Astrana Health (ASTH) 10-Q 12 Nov 24 2024 Q3 Quarterly report Financial data

Cover

Cover - shares	9 Months Ended
	Sep. 30, 2024	Nov. 06, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2024
Document Transition Report	false
Entity File Number	001-37392
Entity Registrant Name	Astrana Health, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	95-4472349
Entity Address, Address Line One	1668 S. Garfield Avenue
Entity Address, Address Line Two	2nd Floor
Entity Address, City or Town	Alhambra
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	91801
City Area Code	626
Local Phone Number	282-0288
Title of 12(b) Security	Common Stock, $0.001 par value per share
Trading Symbol	ASTH
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		56,252,730
Amendment Flag	false
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Entity Central Index Key	0001083446
Current Fiscal Year End Date	--12-31

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands		Sep. 30, 2024	Dec. 31, 2023
Current assets
Cash and cash equivalents		$ 347,994	$ 293,807
Investment in marketable securities		2,354	2,498
Income taxes receivable		16,211	10,657
Other receivables		1,120	1,335
Prepaid expenses and other current assets		20,506	17,450
Total current assets		596,990	461,507
Non-current assets
Land, property and equipment, net		12,172	7,171
Intangible assets, net		109,108	71,648
Goodwill		409,711	278,831
Income taxes receivable		15,943	15,943
Investments in other entities – equity method		34,629	25,774
Investments in privately held entities		8,896	6,396
Restricted cash		646	345
Operating lease right-of-use assets		33,119	37,396
Other assets		8,878	1,877
Total non-current assets		688,386	471,854
Total assets		1,285,376	933,361	[1]
Current liabilities
Accounts payable and accrued expenses		94,811	59,949
Fiduciary accounts payable		6,041	7,737
Medical liabilities		160,279	106,657
Dividend payable		638	638
Finance lease liabilities		554	646
Operating lease liabilities		5,241	4,607
Current portion of long-term debt		15,000	19,500
Other liabilities		30,364	18,940
Total current liabilities		312,928	218,674
Non-current liabilities
Deferred tax liability		2,857	4,072
Finance lease liabilities, net of current portion		743	1,033
Operating lease liabilities, net of current portion		31,162	36,289
Long-term debt, net of current portion and deferred financing costs		423,119	258,939
Other long-term liabilities		7,460	3,586
Total non-current liabilities		465,341	303,919
Total liabilities	[1]	778,269	522,593
Commitments and contingencies (Note 12)
Mezzanine equity
Noncontrolling interest in Allied Physicians of California, a Professional Medical Corporation ("APC")		(202,512)	(205,883)
Stockholders’ equity
Common stock, $0.001 par value per share; 100,000,000 shares authorized, 47,780,523 and 46,843,743 shares issued and outstanding, excluding 10,598,749 and 10,584,340 treasury shares, as of September 30, 2024 and December 31, 2023, respectively		48	47
Additional paid-in capital		411,334	371,037
Retained earnings		293,234	243,134
Total stockholders’ equity		704,616	614,218
Non-controlling interest		5,003	2,433
Total equity		709,619	616,651
Total liabilities, mezzanine equity and equity		1,285,376	933,361
Series A Preferred Stock
Stockholders’ equity
Preferred stock		0	0
Series B Preferred Stock
Stockholders’ equity
Preferred stock		0	0
Nonrelated Party
Current assets
Receivables, net		132,237	76,780
Non-current assets
Loans receivable, non-current		55,284	26,473
Related Party
Current assets
Receivables, net		$ 76,568	$ 58,980
[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 $ 701.1 million and $ 540.8 million as of September 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 $ 194.1 million and $ 146.0 million as of September 30, 2024 and December 31, 2023, respectively. These VIE balances do not include $ 413.3 million of investment in affiliates and $ 76.3 million of amounts due to affiliates as of September 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.

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands		Sep. 30, 2024	Dec. 31, 2023
Preferred stock, par value (in dollars per share)		$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)		5,000,000	5,000,000
Common stock, par value (in dollars per share)		$ 0.001	$ 0.001
Common stock, shares authorized (in shares)		100,000,000	100,000,000
Common stock, shares issued (in shares)		47,780,523	46,843,743
Common stock, shares outstanding (in shares)		47,780,523	46,843,743
Treasury stock, common, shares (in shares)		10,598,749	10,584,340
Assets		$ 1,285,376	$ 933,361	[1]
Total liabilities	[1]	778,269	522,593
Variable Interest Entity, Not Primary Beneficiary
Assets		701,100	540,800
Total liabilities		194,100	146,000
Investments in affiliates		413,300	273,200
Amount due to affiliates		$ 76,300	$ 107,300
Series A Preferred Stock
Preferred stock, shares authorized (in shares)		0	1,111,111
Preferred stock, shares issued (in shares)		0	1,111,111
Preferred stock, shares outstanding (in shares)		0	0
Series B Preferred Stock
Preferred stock, shares authorized (in shares)		0	555,555
Preferred stock, shares issued (in shares)		0	555,555
Preferred stock, shares outstanding (in shares)		0	0
[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 $ 701.1 million and $ 540.8 million as of September 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 $ 194.1 million and $ 146.0 million as of September 30, 2024 and December 31, 2023, respectively. These VIE balances do not include $ 413.3 million of investment in affiliates and $ 76.3 million of amounts due to affiliates as of September 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.

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF INCOME (UNAUDITED) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Revenue
Total revenue	$ 478,710	$ 348,173	$ 1,369,331	$ 1,033,625
Operating expenses
Cost of services, excluding depreciation and amortization	405,218	275,375	1,148,422	857,648
General and administrative expenses	37,803	29,410	112,478	74,648
Depreciation and amortization	7,264	4,305	19,801	12,846
Total expenses	450,285	309,090	1,280,701	945,142
Income from operations	28,425	39,083	88,630	88,483
Other income (expense)
Income (loss) from equity method investments	1,353	(2,104)	2,887	3,104
Interest expense	(8,856)	(3,779)	(25,028)	(10,680)
Interest income	3,778	3,281	11,287	9,617
Unrealized (loss) gain on investments	(561)	(342)	415	(5,875)
Other income	2,673	1,876	4,522	4,265
Total other (expense) income, net	(1,613)	(1,068)	(5,917)	431
Income before provision for income taxes	26,812	38,015	82,713	88,914
Provision for income taxes	7,831	10,042	25,004	30,971
Net income	18,981	27,973	57,709	57,943
Net income attributable to non-controlling interest	2,887	5,914	7,609	9,582
Net income attributable to Astrana Health, Inc.	$ 16,094	$ 22,059	$ 50,100	$ 48,361
Earnings per share – basic (in dollars per share)	$ 0.34	$ 0.47	$ 1.05	$ 1.04
Earnings per share – diluted (in dollars per share)	$ 0.33	$ 0.47	$ 1.04	$ 1.03
Capitation, net
Revenue
Total revenue	$ 431,401	$ 305,678	$ 1,239,885	$ 906,430
Risk pool settlements and incentives
Revenue
Total revenue	21,779	15,022	57,564	48,605
Management fee income
Revenue
Total revenue	2,747	9,898	8,429	32,287
Fee-for-service, net
Revenue
Total revenue	18,692	15,892	54,588	41,216
Other revenue
Revenue
Total revenue	$ 4,091	$ 1,683	$ 8,865	$ 5,087

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF MEZZANINE AND STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock Outstanding	Additional Paid-in  Capital	Retained Earnings	Non-controlling Interest	Non-controlling Interest Mezzanine
Temporary equity, carrying amount, beginning balance at Dec. 31, 2022						$ 14,237
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income						(1,729)
Temporary Equity, Transfer Of Common Control Entities						1,769
Temporary equity, carrying amount, ending balance at Mar. 31, 2023						14,277
Equity, beginning balance (in shares) at Dec. 31, 2022		46,575,699
Equity, beginning balance at Dec. 31, 2022	$ 544,310	$ 47	$ 360,097	$ 182,417	$ 1,749
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	14,217			13,132	1,085
Shares issued for vesting of restricted stock awards (in shares)		57,825
Shares issued for vesting of restricted stock awards	(109)		(109)
Shares issued for cash and exercise of options and warrants (in shares)		125,000
Shares issued for cash and exercise of options and warrants	1,250		1,250
Purchase of treasury shares (in shares)		(270,081)
Purchase of treasury shares	(9,539)		(9,539)
Share-based compensation	3,445		3,445
Dividends	(120)				(120)
Transfer of common control entities	(2,447)		(2,447)
Equity, ending balance (in shares) at Mar. 31, 2023		46,488,443
Equity, ending balance at Mar. 31, 2023	551,007	$ 47	352,697	195,549	2,714
Temporary equity, carrying amount, beginning balance at Dec. 31, 2022						14,237
Temporary equity, carrying amount, ending balance at Sep. 30, 2023						17,931
Equity, beginning balance (in shares) at Dec. 31, 2022		46,575,699
Equity, beginning balance at Dec. 31, 2022	$ 544,310	$ 47	360,097	182,417	1,749
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Shares issued for cash and exercise of options (in shares)	125,000
Equity, ending balance (in shares) at Sep. 30, 2023		46,607,356
Equity, ending balance at Sep. 30, 2023	$ 597,709	$ 47	362,889	230,778	3,995
Temporary equity, carrying amount, beginning balance at Dec. 31, 2022						14,237
Temporary equity, carrying amount, ending balance at Dec. 31, 2023						(205,883)
Equity, beginning balance (in shares) at Dec. 31, 2022		46,575,699
Equity, beginning balance at Dec. 31, 2022	$ 544,310	$ 47	360,097	182,417	1,749
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Purchase of treasury shares (in shares)	(3,451,642)
Equity, ending balance (in shares) at Dec. 31, 2023	46,843,743	46,843,743
Equity, ending balance at Dec. 31, 2023	$ 616,651	$ 47	371,037	243,134	2,433
Temporary equity, carrying amount, beginning balance at Mar. 31, 2023						14,277
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income						3,245
Temporary Equity, Dividends						(601)
Temporary equity, Tax impact from dividends						(3,076)
Temporary equity, carrying amount, ending balance at Jun. 30, 2023						13,845
Equity, beginning balance (in shares) at Mar. 31, 2023		46,488,443
Equity, beginning balance at Mar. 31, 2023	551,007	$ 47	352,697	195,549	2,714
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	14,237			13,170	1,067
Purchase of non-controlling interest	(50)				(50)
Sale of non-controlling interest	106				106
Shares issued for vesting of restricted stock awards (in shares)		42,734
Shares issued for vesting of restricted stock awards	(464)		(464)
Share-based compensation	4,213		4,213
Issuance of shares for business acquisition (in shares)		22,340
Issuance of shares for business acquisition	800		800
Dividends	(96)				(96)
Equity, ending balance (in shares) at Jun. 30, 2023		46,553,517
Equity, ending balance at Jun. 30, 2023	569,753	$ 47	357,246	208,719	3,741
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income						4,236
Temporary Equity, Purchase of treasury shares						(150)
Temporary equity, carrying amount, ending balance at Sep. 30, 2023						17,931
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	23,737			22,059	1,678
Shares issued for vesting of restricted stock awards (in shares)		53,839
Shares issued for vesting of restricted stock awards	(63)		(63)
Share-based compensation	5,706		5,706
Dividends	(1,424)				(1,424)
Equity, ending balance (in shares) at Sep. 30, 2023		46,607,356
Equity, ending balance at Sep. 30, 2023	$ 597,709	$ 47	362,889	230,778	3,995
Temporary equity, carrying amount, beginning balance at Dec. 31, 2023						(205,883)
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income						326
Temporary equity, carrying amount, ending balance at Mar. 31, 2024						(205,557)
Equity, beginning balance (in shares) at Dec. 31, 2023	46,843,743	46,843,743
Equity, beginning balance at Dec. 31, 2023	$ 616,651	$ 47	371,037	243,134	2,433
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	16,536			14,835	1,701
Purchase of non-controlling interest	(25)				(25)
Sale of non-controlling interest	150				150
Shares issued for vesting of restricted stock awards (in shares)		5,149
Shares issued for vesting of restricted stock awards	(2,407)		(2,407)
Share-based compensation	5,748		5,748
Issuance of shares for business acquisition (in shares)		631,712
Issuance of shares for business acquisition	21,952	$ 1	21,951
Acquisition of non-controlling interest (in shares)		(22,340)
Acquisition of non-controlling interest	(535)		(856)		321
Dividends	(95)				(95)
Equity, ending balance (in shares) at Mar. 31, 2024		47,458,264
Equity, ending balance at Mar. 31, 2024	$ 657,975	$ 48	395,473	257,969	4,485
Temporary equity, carrying amount, beginning balance at Dec. 31, 2023						(205,883)
Temporary equity, carrying amount, ending balance at Sep. 30, 2024						(202,512)
Equity, beginning balance (in shares) at Dec. 31, 2023	46,843,743	46,843,743
Equity, beginning balance at Dec. 31, 2023	$ 616,651	$ 47	371,037	243,134	2,433
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Shares issued for cash and exercise of options (in shares)	75,455
Purchase of treasury shares (in shares)	(3,466,051)
Issuance of shares for Employee Stock Purchase Plan ("ESPP") (in shares)	7,789
Equity, ending balance (in shares) at Sep. 30, 2024	47,780,523	47,780,523
Equity, ending balance at Sep. 30, 2024	$ 709,619	$ 48	411,334	293,234	5,003
Temporary equity, carrying amount, beginning balance at Mar. 31, 2024						(205,557)
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income						1,245
Temporary equity, carrying amount, ending balance at Jun. 30, 2024						(204,312)
Equity, beginning balance (in shares) at Mar. 31, 2024		47,458,264
Equity, beginning balance at Mar. 31, 2024	657,975	$ 48	395,473	257,969	4,485
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	20,621			19,171	1,450
Shares issued for vesting of restricted stock awards (in shares)		83,285
Shares issued for vesting of restricted stock awards	(1,177)		(1,177)
Share-based compensation	7,390		7,390
Dividends	(1,801)				(1,801)
Equity, ending balance (in shares) at Jun. 30, 2024		47,541,549
Equity, ending balance at Jun. 30, 2024	683,008	$ 48	401,686	277,140	4,134
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income						1,800
Temporary equity, carrying amount, ending balance at Sep. 30, 2024						$ (202,512)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	17,181			16,094	1,087
Shares issued for vesting of restricted stock awards (in shares)		34,735
Shares issued for vesting of restricted stock awards	$ (391)		(391)
Shares issued for cash and exercise of options (in shares)	75,455	53,800
Shares issued for cash and exercise of options	$ 232		232
Purchase of treasury shares (in shares)		(14,409)
Purchase of treasury shares	(717)		(717)
Share-based compensation	6,230		6,230
Issuance of shares for Employee Stock Purchase Plan ("ESPP") (in shares)		7,789
Issuance of shares for Employee Stock Purchase Plan ("ESPP")	271		271
Stock Contingent Consideration (in shares)		157,059
Stock Contingent Consideration	4,023		4,023
Dividends	$ (218)				(218)
Equity, ending balance (in shares) at Sep. 30, 2024	47,780,523	47,780,523
Equity, ending balance at Sep. 30, 2024	$ 709,619	$ 48	$ 411,334	$ 293,234	$ 5,003

