Astrana Health, Inc. (NASDAQ:ASTH) shares gained over 3% in premarket trading on Monday after the healthcare management company reported fourth-quarter results that surpassed analyst expectations and pointed to continued growth momentum heading into 2026.
The company posted adjusted earnings per share of $0.54 for the fourth quarter, significantly exceeding the analyst consensus forecast of $0.10 by $0.44.
Quarterly revenue came in at $950.5 million, representing a 43% year-over-year increase from $665.2 million and topping analyst estimates of $930.46 million. For the full year 2025, Astrana generated total revenue of $3.18 billion, up 56% compared with the prior year.
Looking ahead, Astrana issued fiscal 2026 revenue guidance in the range of $3.8 billion to $4.1 billion. The midpoint forecast of $3.95 billion sits slightly below analyst consensus estimates of $3.96 billion.
The company also expects adjusted EBITDA for 2026 to fall between $250 million and $280 million.
“Astrana delivered record revenue, adjusted EBITDA, and free cash flow in 2025, demonstrating the strength and predictability of our fully delegated, payer-agnostic care model and AI-enabled technology platform in a dynamic operating environment,” said President and Chief Executive Officer Brandon Sim.
Adding, “With Prospect Health integration ahead of schedule, we are confident in our ability to deliver on guidance that reflects approximately 24% revenue growth and 29% adjusted EBITDA growth at the midpoint.”
For the full year 2025, Astrana reported adjusted EBITDA of $205.4 million, a 21% year-over-year increase, alongside free cash flow of $104.5 million. Fourth-quarter adjusted EBITDA totaled $52.5 million, rising 50% compared with the same period a year earlier.
The company also said it will file a Form 12b-25 to extend the deadline for submitting its Annual Report on Form 10-K, citing a material weakness in internal controls related to acquisition and purchase accounting processes.
Astrana’s board of directors approved an increase in its share repurchase authorization, raising the program from $50 million to $100 million.