Healthcare services company Astrana Health fell short of the market’s revenue expectations in Q2 CY2026, but sales rose 48.5% year on year to $972.5 million. Next quarter’s revenue guidance of $1.02 billion underwhelmed, coming in 1.1% below analysts’ estimates. Its non-GAAP profit of $0.80 per share was 9.6% above analysts’ consensus estimates.
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Astrana Health (ASTH) Q2 CY2026 Highlights:
- Revenue: $972.5 million vs analyst estimates of $985.4 million (48.5% year-on-year growth, 1.3% miss)
- Adjusted EPS: $0.80 vs analyst estimates of $0.73 (9.6% beat)
- Adjusted EBITDA: $68.89 million vs analyst estimates of $67.93 million (7.1% margin, 1.4% beat)
- The company reconfirmed its revenue guidance for the full year of $3.95 billion at the midpoint
- EBITDA guidance for the full year is $267.5 million at the midpoint, in line with analyst expectations
- Operating Margin: 3.5%, in line with the same quarter last year
- Free Cash Flow Margin: 3%, down from 13.7% in the same quarter last year
- Market Capitalization: $1.61 billion
"Our second quarter results reflect the strength of Astrana's physician-centric, AI-native healthcare operating system and the disciplined execution of our team," said Brandon Sim, President and Chief Executive Officer of Astrana Health.
Company Overview
Formerly known as Apollo Medical Holdings until early 2024, Astrana Health (NASDAQ: ASTH) operates a technology-powered healthcare platform that enables physicians to deliver coordinated care while successfully participating in value-based payment models.
Revenue Growth
A company’s long-term performance is an indicator of its overall quality. Any business can put up a good quarter or two, but many enduring ones grow for years. Thankfully, Astrana Health’s 40.2% annualized revenue growth over the last five years was incredible. Its growth beat the average healthcare company and shows its offerings resonate with customers, a helpful starting point for our analysis.
Long-term growth is the most important, but within healthcare, a half-decade historical view may miss new innovations or demand cycles. Astrana Health’s annualized revenue growth of 55.4% over the last two years is above its five-year trend, suggesting its demand was strong and recently accelerated. 
This quarter, Astrana Health achieved a magnificent 48.5% year-on-year revenue growth rate, but its $972.5 million of revenue fell short of Wall Street’s lofty estimates. Company management is currently guiding for a 6.2% year-on-year increase in sales next quarter.
Looking further ahead, sell-side analysts expect revenue to grow 9.6% over the next 12 months, a deceleration versus the last two years. Despite the slowdown, this projection is noteworthy and suggests the market sees success for its products and services.
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Adjusted Operating Margin
Astrana Health was profitable over the last five years but held back by its large cost base. Its average adjusted operating margin of 7.1% was weak for a healthcare business.
Analyzing the trend in its profitability, Astrana Health’s adjusted operating margin decreased by 7.7 percentage points over the last five years. The company’s two-year trajectory also shows it failed to get its profitability back to the peak as its margin fell by 4.6 percentage points. This performance was poor no matter how you look at it - it shows its expenses were rising and it couldn’t pass those costs onto its customers.
In Q2, Astrana Health generated an adjusted operating margin profit margin of 4.7%, down 1.6 percentage points year on year. This reduction is quite minuscule and indicates the company’s overall cost structure has been relatively stable.
Earnings Per Share
We track the long-term change in earnings per share (EPS) for the same reason as long-term revenue growth. Compared to revenue, however, EPS highlights whether a company’s growth is profitable.
Astrana Health’s EPS grew at a remarkable 11.6% compounded annual growth rate over the last five years. However, this performance was lower than its 40.2% annualized revenue growth, telling us the company became less profitable on a per-share basis as it expanded.
Diving into Astrana Health’s quality of earnings can give us a better understanding of its performance. As we mentioned earlier, Astrana Health’s adjusted operating margin declined by 7.7 percentage points over the last five years. Its share count also grew by 8.6%, meaning the company not only became less efficient with its operating expenses but also diluted its shareholders. 
In Q2, Astrana Health reported adjusted EPS of $0.80, up from $0.58 in the same quarter last year. This print beat analysts’ estimates by 9.6%. Over the next 12 months, Wall Street expects Astrana Health’s full-year EPS to grow 19.4% from $2.64 to $3.15.
Key Takeaways from Astrana Health’s Q2 Results
We were impressed by Astrana Health’s optimistic EBITDA guidance for next quarter, which blew past analysts’ expectations. We were also glad its EPS outperformed Wall Street’s estimates. On the other hand, its revenue guidance for next quarter slightly missed and its revenue fell slightly short of Wall Street’s estimates. Overall, this was a mixed quarter. The stock traded up 5.1% to $35.89 immediately following the results.
Is Astrana Health an attractive investment opportunity right now? What happened in the latest quarter matters, but not as much as longer-term business quality and valuation, when deciding whether to invest in this stock. We cover that in our actionable full research report which you can read here (it’s free).