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities
Net income	$ 57,709	$ 57,943
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	19,801	12,846
Amortization of debt issuance cost	1,374	711
Share-based compensation	19,301	13,364
Non-cash lease expense	3,946	5,223
Gain on debt extinguishment	(2,398)	0
Unrealized (gain) loss on investments	(415)	6,898
Income from equity method investments	(2,887)	(3,104)
Unrealized gain on interest rate swaps	0	(1,022)
Deferred tax	(7,596)	(3,936)
Other	8,394	0
Changes in operating assets and liabilities, net of business combinations:
Receivables, net	(37,927)	(46,261)
Receivables, net - related parties	(17,588)	(21,801)
Other receivables	(2,986)	2,303
Prepaid expenses and other current assets	(7,825)	(1,246)
Loan receivable, non-current	0	(40)
Other assets	(2,996)	(180)
Accounts payable and accrued expenses	25,866	(1,119)
Fiduciary accounts payable	(1,696)	(1,808)
Medical liabilities	21,517	10,108
Income taxes receivable	(7,266)	25,154
Operating lease liabilities	(3,611)	(5,215)
Other long-term liabilities	429	109
Net cash provided by operating activities	63,146	48,927
Cash flows from investing activities
Payments for business acquisition, net of cash acquired	(115,494)	(4,674)
Proceeds from repayment of promissory notes, including those with related parties	256	2,200
Purchase of marketable securities	(82)	(2,125)
Proceeds from sale of marketable securities	124	0
Purchase of investments - privately held	(2,500)	(2,000)
Purchase of investment – equity method	(5,968)	(325)
Purchase of call option issued in conjunction with equity method investment	(3,907)	0
Issuance of promissory notes	(26,000)	(25,000)
Purchases of property and equipment	(5,500)	(21,472)
Contribution to investment - equity method	0	(700)
Net cash used in investing activities	(159,071)	(54,096)
Cash flows from financing activities
Dividends paid	(2,114)	(2,266)
Borrowings on long-term debt	171,875	0
Repayment of long-term debt	(14,750)	(461)
Payment of finance lease obligations	(534)	(505)
Proceeds from the exercise of stock options	232	1,250
Proceeds from ESPP purchases	271	0
Taxes paid from net share settlement of restricted stock	(3,975)	0
Repurchase of treasury shares	(717)	(9,689)
Proceeds from sale of non-controlling interest	150	0
Purchase of non-controlling interest	(25)	(50)
Borrowings on loans	0	3,149
Net cash provided by (used in) financing activities	150,413	(8,572)
Net increase (decrease) in cash and cash equivalents	54,488	(13,741)
Cash, cash equivalents, and restricted cash, beginning of period	294,152	288,027
Cash, cash equivalents, and restricted cash, end of period	348,640	274,286
Supplemental disclosures of cash flow information
Cash paid for income taxes	38,270	7,881
Cash paid for interest	23,190	9,670
Supplemental disclosures of non-cash investing and financing activities
Fixed assets obtained in exchange for finance lease liabilities	152	0
Right-of-use assets obtained in exchange for operating lease liabilities	13,303	6,626
Common stock issued in business combination	21,952	0
Common stock issued for contingent consideration payment	4,023	0
Tax impact from APC dividends to APC Shareholders	0	3,076
Draw on letter of credit through Revolver Loan	4,732	0
Reconciliation of cash, cash equivalents, and restricted cash
Cash and cash equivalents	347,994	273,941
Restricted cash	646	345
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows	$ 348,640	$ 274,286

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 16,094	$ 22,059	$ 50,100	$ 48,361

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Rule 10b5-1 Arr Modified Flag	false
Non Rule 10b5-1 Arr Modified Flag	false

Description of Business

Description of Business	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business	1. Description of Business Overview Unless the context dictates otherwise, references in these notes to the financial statements to the “Company,” “we,” “us,” “our,” and similar words are references to Astrana Health, Inc. (“Astrana”), formerly known as Apollo Medical Holdings, Inc., and its consolidated subsidiaries and affiliated entities, as appropriate, including its consolidated variable interest entities (“VIEs”). Headquartered in Alhambra, California, Astrana is a leading provider-centric, technology-powered, risk-bearing healthcare company. Leveraging its proprietary end-to-end technology solutions, Astrana operates an integrated healthcare delivery platform that enables providers to successfully participate in value-based care arrangements, thus empowering them to deliver accessible, high-quality care to patients in a cost-effective manner. Together with Astrana’s affiliated physician groups and consolidated subsidiaries and VIEs, the Company provides value-based care enablement services and care delivery with its consolidated care partners to serve patients in California, Nevada, and Texas, the majority of whom are covered by private or public insurance provided through Medicare, Medicaid, and commercial, with some portion of revenue from self-pay patients. The Company provides value-based care services to each major constituent of the healthcare delivery system, including patients, families, primary care physicians, specialists, acute care hospitals, alternative sites of inpatient care, ancillary providers, and health plans. The Company’s physician network consists of primary care physicians, specialist physicians, physician and specialist extenders, and hospitalists. Segments The Company’s three reportable segments are Care Partners, Care Delivery, and Care Enablement, which are described as follows: Care Partners The Care Partners segment is focused on building and managing high-quality and high-performance provider networks by partnering with, empowering, and investing in strong provider partners aligned on a shared vision for coordinated care delivery. By leveraging the Company’s unique care enablement platform and ability to recruit, empower, and incentivize physicians to effectively manage total cost of care, the Company is able to organize partnered providers into successful multi-payer, risk-bearing organizations that take on varying levels of risk based on total cost of care across membership in all lines of business, including Medicare Advantage, Medicaid, Commercial, Exchange, and Medicare fee for service (“FFS”). The Company’s healthcare delivery entities consist of a network of risk-bearing organizations (“RBOs”) that encompass independent practice associations (“IPAs”), accountable care organizations (“ACOs”), and state-specific entities such as Restricted Knox-Keene licensed health plans in California. These entities are tasked with the coordination and provision of high-quality care to patients within Astrana’s ecosystem. This helps provide a seamless continuity of care among patients in different age groups, stages of life, and life circumstances. Beginning in 2024, in addition to participating in the ACO REACH Model, the Company began participating in the Medicare Shared Savings Program (“MSSP”). The MSSP was created to promote accountability and improve coordination of care for Medicare beneficiaries. Care Delivery The Company’s Care Delivery segment is a patient-centric, data-driven care delivery organization focused on delivering high-quality and accessible care to all patients. The Company’s care delivery organization includes primary care, multi-specialty care, and ancillary care services. This segment includes the following: • Primary care clinics, including post-acute care services; • Specialty care clinics and inpatient services, including cardiac care, endocrinology, and ophthalmology as well as hospitalist and intensivist services; and • Ancillary service providers, such as urgent care centers, outpatient imaging centers, ambulatory surgery centers, and full-service labs. Care Enablement The Company’s Care Enablement segment represents a comprehensive platform that integrates clinical, operational, financial, and administrative information, all powered by the Company’s proprietary technology suite. This platform enhances the delivery of high-quality, value-based care to patients and helps lead to superior clinical and financial outcomes. The Company provides solutions to payers and providers, including independent physicians, provider and medical groups, and ACOs. The Company’s platform meets providers and payers wherever they are on the spectrum of total cost of care, offering solutions for fee-for-service entities to providers open to taking upside and downside risk on professional and institutional spend, and across all patient types, including Medicare, Medicaid, Commercial, and Exchange patients. This segment includes the Company’s wholly owned subsidiaries that operate as management services organizations (“MSOs”), which enter into long-term management and/or administrative services agreements with RBOs and other providers. By leveraging the Company’s care enablement platform, providers and payers can improve their ability to deliver high-quality care to their patients and achieve better patient outcomes.

Basis of Presentation and Summa

Basis of Presentation and Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation and Summary of Significant Accounting Policies	2. Basis of Presentation and Summary of Significant Accounting Policies Basis of Presentation The accompanying condensed consolidated balance sheet at December 31, 2023, has been derived from the Company’s audited consolidated financial statements, but does not include all annual disclosures required by generally accepted accounting principles in the United States of America (“U.S. GAAP”). The accompanying unaudited condensed consolidated financial statements as of September 30, 2024, and for the three and nine months ended September 30, 2024 and 2023, have been prepared in accordance with U.S. GAAP for interim financial statements and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, these unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and related notes to the financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023, as filed with the SEC on February 29, 2024. In the opinion of management, all material adjustments (consisting of normal recurring adjustments as well as intercompany accounts and transactions, which have been eliminated) considered necessary for a fair presentation have been made to make the condensed consolidated financial statements not misleading, as required by Regulation S-X, Rule 10-01. Operating results for the three and nine months ended September 30, 2024, are not necessarily indicative of the results that may be expected for the year ending December 31, 2024 , or any future periods. Principles of Consolidation The condensed consolidated balance sheets as of September 30, 2024 and December 31, 2023, and the condensed consolidated statements of income for the three and nine months ended September 30, 2024 and 2023, include Astrana’s wholly owned subsidiaries and consolidated VIEs. The unaudited condensed consolidated interim financial statements have been prepared under the assumption that users of the interim financial data have either read, or have access to, our audited consolidated financial statements for the fiscal year ended December 31, 2023 . Use of Estimates The preparation of the condensed consolidated financial statements and related disclosures in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, and disclosure of contingent assets and liabilities, at the date of the condensed consolidated financial statements as well as the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates and assumptions include collectability of receivables, recoverability of long-lived and intangible assets, business combination and goodwill valuation and impairment assessment, accrual of medical liabilities (incurred but not reported claims), determination of hospital shared-risk and health plan shared-risk revenue and receivables (including constraints and completion factors), income tax-valuation allowance, share-based compensation, and right-of-use assets and lease liabilities. Management evaluates its estimates and assumptions on an ongoing basis using historical experience and other factors, including the current economic environment, and makes adjustments when facts and circumstances dictate. As future events and their effects cannot be determined with precision, actual results could differ materially from those estimates and assumptions. Business Combinations The Company uses the acquisition method of accounting for all business combinations, which requires assets and liabilities of the acquiree to be recorded at fair value, to measure the fair value of the consideration transferred, including contingent consideration, to be determined on the acquisition date, and to account for acquisition-related costs separately from the business combination. Reportable Segments As of September 30, 2024 , the Company operates in three reportable segments: • Care Partners; • Care Delivery; and • Care Enablement. Refer to Note 1 — “Description of Business” and Note 18 — “Segments” to the condensed consolidated financial statements for information on the Company’s segments. Cash and Cash Equivalents The Company’s cash and cash equivalents primarily consist of money market funds and certificates of deposit. The Company considers all highly liquid investments that are both readily convertible into known amounts of cash and mature within ninety days from their date of purchase to be cash equivalents. The Company maintains its cash in deposit accounts with several banks, which at times may exceed the insured limits of the Federal Deposit Insurance Corporation (“FDIC”). The Company believes it is not exposed to any significant credit risk with respect to its cash and cash equivalents and restricted cash. As of September 30, 2024 and December 31, 2023, the Company’s deposit accounts with banks exceeded the FDIC’s insured limit by approximately $ 359.3 million and $ 318.9 million , respectively. The Company has not experienced any losses to date and performs ongoing evaluations of these financial institutions to limit the Company’s concentration of risk exposure. Receivables, Receivables – Related Parties, Other Receivables, and Loan Receivables The Company’s receivables are comprised of accounts receivable, capitation and fee for service receivable, risk pool settlements, incentive receivables, management fee income, and other receivables. Accounts receivable are recorded and stated at the amount expected to be collected. The Company’s receivables – related parties are comprised of risk pool settlements, management fee income, and other receivables. Receivables – related parties are recorded and stated at the amount expected to be collected. The Company’s loan receivables consist of promissory notes that accrue interest per annum. As of September 30, 2024, promissory notes are expected to be collected by their maturity dates. Capitation receivables relate to each health plan’s capitation and are received by the Company in the month following the month of service. Capitation receivables also include receivables from CMS related to the Company’s participation in the ACO REACH model. Risk pool settlements and incentive receivables mainly consist of the Company’s hospital shared-risk pool receivable, which is recorded quarterly based on reports received from the Company’s hospital partners and management’s estimate of the Company’s portion of the estimated risk pool surplus for open performance years. Settlement of risk pool surplus or deficits occurs approximately 18 months after the risk pool performance year is completed. Other receivables consist of receivables from fee-for-service (“FFS”) reimbursement for patient care, certain expense reimbursements, transportation reimbursements from the hospitals, and stop-loss insurance premium reimbursements. The Company maintains reserves for potential credit losses on the receivables. Management reviews the composition of the Company’s receivables and analyzes historical bad debts, customer concentrations, customer creditworthiness, current economic trends, and changes in customer payment patterns to evaluate the adequacy of these reserves. The Company also regularly analyzes the ultimate collectability of accounts receivable after certain stages of the collection cycle using a look-back analysis to determine the amount of receivables subsequently collected, and adjustments are recorded when necessary. Reserves are recorded primarily on a specific identification basis. Receivables are recorded when the Company is able to determine amounts receivable under applicable contracts and agreements based on information provided and collection is reasonably likely to occur. Regarding the credit loss standard, the Company continuously monitors its collections of receivables. Our expectation is that the historical credit loss experienced across our receivable portfolio is materially similar to any current expected credit losses that would be estimated under the current expected credit losses (“CECL”) model. Concentrations of Credit Risks The Company disaggregates revenue from contracts by service type and payer type. This level of detail provides useful information pertaining to how the Company generates revenue by significant revenue stream and by type of direct contracts. The condensed consolidated statements of income present disaggregated revenue by service type. The following table presents disaggregated revenue generated by payer type for the three and nine months ended September 30, 2024 and 2023 (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Commercial $ 52,961 $ 43,495 $ 142,667 $ 122,421 Medicare 258,377 222,387 747,418 660,855 Medicaid 151,943 65,469 414,453 201,920 Other third parties 15,429 16,822 64,793 48,429 Revenue $ 478,710 $ 348,173 $ 1,369,331 $ 1,033,625 The Company had major payers that contributed the following percentages of net revenue for the three and nine months ended September 30, 2024 and 2023: Three Months Ended Nine Months Ended 2024 2023 2024 2023 Payer A 27.7 % 37.4 % 30.0 % 39.0 % Payer B 15.4 % 12.4 % 14.8 % * Payer D 12.0 % * * * *Less than 10% of total net revenues The Company had major payers that contributed to the following percentages of receivables and receivables – related parties: As of September 30, As of December 31, Payer A 31.3 % 36.0 % Payer C 36.0 % 41.0 % Revenue Recognition The Company receives payments from the following sources for services rendered: • Commercial insurers; • Federal government under the Medicare program administered by CMS; • State governments under Medicaid and other programs; • Other third-party payers (e.g., hospitals and IPAs); and • Individual patients and clients. Revenue primarily consists of the following: • Capitation revenue; • Risk pool settlements and incentives; • Management fee revenue; and • FFS revenue. Revenue is recorded in the period in which services are rendered or the period in which the Company is obligated to provide services. The form of billing and related risk of collection for such services may vary by type of revenue and the customer. Risk Pool Settlements and Incentives Medicare Shared Savings Program Revenue Beginning in 2024, Astrana participates in MSSP. The MSSP has multiple risk tracks, and Astrana is currently participating in the ENHANCED risk track. Under the MSSP Model, Astrana recruits a group of Participant and Preferred (in-network) Providers. Based on the Participant Providers that join our ACO, CMS grants the Company a pool of Traditional Medicare patients (beneficiaries) to manage (the “MSSP Aligned Beneficiaries”). The Company’s MSSP Aligned Beneficiaries will receive services from physicians and other medical service providers that are both in-network and out-of-network. CMS continues to pay participants and preferred providers on a fee-for-service basis for Medicare-covered services provided to MSSP Aligned Beneficiaries. The Company continues to bear risk on all Medicare expenditures (both in-network and out-of-network), excluding drug expenditures covered by Medicare Part D, based on a budgetary benchmark established with CMS. Astrana’s shared savings or losses in managing the Company’s beneficiaries are generally determined on an annual basis after reconciliation with CMS. Pursuant to Astrana’s risk-share agreement with CMS, the Company is eligible to receive the surplus (“shared savings”) or is liable for the deficit (“shared losses”) according to the budgetary benchmark established by CMS based on Astrana’s efficiency, or lack thereof, in managing the expenditures associated with the Company’s MSSP Aligned Beneficiaries. The Company estimates the shared service revenue by analyzing the activities during the relevant time period in contemplation of the agreed-upon benchmarks, metrics, performance criteria, and attribution criteria based on those and any other contractually defined factors. Revenue is not recorded and is constrained until the shared service revenue can be reasonably estimated by the Company and to the extent that it is probable that a significant reversal will not occur once any uncertainty associated with the variable consideration is subsequently resolved. Contract Liabilities (Deferred Revenue) Contract liabilities are recorded when cash payments are received in advance of the Company’s performance. As of September 30, 2024 and December 31, 2023, the Company’s contract liability balance was $ 2.2 million and $ 0.7 million, respectively. Approximately $ 0.7 million of the Company’s contract liability accrued as of December 31, 2023, has been recognized as revenue during the nine months ended September 30, 2024 . Contract liability is presented within accounts payable and accrued expenses in the accompanying condensed balance sheets. Income Taxes Federal and state income taxes are computed at currently enacted tax rates less tax credits using the asset and liability method. Deferred taxes are adjusted for both items that do not have tax consequences and for the cumulative effect of any changes in tax rates from those previously used to determine deferred tax assets or liabilities. Tax provisions include amounts that are currently payable, changes in deferred tax assets and liabilities that arise because of temporary differences between the timing of when items of income and expense are recognized for financial reporting and income tax purposes, changes in recognition of tax positions, and any changes in the valuation allowance caused by a change in judgment about the realizability of the related deferred tax assets. A valuation allowance is established when necessary to reduce deferred tax assets to amounts expected to be realized. The Company uses a recognition threshold of more-likely-than-not and a measurement attribute on all tax positions taken, or expected to be taken, in a tax return in order to be recognized in the condensed consolidated financial statements. Once the recognition threshold is met, the tax position is measured to determine the actual amount of benefit to recognize in the condensed consolidated financial statements. Recent Accounting Pronouncements Not Yet Adopted In November 2023, the Financial Standards Accounting Board (FASB) issued Accounting Standards Update (ASU) 2023-07 “Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures,” which expands annual and interim disclosure requirements for reportable segments, primarily through enhanced disclosures about significant segment expenses. ASU 2023-07 is effective for the Company’s annual periods beginning January 1, 2024, and for interim periods beginning January 1, 2025, with early adoption permitted. The Company does not expect the adoption of ASU 2023-07 to have a significant impact on its consolidated financial statements and related disclosures. In December 2023, the FASB issued ASU 2023-09 “Income Taxes (Topics 740): Improvements to Income Tax Disclosures” to expand the disclosure requirements for income taxes, specifically related to the rate reconciliation and income taxes paid. ASU 2023-09 is effective for the Company’s annual periods beginning January 1, 2025, with early adoption permitted. The Company does not expect the adoption of ASU 2023-09 to have a significant impact on its consolidated financial statements and related disclosures.

