPCMember2024-06-300001083446asth:HealthCareCapitationRevenueMember2024-01-012024-06-300001083446asth:ProfessionalMedicalCorporationMemberasth:OfficeLeaseMemberasth:FirstCommonwealthPropertyLLCMember2024-01-012024-06-300001083446us-gaap:CommonStockMember2024-06-300001083446asth:NewTermLoanMember2024-06-300001083446us-gaap:IntersegmentEliminationMember2023-04-012023-06-3000010834462024-04-012024-06-300001083446asth:AurionMemberasth:RelatedPartyTransactionExpensesIncurredMember2023-04-012023-06-300001083446asth:IHealthPromissioryNoteMember2024-04-012024-04-010001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberus-gaap:AllOtherSegmentsMember2024-04-012024-06-300001083446asth:AlliedPacificOfCaliforniaIPAMembersrt:DirectorMember2023-01-012023-06-300001083446us-gaap:SeriesBPreferredStockMember2016-03-012016-03-310001083446asth:PacificMedicalImagingAndOncologyCenterIncMember2024-04-012024-06-300001083446us-gaap:BaseRateMembersrt:MinimumMember2024-01-012024-06-300001083446asth:AHMCMemberasth:RelatedPartyTransactionExpensesIncurredMember2023-01-012023-06-300001083446us-gaap:AdditionalPaidInCapitalMember2024-01-012024-03-310001083446asth:CDSCMember2023-04-012023-06-300001083446asth:LasalleMedicalAssociatesIpaMember2023-12-310001083446asth:CommercialMember2023-01-012023-06-300001083446us-gaap:NonrelatedPartyMemberus-gaap:VariableInterestEntityPrimaryBeneficiaryMember2023-12-310001083446us-gaap:OperatingSegmentsMemberus-gaap:ProductAndServiceOtherMemberus-gaap:AllOtherSegmentsMember2024-01-012024-06-300001083446asth:StockAwardsAndUnitsMember2024-01-012024-06-300001083446us-gaap:TrademarksMember2024-06-300001083446asth:ADSCMember2024-06-300001083446us-gaap:NonrelatedPartyMember2024-06-300001083446us-gaap:IntersegmentEliminationMember2024-01-012024-06-300001083446us-gaap:CorporateNonSegmentMemberus-gaap:ProductAndServiceOtherMember2024-01-012024-06-300001083446asth:OtherThirdPartiesMember2023-04-012023-06-300001083446asth:RelatedPartyTransactionRevenueRecognizedMemberasth:HSMSOMember2023-01-012023-06-3000010834462024-03-310001083446us-gaap:PerformanceSharesMember2023-01-012023-06-300001083446asth:CDSCMember2024-01-012024-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberasth:CarePartnersMember2024-04-012024-06-300001083446asth:VOMGMember2023-12-310001083446asth:HSMSOMemberasth:RelatedPartyTransactionExpensesIncurredMember2023-04-012023-06-300001083446us-gaap:FairValueInputsLevel2Memberasth:InterestRateCollarMember2024-06-300001083446asth:PacificMedicalImagingAndOncologyCenterIncMember2022-12-310001083446asth:ProfessionalMedicalCorporationMemberasth:OfficeLeaseMemberasth:AlliedPacificHoldingsInvestmentManagementLLCMember2024-04-012024-06-300001083446us-gaap:AdditionalPaidInCapitalMember2023-01-012023-03-310001083446asth:CareEnablementMemberus-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMember2024-01-012024-06-300001083446us-gaap:HealthCarePatientServiceMember2023-04-012023-06-300001083446us-gaap:RelatedPartyMemberus-gaap:VariableInterestEntityPrimaryBeneficiaryMember2024-06-300001083446asth:EsppMember2024-01-012024-06-300001083446us-gaap:AdditionalPaidInCapitalMember2022-12-310001083446us-gaap:FairValueInputsLevel3Memberasth:DmgMember2024-06-300001083446us-gaap:RestrictedStockMember2023-04-012023-06-300001083446us-gaap:CommonStockMember2024-01-012024-03-310001083446asth:MezzanineMemberus-gaap:NoncontrollingInterestMember2023-12-310001083446us-gaap:PerformanceSharesMember2024-01-012024-06-300001083446us-gaap:CorporateNonSegmentMember2023-01-012023-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberus-gaap:StandbyLettersOfCreditMember2024-06-300001083446us-gaap:FairValueInputsLevel2Memberasth:InterestRateCollarMember2023-12-310001083446asth:OneMSOLLCMember2023-06-300001083446us-gaap:OperatingSegmentsMemberasth:CareDeliveryMemberus-gaap:ProductAndServiceOtherMember2024-01-012024-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberus-gaap:StandbyLettersOfCreditMember2024-01-012024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CarePartnersMemberus-gaap:ProductAndServiceOtherMember2023-01-012023-06-300001083446us-gaap:BaseRateMembersrt:MaximumMember2024-01-012024-06-300001083446us-gaap:CallOptionMemberasth:IHealthIncMember2024-01-012024-03-310001083446asth:MemberRelationshipsMember2023-12-3100010834462023-01-012023-03-310001083446asth:MezzanineMemberus-gaap:NoncontrollingInterestMember2024-01-012024-03-310001083446asth:ApolloSunLabsManagementLLCMemberus-gaap:FairValueInputsLevel1Member2023-12-310001083446asth:EmployeeStockPurchasePlanMember2024-06-300001083446us-gaap:RetainedEarningsMember2023-01-012023-03-310001083446us-gaap:AdditionalPaidInCapitalMember2023-03-310001083446us-gaap:CorporateNonSegmentMemberus-gaap:ProductAndServiceOtherMember2024-04-012024-06-300001083446us-gaap:FairValueInputsLevel1Memberasth:CFCMember2024-06-300001083446us-gaap:FairValueInputsLevel3Memberasth:InterestRateCollarMember2023-12-310001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:BoardMembersMember2023-01-012023-06-300001083446asth:CAIPAMSOLLCMember2022-12-310001083446us-gaap:NotesReceivableMemberasth:IntraCareConvertiblePromissoryNoteReceivableMember2023-07-310001083446us-gaap:NoncontrollingInterestMember2024-03-310001083446us-gaap:OperatingSegmentsMemberus-gaap:AllOtherSegmentsMember2023-01-012023-06-300001083446us-gaap:IntersegmentEliminationMemberus-gaap:ProductAndServiceOtherMember2024-01-012024-06-300001083446us-gaap:ProductAndServiceOtherMember2023-04-012023-06-300001083446asth:A2023And2024MetricMemberus-gaap:OtherNoncurrentLiabilitiesMemberasth:AAMGMember2023-12-310001083446us-gaap:ProductAndServiceOtherMember2024-01-012024-06-300001083446us-gaap:NonrelatedPartyMember2023-12-310001083446us-gaap:RevolvingCreditFacilityMember2024-06-300001083446us-gaap:NoncontrollingInterestMember2024-01-012024-03-310001083446us-gaap:FairValueInputsLevel3Memberasth:AAMGMember2023-12-310001083446asth:HSMSOMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2024-01-012024-06-300001083446asth:MedicaidMember2024-01-012024-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:AlliedPacificHoldingsInvestmentManagementLLCMemberasth:TaxesAssociatedWithExcludedAssetsSpinOffMember2024-04-012024-06-300001083446us-gaap:AdditionalPaidInCapitalMember2024-03-310001083446asth:AurionMemberasth:RelatedPartyTransactionExpensesIncurredMember2023-01-012023-06-3000010834462023-04-012023-06-300001083446us-gaap:ManagementServiceMember2024-01-012024-06-300001083446asth:AmendedCreditAgreementMemberus-gaap:LetterOfCreditMember2021-06-160001083446us-gaap:NoncontrollingInterestMember2023-06-300001083446asth:FiveThreeOneW.CollegeLLCMember2023-06-300001083446asth:CAIPAMSOLLCMember2023-04-012023-06-300001083446us-gaap:FairValueInputsLevel2Member2024-06-300001083446us-gaap:OtherInvesteesMember2024-03-310001083446asth:CDSCMember2024-04-012024-06-300001083446asth:CollaborativeHealthSystemsLLCSecuritiesPurchaseAgreementMemberus-gaap:SubsequentEventMembersrt:MaximumMember2024-07-240001083446asth:OneMSOLLCMember2023-03-310001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:BoardMembersWhoAreAlsoOfficersMember2023-04-012023-06-300001083446us-gaap:IntersegmentEliminationMemberus-gaap:ProductAndServiceOtherMember2024-04-012024-06-300001083446asth:AurionMemberasth:RelatedPartyTransactionExpensesIncurredMember2024-01-012024-06-300001083446asth:ProfessionalMedicalCorporationMemberasth:OfficeLeaseMemberasth:AlliedPacificHoldingsInvestmentManagementLLCMember2024-01-012024-06-300001083446us-gaap:RelatedPartyMemberasth:ArroyoVistaMemberasth:AHMCMember2023-04-012023-06-300001083446us-gaap:FairValueInputsLevel1Memberasth:AAMGMember2023-12-310001083446asth:CAIPAMSOLLCMember2024-03-310001083446asth:PmiocMember2024-06-300001083446us-gaap:RelatedPartyMemberus-gaap:HealthCareOtherMemberasth:AHMCMember2023-01-012023-06-300001083446asth:LasalleMedicalAssociatesIpaMember2023-03-310001083446asth:CreditAgreementMember2024-01-012024-06-300001083446us-gaap:OperatingSegmentsMemberus-gaap:ProductAndServiceOtherMemberus-gaap:AllOtherSegmentsMember2024-04-012024-06-300001083446asth:MemberRelationshipsMembersrt:MaximumMember2023-12-310001083446us-gaap:RelatedPartyMemberasth:IHealthIncMember2024-04-012024-06-300001083446asth:IHealthIncMember2023-12-310001083446us-gaap:CorporateNonSegmentMemberus-gaap:ProductAndServiceOtherMember2023-04-012023-06-300001083446us-gaap:HealthCarePatientServiceMember2023-04-012023-06-300001083446asth:OtherThirdPartiesMember2023-01-012023-06-300001083446asth:DmgMember2024-06-300001083446asth:NewTermLoanMember2023-12-310001083446asth:AurionMemberasth:RelatedPartyTransactionRevenueRecognizedMember2023-01-012023-06-300001083446asth:IHealthIncMember2024-01-012024-06-300001083446us-gaap:HealthCarePatientServiceMember2023-01-012023-06-300001083446us-gaap:FairValueInputsLevel1Memberasth:InterestRateCollarMember2023-12-310001083446asth:AdvancedDiagnosticAndSurgicalCenterIncMember2024-01-010001083446asth:PCCCVMember2024-06-300001083446us-gaap:EmployeeStockOptionMember2024-01-012024-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberus-gaap:AllOtherSegmentsMember2024-01-012024-06-300001083446us-gaap:RetainedEarningsMember2024-06-300001083446us-gaap:CommonStockMember2022-12-310001083446asth:RelatedPartyTransactionRevenueRecognizedMemberasth:AHMCMember2023-04-012023-06-300001083446us-gaap:EmployeeStockOptionMember2024-04-012024-06-300001083446asth:MedicareMember2023-04-012023-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberasth:CareDeliveryMember2023-01-012023-06-300001083446asth:NetworkRelationshipsMember2024-06-300001083446asth:AmendedCreditAgreementMemberasth:TruistBankMemberus-gaap:StandbyLettersOfCreditMember2024-06-300001083446us-gaap:FairValueInputsLevel3Memberasth:VOMGMember2023-12-310001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberus-gaap:AllOtherSegmentsMember2023-01-012023-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:BoardMembersWhoAreAlsoOfficersMember2024-04-012024-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:SunnyVillageCareCenterMember2024-01-012024-06-300001083446us-gaap:StandbyLettersOfCreditMemberasth:AmendedCreditAgreementMemberasth:TruistBankMember2024-01-012024-06-300001083446us-gaap:EmployeeStockOptionMember2023-01-012023-06-300001083446asth:CAIPAMSOLLCMember2023-03-310001083446us-gaap:OperatingSegmentsMemberasth:CareDeliveryMember2023-01-012023-06-300001083446asth:CareEnablementMemberus-gaap:OperatingSegmentsMemberus-gaap:ProductAndServiceOtherMember2023-04-012023-06-300001083446asth:MedicaidMember2024-04-012024-06-300001083446us-gaap:OtherNoncurrentLiabilitiesMemberasth:AAMGMemberasth:A2024MetricMember2024-06-300001083446us-gaap:ProductAndServiceOtherMember2024-01-012024-06-300001083446asth:AHMCMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2024-01-012024-06-300001083446asth:AurionMemberasth:RelatedPartyTransactionExpensesIncurredMember2024-04-012024-06-300001083446us-gaap:PerformanceSharesMember2024-04-012024-06-300001083446asth:MezzanineMemberus-gaap:NoncontrollingInterestMember2023-01-012023-03-3100010834462024-01-012024-06-300001083446us-gaap:PrivatePlacementMember2015-10-012015-10-310001083446us-gaap:AccountsReceivableMemberus-gaap:CustomerConcentrationRiskMemberasth:PayerCMember2023-01-012023-12-310001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberasth:CarePartnersMember2023-04-012023-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:IntersegmentEliminationMember2023-04-012023-06-300001083446asth:MezzanineMemberus-gaap:NoncontrollingInterestMember2022-12-310001083446asth:AlliedPacificOfCaliforniaIPAMember2023-12-310001083446asth:CAIPAMSOLLCMember2024-06-300001083446asth:ProviderServicesMemberasth:SongPCMember2023-01-012023-06-300001083446asth:TermLoanMember2023-12-310001083446asth:SongPCMember2024-06-300001083446us-gaap:RevolvingCreditFacilityMember2023-11-032023-11-030001083446asth:MedicareMember2024-01-012024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CarePartnersMember2023-01-012023-06-300001083446asth:PacificMedicalImagingAndOncologyCenterIncMember2023-03-310001083446asth:AHMCMember2023-12-310001083446asth:FiveThreeOneW.CollegeLLCMember2023-03-310001083446asth:ConvertiblePromissoryNoteMemberus-gaap:SubsequentEventMember2024-07-170001083446asth:HSMSOMemberasth:RelatedPartyTransactionExpensesIncurredMember2023-01-012023-06-300001083446us-gaap:AccountsReceivableMemberus-gaap:CustomerConcentrationRiskMemberasth:PayorAMember2024-01-012024-06-300001083446us-gaap:RelatedPartyMember2024-06-300001083446asth:PacificMedicalImagingAndOncologyCenterIncMember2023-06-300001083446us-gaap:SeriesBPreferredStockMember2016-03-310001083446us-gaap:OperatingSegmentsMemberus-gaap:AllOtherSegmentsMember2024-04-012024-06-300001083446us-gaap:VariableInterestEntityPrimaryBeneficiaryMember2024-01-012024-01-010001083446asth:CAIPAMSOLLCMember2023-01-012023-06-300001083446asth:AccountsPayableAndAccruedExpensesMember2024-01-012024-06-300001083446asth:RelatedPartyTransactionRevenueRecognizedMemberasth:AurionMember2024-04-012024-06-300001083446us-gaap:FairValueInputsLevel3Memberasth:InterestRateCollarMember2024-06-300001083446asth:SecuredOvernightFinancingRateMemberasth:AmendedCreditAgreementMembersrt:MinimumMember2021-06-162021-06-160001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:BoardMembersMember2024-01-012024-06-300001083446us-gaap:IntersegmentEliminationMember2023-01-012023-06-300001083446us-gaap:HealthCareOtherMember2024-01-012024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CareDeliveryMember2024-04-012024-06-300001083446us-gaap:RelatedPartyMemberasth:IHealthIncMember2024-01-012024-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberus-gaap:AllOtherSegmentsMember2023-04-012023-06-300001083446asth:DMGAndSunLabsMember2024-01-012024-06-300001083446us-gaap:BaseRateMemberasth:AmendedCreditAgreementMembersrt:MaximumMember2021-06-162021-06-160001083446asth:SecuredOvernightFinancingRateMembersrt:MinimumMember2024-01-012024-06-300001083446us-gaap:ProductAndServiceOtherMember2024-04-012024-06-300001083446us-gaap:AdditionalPaidInCapitalMember2024-04-012024-06-300001083446us-gaap:RelatedPartyMemberasth:LmaMember2023-01-012023-06-300001083446asth:ApolloSunLabsManagementLLCMemberus-gaap:FairValueInputsLevel2Member2024-06-300001083446asth:CreditAgreementMember2024-06-300001083446us-gaap:HealthCarePatientServiceMember2023-01-012023-06-300001083446us-gaap:FairValueInputsLevel2Memberasth:AAMGMember2023-12-310001083446us-gaap:RetainedEarningsMember2024-04-012024-06-300001083446us-gaap:NotesReceivableMemberasth:IntraCareConvertiblePromissoryNoteReceivableMember2023-07-012023-07-310001083446us-gaap:HealthCarePatientServiceMemberus-gaap:CorporateNonSegmentMember2024-04-012024-06-300001083446asth:PrimeCommunityCareMember2024