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Astrana Health

ASTH
44
Medical - Care Facilities · Healthcare
Exchange
NASDAQ
Winston Score
44
Winston is serious
Mixed quality — meaningful strengths and weaknesses.
Data as of Aug 23, 2026 · filings through Jun 30, 2026
How the score breaks down
Quality
Weak
Growth
Good
Cash Flow
Strong
Stability
Mixed
Valuation
Good

Winston Score History

The full picture

Astrana Health is a healthcare company that manages a network of doctors and medical clinics, mostly serving patients in California and other western U.S. states. It focuses on value-based care, meaning it takes responsibility for keeping patients healthy rather than just treating them when they get sick. Its main customers are health insurance plans, including Medicare Advantage and Medicaid programs, which pay Astrana to coordinate care for their members.

Astrana makes money primarily through capitation payments — fixed monthly fees per patient from insurance plans — rather than charging for each individual visit. This model can be profitable if patients stay healthy, but thin margins (around 9% gross margin) show how much of that revenue goes to paying the actual doctors and clinics. The company has been growing by acquiring physician groups and expanding into new states, but integrating those acquisitions while managing costs remains its biggest ongoing challenge.

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Growth Profile

When traditional metrics don't capture the full picture, these are the signals growth stock investors use instead.

Revenue Growth

+48.5% YoY

YoY Growth Rate

Strong revenue growth

EPS Growth

+110.5% YoY

YoY Growth Rate

EPS growth accelerating

Insider Activity

20.9%ownership

Declining

Insider ownership declining — could be dilution or selling

Cash Position

Cash flow positive

$429M cash & investments

Quarterly Free Cash Flow

↑ Burn rate improving

Company generates more cash than it spends — no dilution risk from fundraising

Strong grower

Astrana Health is growing revenue at 49% year-over-year. The Winston Score penalises unprofitable companies, but revenue at this pace tells a different story — this is a company still in "build mode."

The Winston Score above measures business quality today. Growth stocks often score lower because they invest in the future rather than maximising current profits. These metrics show what matters most for evaluating that future.

Score breakdown

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Quality

Profit per sale
Gross Margin
10.7%
Thin — 10.7% gross margin
Profit after running costs
Operating Margin
3.5%
Thin — 3.5% operating margin
Return on the money invested
ROCE
5.7%
Weak — 5.7% return on capital

ROIC between 5% and 15%. They earn 5 to 15 cents back per year on every dollar invested.

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Growth

Sales growth
Sales YoY
+58.9%
Fast-growing sales (+58.9% YoY)
Profit growth
EPS YoY
+56.2%
Earnings growing fast (+56.2% YoY)

Earnings growing 25%+ a year. The compounder zone.

How steady the profit is
EPS Consistency
3/8 quarters
Earnings rarely grow — volatile business

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Cash Flow

Profit that turns into cash
Cash Conversion
434%
Turns 434% of profit into real cash
Spare cash per sale
FCF Margin
4.1%
Thin free cash flow (4.1%)

FCF margin between 0% and 10%. Some cash from sales, but not a lot.

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Stability

What it owes vs what it owns
Debt / Equity
1.13
Elevated debt (1.13)
Covers its interest
Interest Cover
1.49x
Dangerous — barely covers interest (1.5x)

Interest coverage between 1 and 3. Profits cover interest, but with little room to spare.

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Valuation

Price vs profit
P/E Ratio (TTM)
47.5x
no trend
Expensive — P/E 47.5

P/E over 35. The market is pricing in heavy, sustained growth.

Cheaper or dearer next year
P/E vs Forward
+32.3
GROWING
Earnings expected to grow meaningfully — cheaper on forward P/E (47.5 → 15.2)

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Dividends

Not applicable for this business.
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