Business Combinations and Goodw

Business Combinations and Goodwill	9 Months Ended
	Sep. 30, 2024
Business Combination and Asset Acquisition [Abstract]
Business Combinations and Goodwill	3. Business Combinations and Goodwill Airline Complete Healthcare of Texas, Ltd. (“Airline Complete”) On July 1, 2024, the Company, through its consolidated VIE, purchased 100 % of the equity interest in Airline Complete. Airline Complete is a primary care clinic located in Texas. The purchase price consisted of cash funded on July 1, 2024. Advanced Health Management Systems, L.P. (“AHMS”) On March 31, 2024, the Company, through its wholly owned subsidiary, purchased all of the outstanding general and limited partnership interests of AHMS. AHMS’s wholly owned subsidiary operates a Restricted Knox-Keene licensed health plan in Los Angeles, California. Total consideration for the acquisition was $ 63.9 million. The consideration is subject to changes based on working capital adjustments, which are settled one year from the close date as per the purchase agreement. Prime Community Care of Central Valley, Inc. (“PCCCV”) On March 29, 2024, the Company, through its consolidated VIE, acquired certain assets of PCCCV, a professional medical corporation that operates in Central California. Total consideration of the acquisition was approximately $ 10.5 million, consisting of cash funded upon the close date and contingent consideration fair valued at $ 2.5 million on March 29, 2024 (“PCCCV contingent considerations”). Refer to Note 19 - “Fair Value Measurements of Financial Instruments” for additional information on contingent considerations. Community Family Care Medical Group IPA, Inc. (“CFC”) On January 31, 2024, the Company, through its consolidated VIE, acquired certain assets of CFC. CFC is an RBO that manages the healthcare of members in the Los Angeles, California, area. The group serves patients across Medicare, Medicaid, and Commercial payers. At September 30, 2024 , the total consideration for the purchase was $ 121.0 million, consisting of $ 91.0 million cash funded upon the close date as per the purchase agreement, $ 22.0 million of the Company’s common stock, resulting in the issuance of 631,712 shares of common stock, and contingent consideration with a fair value of $ 8.0 million on January 31, 2024 (“CFC contingent considerations”). The consideration is subject to changes based on working capital adjustments which is settled one year from the close date as per the purchase agreement. Refer to Note 19 - “Fair Value Measurements of Financial Instruments” for additional information on contingent considerations. Advanced Diagnostic and Surgical Center, Inc. (“ADSC”) On January 1, 2024, the Company acquired 95 % of the equity interest of ADSC. ADSC is a diagnostic and surgical center that also provides ambulatory surgery services. The total consideration consisted of cash funded upon the close of the transaction and contingent consideration with a fair value of $ 3.6 million on January 1, 2024 (“ADSC contingent considerations”). Refer to Note 19 - “Fair Value Measurements of Financial Instruments” for additional information on contingent consideration. The Company is in the process of finalizing the purchase price allocation for CFC and AHMS as a result of the purchase price not being finalized until one year from the close date. Therefore, the balances are subject to change as a result of any working capital adjustments. The following table summarizes the purchase price allocation of the fair value of assets acquired and liabilities assumed related to each acquisition at the acquisition date for acquisitions that closed during the nine months ended September 30, 2024 (in thousands): CFC AHMS Others* Net Total Total purchase consideration: Cash paid $ 90,998 $ 63,935 $ 15,000 $ 169,933 Contingent consideration 8,026 — 6,161 14,187 Common stock issued 21,952 — — 21,952 $ 120,976 $ 63,935 $ 21,161 $ 206,072 Assets: Cash and cash equivalents $ 16,674 $ 33,950 $ 3,515 $ 54,139 Investment in marketable securities — — 30 30 Receivables 6,530 11,007 — 17,537 Other receivables 472 — — 472 Prepaid expenses and other current assets — 36 11 47 Amount due from affiliates 2,902 — — 2,902 Land, property, and equipment — — 823 823 Intangible assets 28,000 23,600 3,900 55,500 Goodwill 83,602 31,048 13,621 128,271 Income tax receivable — — 1 1 Restricted cash — 300 — 300 Total assets acquired $ 138,180 $ 99,941 $ 21,901 $ 260,022 Liabilities: Accounts payable and accrued expenses $ 2,487 $ 7,111 $ 250 $ 9,848 Medical liabilities 14,693 14,942 — 29,635 Amount due from affiliates — 5,890 54 5,944 Income taxes payable 24 1,689 — 1,713 Deferred tax liability — 6,374 8 6,382 Non-controlling interest — — 428 428 Total liabilities assumed $ 17,204 $ 36,006 $ 740 $ 53,950 Total net assets acquired $ 120,976 $ 63,935 $ 21,161 $ 206,072 *Others consist of estimated fair values of the assets acquired, net of cash acquired, related to ADSC, PCCCV, and Airline Complete. Following the acquisition dates, the operating results have been included in our condensed consolidated financial statements. For the period from the acquisition dates through September 30, 2024, the total revenue and net income of CFC, AHMS, ADSC, PCCCV, and Airline Complete, in the aggregate, were $ 235.9 million and $ 26.4 million , respectively. Unaudited Pro Forma Financial Information The pro forma financial information in the table below presents the combined results of the Company and CFC, AHMS, ADSC, PCCCV, and Airline Complete as if the acquisitions had occurred on January 1, 2023. The pro forma information presented is shown for illustrative purposes only and is not necessarily indicative of future results of operations of the Company or results of operations of the Company that would have actually occurred had the transactions been in effect for the periods presented. Three Months Ended Nine Months Ended (in thousands, except per share amounts) 2024 2023 2024 2023 Total revenue $ 478,710 $ 430,399 $ 1,434,813 $ 1,207,867 Net income attributable to Astrana Health, Inc. $ 16,094 $ 26,215 $ 54,148 $ 64,875 Net income per share – basic $ 0.34 $ 0.56 $ 1.14 $ 1.39 Net income per share – diluted $ 0.33 $ 0.56 $ 1.13 $ 1.38 The acquisitions were accounted for under the acquisition method of accounting. The fair value of the consideration for the acquired companies was allocated to acquired tangible and intangible assets and liabilities based upon their fair values. The excess of the purchase consideration over the fair value of the net tangible and identifiable intangible assets acquired was recorded as goodwill. Factors leading to goodwill being recognized are the Company’s expectation of synergies from combining operations of entities acquired and the Company, as well as the value of intangible assets that are not separately recognized, such as assembled workforce. The determination of the fair value of assets and liabilities acquired requires the Company to make estimates and use valuation techniques when market value is not readily available. Transaction costs associated with business acquisitions are expensed as they are incurred. At the time of acquisition, the Company estimates the amount of the identifiable intangible assets based on a valuation and the facts and circumstances available at the time. The Company determines the final value of the identifiable intangible assets as soon as information is available, but not more than one year from the date of acquisition. Goodwill is not deductible for tax purposes. The Company had no impair ment of its goodwill or indefinite-lived intangible assets during the three and nine months ended September 30, 2024 and 2023. The change in the carrying value of goodwill for the nine months ended September 30, 2024 was as follows (in thousands): Amount Balance, January 1, 2024 $ 278,831 Acquisitions 128,271 Adjustments 2,609 Balance, September 30, 2024 $ 409,711

Intangible Assets, Net

Intangible Assets, Net	9 Months Ended
	Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets, Net	4. Intangible Assets, Net At September 30, 2024, the Company’s intangible assets, net, consisted of the following (in thousands): Useful Gross Accumulated Net Indefinite lived assets: Trademarks N/A $ 2,150 $ — $ 2,150 Licenses N/A 1,900 — 1,900 Amortized intangible assets: Network relationships 11 - 21 156,779 ( 111,626 ) 45,153 Management contracts 15 22,832 ( 17,647 ) 5,185 Member relationships 7 - 14 71,577 ( 17,582 ) 53,995 Patient management platform 5 2,060 ( 2,060 ) — Tradename/trademarks 20 1,011 ( 345 ) 666 Developed technology 6 107 ( 48 ) 59 $ 258,416 $ ( 149,308 ) $ 109,108 At December 31, 2023, the Company’s intangible assets, net, consisted of the following (in thousands): Useful Gross Accumulated Net Indefinite lived assets: Trademarks N/A $ 2,150 $ — $ 2,150 Amortized intangible assets: Network relationships 11 - 21 150,679 ( 104,859 ) 45,820 Management contracts 15 22,832 ( 16,662 ) 6,170 Member relationships 10 - 14 24,077 ( 7,345 ) 16,732 Patient management platform 5 2,060 ( 2,060 ) — Tradename/trademarks 20 1,011 ( 308 ) 703 Developed technology 6 107 ( 34 ) 73 $ 202,916 $ ( 131,268 ) $ 71,648 For the three months ended September 30, 2024 and 2023, the Company recognized amortization expenses of $ 6.7 million and $ 3.2 million , respectively, in depreciation and amortization on the accompanying condensed consolidated statements of income. For the nine months ended September 30, 2024 and 2023, the Company recognized amortization expenses of $ 18.0 million and $ 9.5 million , respectively, in depreciation and amortization on the accompanying condensed consolidated statements of income. The Company determined that ther e was no impai rment of its finite-lived intangible or long-lived assets during the nine months ended September 30, 2024 and 2023. Future amortization expense is estimated to be as follows for the following years ending December 31 (in thousands): Amount 2024 (excluding the nine months ended September 30, 2024) $ 6,630 2025 22,856 2026 18,642 2027 15,170 2028 12,459 Thereafter 29,301 Total $ 105,058

Investments in Other Entities

Investments in Other Entities	9 Months Ended
	Sep. 30, 2024
Equity Method Investments and Joint Ventures [Abstract]
Investments in Other Entities	5. Investments in Other Entities Equity Method For the nine months ended September 30, 2024 and 2023, the Company’s equity method investment balance consisted of the following (in thousands): % of December 31, Initial Allocation September 30, 2024 LaSalle Medical Associates – IPA line of business 25 % $ 9,866 $ — $ 2,225 $ 12,091 Pacific Medical Imaging & Oncology Center, Inc. 40 % 1,691 — ( 72 ) 1,619 CAIPA MSO, LLC 30 % 13,660 — 643 14,303 I Health, Inc. 25 % — 5,968 20 5,988 Other* 25 % 557 — 71 628 $ 25,774 $ 5,968 $ 2,887 $ 34,629 % of December 31, Initial Allocation Funding September 30, 2023 LaSalle Medical Associates – IPA line of business 25 % $ 5,684 $ — $ 2,642 $ — $ 8,326 Pacific Medical Imaging & Oncology Center, Inc. 40 % 1,878 — ( 219 ) — 1,659 531 W. College, LLC ** 50 % 17,281 — ( 387 ) 700 17,594 One MSO, LLC ** 50 % 2,718 — 330 — 3,048 CAIPA MSO, LLC 30 % 12,738 — 575 — 13,313 Other* 25 % — 325 163 — 488 $ 40,299 $ 325 $ 3,104 $ 700 $ 44,428 *Other consists of smaller equity method investments. ** Investments were solely for the benefit of APC and its shareholders. For three months ended September 30, 2024 and 2023, the Company’s equity method investment balance consisted of the following (in thousands): % of June 30, Initial Allocation September 30, 2024 LaSalle Medical Associates – IPA line of business 25 % $ 11,027 $ — $ 1,064 $ 12,091 Pacific Medical Imaging & Oncology Center, Inc. 40 % 1,648 — ( 29 ) 1,619 CAIPA MSO, LLC 30 % 14,100 — 203 14,303 I Health, Inc. 25 % 5,923 — 65 5,988 Other* 25 % 578 — 50 628 $ 33,276 $ — $ 1,353 $ 34,629 % of June 30, Initial Allocation Funding September 30, 2023 LaSalle Medical Associates – IPA line of business 25 % $ 10,537 $ — $ ( 2,211 ) $ — $ 8,326 Pacific Medical Imaging & Oncology Center, Inc. 40 % 1,655 — 4 — 1,659 531 W. College, LLC ** 50 % 17,070 — ( 176 ) 700 17,594 One MSO, LLC ** 50 % 2,960 — 88 — 3,048 CAIPA MSO, LLC 30 % 13,190 — 123 — 13,313 Other* 25 % 420 — 68 — 488 $ 45,832 $ — $ ( 2,104 ) $ 700 $ 44,428 * Other consists of smaller equity method investments. ** Investments were solely for the benefit of APC and its shareholders. I Health, Inc. On March 31, 2024, a wholly owned subsidiary of the Company acquired a 25 % equity interest in I Health, Inc. (“I Health”), a management service organization. The Company accounts for its investment in I Health under the equity method of accounting as the Company has the ability to exercise significant influence, but not control over, I Health’s operations. The purchase agreement includes a call option that allows the Company to purchase an additional 25 % equity interest on each of the first, second, and third anniversary of the purchase (“I Health Call Option”). The total purchase price for this arrangement was $ 9.9 million, consisting of $ 3.9 million in the form of a call option, and $ 6.0 million as the initial investment of the 25 % equity interest. Refer to Note 19 - “Fair Value Measurements of Financial Instruments” for additional information about the I Health Call Option. There w as no i mpairment loss recorded related to equity method investments for the three and nine months ended September 30, 2024 and 2023 .