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CarePartnersMember2024-01-012024-06-300001083446us-gaap:NoncontrollingInterestMember2022-12-310001083446us-gaap:AdditionalPaidInCapitalMember2023-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:AlliedPacificHoldingsInvestmentManagementLLCMemberasth:TaxesAssociatedWithExcludedAssetsSpinOffMember2024-01-012024-06-300001083446asth:DmgMemberus-gaap:FairValueInputsLevel1Member2024-06-300001083446us-gaap:CertificatesOfDepositMember2024-06-300001083446asth:A2023MetricMemberus-gaap:OtherLiabilitiesMemberasth:AAMGMember2023-12-310001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:SunnyVillageCareCenterMember2023-01-012023-06-300001083446asth:AHMCMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2023-01-012023-06-300001083446asth:AurionMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2024-04-012024-06-300001083446us-gaap:SalesRevenueNetMemberus-gaap:CustomerConcentrationRiskMemberasth:PayorAMember2023-01-012023-06-300001083446us-gaap:RestrictedStockMember2023-01-012023-06-300001083446us-gaap:OtherInvesteesMember2023-06-300001083446asth:RelatedPartyTransactionRevenueRecognizedMemberasth:AHMCMember2024-01-012024-06-3000010834462023-03-310001083446asth:RelatedPartyTransactionRevenueRecognizedMemberasth:AHMCMember2023-01-012023-06-300001083446asth:InterestRateCollarMember2023-01-012023-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberasth:CarePartnersMember2023-01-012023-06-300001083446asth:OneMSOLLCMember2023-04-012023-06-300001083446us-gaap:NotesPayableToBanksMember2023-12-310001083446asth:ManagementContractsMember2024-06-300001083446us-gaap:SecuredDebtMemberasth:AmendedAndRestatedCreditAgreementMemberasth:TruistBankMemberus-gaap:DebtInstrumentRedemptionPeriodOneMember2023-11-030001083446asth:IHealthPromissioryNoteMember2024-04-010001083446asth:ProviderServicesMemberasth:SongPCMember2024-04-012024-06-300001083446us-gaap:LetterOfCreditMemberasth:AstranaMedicalMember2024-06-300001083446us-gaap:RestrictedStockMember2024-04-012024-06-300001083446us-gaap:OtherInvesteesMember2024-01-012024-06-300001083446asth:OneMSOLLCMember2023-01-012023-06-300001083446asth:AHMCMemberasth:RelatedPartyTransactionExpensesIncurredMember2023-04-012023-06-300001083446us-gaap:FairValueInputsLevel2Memberasth:AAMGMember2024-06-300001083446asth:FirstCommonwealthPropertyLLCMember2023-12-310001083446asth:OtherAcquisitionsMember2024-01-310001083446asth:CAIPAMSOLLCMember2024-01-012024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CarePartnersMemberus-gaap:ProductAndServiceOtherMember2024-01-012024-06-300001083446asth:CompanyAndAPCMember2023-12-310001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberasth:CareDeliveryMember2024-04-012024-06-300001083446asth:HSMSOMemberasth:RelatedPartyTransactionExpensesIncurredMember2024-01-012024-06-300001083446asth:CareEnablementMemberus-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMember2024-04-012024-06-3000010834462024-07-300001083446asth:InterestRateCollarMember2024-04-012024-06-300001083446asth:PrimeCommunityCareOfCentralValleyIncMember2024-03-290001083446asth:LasalleMedicalAssociatesIpaMember2024-04-012024-06-300001083446asth:ProviderServicesMemberasth:PmiocMember2024-01-012024-06-300001083446asth:LasalleMedicalAssociatesIpaMember2023-01-012023-06-300001083446us-gaap:EmployeeStockOptionMember2023-01-012023-06-300001083446asth:AAMGMember2023-12-310001083446us-gaap:HealthCarePatientServiceMemberus-gaap:IntersegmentEliminationMember2024-04-012024-06-300001083446asth:HSMSOMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2023-04-012023-06-300001083446us-gaap:RelatedPartyMemberus-gaap:HealthCareOtherMemberasth:AHMCMember2024-01-012024-06-300001083446us-gaap:FairValueInputsLevel3Memberasth:ApolloSunLabsManagementLLCMember2023-12-310001083446asth:NetworkRelationshipsMembersrt:MaximumMember2024-06-300001083446us-gaap:RetainedEarningsMember2023-06-300001083446asth:CareEnablementMemberus-gaap:OperatingSegmentsMember2023-01-012023-06-300001083446asth:CareEnablementMemberus-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMember2023-01-012023-06-300001083446asth:RelatedPartyTransactionRevenueRecognizedMemberasth:HSMSOMember2023-04-012023-06-300001083446us-gaap:FairValueInputsLevel2Member2023-12-310001083446us-gaap:CommonStockMember2023-04-012023-06-300001083446asth:MezzanineMemberus-gaap:NoncontrollingInterestMember2023-04-012023-06-300001083446asth:MezzanineMemberus-gaap:NoncontrollingInterestMember2023-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:CorporateNonSegmentMember2023-04-012023-06-300001083446us-gaap:SalesRevenueNetMemberus-gaap:CustomerConcentrationRiskMemberasth:PayorBMember2024-01-012024-06-300001083446asth:InterestRateCollarMember2024-01-012024-06-300001083446us-gaap:OperatingSegmentsMemberus-gaap:AllOtherSegmentsMember2024-01-012024-06-300001083446us-gaap:CommonStockMember2023-06-300001083446asth:ApolloSunLabsManagementLLCMemberus-gaap:FairValueInputsLevel1Member2024-06-300001083446asth:SecuredOvernightFinancingRateMembersrt:MaximumMember2024-01-012024-06-300001083446asth:ProfessionalMedicalCorporationMemberasth:AlliedPacificHoldingsInvestmentManagementLLCMemberasth:OfficeLeaseMember2023-04-012023-06-300001083446asth:RelatedPartyTransactionRevenueRecognizedMemberasth:AHMCMember2024-04-012024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CareDeliveryMember2023-04-012023-06-300001083446asth:AurionMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2024-01-012024-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:BoardMembersMember2023-04-012023-06-300001083446us-gaap:ProductAndServiceOtherMember2023-01-012023-06-300001083446us-gaap:IntersegmentEliminationMember2024-04-012024-06-300001083446us-gaap:HealthCareOtherMember2023-01-012023-06-300001083446asth:AlliedPacificOfCaliforniaIPAMember2024-06-300001083446us-gaap:FairValueInputsLevel1Memberasth:AAMGMember2024-06-300001083446us-gaap:VariableInterestEntityNotPrimaryBeneficiaryMember2024-06-300001083446us-gaap:RetainedEarningsMember2023-03-310001083446asth:CareEnablementMemberus-gaap:OperatingSegmentsMemberus-gaap:ProductAndServiceOtherMember2024-04-012024-06-300001083446asth:AdvancedHealthManagementSystemsLPMember2024-01-310001083446us-gaap:ManagementServiceMember2024-04-012024-06-300001083446us-gaap:RevolvingCreditFacilityMember2024-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:BoardMembersMember2024-04-012024-06-300001083446asth:ApolloSunLabsManagementLLCMember2023-04-012023-06-300001083446us-gaap:TrademarksAndTradeNamesMember2024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CareDeliveryMemberus-gaap:ProductAndServiceOtherMember2023-01-012023-06-300001083446asth:ConvertiblePromissoryNoteMemberus-gaap:SubsequentEventMember2024-07-172024-07-170001083446asth:AurionMemberasth:RelatedPartyTransactionRevenueRecognizedMember2024-01-012024-06-300001083446asth:InterestRateCollarMember2023-12-310001083446asth:ADSCMemberus-gaap:FairValueInputsLevel2Member2024-06-300001083446us-gaap:OtherInvesteesMember2023-03-310001083446us-gaap:IntersegmentEliminationMemberus-gaap:ProductAndServiceOtherMember2023-01-012023-06-300001083446asth:EsppMember2023-04-012023-06-3000010834462023-01-012023-06-300001083446us-gaap:SecuredDebtMemberus-gaap:DebtInstrumentRedemptionPeriodTwoMemberasth:AmendedAndRestatedCreditAgreementMemberasth:TruistBankMember2023-11-030001083446us-gaap:FairValueInputsLevel2Memberasth:VOMGMember2024-06-300001083446asth:OtherAcquisitionsMember2024-01-312024-01-310001083446us-gaap:SeriesBPreferredStockMember2023-12-310001083446us-gaap:BaseRateMemberasth:AmendedCreditAgreementMembersrt:MinimumMember2021-06-162021-06-160001083446us-gaap:AdditionalPaidInCapitalMember2023-12-310001083446asth:CAIPAMSOLLCMember2024-04-012024-06-300001083446asth:AurionMemberasth:RelatedPartyTransactionRevenueRecognizedMember2023-04-012023-06-300001083446us-gaap:NoncontrollingInterestMember2023-01-012023-03-310001083446us-gaap:RevolvingCreditFacilityMemberasth:AmendedCreditAgreementMember2021-06-162021-06-160001083446us-gaap:LicenseMember2024-06-300001083446us-gaap:RetainedEarningsMember2023-04-012023-06-3000010834462024-06-300001083446asth:A2023MetricMemberasth:AAMGMember2024-01-012024-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:IntersegmentEliminationMember2024-01-012024-06-300001083446asth:AdvancedHealthManagementSystemsLPMember2024-01-312024-01-310001083446us-gaap:RelatedPartyMemberus-gaap:HealthCareOtherMemberasth:AHMCMember2023-04-012023-06-300001083446us-gaap:VariableInterestEntityPrimaryBeneficiaryMember2024-01-012024-06-300001083446asth:InterestRateCollarMember2024-06-300001083446asth:PerformanceBasedRestrictedStockMember2024-01-012024-06-300001083446asth:PrimeCommunityCareMemberus-gaap:FairValueInputsLevel1Member2024-06-300001083446asth:MedicaidMember2023-01-012023-06-300001083446asth:AlliedPacificOfCaliforniaIPAMembersrt:DirectorMember2024-01-012024-06-300001083446asth:AurionMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2023-04-012023-06-300001083446us-gaap:FairValueInputsLevel3Member2023-12-310001083446asth:MedicareMember2024-04-012024-06-300001083446asth:PrimeCommunityCareOfCentralValleyIncMember2024-03-292024-03-290001083446asth:PacificMedicalImagingAndOncologyCenterIncMember2023-12-310001083446us-gaap:DebtInstrumentRedemptionPeriodThreeMemberus-gaap:SecuredDebtMemberasth:AmendedAndRestatedCreditAgreementMemberasth:TruistBankMember2023-11-030001083446us-gaap:RetainedEarningsMember2022-12-310001083446us-gaap:EmployeeStockOptionMember2024-01-012024-06-300001083446us-gaap:NoncontrollingInterestMember2023-03-310001083446asth:HSMSOMemberasth:RelatedPartyTransactionExpensesIncurredMember2024-04-012024-06-300001083446us-gaap:FairValueInputsLevel3Member2024-06-300001083446us-gaap:ProductAndServiceOtherMember2024-04-012024-06-300001083446us-gaap:HealthCarePatientServiceMember2024-01-012024-06-300001083446us-gaap:RevolvingCreditFacilityMember2023-12-310001083446us-gaap:CorporateNonSegmentMember2024-04-012024-06-300001083446us-gaap:CorporateNonSegmentMemberus-gaap:ProductAndServiceOtherMember2023-01-012023-06-300001083446asth:TermLoanMember2024-06-300001083446us-gaap:RevolvingCreditFacilityMemberasth:AmendedCreditAgreementMember2021-06-160001083446asth:StockAwardsAndUnitsMember2024-04-012024-06-300001083446asth:ProfessionalMedicalCorporationMemberasth:AlliedPacificHoldingsInvestmentManagementLLCMemberasth:OfficeLeaseMember2023-01-012023-06-300001083446asth:MedicareMember2023-01-012023-06-300001083446asth:PacificMedicalImagingAndOncologyCenterIncMember2023-01-012023-06-300001083446asth:A2023And2024MetricMemberus-gaap:OtherNoncurrentLiabilitiesMemberasth:AAMGMember2024-06-300001083446asth:IHealthIncMember2024-04-012024-06-300001083446asth:ApolloSunLabsManagementLLCMemberus-gaap:FairValueInputsLevel3Member2024-06-300001083446asth:AAMGMember2024-06-300001083446us-gaap:CorporateNonSegmentMember2023-04-012023-06-300001083446asth:CareEnablementMemberus-gaap:OperatingSegmentsMember2024-01-012024-06-300001083446asth:NetworkRelationshipsMembersrt:MinimumMember2023-12-310001083446asth:CollaborativeHealthSystemsLLCSecuritiesPurchaseAgreementMemberus-gaap:SubsequentEventMember2024-07-240001083446us-gaap:AccountsReceivableMemberus-gaap:CustomerConcentrationRiskMemberasth:PayorAMember2023-01-012023-12-310001083446us-gaap:OperatingSegmentsMemberasth:CarePartnersMember2024-04-012024-06-300001083446asth:AlliedPacificHoldingsInvestmentManagementLLCMembersrt:ChiefExecutiveOfficerMember2024-06-300001083446us-gaap:LetterOfCreditMemberasth:AmendedCreditAgreementMember2023-09-080001083446asth:CDSCMember2023-01-012023-06-300001083446asth:ProviderServicesMemberasth:SongPCMember2023-04-012023-06-300001083446asth:ApolloSunLabsManagementLLCMember2024-04-012024-06-300001083446asth:EsppMember2023-01-012023-06-300001083446asth:CommercialMember2024-01-012024-06-300001083446asth:LasalleMedicalAssociatesIpaMember2023-06-300001083446us-gaap:CommonStockMember2023-12-310001083446us-gaap:EmployeeStockOptionMember2023-04-012023-06-300001083446us-gaap:OtherInvesteesMember2023-12-310001083446asth:HealthCareCapitationRevenueMember2023-04-012023-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:SunnyVillageCareCenterMember2024-04-012024-06-300001083446us-gaap:VariableInterestEntityPrimaryBeneficiaryMember2023-12-310001083446us-gaap:RelatedPartyMemberus-gaap:HealthCareOtherMemberasth:AHMCMember2024-04-012024-06-300001083446asth:ApolloSunLabsManagementLLCMember2024-06-300001083446asth:ApolloSunLabsManagementLLCMemberus-gaap:FairValueInputsLevel2Member2023-12-310001083446asth:AHMCMember2024-06-300001083446asth:AdvancedHealthManagementSystemsLPMember2024-03-312024-03-310001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:BoardMembersWhoAreAlsoOfficersMember2023-01-012023-06-300001083446asth:EsppMember2024-04-012024-06-300001083446asth:ProviderServicesMemberasth:PmiocMember2023-04-012023-06-300001083446asth:SecuredOvernightFinancingRateMemberasth:AmendedCreditAgreementMembersrt:MaximumMember2021-06-162021-06-160001083446us-gaap:SubordinatedDebtMemberasth:SubordinatedLoanAgreementMember2021-05-012021-05-310001083446us-gaap:CommonStockMember2024-04-012024-06-300001083446us-gaap:HealthCarePatientServiceMember2024-04-012024-06-300001083446asth:A2023MetricMemberasth:AdvancedDiagnosticAndSurgicalCenterIncMemberus-gaap:OtherNoncurrentLiabilitiesMember2024-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberasth:CareDeliveryMember2024-01-012024-06-300001083446asth:AurionMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2023-01-012023-06-300001083446us-gaap:OperatingSegmentsMemberus-gaap:ProductAndServiceOtherMemberus-gaap:AllOtherSegmentsMember2023-04-012023-06-300001083446us-gaap:OtherInvesteesMember2022-12-310001083446us-gaap:FairValueInputsLevel3Memberasth:ADSCMember2024-06-300001083446asth:IHealthIncMember2024-06-300001083446asth:LasalleMedicalAssociatesIpaMember2024-03-310001083446us-gaap:RetainedEarningsMember2024-03-310001083446asth:AHMCMemberasth:RelatedPartyTransactionExpensesIncurredMember2024-04-012024-06-300001083446asth:BassMedicalGroupMemberasth:SeniorSecuredPromissoryNoteMember2024-01-290001083446us-gaap:FairValueInputsLevel3Memberasth:DmgMember2023-12-310001083446asth:ApolloSunLabsManagementLLCMember2024-06-300001083446asth:CareEnablementMemberus-gaap:OperatingSegmentsMember2023-04-012023-06-300001083446us-gaap:DevelopedTechnologyRightsMember2023-12-310001083446asth:StockAwardsAndUnitsMember2023-01-012023-06-300001083446asth:AHMCMemberasth:RelatedPartyTransactionExpensesIncurredMember2024-01-012024-06-300001083446us-gaap:RevolvingCreditFacilityMember2024-01-012024-06-300001083446asth:CareEnablementMemberus-gaap:OperatingSegmentsMemberus-gaap:ProductAndServiceOtherMember2023-01-012023-06-300001083446asth:ApolloSunLabsManagementLLCMember2023-12-310001083446asth:LasalleMedicalAssociatesIpaMember2023-04-012023-06-300001083446asth:OtherThirdPartiesMember2024-01-012024-06-300001083446asth:MezzanineMemberus-gaap:NoncontrollingInterestMember2024-04-012024-06-300001083446us-gaap:OtherInvesteesMember2024-04-012024-06-300001083446us-gaap:CallOptionMemberasth:IHealthIncMember2024-03-310001083446asth:StockAwardsAndUnitsMember2023-04-012023-06-300001083446us-gaap:CorporateNonSegmentMember2024-01-012024-06-300001083446us-gaap:FairValueInputsLevel3Memberasth:AAMGMember2024-06-300001083446asth:AAMGMember2022-10-310001083446asth:FirstMetricMemberus-gaap:OtherNoncurrentLiabilitiesMemberasth:CommunityFamilyCareMedicalGroupIPAInc.Member2024-06-300001083446us-gaap:HealthCarePatientServiceMember2024-04-012024-06-300001083446us-gaap:HealthCarePatientServiceMemberus-gaap:CorporateNonSegmentMember2024-01-012024-06-300001083446asth:IHealthIncMember2024-03-310001083446us-gaap:SeriesBPreferredStockMember2024-06-300001083446asth:DmgMemberus-gaap:FairValueInputsLevel1Member2023-12-3100010834462024-01-012024-03-310001083446us-gaap:RelatedPartyMember2023-12-310001083446asth:PacificMedicalImagingAndOncologyCenterIncMember2024-01-012024-06-300001083446us-gaap:CommonStockMember2024-03-310001083446asth:ADSCMemberus-gaap:FairValueInputsLevel1Member2024-06-300001083446us-gaap:HealthCareOtherMember2023-04-012023-06-300001083446us-gaap:OtherNoncurrentLiabilitiesMemberasth:A2024MetricMemberasth:AAMGMember2023-12-310001083446us-gaap:HealthCarePatientServiceMemberus-gaap:OperatingSegmentsMemberasth:CarePartnersMember2024-01-012024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CareDeliveryMember2024-01-012024-06-300001083446asth:AmendedCreditAgreementMemberus-gaap:StandbyLettersOfCreditMemberasth:TruistBankMember2024-06-300001083446asth:ApolloSunLabsManagementLLCMember2023-12-310001083446asth:PacificMedicalImagingAndOncologyCenterIncMember2024-06-300001083446us-gaap:RelatedPartyMemberus-gaap:VariableInterestEntityPrimaryBeneficiaryMember2023-12-310001083446us-gaap:PrivateEquityFundsMemberasth:ThirdWayHealthIncMember2023-12-310001083446us-gaap:SubordinatedDebtMemberasth:SubordinatedLoanAgreementMember2021-05-310001083446asth:DmgMember2023-12-310001083446asth:LasalleMedicalAssociatesIpaMember2024-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ApolloMedicalHoldingsIncMember2023-12-3100010834462022-12-310001083446us-gaap:RelatedPartyMemberasth:ArroyoVistaMemberasth:AHMCMember2024-01-012024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CareDeliveryMemberus-gaap:ProductAndServiceOtherMember2024-04-012024-06-300001083446us-gaap:FairValueInputsLevel2Memberasth:DmgMember2023-12-310001083446asth:OtherThirdPartiesMember2024-04-012024-06-300001083446asth:FirstCommonwealthPropertyLLCMember2024-06-300001083446asth:FiveThreeOneW.CollegeLLCMember2023-04-012023-06-300001083446asth:CommunityFamilyCareMedicalGroupIPAInc.Member2024-01-312024-01-310001083446us-gaap:OtherInvesteesMember2024-06-300001083446us-gaap:SalesRevenueNetMemberus-gaap:CustomerConcentrationRiskMemberasth:PayorAMember2024-01-012024-06-300001083446asth:ApolloSunLabsManagementLLCMember2024-01-012024-06-300001083446us-gaap:SubsequentEventMemberasth:ElationPartnershipIncludingConvertiblePromissoryNoteMember2024-07-170001083446asth:AlliedPacificOfCaliforniaIPAMember2024-01-012024-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ApolloMedicalHoldingsIncMember2024-06-300001083446us-gaap:NonrelatedPartyMemberus-gaap:VariableInterestEntityPrimaryBeneficiaryMember2024-06-300001083446us-gaap:ProductAndServiceOtherMember2023-04-012023-06-300001083446asth:AHMCMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2024-04-012024-06-300001083446asth:CareEnablementMemberus-gaap:OperatingSegmentsMember2024-04-012024-06-300001083446us-gaap:OtherNoncurrentLiabilitiesMemberasth:CommunityFamilyCareMedicalGroupIPAInc.Member2024-06-300001083446us-gaap:NoncontrollingInterestMember2024-04-012024-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberasth:ProviderServicesMemberasth:BoardMembersWhoAreAlsoOfficersMember2024-01-012024-06-300001083446asth:NetworkRelationshipsMembersrt:MaximumMember2023-12-310001083446asth:ProviderServicesMemberasth:SongPCMember2024-01-012024-06-300001083446us-gaap:NoncontrollingInterestMember2024-06-300001083446asth:CommercialMember2024-04-012024-06-300001083446us-gaap:TrademarksMember2023-12-310001083446us-gaap:PerformanceSharesMember2023-04-012023-06-3000010834462023-01-012023-12-310001083446us-gaap:FairValueInputsLevel1Member2024-06-300001083446asth:MedicaidMember2023-04-012023-06-300001083446asth:A2023MetricMemberus-gaap:OtherLiabilitiesMemberasth:AAMGMember2024-06-300001083446asth:HSMSOMemberasth:RelatedPartyTransactionRevenueExpenseNetMember2024-04-012024-06-300001083446asth:RelatedPartyTransactionRevenueRecognizedMemberasth:HSMSOMember2024-01-012024-06-300001083446asth:CAIPAMSOLLCMember2023-06-300001083446asth:FiveThreeOneW.CollegeLLCMember2022-12-310001083446asth:CareEnablementMemberus-gaap:OperatingSegmentsMemberus-gaap:ProductAndServiceOtherMember2024-01-012024-06-300001083446asth:PrimeCommunityCareMemberus-gaap:FairValueInputsLevel2Member2024-06-300001083446us-gaap:HealthCarePatientServiceMember2024-01-012024-06-300001083446us-gaap:NoncontrollingInterestMember2023-12-310001083446asth:MemberRelationshipsMembersrt:MinimumMember2023-12-310001083446us-gaap:SalesRevenueNetMemberus-gaap:CustomerConcentrationRiskMemberasth:PayorAMember2023-04-012023-06-300001083446us-gaap:OtherInvesteesMember2023-01-012023-06-300001083446us-gaap:SeriesAPreferredStockMember2023-12-310001083446us-gaap:SalesRevenueNetMemberus-gaap:CustomerConcentrationRiskMemberasth:PayorAMember2024-04-012024-06-300001083446asth:InterestRateCollarMember2023-04-012023-06-300001083446asth:AlliedPacificOfCaliforniaIPAMemberus-gaap:StandbyLettersOfCreditMember2024-06-300001083446us-gaap:CommonStockMember2023-03-310001083446asth:PacificMedicalImagingAndOncologyCenterIncMember2023-04-012023-06-300001083446asth:AmendedAndRestatedCreditAgreementMemberus-gaap:LetterOfCreditMemberasth:TruistBankMember2023-11-030001083446us-gaap:OperatingSegmentsMemberasth:CarePartnersMemberus-gaap:ProductAndServiceOtherMember2023-04-012023-06-300001083446asth:CAIPAMSOLLCMember2023-12-310001083446asth:AdvancedDiagnosticAndSurgicalCenterIncMemberus-gaap:OtherNoncurrentLiabilitiesMemberasth:A2024MetricMember2024-06-300001083446asth:LasalleMedicalAssociatesIpaMember2022-12-310001083446us-gaap:ProductAndServiceOtherMember2023-01-012023-06-300001083446us-gaap:OperatingSegmentsMemberasth:CarePartnersMember2023-04-012023-06-300001083446us-gaap:RetainedEarningsMember2024-01-012024-03-310001083446us-gaap:AdditionalPaidInCapitalMember2024-06-300001083446us-gaap:OperatingSegmentsMemberasth:CarePartnersMemberus-gaap:ProductAndServiceOtherMember2024-04-012024-06-300001083446us-gaap:RelatedPartyMemberasth:LmaMember2023-04-012023-06-300001083446us-gaap:FairValueInputsLevel2Memberasth:DmgMember2024-06-300001083446us-gaap:VariableInterestEntityPrimaryBeneficiaryMember2024-06-300001083446asth:MezzanineMemberus-gaap:NoncontrollingInterestMember2024-06-300001083446asth:FiveThreeOneW.CollegeLLCMember2023-01-012023-06-300001083446us-gaap:ManagementServiceMember2023-04-012023-06-30iso4217:USDxbrli:sharesasth:Segmentxbrli:pureasth:Stateasth:Memberxbrli:sharesiso4217:USDasth:FinancialRatio

