ASTHAstrana Health, Inc.

Services-Management Consulting Services

Revenue: $3.2B; 56% YoY
Operating margin: 2.5%; 44% YoY
EBITDA: $124M; 6.0% YoY
Market cap: $1.8B
Employees: 3,000; $1M revenue each
Net debt / EBITDA: -1.4×; −$175M net debt
AI in 10-K: 4.5; mentions per 10K words

Takeover score 3 of 13

Fixable underperformance 1 of 7

TSR below peersNo
1 of 5 years
3+ of last 5 years
High CEO pay despite TSRNo
—
Median CEO pay ≥ $15M while TSR trails
Earnings not backed by cashNo
477% of net income
Cash flow under 80% of net income
Dilutive SBCNo
1% of revenue
Over 10% of revenue
Payouts exceed cash flowNo
29% of cash flow
Buybacks + dividends over cash flow
Goodwill-heavyNo
39% of assets
Over 40% of assets
Shareholder dissentYes
79% lowest support
Any vote under 80% support

Buyer economics 2 of 4

Low revenue per employeeNo
$1M · 96th pct
Bottom quartile of its SIC industry
Quiet on AINo
4.5 per 10K words · 81st pct
Bottom quartile of AI mentions in 10-Ks
Net cashYes
Net cash · 1.4× EBITDA
More cash than debt, positive EBITDA
Buyout-sizedYes
$1.8B market cap
Market cap $500M–$5B

Catalysts 0 of 2

Active 13DNo
0 filings
Active-intent 13D in 18 months
Net insider sellingNo
$0 net
Net sales over $10M in 12 months

Financials

Metric	FY2021	FY2022	FY2023	FY2024	FY2025	YoY	Trend
Revenue	$774M	$1.1B	$1.4B	$2.0B	$3.2B	56%
Operating income	$98M	$104M	$85M	$89M	$79M	12%
Net income	$46M	$46M	$58M	$50M	$24M	52%
Operating cash flow	$70M	$82M	$68M	$52M	$115M	120%
Capex	$19M	$23M	$29M	$8M	$10M	26%
Stock-based comp	$7M	$16M	$22M	$35M	$39M	12%
Buybacks	$6M	$9M	$10M	$900K	$26M	2744%
Dividends	$31M	$14M	$62M	$4M	$8M	95%

Deal filings

None.

13D filers

Filed	Filer	Form	Stake	Intent
Feb 18, 2025	ALLIED PHYSICIANS OF CALIFORNIA, A PROFESSIONAL MEDICAL Corp	SCHEDULE 13D/A	11.0%	Passive
Jan 22, 2025	ALLIED PHYSICIANS OF CALIFORNIA, A PROFESSIONAL MEDICAL Corp	SCHEDULE 13D/A	12.2%	Passive
Nov 17, 2023	ALLIED PHYSICIANS OF CALIFORNIA, A PROFESSION MEDICAL Corp	SC 13D/A	12.9%	Passive
Jul 8, 2021	ALLIED PHYSICIANS OF CALIFORNIA, A PROFESSION MEDICAL Corp	SC 13D/A	20.0%	Passive
Feb 25, 2020	ALLIED PHYSICIANS OF CALIFORNIA, A PROFESSION MEDICAL Corp	SC 13D/A	33.0%	Passive
Feb 24, 2020	Lam Thomas S.	SC 13D/A	3.7%	Passive
Feb 24, 2020	Sakhrani Lakhi	SC 13D/A	3.7%	Passive
Feb 24, 2020	Sim Kenneth T.	SC 13D/A	3.7%	Passive
Sep 17, 2019	ALLIED PHYSICIANS OF CALIFORNIA, A PROFESSION MEDICAL Corp	SC 13D/A	33.3%	Passive
Sep 16, 2019	ALLIED PHYSICIANS OF CALIFORNIA, A PROFESSION MEDICAL Corp	SC 13D/A	33.3%	Passive

Insider trading

No open-market trades in the last 12 months.

Pay vs performance

Year	CEO total comp	Comp actually paid	TSR (indexed)	Peer TSR
FY2025	—	—	136	148
FY2024	—	—	173	129
FY2023	—	—	210	126
FY2022	—	—	162	124
FY2021	—	—	402	126