Loans Receivable

Loans Receivable	9 Months Ended
	Sep. 30, 2024
Receivables [Abstract]
Loans Receivable	6. Loans Receivable Loans receivable IntraCare In July 2023, the Company entered into a five-year convertible promissory note with IntraCare as the borrower. The principal on the note is $ 25.0 million, with interest on the outstanding principal amount and unpaid interest at a rate per annum equal to 8.81 %, compounded annually. In the event that the convertible promissory note remains outstanding on or after the maturity date of July 27, 2028 , the outstanding principal balance and any unpaid accrued interest shall, upon the election of the Company, convert into IntraCare preferred shares. BASS Medical Group On January 29, 2024, the Company provided BASS Medical Group (“BASS”) with a $ 20.0 million senior secured promissory note (“BASS secured promissory note”). The promissory note is secured by certain assets of BASS. The BASS secured promissory note matures on January 11, 2031 , and has an interest rate per annum equal to 8.21 %, compounded annually. The principal on the note, including unpaid interest, is due and payable on the maturity date. DWGAS, Inc. ("DWGAS") On July 17, 2024, the Company entered into a five-year secured convertible promissory note with DWGAS, Inc. as the borrower (“DWGAS convertible note”). The principal on the DWGAS convertible note is $ 5.0 million, with interest on the outstanding principal amount and unpaid interest at a rate per annum equal to 7.5 %. The promissory note is secured by a pledge of all the assets of DWGAS. On or before December 31, 2024, the Company has the option to convert the outstanding principal amount and unpaid interest into 80 % ownership of DWGAS ’ s issued and outstanding capital stock. If the conversion is not exercised by December 31, 2024 , the note will mature on July 17, 2029 . The Company assessed the outstanding loans receivable under the CECL model by assessing the party’s ability to pay by reviewing their financial history quarterly and reassessing any identified insolvency risk.

Accounts Payable and Accrued Ex

Accounts Payable and Accrued Expenses	9 Months Ended
	Sep. 30, 2024
Payables and Accruals [Abstract]
Accounts Payable and Accrued Expenses	7. Accounts Payable and Accrued Expenses The Company’s accounts payable and accrued expenses consisted of the following (in thousands): September 30, December 31, Accounts payable and other accruals $ 36,908 $ 9,075 Capitation payable 13,317 4,503 Subcontractor IPA payable 2,440 2,529 Professional fees 4,152 4,407 Due to related parties 3,785 9,271 Contract liabilities 2,246 744 Accrued compensation 17,498 20,098 Other provider payable 14,465 9,322 Total accounts payable and accrued expenses $ 94,811 $ 59,949

Medical Liabilities

Medical Liabilities	9 Months Ended
	Sep. 30, 2024
Liability for Unpaid Claims and Claims Adjustment Expense, Activity in Liability [Abstract]
Medical Liabilities	8. Medical Liabilities The Company’s medical liabilities consisted of the following (in thousands): September 30, September 30, Medical liabilities, beginning of period $ 106,657 $ 81,255 Acquired* (see Note 3) 32,106 6,157 Components of medical care costs related to claims incurred: Current period 797,906 642,880 Prior periods ( 7,890 ) ( 13,251 ) Total medical care costs 790,016 629,629 Payments for medical care costs related to claims incurred: Current period ( 654,625 ) ( 547,212 ) Prior periods ( 112,847 ) ( 74,966 ) Total paid ( 767,472 ) ( 622,178 ) Adjustments ( 1,028 ) 2,656 Medical liabilities, end of period $ 160,279 $ 97,519 *The acquired balance includes medical liabilities from current and prior periods.

Credit Facility, Promissory Not

Credit Facility, Promissory Notes Payable, Bank Loans, and Lines of Credit	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Credit Facility, Promissory Notes Payable, Bank Loans, and Lines of Credit	9. Credit Facility, Promissory Notes Payable, Bank Loans, and Lines of Credit The Company’s debt balance consisted of the following (in thousands): September 30, December 31, Term Loan $ 285,250 $ 280,000 Revolver Loan 146,732 — Promissory Note Payable 9,875 2,000 Total debt 441,857 282,000 Less: Current portion of debt ( 15,000 ) ( 19,500 ) Less: Unamortized financing costs ( 3,738 ) ( 3,561 ) Long-term debt $ 423,119 $ 258,939 The estimated fair value of our long-term debt was determined using Level 2 inputs primarily related to comparable market prices. As of September 30, 2024 and December 31, 2023, the carrying value was not materially different from fair value, as the interest rates on the Company’s debt approximated rates currently available to the Company. The following are the future commitments of the Company’s debt for the years ending December 31 (in thousands): Amount 2024 (excluding the nine months ended September 30, 2024) $ 3,750 2025 16,875 2026 169,232 2027 34,250 2028 217,750 Total $ 441,857 Amended Credit Facility Amended Credit Agreement On June 16, 2021, the Company entered into an amended and restated credit agreement (as subsequently amended as described below, the “Amended Credit Agreement”) with Truist Bank, in its capacity as administrative agent for the lenders, issuing bank, swingline lender, and lender, and the banks and other financial institutions from time to time as party thereto, to, among other things, to amend and restate that certain credit agreement, dated September 11, 2019, by and among the Company, Truist Bank, and certain lenders thereto, in its entirety. The Amended Credit Agreement provides for a five-year revolving credit facility (the “Amended Credit Facility”) to the Company of $ 400.0 million (“Revolver Loan”), which includes a letter of credit sub-facility of up to $ 25.0 million (which was amended to $ 50.0 million, as described below) and a swingline loan sub-facility of $ 25.0 million which expires on June 16, 2026. On December 20, 2022, an amendment was made to the Amended Credit Agreement, in which all amounts borrowed under the Amended Credit Agreement as of the effective date were automatically converted from London Interbank Offer Rate (“LIBOR”) Loans to Secured Overnight Financing Rate (“SOFR”) Loans with an initial interest period of one month on, and as of, the amendment effective date. Amounts borrowed under the Revolver Loan bear interest at an annual rate equal to either, at the Company’s option, (a) the Term SOFR Reference Rate (as defined in the Amended Credit Agreement), adjusted for any Term SOFR Adjustment (as defined in the Amended Credit Agreement) plus a spread ranging from 1.25 % to 2.50 %, as determined on a quarterly basis based on the Company’s Consolidated Total Net Leverage Ratio (as defined in the Amended Credit Agreement), or (b) a base rate, plus a spread ranging from 0.25 % to 1.50 %, as determined on a quarterly basis based on the Company’s Consolidated Total Net Leverage Ratio. As of September 30, 2024, the Company had borrowings of $ 146.7 million outstanding on the Revolver Loan, and the interest rate on the Revolver Loan was 7.20 % . On September 8, 2023, a Second Amendment to the Amended Credit Agreement was entered into, which, among other things, increased the letter of credit sub-facility from $ 25.0 million to $ 50.0 million. On November 3, 2023, the Company entered into a Third Amendment to the Amended Credit Agreement (“Third Amendment”) with Truist Bank and the other financial institutions party thereto. The Third Amendment provided a new term loan to the Company in an aggregate amount of up to $ 300.0 million, with $ 180.0 million funded at the closing of the Third Amendment, and $ 120.0 million available to be drawn by the Company as delayed draw loans during the six months subsequent to the closing of the Third Amendment (collectively, the “Term Loan”). The Term Loan matures on November 3, 2028 (or such earlier date on which it is terminated in accordance with the provisions of the Amended Credit Agreement) and amortizes quarterly at 5 % per annum for each of the first two years, 7.5 % per annum for years three and four, and 10 % per annum for year five. The Term Loan bears interest at an annual rate equal to either, at the Company’s option, (a) the Term SOFR Reference Rate, adjusted for any Term SOFR Adjustment, plus a spread from 1.50 % to 2.75 %, as determined on a quarterly basis based on the Company’s Consolidated Total Net Leverage Ratio, or (b) a base rate, plus a spread of 0.50 % to 1.75 %, as determined on a quarterly basis based on the Company’s Consolidated Total Net Leverage Ratio. As of September 30, 2024, the outstanding borrowings on the Term Loan were $ 285.3 million, and the interest rate on the Term Loan was 7.20 % . In May 2024, the Company entered into a Fourth Amendment to the Amended Credit Agreement, which updates the letter of credit provisions in the Amended Credit Agreement to provide the Company with the ability to have letters of credit issued under the Amended Credit Agreement that extend beyond the maturity date of the Amended Credit Agreement. The Amended Credit Agreement requires the Company to comply with two key financial ratios, each calculated on a consolidated basis. The Company must maintain a maximum consolidated total net leverage ratio of not greater than 3.75 to 1.00 as of the last day of each fiscal quarter, provided that for any fiscal quarter during which the Company or certain subsidiaries consummate a permitted acquisition or investment, and the aggregate purchase price is greater than $ 75.0 million, the maximum consolidated total net leverage ratio may temporarily increase by 0.25 to 1.00 to 4.00 to 1.00. The Company must maintain a minimum consolidated interest coverage ratio of not less than 3.25 to 1.00 as of the last day of each fiscal quarter. Under the Amended Credit Agreement, the terms and conditions of the Guaranty and Security Agreement (the “Guaranty and Security Agreement”) between the Company, Astrana Health Management, Inc. (“AHM”), and Truist Bank remain in effect. Pursuant to the Guaranty and Security Agreement, the Company and AHM have granted the lenders under the Amended Credit Agreement a security interest in substantially all of their assets to secure obligations under the Amended Credit Agreement, including, without limitation, all stock and other equity issued by their subsidiaries (including AHM) and all rights with respect to the $ 545.0 million loan from the Company to Astrana Medical. Promissory Note Payable FYB Promissory Note Agreement with CCHCA On May 1, 2023, the Company acquired 100 % of the equity interest in For Your Benefit, Inc. ( “FYB”). As part of the acquisition, the Company assumed FYB's promissory note payable to Chinese Community Health Care Association ( “CCHCA”). The principal on the promissory note was $ 2.0 million, with a maturity date of May 9, 2024. The interest rate was the prime rate plus 1.0 %. The prime rate was updated annually on the effective date of the note and as published by the Wall Street Journal . On September 30, 2024, upon the settlement of the purchase price of the Company ’ s acquisition of FYB, the FYB promissory note was forgiven to resolve the settlement amount due from the sellers to the Company. As a result, during the three and nine months ended September 30, 2024 , the Company wrote off the principal of $ 2.0 million and any unpaid interest within other income in the accompanying condensed consolidated statements of income. I Health Promissory Note Payable - Related Party On April 1, 2024, the Company received $ 8.3 million as a promissory note (the “I Health Promissory Note” ) with a maturity date of March 31, 2027. I Health may accelerate the maturity date if the Company does not exercise the I Health Call Option (see Note 5 — “Investments in Other Entities - Equity Method”). The promissory note has an interest rate of 4.30 % per annum on the principal amount. Accrued interest is payable on each anniversary of the promissory note payable. I Health is accounted for under the equity method based on the 25 % equity ownership interest held by the Company (see Note 5 — “Investments in Other Entities - Equity Method”). On July 1, 2024, an amendment was made to the I Health Promissory Note that, among other things, increased the original principal amount by an additional $ 1.6 million. As a result, the total amount payable under the I Health Promissory Note is $ 9.9 million. Deferred Financing Costs At September 30, 2024 and December 31, 2023, unamortized deferred financing costs were $ 4.8 million and $ 6.1 million , respectively. As of September 30, 2024 and December 31, 2023, $ 1.0 million and $ 2.6 million , respectively, of unamortized deferred financing costs was recognized in prepaid expenses and other current assets in the accompanying condensed consolidated balance sheets, and consisted of unamortized deferred financing costs related to unborrowed amounts available on the Revolver Loan. As of September 30, 2024 and December 31, 2023, $ 3.7 million and $ 3.6 million , respectively, of unamortized deferred financing costs was recorded as a direct reduction against the amounts borrowed on the Term Loan and Revolver. The remaining unamortized deferred financing costs related to the Revolver Loan are amortized over the life of the Revolver Loan using the straight-line method. The remaining unamortized deferred financing costs related to the Term Loan are amortized over the life of the Term Loan using the effective interest rate method. Interest expense in the condensed consolidated statements of income included amortization of deferred debt issuance costs. Effective Interest Rate The Company’s average effective interest rate on its total debt during the nine months ended September 30, 2024 and 2023, was 7.08 % and 6.07 % , respectively. Lines of Credit APC Business Loan On September 10, 2019, the APC Business Loan Agreement with Preferred Bank (the “APC Business Loan Agreement”) was amended to, among other things, decrease loan availability to $ 4.1 million, limit the purpose of the indebtedness under the APC Business Loan Agreement to the issuance of standby letters of credit, and include as a permitted lien, the security interest in all of its assets that APC granted to AHM under a Security Agreement dated on or about September 11, 2019, securing APC’s obligations to AHM under their management services agreement dated as of July 1, 1999, as amended. Standby Letters of Credit The Company established irrevocable standby letters of credit with Truist Bank under the Amended Credit Agreement for a total of $ 25.0 million for the benefit of CMS and certain health plans as of September 30, 2024 . Unless the institution provides notification that the standby letters of credit will be terminated prior to the expiration date, the letters will be automatically extended without amendment for additional one-year periods from the present or any future expiration date. Certain IPAs consolidated by the Company established irrevocable standby letters of credit with Preferred Bank under the APC Business Loan Agreement for a total of $ 3.9 million for the benefit of certain health plans as of September 30, 2024 . The standby letters of credit are automatically extended without amendment for additional one-year periods from the present or any future expiration date, unless notified by the institution in advance of the expiration date that the letter will be terminated.