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended June 30, 2024

OR

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from ___ to ___.

Commission File No. 001-37392

img123522986_0.jpg 

Astrana Health, Inc.

(Exact name of registrant as specified in its charter)

Delaware

95-4472349

(State or Other Jurisdiction

(I.R.S. Employer

of Incorporation or Organization)

Identification Number)

1668 S. Garfield Avenue, 2nd Floor, Alhambra, California 91801

(Address of principal executive offices and zip code)

(626) 282-0288

(Registrant’s telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Act:

Title of Each Class

 

Trading Symbol

 

Name of Each Exchange on Which Registered

Common Stock, $0.001 par value per share

 

ASTH

 

The Nasdaq Stock Market LLC

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes No

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes No

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer

Accelerated filer

Non-accelerated filer

Smaller reporting company

 

 

Emerging growth company

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes No

As of July 30, 2024, there were 56,213,519 shares of common stock of the registrant, $0.001 par value per share, issued and outstanding, which includes 7,132,698 treasury shares that are owned by Allied Physicians of California, a Professional Medical Corporation d.b.a. Allied Pacific of California IPA (“APC”), a consolidated affiliate of Astrana Health, Inc. These shares are legally issued and outstanding but treated as treasury shares for accounting purposes.

 

 


 

Astrana Health, Inc.

INDEX TO FORM 10-Q FILING

TABLE OF CONTENTS

 

 

 

PAGE

 

Glossary

3

 

Introductory Note

4

 

Note About Forward-Looking Statements

4

 

 

 

 

PART I

FINANCIAL INFORMATION

 

 

 

 

Item 1.

Condensed Consolidated Financial Statements

6

 

Condensed Consolidated Balance Sheets as of June 30, 2024 and December 31, 2023

6

 

Condensed Consolidated Statements of Income for the three and six months ended June 30, 2024 and 2023

9

 

Condensed Consolidated Statements of Mezzanine and Stockholders’ Equity for the three and six months ended June 30, 2024 and 2023

10

 

Condensed Consolidated Statements of Cash Flows for the six months ended June 30, 2024 and 2023

12

 

Notes to Condensed Consolidated Financial Statements

14

Item 2.

Management’s Discussion and Analysis of Financial Condition and Results of Operations

45

Item 3.

Quantitative and Qualitative Disclosures about Market Risk

59

Item 4.

Controls and Procedures

59

 

 

 

 

PART II

OTHER INFORMATION

 

 

 

 

Item 1.

Legal Proceedings

60

Item 1A.

Risk Factors

60

Item 2.

Unregistered Sales of Equity Securities and Use of Proceeds

61

Item 3.

Defaults Upon Senior Securities

61

Item 4.

Mine Safety Disclosures

61

Item 5.

Other Information

61

Item 6.

Exhibits

62

 

2


 

Glossary

The following abbreviations or acronyms that may be used in this document shall have the adjacent meanings set forth below:

 

AAMG

 

All-American Medical Group

ACO REACH

 

ACO Realizing Equity, Access, and Community Health

ADSC

 

Advanced Diagnostic and Surgical Center, Inc.

AHMC

 

AHMC Healthcare Inc.

AHMS

 

Advanced Health Management Systems, L.P.

AHM

 

Astrana Health Management, Inc. (f/k/a Network Medical Management Inc.)

APAACO

 

APA ACO, Inc.

APC

 

Allied Physicians of California, a Professional Medical Corporation

APC-LSMA

 

APC-LSMA Designated Shareholder Medical Corporation

Astrana

 

Astrana Health Inc. (f/k/a Apollo Medical Holdings, Inc.)

Astrana Medical

 

Astrana Health Medical Corporation (f/k/a AP-AMH Medical Corporation)

Astrana Care Partners Medical

 

Astrana Care Partners Medical Corporation (f/k/a AP - AMH 2 Medical Corporation)

CAIPA MSO

 

CAIPA MSO, LLC

CFC

 

Community Family Care Medical Group IPA, Inc.

CMS

 

Centers for Medicare & Medicaid Services

DMHC

 

California Department of Managed Health Care

DMG

 

Diagnostic Medical Group of Southern California

HSMSO

 

Health Source MSO Inc., a California corporation

IPA

 

Independent Practice Association

Jade

 

Jade Health Care Medical Group, Inc.

LMA

 

LaSalle Medical Associates

PCCCV

 

Primary Community Care of Central Valley, Inc.

PMIOC

 

Pacific Medical Imaging and Oncology Center, Inc.

Sun Labs

 

Sun Clinical Labs

VIE

 

Variable Interest Entity

 

3


 

INTRODUCTORY NOTE

Unless the context dictates otherwise, references in this Quarterly Report on Form 10-Q to the “Company,” “we,” “us,” “our,” and similar words are references to Astrana Health, Inc., a Delaware corporation (“Astrana”), and its consolidated subsidiaries and affiliated entities, as appropriate, including its consolidated variable interest entities (“VIEs”).

The Centers for Medicare & Medicaid Services (“CMS”) have not reviewed any statements contained in this Report, including statements describing the participation of APA ACO, Inc. (“APAACO”) in the ACO Realizing Equity, Access, and Community Health Model (“ACO REACH Model”) and ApolloMed MSSP I, Inc. in the Medicare Shared Savings Program (“MSSP”).

Trade names and trademarks of Astrana and its subsidiaries referred to herein, and their respective logos, are our property. This Quarterly Report on Form 10-Q may contain additional trade names and/or trademarks of other companies, which are the property of their respective owners. We do not intend our use or display of other companies’ trade names and/or trademarks, if any, to imply an endorsement or sponsorship of us by such companies, or any relationship with any of these companies.

NOTE ABOUT FORWARD-LOOKING STATEMENTS

This Quarterly Report on Form 10-Q contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). All statements other than statements of historical fact are “forward-looking statements” for purposes of federal and state securities laws, including, but not limited to, any statements about our business, financial condition, operating results, plans, objectives, expectations, and intentions; any projections of earnings, revenue, earnings before interest, taxes, depreciation, and amortization (“EBITDA”), Adjusted EBITDA, or other financial items, such as our projected capitation from CMS, our forward-looking guidance and our future liquidity; any statements of any plans, strategies, and objectives of management for future operations, such as the material opportunities that we believe exist for our Company; any statements concerning proposed services, developments, mergers, or acquisitions; any statements with respect to dividends or stock repurchases and timing, methods, and payment of same; any statements regarding the outlook of the ACO REACH Model, the MSSP, or strategic transactions; any statements regarding management’s view of future expectations and prospects for us; any statements about prospective adoption of new accounting standards or effects of changes in accounting standards; any statements regarding our ability to maintain effective internal control over financial reporting and disclosure controls and procedures; any statements regarding potential changes to our tax structure; any statements regarding future economic conditions or performance; any statements relating to the potential impact of cybersecurity breaches or disruptions to our management information systems or widespread outages, interruptions or other failures of operational, communication, and other systems; any statements of belief; any statements of assumptions underlying any of the foregoing; and other statements that are not historical facts. Forward-looking statements may be identified by the use of forward-looking terms, such as “anticipate,” “could,” “can,” “may,” “might,” “potential,” “predict,” “should,” “estimate,” “expect,” “project,” “believe,” “think,” “plan,” “envision,” “intend,” “continue,” “target,” “seek,” “contemplate,” “budgeted,” “will,” or “would,” and the negative of such terms, other variations on such terms or other similar or comparable words, phrases, or terminology. These forward-looking statements present our estimates and assumptions only as of the date of this Quarterly Report on Form 10-Q and are subject to change.