Mezzanine and Stockholders' Equ

Mezzanine and Stockholders' Equity	9 Months Ended
	Sep. 30, 2024
Stockholders' Equity Note [Abstract]
Mezzanine and Stockholders' Equity	10. Mezzanine and Stockholders’ Equity Mezzanine Equity APC As the redemption feature of the APC shares is not solely within the control of APC, the equity of APC does not qualify as permanent equity and has been classified as non-controlling interests in APC as mezzanine or temporary equity. APC’s shares were not redeemable, and it was not probable that the shares would become redeemable as of September 30, 2024 and December 31, 2023 . Stockholders’ Equity As of September 30, 2024, 41,048 holdback shares have not been issued to certain former AHM shareholders who were AHM shareholders at the time of closing of the 2017 merger of Astrana with AHM, as they have yet to submit properly completed letters of transmittal to Astrana in order to receive their pro rata portion of Astrana common stock as contemplated under the 2017 merger agreement. Pending such receipt, such former AHM shareholders have the right to receive, without interest, their pro rata share of dividends or distributions with a record date after the effectiveness of the 2017 merger. The condensed consolidated financial statements have treated such shares of common stock as outstanding, given the receipt of the letter of transmittal is considered perfunctory, and the Company is legally obligated to issue these shares in connection with the 2017 merger. Preferred Stock – Series A and Series B In October 2015, AHM purchased from Astrana, in a private offering of securities, 1,111,111 units, each unit consisting of one share of Astrana’s Series A Convertible Preferred Stock (the “Series A Preferred Stock”), and a common stock warrant to purchase one share of Astrana’s common stock at an exercise price of $ 9.00 per share, which expired in October 2020. In March 2016, AHM purchased from Astrana, in a private offering of securities, 555,555 units, each unit consisting of one share of Astrana’s Series B Convertible Preferred Stock (the “Series B Preferred Stock”), and a common stock warrant to purchase one share of Astrana’s common stock at an exercise price of $ 10.00 per share, which expired in March 2021. In April 2024, the Company repurchased all outstanding shares of preferred stock held by AHM. On April 24, 2024, the Company filed a Certificate of Elimination to its Restated Certificate of Incorporation with the Secretary of State of the State of Delaware, eliminating from the Restated Certificate of Incorporation all matters set forth in the Amended and Restated Certificate of Designation with respect to the Company’s Series A Preferred Stock and Series B Preferred Stock and returning each of the Series A Preferred Stock and Series B Preferred Stock to the status of authorized and unissued shares of preferred stock of the Company, without designation as to series. As a result, there were no authorized or outstanding shares of the Series A Preferred Stock or Series B Preferred Stock as of September 30, 2024 . Treasury Stock As of September 30, 2024 and December 31, 2023, APC owned 7,132,698 shares of Astrana’s common stock. While such shares of Astrana’s common stock are legally issued and outstanding, they are treated as treasury shares for accounting purposes and excluded from shares of common stock outstanding in the condensed consolidated financial statements. APC’s ownership in Astrana was 13.00 % and 13.22 % as of September 30, 2024 and December 31, 2023, respectively. As of September 30, 2024 and December 31, 2023 , the Company had repurchased 3,466,051 and 3,451,642 shares, respectively, of its common stock. These are included as treasury stock. As of September 30, 2024 and December 31, 2023, the total treasury stock, including the Company’s stock held by APC, was 10,598,749 and 10,584,340 , respectively. Dividends During the three months ended September 30, 2024 and 2023, certain consolidated subsidiaries of the Company paid distributions of $ 0.2 million and $ 1.4 million , respectively, to the shareholders who own the non-controlling interests in the entities. During the nine months ended September 30, 2024 and 2023, certain consolidated subsidiaries of the Company paid distributions of $ 2.1 million and $ 1.6 million , respectively, to the shareholders who own the non-controlling interests in the entities.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2024
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	11. Stock-Based Compensation The following table summarizes the stock-based compensation expense recognized under all of the Company’s stock plans for the three and nine months ended September 30, 2024 and 2023, and associated with the issuance of restricted stock awards and units and vesting of stock options that are included in general and administrative expenses in the accompanying condensed consolidated statements of income (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Stock options and ESPP $ 349 $ 406 $ 1,125 $ 1,393 Restricted stock awards and units 5,814 5,300 18,176 11,971 Total stock-based compensation expense $ 6,163 $ 5,706 $ 19,301 $ 13,364 Unrecognized compensation expense related to total share-based payments outstanding as of September 30, 2024, was $ 31.7 million . Options The Company’s outstanding stock options consisted of the following: Shares Weighted Weighted Aggregate Options outstanding at January 1, 2024 504,241 $ 34.03 2.10 $ 4.7 Options granted — — — — Options exercised ( 75,455 ) 16.71 — 2.3 Options forfeited ( 7,271 ) 50.56 — — Options outstanding at September 30, 2024 421,515 $ 36.84 1.28 $ 10.9 Options exercisable at September 30, 2024 383,685 $ 30.06 1.10 $ 10.9 No options were granted during the three and nine months ended September 30, 2024. For the three and nine months ended September 30, 2024 , there were 75,455 options exercised from which the Company received cash proceeds of $ 0.2 million and from which 21,655 shares were withheld from issuance upon exercise of options in order to cover the cost of the exercise by the participants. During the nine months ended September 30, 2023, options were exercised for 125,000 shares of the Company’s common stock, resulting in proceeds of $ 1.3 million . There were no shares withheld from issuance upon exercise of options in order to cover the cost of the exercise by the participant during the three and nine months ended September 30, 2023. Restricted Stock Awards and Units The Company grants restricted stock awards and units to officers and employees, which are earned based on service and/or performance conditions. The grant date fair value of the restricted stock awards and units are the grant date’s closing market price of the Company’s common stock. During the nine months ended September 30, 2024, the Company granted 519,696 shares of restricted stock awards and units with performance-based conditions and 405,164 shares of restricted stock awards and units without performance-based conditions. During the nine months ended September 30, 2024, the weighted average grant date fair value of restricted stock awards and units with and without performance-based conditions was $ 43.01 and $ 41.31 , respectively. Employee Stock Purchase Plan (“ESPP”) The Company’s ESPP is a shareholder-approved plan that allows eligible employees to contribute a portion of their eligible earnings toward the semi-annual purchase of the Company’s common stock at a discounted price equal to 85 % up to 90 % of the fair market values of the stock on the exercise date, subject to a maximum number of shares that can be purchased during any single offering period as well as an annual maximum dollar amount of shares during any single calendar year. A maximum of 5,000,000 shares were authorized for issuance at the time the ESPP was approved. There were 7,789 shares issued for the nine months ended September 30, 2024 .

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	12. Commitments and Contingencies Regulatory Matters Laws and regulations governing the Medicare program and healthcare generally are complex and subject to interpretation. The Company believes it complies with all applicable laws and regulations and is unaware of any pending or threatened investigations involving allegations of potential wrongdoing. While no regulatory inquiries have been made, compliance with such laws and regulations can be subject to future government review and interpretation, as well as significant regulatory action, including fines, penalties, and exclusion from the Medicare and Medi-Cal programs. As a risk-bearing organization, the Company is required to follow regulations of the Department of Managed Health Care (“DMHC”). The Company must comply with a minimum working capital requirement, tangible net equity (“TNE”) requirement, cash-to-claims ratio, and claims payment requirements prescribed by the DMHC. TNE is defined as net assets less intangibles, less non-allowable assets (which include amounts due from affiliates), plus subordinated obligations. Many of the Company’s payer and provider contracts are complex in nature and may be subject to differing interpretations regarding amounts due for the provision of medical services. Such differing interpretations may not come to light until a substantial period of time has passed following contract implementation. Liabilities for claims disputes are recorded when the loss is probable and can be estimated. Any adjustments to reserves are reflected in current operations. Standby Letters of Credit The Company established irrevocable standby letters of credit with Truist Bank for a total of $ 25.0 million for the benefit of CMS and certain health plans as of September 30, 2024 (see Note 9 — “Credit Facility, Promissory Notes Payable, Bank Loans, and Lines of Credit — Standby Letters of Credit”). Certain IPAs consolidated by the Company established irrevocable standby letters of credit with Preferred Bank for a total of $ 3.9 million for the benefit of certain health plans as of September 30, 2024 (see Note 9 — “Credit Facility, Promissory Notes Payable, Bank Loans, and Lines of Credit — Standby Letters of Credit”). Litigation From time to time, the Company is involved in various legal proceedings and other matters arising in the normal course of its business. The resolution of any claim or litigation is subject to inherent uncertainty and could have a material adverse effect on the Company’s financial condition, cash flows, or results of operations. Liability Insurance The Company believes that its insurance coverage is appropriate based upon the Company’s claims experience and the nature and risks of the Company’s business. In addition to the known incidents that have resulted in the assertion of claims, the Company cannot be certain that its insurance coverage will be adequate to cover liabilities arising out of claims asserted against the Company, the Company’s affiliated professional organizations or the Company’s affiliated hospitalists in the future where the outcomes of such claims are unfavorable. The Company believes that the ultimate resolution of all pending claims, including liabilities in excess of the Company’s insurance coverage, will not have a material adverse effect on the Company’s financial position, results of operations, or cash flows; however, there can be no assurance that future claims will not have such a material adverse effect on the Company’s business. Contracted physicians are required to obtain their own insurance coverage. Although the Company currently maintains liability insurance policies on a claims-made basis which are intended to cover malpractice liability and certain other claims, the coverage must be renewed annually and may not continue to be available to the Company in future years at acceptable costs and on favorable terms.

Related-Party Transactions

Related-Party Transactions	9 Months Ended
	Sep. 30, 2024
Related Party Transactions [Abstract]
Related-Party Transactions	13. Related-Party Transactions Equity Method Investments During the three and nine months ended September 30, 2023, the Company recognized approximately $ 4.3 million and $ 16.2 million , respectively, in management fees from LaSalle Medical Associates – IPA line of business (“LMA”). On August 31, 2023, the management service agreement with LMA’s IPA was terminated. LMA is accounted for under the equity method based on the 25 % equity ownership interest held in LMA’s IPA line of business (see Note 5 — “Investments in Other Entities - Equity Method”). During the three months ended September 30, 2024 and 2023, the Company paid approximately $ 0.8 million and $ 0.8 million , respectively, to Pacific Medical Imaging & Oncology Center, Inc. (“PMIOC”) for provider services. During the nine months ended September 30, 2024 and 2023, the Company paid approximately $ 2.2 million and $ 1.9 million , respectively, to PMIOC for provider services. PMIOC provides covered services on behalf of the Company ’s RBOs to enrollees of the plans. PMIOC is accounted for under the equity method based on the 40 % equity ownership interest held (see Note 5 — “Investments in Other Entities - Equity Method”). During each of the three months ended September 30, 2024 and 2023, the Company paid approximately $ 0.3 million and $ 0.3 million , respectively, for provider services to an equity method investment in which the Company has a 25 % equity ownership in (see Note 5 — “Investments in Other Entities - Equity Method”). During the nine months ended September 30, 2024 and 2023, the Company paid approximately $ 0.7 million and $ 0.8 million , respectively, for provider services. During the three and nine months ended September 30, 2024, the Company incurred expenses of approximately $ 0.6 million and $ 1.2 million , respectively, in management fees to I Health. The Company has a management service agreement with I Health. I Health is accounted for under the equity method based on the 25 % equity ownership interest held (see Note 5 — “Investments in Other Entities - Equity Method”). Astrana Board Members and Officers During the three months ended September 30, 2024 and 2023, the Company recognized approximately $ 0.4 million and $ 0.5 million , respectively, in revenue, net of costs, from Arroyo Vista Family Health Center (“Arroyo Vista”). During the nine months ended September 30, 2024 and 2023, the Company recognized approximately $ 1.5 million and $ 1.3 million , respectively, in revenue, net of costs. Revenue consisted of management fees and surplus from shared risk arrangements. Expenses consisted of fees for provider services. Arroyo Vista’s chief executive officer is a member of the Company’s board of directors. During the three months ended September 30, 2024 and 2023, the Company incurred rent expenses of approximately $ 1.3 million and $ 0.8 million , respectively, from certain properties that are managed by Allied Pacific Holdings Investment Management, LLC. During the nine months ended September 30, 2024 and 2023, the Company incurred $ 3.0 million and $ 2.5 million , respectively, in rent expense from the same properties. As of September 30, 2024, and December 31, 2023, the Company’s operating right-of-use asset balance included $ 2.0 million and $ 14.1 million , respectively, and the Company’s operating lease liabilities included $ 2.0 million and $ 14.5 million , respectively, for certain properties that are managed by Allied Pacific Holdings Investment Management, LLC. These properties were previously consolidated and eliminated by Astrana until they were spun off on December 26, 2023. The chief executive officer of Allied Pacific Holdings Investment Management, LLC is a member of the Company’s board of directors. During the nine months ended September 30, 2024, Allied Pacific Holdings Investment Management, LLC paid APC $ 5.3 million for taxes associated with the APC Excluded Assets spin-off on December 26, 2023. During the three months ended September 30, 2024 and 2023, the Company incurred approximately $ 0.4 million and $ 0.5 million , respectively, in expenses payable to Third Way Health for call center and credentialing services. During the nine months ended September 30, 2024 and 2023, the Company incurred approximately $ 2.1 million and $ 0.9 million , respectively, in expenses for call center services. As of September 30, 2024 and December 31, 2023 , via a Simple Agreement for Future Equity, the Company funded $ 6.0 million and $ 3.5 million, respectively, in Third Way Health. The investment is included in investments in privately held entities in the accompanying condensed consolidated balance sheets. One of Astrana’s officers is a board member of Third Way Health. During the three months ended September 30, 2024 and 2023, the Company paid approximately $ 0.1 million and $ 0.2 million , respectively, to Sunny Village Care Center for services as a provider. During the nine months ended September 30, 2024 and 2023, the Company paid approximately $ 0.3 million and $ 1.0 million , respectively, for provider services. The Company has provider contracts with Sunny Village Care Center. Sunny Village Care Center shares common ownership with certain Astrana board members. During the three and nine months ended September 30, 2024 , Astrana paid approximately $ 0.7 million to purchase Astrana’s stock from a board member. During the nine months ended September 30, 2023 , Astrana paid approximately $ 9.5 million to purchase Astrana’s stock from a board member. During the three months ended September 30, 2024 and 2023, the Company incurred rent expenses of approximately $ 0.1 million and $ 0.1 million , respectively, from First Commonwealth Property, LLC for an office lease. During the nine months ended September 30, 2024 and 2023, the Company incurred rent expenses of approximately $ 0.1 million and $ 0.1 million , respectively. First Commonwealth Property, LLC shares common ownership with certain board members of APC and AHM. As of September 30, 2024 and December 31, 2023, the Company’s operating right-of-use asset balance included $ 0.7 million and $ 0.8 million , respectively, and the Company’s operating lease liabilities included $ 0.8 million and $ 0.8 million , respectively, for certain properties owned by First Commonwealth Property, LLC. The Company has agreements with Health Source MSO Inc., a California corporation (“HSMSO”), Aurion Corporation (“Aurion”), and AHMC Healthcare Inc. (“AHMC”) for services provided to the Company. One of the Company’s board members is an officer of AHMC, HSMSO, and Aurion. Aurion is also partially owned by one of the Company’s board members. Revenue with AHMC and HSMSO consists of capitation, risk pool, and miscellaneous fees and expenses consisting of claims expenses, management fees, and consulting fees. The following tables set forth revenue recognized and fees incurred related to AHMC, HSMSO, and Aurion for the three and nine months ended September 30, 2024 and 2023 (in thousands): Three Months Ended September 30, 2024 Three Months Ended September 30, 2023 AHMC HSMSO Aurion AHMC HSMSO Aurion Revenue $ 11,167 $ 626 $ — $ 5,619 $ 326 $ — Expenses 9,169 — 50 6,445 ( 200 ) 75 Net $ 1,998 $ 626 $ ( 50 ) $ ( 826 ) $ 526 $ ( 75 ) Nine Months Ended September 30, 2024 Nine Months Ended September 30, 2023 AHMC HSMSO Aurion AHMC HSMSO Aurion Revenue $ 33,944 $ 1,239 $ — $ 37,337 $ 950 $ — Expenses 24,134 — 200 18,505 35 225 Net $ 9,810 $ 1,239 $ ( 200 ) $ 18,832 $ 915 $ ( 225 ) The Company and AHMC have a risk-sharing agreement with certain AHMC hospitals to share the surplus and deficits of each of the hospital pools. Under this agreement, during the three months ended September 30, 2024 and 2023, the Company had recognized risk pool revenues of $ 9.4 million and $ 4.2 million , respectively. During the nine months ended September 30, 2024 and 2023, the Company had recognized risk pool revenues of $ 28.5 million and $ 33.0 million , respectively. The Company had a risk pool receivable balance of $ 74.7 million and $ 54.0 million as of September 30, 2024 and December 31, 2023 , respectively. APC Board Members During the three months ended September 30, 2024 and 2023, the Company paid an aggregate of approximately $ 4.6 million and $ 11.6 million , respectively, to board members for provider services which included approximately $ 0.8 million and $ 0.7 million , respectively, to Astrana board members and officers who are also board members and officers of APC. During the nine months ended September 30, 2024 and 2023, the Company paid an aggregate of approximately $ 14.1 million and $ 30.5 million , respectively, to board members for provider services which included approximately $ 2.2 million and $ 2.3 million , respectively, to Astrana board members and officers who are also board members and officers of APC. In addition, affiliates wholly owned by the Company’s key personnel are reported in the accompanying condensed consolidated statements of income on a consolidated basis, together with the Company’s subsidiaries, and therefore, the Company does not separately disclose transactions between such affiliates and the Company’s subsidiaries as related-party transactions. Intercompany Transactions Because of corporate practice of medicine laws, the Company uses designated shareholder professional corporations, of which the sole shareholder is a member of the Company’s key personnel, to engage in certain transactions and make intercompany loans from time to time. For equity method investments, see Note 5 — “Investment in Other Entities - Equity Method”.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2024
Income Tax Disclosure [Abstract]
Income Taxes	14. Income Taxes The Company uses the liability method of accounting for income taxes as set forth in ASC 740 Income Taxes. Under the liability method, deferred taxes are determined based on differences between the financial statement and tax bases of assets and liabilities using enacted tax rates. On an interim basis, the Company estimates what its anticipated annual effective tax rate will be and records a quarterly income tax provision in accordance with the estimated annual rate, plus the tax effect of certain discrete items that arise during the quarter. As the fiscal year progresses, the Company refines its estimates based on actual events and financial results during the quarter. This process can result in significant changes to the Company’s estimated effective tax rate. When this occurs, the income tax provision is adjusted during the quarter in which the estimates are refined so that the year-to-date provision reflects the estimated annual effective tax rate. These changes, along with adjustments to the Company’s deferred taxes and related valuation allowance, may create fluctuations in the overall effective tax rate from quarter to quarter. The Company’s effective income tax rate for the nine months ended September 30, 2024 and 2023, was 30.2 % and 34.8 % , respectively. The tax rate for the nine months ended September 30, 2024, differed from the U.S. federal statutory rate primarily due to state income taxes and income from flow-through entities. As of September 30, 2024, the Company does no t have any unrecognized tax benefits related to various federal and state income tax matters. The Company will recognize accrued interest and penalties related to unrecognized tax benefits in income tax expense. The Company is subject to U.S. federal income tax as well as income tax in California. The Company and its subsidiaries’ state and federal income tax returns are open to audit under the statute of limitations for the years ended December 31, 2019 through December 31, 2023, and for the years ended December 31, 2020 through December 31, 2023 , respectively.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Earnings Per Share	15. Earnings Per Share Basic earnings per share is calculated using the weighted average number of shares of the Company’s common stock issued and outstanding during a certain period and is calculated by dividing net income attributable to Astrana by the weighted average number of shares of the Company’s common stock issued and outstanding during such period. Diluted earnings per share is calculated using the weighted average number of shares of common stock and potentially dilutive shares of common stock outstanding during the period, using the as-if converted method for secured convertible notes and preferred stock, and the treasury stock method for options and common stock warrants. As of September 30, 2024 and December 31, 2023 , APC held 7,132,698 shares of Astrana’s common stock, which are treated as treasury shares for accounting purposes and not included in the number of shares of common stock outstanding used to calculate earnings per share. For the three and nine months ended September 30, 2024 , there were no restricted stock awards and units excluded from the computation of diluted weighted average common shares outstanding as calculated under the treasury stock method. For the three and nine months ended September 30, 2023, 243,689 of restricted stock awards and units were excluded from the computation of diluted weighted average common shares outstanding because the assumed proceeds, as calculated under the treasury stock method, resulted in these awards being antidilutive. For the three and nine months ended September 30, 2024, stock options of 155,990 were excluded from the computation of diluted weighted average common shares outstanding because the assumed proceeds, as calculated under the treasury stock method, resulted in these awards being antidilutive. For the three and nine months ended September 30, 2023, stock options of 200,978 were excluded from the computation of diluted weighted average common shares outstanding because the assumed proceeds, as calculated under the treasury stock method, resulted in these awards being antidilutive. For the three and nine months ended September 30, 2024, contingently issuable shares of 1,085,808 were excluded from the computation of diluted weighted average common shares outstanding because these conditions were not achieved as of September 30, 2024. For the three and nine months ended September 30, 2023 , contingently issuable shares of 925,558 were excluded from the computation of diluted weighted average common shares outstanding because these conditions were not achieved as of September 30, 2023. Below is a summary of the earnings per share computations: Three months ended September 30, 2024 2023 Earnings per share – basic $ 0.34 $ 0.47 Earnings per share – diluted $ 0.33 $ 0.47 Weighted average shares of common stock outstanding – basic 47,686,841 46,547,502 Weighted average shares of common stock outstanding – diluted 48,223,788 46,920,607 Nine months ended September 30, 2024 2023 Earnings per share – basic $ 1.05 $ 1.04 Earnings per share – diluted $ 1.04 $ 1.03 Weighted average shares of common stock outstanding – basic 47,521,368 46,527,350 Weighted average shares of common stock outstanding – diluted 47,960,686 46,881,567 Below is a summary of the shares included in the diluted earnings per share computations: Three months ended September 30, 2024 2023 Weighted average shares of common stock outstanding – basic 47,686,841 46,547,502 Stock options 169,785 253,767 Restricted stock awards and units 321,348 88,450 Contingently issuable shares 45,814 30,888 Weighted average shares of common stock outstanding – diluted 48,223,788 46,920,607 Nine months ended September 30, 2024 2023 Weighted average shares of common stock outstanding – basic 47,521,368 46,527,350 Stock options 155,309 254,399 Restricted stock awards and units 243,806 89,409 Contingently issuable shares 40,203 10,409 Weighted average shares of common stock outstanding – diluted 47,960,686 46,881,567

Variable Interest Entities (VIE

Variable Interest Entities (VIEs)	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Variable Interest Entities (VIEs)	16. Variable Interest Entities (VIEs) The Company’s condensed consolidated financial statements include its subsidiaries and consolidated VIEs. A VIE is defined as a legal entity whose equity owners do not have sufficient equity at risk, or, as a group, the holders of the equity investment at risk lack any of the following three characteristics: decision-making rights, the obligation to absorb losses, or the right to receive the expected residual returns of the entity. The primary beneficiary is identified as the variable interest holder that has both the power to direct the activities of the VIE that most significantly affect the entity’s economic performance and the obligation to absorb expected losses or the right to receive benefits from the entity that could potentially be significant to the VIE. Certain state laws prohibit a professional corporation that has more than one shareholder from being a shareholder in another professional corporation. As a result, the Company cannot directly own shares in other professional corporations. However, an exception to this regulation permits a professional corporation that has only one shareholder to own shares in another professional corporation. In reliance on this exception, the Company designated certain key personnel as the nominee shareholders of professional corporations that hold controlling and non-controlling ownership interests in several medical corporations. Via a Physician Shareholder Agreement with the nominee shareholder, the Company has the ability to designate another person to be the equity holder of the professional corporation. In addition, these entities are managed by the Company’s wholly owned MSOs via MSA. In accordance with relevant accounting guidance, the professional corporations and their consolidated medical corporations are consolidated by the Company in the accompanying condensed financial statements. Due to corporate practice of medicine laws, the Company operates by maintaining long-term MSAs with its affiliated IPAs and medical groups, each of which is owned and operated by physicians only, and employs or contracts with additional physicians to provide medical services. AHM is a wholly owned subsidiary of the Company and has entered into MSAs with several affiliated IPAs, including APC. APC arranges for the delivery of healthcare services by contracting with physicians or professional medical corporations for primary care and specialty care services. The physicians in the IPA are exclusively in control of, and responsible for, all aspects of the practice of medicine for enrolled patients. In accordance with relevant accounting guidance, APC has been determined to be a VIE of AHM, as AHM is its primary beneficiary with the ability, through majority representation on the APC Joint Planning Board and otherwise, to direct the activities (excluding clinical decisions) that most significantly affect APC’s economic performance. Therefore, APC and its wholly owned subsidiaries and VIEs are consolidated in the accompanying financial statements. Astrana Medical and Astrana Care Partners Medical were formed in May 2019 and July 2021, respectively, as designated shareholder professional corporations. The Company’s Vice Chairman is the sole shareholder of Astrana Medical and Astrana Care Partners Medical. Via a Physician Shareholder Agreement, Astrana makes all the decisions on behalf of Astrana Medical and Astrana Care Partners Medical. Astrana has the obligation to absorb losses of, or the right to receive benefits from, Astrana Medical and Astrana Care Partners Medical. Therefore, Astrana Medical and Astrana Care Partners Medical are controlled by and consolidated by Astrana as the primary beneficiary of the VIEs. On January 1, 2024, a 25 % equity interest of Eleanor Leung M.D. was re-acquired by the Company. As a result, Astrana Care Partners Medical now owns 100 % of Eleanor Leung M.D. The following table includes assets that can only be used to settle the liabilities of the Company’s VIEs, and to which the creditors of Astrana have no recourse, and liabilities to which the creditors of the Company’s VIEs have no recourse to the general credit of Astrana, as the primary beneficiary of the VIEs. These assets and liabilities, with the exception of investments in affiliates and amounts due to, or from, affiliates, which are eliminated upon consolida tion, are included in the accompanying condensed consolidated balance sheets (in thousands). September 30, 2024 December 31, 2023 Assets Current assets Cash and cash equivalents $ 181,340 $ 184,078 Investment in marketable securities 2,233 — Receivables, net 54,356 21,120 Receivables, net – related party 76,010 58,707 Income taxes receivable — 1,600 Other receivables 385 454 Prepaid expenses and other current assets 9,763 9,991 Total current assets 324,087 275,950 Non-current assets Land, property and equipment, net 5,619 5,306 Intangible assets, net 82,264 60,906 Goodwill 235,638 140,157 Income taxes receivable, non-current 15,943 15,943 Investments in other entities – equity method 14,338 12,114 Investment in affiliates* 413,269 273,182 Investment in a privately held entity 405 405 Restricted cash 40 40 Operating lease right-of-use assets 21,648 28,796 Other assets 1,147 1,149 Total non-current assets 790,311 537,998 Total assets $ 1,114,398 $ 813,948 Current liabilities Accounts payable and accrued expenses $ 41,416 $ 32,707 Fiduciary accounts payable 6,041 7,737 Medical liabilities 75,648 55,157 Dividend payable 638 638 Income tax payable 26,105 — Finance lease liabilities 520 646 Operating lease liabilities 3,434 3,305 Amount due to affiliates* 76,294 107,340 Other liabilities 11,139 8,542 Total current liabilities 241,235 216,072 Non-current liabilities Finance lease liabilities, net of current portion 649 1,033 Operating lease liabilities, net of current portion 21,054 28,675 Deferred tax liability 7,198 7,284 Other long-term liabilities 299 230 Total non-current liabilities 29,200 37,222 Total liabilities $ 270,435 $ 253,294 *Investment in affiliates includes the Company’s VIEs’ investment in Astrana, which is reflected as treasury shares and eliminated upon consolidation. Amounts due to, or from, affiliates are receivables with Astrana’s subsidiaries. As a result, these balances are eliminated upon consolidation and are not reflected on Astrana’s condensed consolidated balance sheets as of September 30, 2024 and December 31, 2023 .

Leases

Leases	9 Months Ended
	Sep. 30, 2024
Leases [Abstract]
Leases	17. Leases The Company has operating and finance leases for corporate offices, physicians’ offices, and certain equipment. These leases have remaining lease terms of one month to 16 years. Some of the leases may include options to extend the lease terms for up to ten years , and some of the leases may include options to terminate the leases within one year . As of September 30, 2024 and December 31, 2023, assets recorded under finance leases were $ 1.4 million and $ 1.7 million , respectively, and accumulated depreciation associated with finance leases was $ 2.0 million and $ 1.6 million , respectively. Also, the Company rents or subleases certain real estate to third parties, which are accounted for as operating leases. Leases with an initial term of 12 months or less are not recorded on the balance sheets. The components of lease expense were as follows (dollars in thousands): Three Months Ended September 30, 2024 2023 Operating lease cost $ 3,205 $ 2,187 Finance lease cost Amortization of lease expense 172 202 Interest on lease liabilities 20 35 Sublease income ( 3 ) ( 307 ) Total lease cost, net $ 3,394 $ 2,117 Nine Months Ended September 30, 2024 2023 Operating lease cost $ 9,438 $ 5,570 Finance lease cost Amortization of lease expense 534 505 Interest on lease liabilities 66 80 Sublease income ( 246 ) ( 806 ) Total lease cost, net $ 9,792 $ 5,349 Other information related to leases was as follows (in thousands): Three Months Ended September 30, 2024 2023 Supplemental Cash Flow Information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 3,089 $ 2,016 Operating cash flows from finance leases 20 35 Financing cash flows from finance leases 172 202 Nine Months Ended September 30, 2024 2023 Supplemental Cash Flow Information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 8,684 $ 5,636 Operating cash flows from finance leases 66 80 Financing cash flows from finance leases 534 505 Nine Months Ended September 30, 2024 2023 Weighted Average Remaining Lease Term Operating leases 6.93 years 6.84 years Finance leases 2.69 years 3.18 years Weighted Average Discount Rate Operating leases 6.68 % 5.75 % Finance leases 5.70 % 5.19 % The following are future minimum lease payments under non-cancellable leases for the years ending December 31 (in thousands) below: Operating Finance 2024 (excluding the nine months ended September 30, 2024) $ 1,855 $ 160 2025 7,523 599 2026 7,213 345 2027 6,729 267 2028 6,472 27 Thereafter 16,902 9 Total future minimum lease payments 46,694 1,407 Less: imputed interest 10,291 110 Total lease liabilities 36,403 1,297 Less: current portion 5,241 554 Long-term lease liabilities $ 31,162 $ 743