Forward-looking statements involve risks and uncertainties, many of which are difficult to predict and are outside of our control, and are based on the current beliefs, expectations, and certain assumptions of management. Some or all of such beliefs, expectations, and assumptions may not materialize or may vary significantly from actual results. Such statements are qualified by important economic, competitive, governmental, and technological factors that could cause our business, strategy, or actual results or events to differ materially from those in our forward-looking statements. Factors that might cause or contribute to such differences include, but are not limited to, those discussed in our Annual Report on Form 10-K for the year ended December 31, 2023, filed with the Securities and Exchange Commission (the “SEC”) on February 29, 2024, including the risk factors discussed under the heading “Risk Factors” in Part I, Item 1A thereof. Although we believe that the expectations reflected in our forward-looking statements are reasonable, actual results could differ materially from those projected or assumed in any of our forward-looking statements. Our future financial condition and results of operations, as well as any forward-looking statements, are subject

4


 

to change and to significant risks and uncertainties that could cause actual conditions, outcomes, and results to differ materially from those indicated by such statements. Any forward-looking statement made by the Company in this Form 10-Q speaks only as of the date on which it is made. The Company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future developments or otherwise, except as may be required by any applicable securities laws.

5


 

PART I - FINANCIAL INFORMATION

ITEM 1. CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

ASTRANA HEALTH, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)

6


 

 

 

June 30,
2024

 

 

December 31,
2023

 

 

 

(Unaudited)

 

 

 

 

Assets

 

 

 

 

 

 

 

 

 

 

 

 

 

Current assets

 

 

 

 

 

 

Cash and cash equivalents

 

$

325,310

 

 

$

293,807

 

Investment in marketable securities

 

 

2,383

 

 

 

2,498

 

Receivables, net

 

 

132,323

 

 

 

76,780

 

Receivables, net – related parties

 

 

69,269

 

 

 

58,980

 

Income taxes receivable

 

 

22,005

 

 

 

10,657

 

Other receivables

 

 

1,642

 

 

 

1,335

 

Prepaid expenses and other current assets

 

 

17,417

 

 

 

17,450

 

 

 

 

 

 

 

 

Total current assets

 

 

570,349

 

 

 

461,507

 

 

 

 

 

 

 

 

Non-current assets

 

 

 

 

 

 

Land, property and equipment, net

 

 

10,305

 

 

 

7,171

 

Intangible assets, net

 

 

116,231

 

 

 

71,648

 

Goodwill

 

 

409,581

 

 

 

278,831

 

Income taxes receivable

 

 

15,943

 

 

 

15,943

 

Loans receivable, non-current

 

 

49,163

 

 

 

26,473

 

Investments in other entities – equity method

 

 

33,276

 

 

 

25,774

 

Investments in privately held entities

 

 

8,896

 

 

 

6,396

 

Restricted cash

 

 

646

 

 

 

345

 

Operating lease right-of-use assets

 

 

28,792

 

 

 

37,396

 

Other assets

 

 

9,289

 

 

 

1,877

 

 

 

 

 

 

 

 

Total non-current assets

 

 

682,122

 

 

 

471,854

 

 

 

 

 

 

 

 

Total assets(1)

 

$

1,252,471

 

 

$

933,361

 

 

 

 

 

 

 

 

Liabilities, mezzanine equity and equity

 

 

 

 

 

 

 

 

 

 

 

 

 

Current liabilities

 

 

 

 

 

 

Accounts payable and accrued expenses

 

$

95,757

 

 

$

59,949

 

Fiduciary accounts payable

 

 

7,321

 

 

 

7,737

 

Medical liabilities

 

 

151,482

 

 

 

106,657

 

Dividend payable

 

 

638

 

 

 

638

 

Finance lease liabilities

 

 

591

 

 

 

646

 

Operating lease liabilities

 

 

4,884

 

 

 

4,607

 

Current portion of long-term debt

 

 

17,000

 

 

 

19,500

 

Other liabilities

 

 

32,152

 

 

 

18,940

 

 

 

 

 

 

 

 

Total current liabilities

 

 

309,825

 

 

 

218,674

 

 

 

 

 

 

 

 

Non-current liabilities

 

 

 

 

 

 

Deferred tax liability

 

 

3,250

 

 

 

4,072

 

Finance lease liabilities, net of current portion

 

 

879

 

 

 

1,033

 

Operating lease liabilities, net of current portion

 

 

27,092

 

 

 

36,289

 

Long-term debt, net of current portion and deferred financing costs

 

 

425,006

 

 

 

258,939

 

Other long-term liabilities

 

 

7,723

 

 

 

3,586

 

 

 

 

 

 

 

 

Total non-current liabilities

 

 

463,950

 

 

 

303,919

 

 

 

 

 

 

 

 

Total liabilities(1)

 

 

773,775

 

 

 

522,593

 

 

 

 

 

 

 

 

Commitments and contingencies (Note 12)

 

 

 

 

 

 

 

 

 

 

 

 

 

Mezzanine equity

 

 

 

 

 

 

7


 

Noncontrolling interest in Allied Physicians of California, a Professional Medical Corporation ("APC")

 

 

(204,312

)

 

 

(205,883

)

 

 

 

 

 

 

 

Stockholders’ equity

 

 

 

 

 

 

Preferred stock, $0.001 par value per share; 5,000,000 shares authorized as of June 30, 2024 and December 31, 2023

 

 

 

 

 

 

Series A Preferred stock, zero authorized and issued and zero outstanding as of June 30, 2024 and 1,111,111 authorized and issued and zero outstanding as of December 31, 2023

 

 

 

 

 

 

Series B Preferred stock, zero authorized and issued and zero outstanding as of June 30, 2024 and 555,555 authorized and issued and zero outstanding as of December 31, 2023

 

 

 

 

 

 

Common stock, $0.001 par value per share; 100,000,000 shares authorized, 47,541,549 and 46,843,743 shares issued and outstanding, excluding 10,584,340 and 10,584,340 treasury shares, as of June 30, 2024 and December 31, 2023, respectively

 

 

48

 

 

 

47

 

Additional paid-in capital

 

 

401,686

 

 

 

371,037

 

Retained earnings

 

 

277,140

 

 

 

243,134

 

Total stockholders’ equity

 

 

678,874

 

 

 

614,218

 

 

 

 

 

 

 

 

Non-controlling interest

 

 

4,134

 

 

 

2,433

 

 

 

 

 

 

 

 

Total equity

 

 

683,008

 

 

 

616,651

 

 

 

 

 

 

 

 

Total liabilities, mezzanine equity and equity

 

$

1,252,471

 

 

$

933,361

 

 

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

 

(1)The Company’s condensed consolidated balance sheets include the assets and liabilities of its consolidated VIEs. The condensed consolidated balance sheets include total assets that can be used only to settle obligations of the Company’s consolidated VIEs totaling $671.9 million and $540.8 million as of June 30, 2024 and December 31, 2023, respectively, and total liabilities of the Company’s consolidated VIEs for which creditors do not have recourse to the general credit of the primary beneficiary of $175.8 million and $146.0 million as of June 30, 2024 and December 31, 2023, respectively. These VIE balances do not include $516.4 million of investment in affiliates and $72.8 million of amounts due to affiliates as of June 30, 2024, and $273.2 million of investment in affiliates and $107.3 million of amounts due to affiliates as of December 31, 2023, as these are eliminated upon consolidation and not presented within the condensed consolidated balance sheets. See Note 16 — “Variable Interest Entities (VIEs)” for further details.