Segments

Segments	9 Months Ended
	Sep. 30, 2024
Segment Reporting [Abstract]
Segments	18. Segments The Company evaluates the performance of its operating segments based on segment revenue growth as well as operating income. Management uses revenue growth and total segment operating income as a measure of the performance of operating businesses separate from non-operating factors. The Company’s operations are based in the United States. All revenues of the Company are derived from the United States. The Company’s segments are not evaluated using asset information. In the normal course of business, the Company’s reportable segments enter into transactions with each other. While intersegment transactions are treated like third-party transactions to determine segment performance, the revenues recognized by a segment and expenses incurred by the counterparty are eliminated in consolidation and do not affect consolidated results. Corporate costs are unallocated and primarily include corporate initiatives, corporate infrastructure costs and corporate shared costs, such as finance, human resources, legal, and executives. Certain amounts disclosed in the prior period have been recast to conform to the current period presentation. Specifically, reclassifications were made between cost of services and general and administrative expenses in the accompanying segment table for the three and nine months ended September 30, 2023, and the segments are presented net of intrasegment eliminations. The following table presents information about our segments (in thousands): Three Months Ended September 30, 2024 Care Care Care Other Intersegment Corporate Consolidated Third-Party $ 455,760 $ 20,083 $ 2,867 $ — $ — $ — $ 478,710 Intersegment — 14,645 38,063 — ( 52,708 ) — — Total revenues 455,760 34,728 40,930 — ( 52,708 ) — 478,710 Cost of services 369,835 29,114 19,604 — ( 13,335 ) — 405,218 General and administrative (1) 47,139 6,971 15,012 — ( 39,370 ) 15,315 45,067 Total expenses 416,974 36,085 34,616 — ( 52,705 ) 15,315 450,285 Income (loss) from operations $ 38,786 $ ( 1,357 ) $ 6,314 $ — $ ( 3 ) (2) $ ( 15,315 ) $ 28,425 Three Months Ended September 30, 2023 Care Care Care Other Intersegment Corporate Consolidated Third-Party $ 320,885 $ 16,737 $ 10,306 $ 245 $ — $ — $ 348,173 Intersegment — 12,234 26,604 49 ( 38,887 ) — — Total revenues 320,885 28,971 36,910 294 ( 38,887 ) — 348,173 Cost of services 249,917 23,060 13,658 76 ( 11,336 ) — 275,375 General and administrative (1) 30,628 6,946 16,804 875 ( 28,621 ) 7,083 33,715 Total expenses 280,545 30,006 30,462 951 ( 39,957 ) 7,083 309,090 Income (loss) from operations $ 40,340 $ ( 1,035 ) $ 6,448 $ ( 657 ) $ 1,070 (2) $ ( 7,083 ) $ 39,083 Nine Months Ended September 30, 2024 Care Care Care Other Intersegment Corporate Consolidated Third-Party $ 1,301,355 $ 59,179 $ 8,797 $ — $ — $ — $ 1,369,331 Intersegment — 41,125 101,579 — ( 142,704 ) — — Total revenues 1,301,355 100,304 110,376 — ( 142,704 ) — 1,369,331 Cost of services 1,049,437 80,160 56,916 — ( 38,091 ) — 1,148,422 General and administrative (1) 129,613 19,914 36,724 — ( 104,692 ) 50,720 132,279 Total expenses 1,179,050 100,074 93,640 — ( 142,783 ) 50,720 1,280,701 Income (loss) from operations $ 122,305 $ 230 $ 16,736 $ — $ 79 (2) $ ( 50,720 ) $ 88,630 Nine Months Ended September 30, 2023 Care Care Care Other Intersegment Corporate Consolidated Third-Party $ 957,297 $ 42,603 $ 33,164 $ 561 $ — $ — $ 1,033,625 Intersegment — 37,228 69,287 131 ( 106,646 ) — — Total revenues 957,297 79,831 102,451 692 ( 106,646 ) — 1,033,625 Cost of services 783,333 65,187 44,441 209 ( 35,522 ) — 857,648 General and administrative (1) 83,475 16,076 38,181 2,459 ( 74,401 ) 21,704 87,494 Total expenses 866,808 81,263 82,622 2,668 ( 109,923 ) 21,704 945,142 Income (loss) from operations $ 90,489 $ ( 1,432 ) $ 19,829 $ ( 1,976 ) $ 3,277 (2) $ ( 21,704 ) $ 88,483 (1) Balance includes general and administrative expenses, and depreciation and amortization. (2) Income from operations for the intersegment elimination represents rental income from segments renting from other segments. Rental income is presented within other income that is not presented in the table.

Fair Value Measurements of Fina

Fair Value Measurements of Financial Instruments	9 Months Ended
	Sep. 30, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements of Financial Instruments	19. Fair Value Measurements of Financial Instruments The carrying amounts and fair values of the Company’s financial instruments as of September 30, 2024, are presented below (in thousands): Fair Value Measurements Level 1 Level 2 Level 3 Total Assets Money market accounts* $ 28,044 $ — $ — $ 28,044 Marketable securities – certificates of deposit 2,263 — — 2,263 Marketable securities – equity securities 91 — — 91 I Health call option — — 3,907 3,907 Total assets $ 30,398 $ — $ 3,907 $ 34,305 Liabilities Interest rate collar $ — $ 154 $ — $ 154 AAMG contingent consideration — — 3,876 3,876 VOMG contingent consideration — — 15 15 DMG remaining equity interest purchase — — 8,542 8,542 Sun Labs remaining equity interest purchase — — 7,352 7,352 ADSC contingent considerations — — 4,138 4,138 CFC contingent considerations — — 9,138 9,138 PCCCV contingent considerations — — 2,597 2,597 Total liabilities $ — $ 154 $ 35,658 $ 35,812 * Included in cash and cash equivalents The carrying amounts and fair values of the Company’s financial instruments as of December 31, 2023, are presented below (in thousands): Fair Value Measurements Level 1 Level 2 Level 3 Total Assets Money market accounts* $ 4,842 $ — $ — $ 4,842 Marketable securities – certificates of deposit 2,150 — — 2,150 Marketable securities – equity securities 348 — — 348 Total assets $ 7,340 $ — $ — $ 7,340 Liabilities AAMG contingent consideration $ — $ — $ 5,475 $ 5,475 VOMG contingent consideration — — 17 17 DMG remaining equity interest purchase — — 8,542 8,542 Sun Labs remaining equity interest purchase — — 7,802 7,802 Interest rate collar — 252 — 252 Total liabilities $ — $ 252 $ 21,836 $ 22,088 * Included in cash and cash equivalents The change in the fair value of Level 3 liabilities for the nine months ended September 30, 2024, was as follows (in thousands): Amount Balance at January 1, 2024 $ 21,836 Additions 14,202 Change in fair value of existing Level 3 liabilities 3,643 Settlements ( 4,023 ) Balance at September 30, 2024 $ 35,658 Investments in Marketable Securities Certificates of deposit are reported at par value, plus accrued interest, with maturity dates greater than ninety days . As of September 30, 2024 and December 31, 2023, certificates of deposit amounted to approximately $ 2.3 million and $ 2.2 million , respectively. Investments in certificates of deposit are classified as Level 1 investments in the fair value hierarchy. Equity securities are reported at fair value. These securities are classified as Level 1 in the valuation hierarchy, where quoted market prices from reputable third-party brokers are available in an active market and unadjusted. As of September 30, 2024 and December 31, 2023, the equity securities were approximately $ 0.1 million and $ 0.3 million , respectively, in the accompanying condensed consolidated balance sheets. Gains and losses recognized on equity securities sold are recognized in the accompanying condensed consolidated statements of income as other income. The components comprising total gains and losses on equity securities are as follows (in thousands) for the periods listed below: Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Total gains (losses) recognized on equity securities $ 68 $ ( 870 ) $ ( 133 ) $ ( 6,571 ) Gains (losses) recognized on equity securities sold 65 — ( 146 ) — Unrealized gains (losses) recognized on equity securities held at end of period $ 3 $ ( 870 ) $ 13 $ ( 6,571 ) Derivative Financial Instruments Interest Rate Collar Agreements The Company’s collar agreement is designed to limit the interest rate risk associated with the Company’s Revolver Loan. The principal objective of the collar agreement is to eliminate or reduce the variability of the cash flows in interest payments associated with the Company’s floating-rate debt, thus reducing the impact of interest rate changes on future interest payment cash flows. Refer to Note 9 — “Credit Facility, Promissory Notes Payable, Bank Loans, and Lines of Credit” for further information on the Company’s debt. Under the terms of the agreement, the ceiling is 5.0 % and the floor is 2.34 %. The collar agreement is not designated as a hedging instrument. Changes in the fair value of this contract are recognized as unrealized gain or loss on investments in the accompanying condensed consolidated statements of income and reflected in the accompanying condensed consolidated statements of cash flows as unrealized (gain) loss on investments. The estimated fair value of the collar was determined using Level 2. As of September 30, 2024 and December 31, 2023, the fair value of the collar was $ 0.2 million and $ 0.3 million , respectively, and presented within other long-term liabilities, in the accompanying condensed consolidated balance sheets. For the three months ended September 30, 2024 and 2023, the Company recognized unrealized loss of $ 0.6 million and unrealized gains of $ 0.1 million , respectively. For the nine months ended September 30, 2024 and 2023, the Company recognized unrealized gains of $ 0.1 million and $ 1.3 million , respectively. I Health Call Option The Company acquired a 25 % equity interest in I Health which included a call option that allows the Company to purchase an additional 25 % equity interest on each of the first, second, and third anniversaries of the purchase. The Company determined the fair value of the contingent considerations using a probability-weighted model that includes significant unobservable inputs (Level 3). Specifically, the Company considered various scenarios of revenue and assigned probabilities to each such scenario in determining fair value. As of September 30, 2024, the value of the call option was valued at $ 3.9 million . The I Health call option is presented within other assets in the accompanying condensed consolidated balance sheet. The 25 % equity interest in I Health is accounted for under the equity method (see Note 5 — “Investments in Other Entities - Equity Method”). Remaining equity interest purchase In 2021, the Company entered into a financing obligation to purchase the remaining equity interest in Diagnostic Medical Group of Southern California (“DMG”) and Sun Clinical Laboratories (“Sun Labs”) within three years from the date the Company consolidated DMG and Sun Labs. The purchase of the remaining DMG equity value is considered a financing obligation with a carrying value of $ 8.5 million as of September 30, 2024 and December 31, 2023. Changes in the fair value of the remaining equity purchase are presented in unrealized gain and loss on investments in the accompanying condensed consolidated statements of income. The purchase of the remaining Sun Labs equity value is considered a financing obligation with a carrying value of $ 7.4 million and $ 7.8 million as of September 30, 2024 and December 31, 2023, respectively. For the three months ended September 30, 2024 and 2023, the Company recognized a loss of $ 0.1 million and $ 0.5 million , respectively, due to the change in the fair value of Sun Labs equity value obligation. For the nine months ended September 30, 2024 and 2023, the Company recognized an unrealized gain of $ 0.4 million and unrealized loss of $ 2.3 million , respectively, due to the change in the fair value of Sun Labs equity value obligation. As the financing obligations are embedded in the non-controlling interest, the non-controlling interests are recognized in other liabilities in the accompanying condensed consolidated balance sheets. Contingent considerations All American Medical Group (“ AAMG”) Upon acquiring 100 % of the equity interest in AAMG, the purchase price consisted of cash funded upon close of the transaction and additional consideration (“AAMG contingent consideration”) and stock consideration (“AAMG stock contingent consideration”) contingent on AAMG meeting revenue and capitated member metrics for fiscal years 2023 (“2023 metric”) and 2024 (“2024 metric”). If the contingent consideration metrics are met, the settlement will be paid in the Company’s common stock. The total amount of stock that can be issued for the 2023 and 2024 metrics is 157,059 and 184,357 , respectively. The Company determined the fair value of the contingent considerations using a probability-weighted model that includes significant unobservable inputs (Level 3). Specifically, the Company considered various scenarios of revenue and assigned probabilities to each such scenario in determining fair value. As of September 30, 2024, the AAMG contingent consideration for the 2023 metric was met and 78,535 shares were issued to the sellers. On the day of issuance, the shares were valued at $ 4.0 million . which is included in additional paid-in capital in the accompanying condensed consolidated balance sheets. As of December 31, 2023, the AAMG contingent consideration for the 2023 metric was valued at $ 2.6 million and was presented within other liabilities in the accompanying condensed consolidated balance sheets. The AAMG contingent consideration for the 2024 metric was valued at $ 3.9 million and $ 2.9 million as of September 30, 2024 and December 31, 2023, respectively, and was included in other liabilities and other long-term liabilities in the accompanying condensed consolidated balance sheets, respectively. Changes in the AAMG contingent consideration are presented in general and administrative expenses in the accompanying condensed consolidated statements of income. As of September 30, 2024 , the AAMG stock contingent consideration for 2023 metric was met, and 78,524 shares were issued to the sellers. The AAMG stock contingent consideration for 2023 and 2024 metric was valued at $ 5.6 million , in aggregate, as of September 30, 2024 and December 31, 2023 , and is included in additional paid-in capital in the accompanying condensed consolidated balance sheets. ADSC Upon acquiring 95 % of the equity interest of Advanced Diagnostic and Surgical Center in 2024, the total consideration of the acquisition included contingent consideration. The contingent consideration will be settled in cash contingent on ADSC achieving revenue and EBITDA metrics for fiscal years 2023 (“ADSC 2023 Metric”) and 2024 (“ADSC 2024 Metric”) (collectively, “ADSC contingent considerations”). The Company determined the fair value of the contingent consideration using a probability-weighted model that includes significant unobservable inputs (Level 3). Specifically, the Company considered various scenarios of revenue and assigned probabilities to each such scenario in determining fair value. As of September 30, 2024, the ADSC 2023 Metric and the 2024 Metric were valued at $ 2.1 million and $ 2.1 million, re spectively, and were included in other liabilities in the accompanying condensed consolidated balance sheets. Changes in the ADSC contingent considerations are presented in general and administrative expenses in the accompanying condensed consolidated statements of income. CFC Upon acquiring certain assets of CFC in 2024, the total consideration of the acquisition included contingent consideration. The contingent consideration will be settled in cash contingent upon CFC maintaining or exceeding the target member month amount for the first, second, and third measurement period (“CFC contingent considerations”). The first measurement period means the period commencing on the first day of the month immediately following the close of AHMS and ending on the one-year anniversary thereof. The second measurement period is for one year after the first measurement period, and the third measurement period is for one year after the second measurement period. The contingent liability will be paid after achieving the metric in each measurement period. The Company will pay $ 5.0 million for each metric achieved for each measurement period, or a total of $ 15.0 million. In the event that the CFC first and/or second contingent consideration metrics are not achieved during the first and/or the second measurement period, if the metric is met within the second and/or third measurement period, there is a catch-up payment that shall be paid concurrently with the payments of the CFC second contingent consideration and/or CFC third contingent consideration. The Company determined the fair value of the contingent consideration using a probability-weighted model that includes significant unobservable inputs (Level 3). Specifically, the Company considered various scenarios of revenue and assigned probabilities to each such scenario in determining fair value. As of September 30, 2024, the first metric was valued at $ 3.7 million and was included in other liabilities in the accompanying condensed consolidated balance sheets. As of September 30, 2024 , the second and third metrics were valued at $ 5.4 million in aggregate, and were included in other long-term liabilities in the accompanying condensed consolidated balance sheets. Changes in the CFC contingent considerations are presented in general and administrative expenses in the accompanying condensed consolidated statements of income. PCCCV Upon acquiring certain assets of PCCCV in 2024, the total consideration of the acquisition included contingent consideration. The contingent consideration will be settled in cash, contingent upon PCCCV meeting certain metrics related to financial ratios and member months for the first and second measurement periods (“PCCCV contingent consideration”). The first measurement period is the first day of the month immediately following the close and ending on June 30, 2024. The second measurement period is for one year after the first measurement period. The Company determined the fair value of the contingent consideration using a probability-weighted model that includes significant unobservable inputs (Level 3). Specifically, the Company considered various scenarios of revenue and assigned probabilities to each such scenario in determining fair value. As of September 30, 2024, the value of the contingent consideration was valued at $ 2.6 million . Changes in the PCCCV contingent considerations are presented in general and administrative expenses in the accompanying condensed consolidated statements of income.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2024
Subsequent Events [Abstract]
Subsequent Events	20. Subsequent Events Closing of Collaborative Health Systems, LLC Securities Purchase On July 24, 2024, the Company and its affiliated professional entity entered into a definitive agreement to acquire all of the outstanding membership interest relating to Collaborative Health Systems, LLC (“CHS”), Golden Triangle Physician Alliance, and Heritage Physician Networks, for an aggregate purchase price of $ 37.5 million, subject to customary adjustments, plus earnout payments in an aggregate amount of up to $ 21.5 million. On October 4, 2024, the Company closed the acquisition of all of the outstanding membership interest in Collaborative Health Systems, LLC and all of the outstanding equity interests in Golden Triangle Physician Alliance and Heritage Physician Networks . The transaction was funded with cash. CHS partners with independent providers in caring for over 129,000 Medicare members across 17 states. CHS provides comprehensive support for its physician partners by providing management services, risk contracting, and population health capabilities, including actionable data and other tools, to deliver care coordination and closure of gaps in care. CHS provides additional services to secure and deliver favorable value-based contracts with commercial and other health plans. The Company is in the process of finalizing its purchase price allocation. Agreement to Acquire Certain Assets and Businesses of Prospect On November 8, 2024, the Company and certain direct and indirect subsidiaries party thereto entered into an Asset and Equity Purchase Agreement (the “Purchase Agreement”) with PHP Holdings, LLC (“PHPH”), PHS Holdings, LLC (“PHS”), Prospect Intermediate Holdings, LLC (“PIH” and, together with PHPH and PHS, the “Prospect Equity Sellers”), certain other related entities party thereto (such entities, the “Prospect Asset Sellers” and, together with the Prospect Equity Sellers, the “Sellers”) and Prospect Medical Holdings, Inc. (“Prospect”), as Seller Representative. Under the terms of the Purchase Agreement, subject to satisfaction of customary conditions, the Company will purchase all of the outstanding equity interests of Prospect Health Services RI, Inc. (d/b/a Prospect ACO Rhode Island), Alta Newport Hospital, LLC (d/b/a Foothill Regional Medical Center) (the “Hospital”) and Prospect Health Plan, Inc., and substantially all the assets of certain direct and indirect subsidiaries of PHPH, for an aggregate purchase price of $ 745.0 million, including $ 55.0 million that will be held in escrow for purchase price adjustment and indemnity purposes, subject to customary adjustments, plus the assumption of certain identified liabilities of the Sellers (the “Transaction”). The Sellers provide a range of services through owned and managed medical groups, IPAs, and a Managed Services Organization, which provides administrative support to Sellers’ affiliated medical groups and IPAs. The Sellers also support health plan delegated functions for Medicare Advantage, Medicaid/Medi-Cal, and commercial insurance products, while participating in risk models such as Accountable Care Organizations and Direct Contracting Entities. The Hospital, as a direct subsidiary of PIH, is a fully accredited acute care hospital based in Tustin, California, that offers a variety of services and programs, including general and specialized surgery, orthopedics and spine surgery, rehabilitation, imaging and radiology, intensive care and skilled nursing. The Purchase Agreement includes customary representations, warranties, indemnification provisions, covenants, conditions and other agreements, including that each party is bound by a non-solicitation covenant and Sellers will abide by certain exclusivity and non-competition covenants. The Purchase Agreement also contains certain customary termination rights, including termination by either party if the conditions to closing the Purchase Agreement have not been met or waived by August 8, 2025, provided, that if certain required regulatory approvals have not been met by such date, then the Sellers may extend such date for up to an additional three months. The obligations of the parties to complete the Transaction are subject to the satisfaction, or waiver, of customary closing conditions, including receipt of applicable regulatory and governmental approvals. It is currently anticipated that the Transaction will close in the middle of 2025. The Company cannot provide any assurance that the Transaction will close in a timely manner, or at all. To provide additional financial flexibility for the Company, in connection with the execution of the Purchase Agreement, the Company entered into a commitment letter (the “Commitment Letter”), dated as of November 8, 2024, with Truist Bank and JPMorgan Chase Bank, N.A. (together, the “Banks”) and the other affiliates of the Banks party thereto, pursuant to which the Banks committed to provide (i) a 364-day senior secured bridge term loan in an aggregate principal amount of up to $ 1,095.0 million (the “Bridge Facility”) and (ii) a five-year senior secured revolving credit facility in an aggregate principal amount of up to $ 100.0 million. The Company intends to use the proceeds of the Bridge Facility, together with cash on hand, to fund the Transaction, to refinance the Company’s existing credit facilities and to pay for fees, costs and expenses incurred in connection with the foregoing. The funding of the Bridge Facility provided for in the Commitment Letter is contingent on the satisfaction of customary conditions, including but not limited to (i) the execution and delivery of definitive documentation with respect to the Bridge Facility in accordance with the terms set forth in the Commitment Letter, and (ii) the consummation of the Transaction in accordance with the Purchase Agreement. Amounts funded under the Bridge Facility, if any, will be reduced by the aggregate amount of gross proceeds that the Company elects to raise in a long-term debt and/or equity financing transaction on or prior to the closing of the Transaction as further set forth in the Commitment Letter.