8


 

ASTRANA HEALTH, INC.

CONDENSED CONSOLIDATED STATEMENTS OF INCOME

(IN THOUSANDS, EXCEPT PER SHARE AMOUNTS)

(UNAUDITED)

 

 

 

Three Months Ended
June 30,

 

 

Six Months Ended
June 30,

 

 

 

2024

 

 

2023

 

 

2024

 

 

2023

 

Revenue

 

 

 

 

 

 

 

 

 

 

 

 

Capitation, net

 

$

442,574

 

 

$

300,549

 

 

$

808,484

 

 

$

600,753

 

Risk pool settlements and incentives

 

 

18,408

 

 

 

20,121

 

 

 

35,785

 

 

 

33,583

 

Management fee income

 

 

1,604

 

 

 

12,493

 

 

 

5,682

 

 

 

22,389

 

Fee-for-service, net

 

 

19,959

 

 

 

13,262

 

 

 

35,896

 

 

 

25,324

 

Other revenue

 

 

3,720

 

 

 

1,784

 

 

 

4,774

 

 

 

3,404

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total revenue

 

 

486,265

 

 

 

348,209

 

 

 

890,621

 

 

 

685,453

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Operating expenses

 

 

 

 

 

 

 

 

 

 

 

 

Cost of services, excluding depreciation and amortization

 

 

412,805

 

 

 

292,876

 

 

 

743,204

 

 

 

582,273

 

General and administrative expenses

 

 

35,953

 

 

 

24,056

 

 

 

74,675

 

 

 

45,236

 

Depreciation and amortization

 

 

7,441

 

 

 

4,248

 

 

 

12,537

 

 

 

8,541

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total expenses

 

 

456,199

 

 

 

321,180

 

 

 

830,416

 

 

 

636,050

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Income from operations

 

 

30,066

 

 

 

27,029

 

 

 

60,205

 

 

 

49,403

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other income (expense)

 

 

 

 

 

 

 

 

 

 

 

 

Income from equity method investments

 

 

902

 

 

 

2,723

 

 

 

1,534

 

 

 

5,207

 

Interest expense

 

 

(8,587

)

 

 

(3,632

)

 

 

(16,172

)

 

 

(6,901

)

Interest income

 

 

3,513

 

 

 

3,327

 

 

 

7,509

 

 

 

6,335

 

Unrealized (loss) gain on investments

 

 

(123

)

 

 

859

 

 

 

976

 

 

 

(5,533

)

Other income

 

 

6,126

 

 

 

1,185

 

 

 

1,849

 

 

 

2,389

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total other income (expenses), net

 

 

1,831

 

 

 

4,462

 

 

 

(4,304

)

 

 

1,497

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Income before provision for income taxes

 

 

31,897

 

 

 

31,491

 

 

 

55,901

 

 

 

50,900

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Provision for income taxes

 

 

10,031

 

 

 

14,009

 

 

 

17,173

 

 

 

20,930

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

 

 

21,866

 

 

 

17,482

 

 

 

38,728

 

 

 

29,970

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to non-controlling interest

 

 

2,695

 

 

 

4,312

 

 

 

4,722

 

 

 

3,668

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to Astrana Health, Inc.

 

$

19,171

 

 

$

13,170

 

 

$

34,006

 

 

$

26,302

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share – basic

 

$

0.40

 

 

$

0.28

 

 

$

0.72

 

 

$

0.57

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share – diluted

 

$

0.40

 

 

$

0.28

 

 

$

0.71

 

 

$

0.56

 

 

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

9


 

ASTRANA HEALTH, INC.

CONDENSED CONSOLIDATED STATEMENTS OF MEZZANINE AND STOCKHOLDERS’ EQUITY

(IN THOUSANDS, EXCEPT SHARE DATA)

(UNAUDITED)

 

Mezzanine
Equity –
Non-controlling

 

 

Common Stock Outstanding

 

 

Additional
Paid-in

 

 

Retained

 

 

Non-controlling

 

 

Stockholders’

 

 

Interest in APC

 

 

Shares

 

 

Amount

 

 

Capital

 

 

Earnings

 

 

Interest

 

 

Equity

 

Balance at January 1, 2024

 

$

(205,883

)

 

 

46,843,743

 

 

$

47

 

 

$

371,037

 

 

$

243,134

 

 

$

2,433

 

 

$

616,651

 

Net income

 

 

326

 

 

 

 

 

 

 

 

 

 

 

 

14,835

 

 

 

1,701

 

 

 

16,536

 

Purchase of non-controlling interest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(25

)

 

 

(25

)

Sale of non-controlling interest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

150

 

 

 

150

 

Shares issued for vesting of restricted stock awards

 

 

 

 

 

5,149

 

 

 

 

 

 

(2,407

)

 

 

 

 

 

 

 

 

(2,407

)

Share-based compensation

 

 

 

 

 

 

 

 

 

 

 

5,748

 

 

 

 

 

 

 

 

 

5,748

 

Issuance of shares for business acquisition

 

 

 

 

 

631,712

 

 

 

1

 

 

 

21,951

 

 

 

 

 

 

 

 

 

21,952

 

Acquisition of non-controlling interest

 

 

 

 

 

(22,340

)

 

 

 

 

 

(856

)

 

 

 

 

 

321

 

 

 

(535

)

Dividends

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(95

)

 

 

(95

)

Balance at March 31, 2024

 

$

(205,557

)

 

 

47,458,264

 

 

$

48

 

 

$

395,473

 

 

$

257,969

 

 

$

4,485

 

 

$

657,975

 

Net income

 

 

1,245

 

 

 

 

 

 

 

 

 

 

 

 

19,171

 

 

 

1,450

 

 

 

20,621

 

Shares issued for vesting of restricted stock awards

 

 

 

 

 

83,285

 

 

 

 

 

 

(1,177

)

 

 

 

 

 

 

 

 

(1,177

)

Share-based compensation

 

 

 

 

 

 

 

 

 

 

 

7,390

 

 

 

 

 

 

 

 

 

7,390

 

Dividends

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1,801

)

 

 

(1,801

)

Balance at June 30, 2024

 

$

(204,312

)

 

 

47,541,549

 

 

$

48

 

 

$

401,686

 

 

$

277,140

 

 

$

4,134

 

 

$

683,008

 

 

10


 

 

Mezzanine
Equity –
Non-controlling

 

 

Common Stock Outstanding

 

 

Additional
Paid-in

 

 

Retained

 

 

Non-controlling

 

 

Stockholders’

 

 

Interest in APC

 

 

Shares

 

 

Amount

 

 

Capital

 

 

Earnings

 

 

Interest

 

 

Equity

 

Balance at January 1, 2023

 

$

14,237

 

 

 

46,575,699

 

 

$

47

 

 

$

360,097

 

 

$

182,417

 

 

$

1,749

 

 

$

544,310

 

Net (loss) income

 

 

(1,729

)

 

 

 

 

 

 

 

 

 

 

 

13,132

 

 

 

1,085

 

 

 

14,217

 

Shares issued for vesting of restricted stock awards

 

 

 

 

 

57,825

 

 

 

 

 

 

(109

)

 

 

 

 

 

 

 

 

(109

)

Shares issued for exercise of options and warrants

 

 

 

 

 

125,000

 

 

 

 

 

 

1,250

 

 

 

 

 

 

 

 

 

1,250

 

Purchase of treasury shares

 

 

 

 

 

(270,081

)

 

 

 

 

 

(9,539

)

 

 

 

 

 

 

 

 

(9,539

)

Share-based compensation

 

 

 

 

 

 

 

 

 

 

 

3,445

 

 

 

 

 

 

 

 

 

3,445

 

Dividends

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(120

)

 

 

(120

)

Transfer of common control entities

 

 

1,769

 

 

 

 

 

 

 

 

 

(2,447

)

 

 

 

 

 

 

 

 

(2,447

)

Balance at March 31, 2023

 

$

14,277

 

 

 

46,488,443

 

 

$

47

 

 

$

352,697

 

 

$

195,549

 

 

$

2,714

 

 

$

551,007

 

Net income

 

 

3,245

 

 

 

 

 

 

 

 

 

 

 

 

13,170

 

 

 

1,067

 

 

 

14,237

 

Purchase of non-controlling interest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(50

)

 

 

(50

)

Sale of non-controlling interest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

106

 

 

 

106