Basis of Presentation and Sum_2

Basis of Presentation and Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying condensed consolidated balance sheet at December 31, 2023, has been derived from the Company’s audited consolidated financial statements, but does not include all annual disclosures required by generally accepted accounting principles in the United States of America (“U.S. GAAP”). The accompanying unaudited condensed consolidated financial statements as of September 30, 2024, and for the three and nine months ended September 30, 2024 and 2023, have been prepared in accordance with U.S. GAAP for interim financial statements and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, these unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and related notes to the financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023, as filed with the SEC on February 29, 2024. In the opinion of management, all material adjustments (consisting of normal recurring adjustments as well as intercompany accounts and transactions, which have been eliminated) considered necessary for a fair presentation have been made to make the condensed consolidated financial statements not misleading, as required by Regulation S-X, Rule 10-01. Operating results for the three and nine months ended September 30, 2024, are not necessarily indicative of the results that may be expected for the year ending December 31, 2024 , or any future periods.
Principles of Consolidation	Principles of Consolidation The condensed consolidated balance sheets as of September 30, 2024 and December 31, 2023, and the condensed consolidated statements of income for the three and nine months ended September 30, 2024 and 2023, include Astrana’s wholly owned subsidiaries and consolidated VIEs. The unaudited condensed consolidated interim financial statements have been prepared under the assumption that users of the interim financial data have either read, or have access to, our audited consolidated financial statements for the fiscal year ended December 31, 2023 .
Use of Estimates	Use of Estimates The preparation of the condensed consolidated financial statements and related disclosures in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, and disclosure of contingent assets and liabilities, at the date of the condensed consolidated financial statements as well as the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates and assumptions include collectability of receivables, recoverability of long-lived and intangible assets, business combination and goodwill valuation and impairment assessment, accrual of medical liabilities (incurred but not reported claims), determination of hospital shared-risk and health plan shared-risk revenue and receivables (including constraints and completion factors), income tax-valuation allowance, share-based compensation, and right-of-use assets and lease liabilities. Management evaluates its estimates and assumptions on an ongoing basis using historical experience and other factors, including the current economic environment, and makes adjustments when facts and circumstances dictate. As future events and their effects cannot be determined with precision, actual results could differ materially from those estimates and assumptions.
Business Combinations	Business Combinations The Company uses the acquisition method of accounting for all business combinations, which requires assets and liabilities of the acquiree to be recorded at fair value, to measure the fair value of the consideration transferred, including contingent consideration, to be determined on the acquisition date, and to account for acquisition-related costs separately from the business combination.
Reportable Segments	Reportable Segments As of September 30, 2024 , the Company operates in three reportable segments: • Care Partners; • Care Delivery; and • Care Enablement. Refer to Note 1 — “Description of Business” and Note 18 — “Segments” to the condensed consolidated financial statements for information on the Company’s segments.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company’s cash and cash equivalents primarily consist of money market funds and certificates of deposit. The Company considers all highly liquid investments that are both readily convertible into known amounts of cash and mature within ninety days from their date of purchase to be cash equivalents. The Company maintains its cash in deposit accounts with several banks, which at times may exceed the insured limits of the Federal Deposit Insurance Corporation (“FDIC”). The Company believes it is not exposed to any significant credit risk with respect to its cash and cash equivalents and restricted cash. As of September 30, 2024 and December 31, 2023, the Company’s deposit accounts with banks exceeded the FDIC’s insured limit by approximately $ 359.3 million and $ 318.9 million , respectively. The Company has not experienced any losses to date and performs ongoing evaluations of these financial institutions to limit the Company’s concentration of risk exposure.
Receivables, Receivables – Related Parties, Other Receivables and Loan Receivables	Receivables, Receivables – Related Parties, Other Receivables, and Loan Receivables The Company’s receivables are comprised of accounts receivable, capitation and fee for service receivable, risk pool settlements, incentive receivables, management fee income, and other receivables. Accounts receivable are recorded and stated at the amount expected to be collected. The Company’s receivables – related parties are comprised of risk pool settlements, management fee income, and other receivables. Receivables – related parties are recorded and stated at the amount expected to be collected. The Company’s loan receivables consist of promissory notes that accrue interest per annum. As of September 30, 2024, promissory notes are expected to be collected by their maturity dates. Capitation receivables relate to each health plan’s capitation and are received by the Company in the month following the month of service. Capitation receivables also include receivables from CMS related to the Company’s participation in the ACO REACH model. Risk pool settlements and incentive receivables mainly consist of the Company’s hospital shared-risk pool receivable, which is recorded quarterly based on reports received from the Company’s hospital partners and management’s estimate of the Company’s portion of the estimated risk pool surplus for open performance years. Settlement of risk pool surplus or deficits occurs approximately 18 months after the risk pool performance year is completed. Other receivables consist of receivables from fee-for-service (“FFS”) reimbursement for patient care, certain expense reimbursements, transportation reimbursements from the hospitals, and stop-loss insurance premium reimbursements. The Company maintains reserves for potential credit losses on the receivables. Management reviews the composition of the Company’s receivables and analyzes historical bad debts, customer concentrations, customer creditworthiness, current economic trends, and changes in customer payment patterns to evaluate the adequacy of these reserves. The Company also regularly analyzes the ultimate collectability of accounts receivable after certain stages of the collection cycle using a look-back analysis to determine the amount of receivables subsequently collected, and adjustments are recorded when necessary. Reserves are recorded primarily on a specific identification basis. Receivables are recorded when the Company is able to determine amounts receivable under applicable contracts and agreements based on information provided and collection is reasonably likely to occur. Regarding the credit loss standard, the Company continuously monitors its collections of receivables. Our expectation is that the historical credit loss experienced across our receivable portfolio is materially similar to any current expected credit losses that would be estimated under the current expected credit losses (“CECL”) model.
Concentrations of Credit Risks	Concentrations of Credit Risks The Company disaggregates revenue from contracts by service type and payer type. This level of detail provides useful information pertaining to how the Company generates revenue by significant revenue stream and by type of direct contracts. The condensed consolidated statements of income present disaggregated revenue by service type.
Revenue Recognition	Revenue Recognition The Company receives payments from the following sources for services rendered: • Commercial insurers; • Federal government under the Medicare program administered by CMS; • State governments under Medicaid and other programs; • Other third-party payers (e.g., hospitals and IPAs); and • Individual patients and clients. Revenue primarily consists of the following: • Capitation revenue; • Risk pool settlements and incentives; • Management fee revenue; and • FFS revenue. Revenue is recorded in the period in which services are rendered or the period in which the Company is obligated to provide services. The form of billing and related risk of collection for such services may vary by type of revenue and the customer. Risk Pool Settlements and Incentives Medicare Shared Savings Program Revenue Beginning in 2024, Astrana participates in MSSP. The MSSP has multiple risk tracks, and Astrana is currently participating in the ENHANCED risk track. Under the MSSP Model, Astrana recruits a group of Participant and Preferred (in-network) Providers. Based on the Participant Providers that join our ACO, CMS grants the Company a pool of Traditional Medicare patients (beneficiaries) to manage (the “MSSP Aligned Beneficiaries”). The Company’s MSSP Aligned Beneficiaries will receive services from physicians and other medical service providers that are both in-network and out-of-network. CMS continues to pay participants and preferred providers on a fee-for-service basis for Medicare-covered services provided to MSSP Aligned Beneficiaries. The Company continues to bear risk on all Medicare expenditures (both in-network and out-of-network), excluding drug expenditures covered by Medicare Part D, based on a budgetary benchmark established with CMS. Astrana’s shared savings or losses in managing the Company’s beneficiaries are generally determined on an annual basis after reconciliation with CMS. Pursuant to Astrana’s risk-share agreement with CMS, the Company is eligible to receive the surplus (“shared savings”) or is liable for the deficit (“shared losses”) according to the budgetary benchmark established by CMS based on Astrana’s efficiency, or lack thereof, in managing the expenditures associated with the Company’s MSSP Aligned Beneficiaries. The Company estimates the shared service revenue by analyzing the activities during the relevant time period in contemplation of the agreed-upon benchmarks, metrics, performance criteria, and attribution criteria based on those and any other contractually defined factors. Revenue is not recorded and is constrained until the shared service revenue can be reasonably estimated by the Company and to the extent that it is probable that a significant reversal will not occur once any uncertainty associated with the variable consideration is subsequently resolved. Contract Liabilities (Deferred Revenue) Contract liabilities are recorded when cash payments are received in advance of the Company’s performance. As of September 30, 2024 and December 31, 2023, the Company’s contract liability balance was $ 2.2 million and $ 0.7 million, respectively. Approximately $ 0.7 million of the Company’s contract liability accrued as of December 31, 2023, has been recognized as revenue during the nine months ended September 30, 2024 . Contract liability is presented within accounts payable and accrued expenses in the accompanying condensed balance sheets.
Income Taxes	Income Taxes Federal and state income taxes are computed at currently enacted tax rates less tax credits using the asset and liability method. Deferred taxes are adjusted for both items that do not have tax consequences and for the cumulative effect of any changes in tax rates from those previously used to determine deferred tax assets or liabilities. Tax provisions include amounts that are currently payable, changes in deferred tax assets and liabilities that arise because of temporary differences between the timing of when items of income and expense are recognized for financial reporting and income tax purposes, changes in recognition of tax positions, and any changes in the valuation allowance caused by a change in judgment about the realizability of the related deferred tax assets. A valuation allowance is established when necessary to reduce deferred tax assets to amounts expected to be realized. The Company uses a recognition threshold of more-likely-than-not and a measurement attribute on all tax positions taken, or expected to be taken, in a tax return in order to be recognized in the condensed consolidated financial statements. Once the recognition threshold is met, the tax position is measured to determine the actual amount of benefit to recognize in the condensed consolidated financial statements.
Recent Accounting Pronouncements Not Yet Adopted	Recent Accounting Pronouncements Not Yet Adopted In November 2023, the Financial Standards Accounting Board (FASB) issued Accounting Standards Update (ASU) 2023-07 “Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures,” which expands annual and interim disclosure requirements for reportable segments, primarily through enhanced disclosures about significant segment expenses. ASU 2023-07 is effective for the Company’s annual periods beginning January 1, 2024, and for interim periods beginning January 1, 2025, with early adoption permitted. The Company does not expect the adoption of ASU 2023-07 to have a significant impact on its consolidated financial statements and related disclosures. In December 2023, the FASB issued ASU 2023-09 “Income Taxes (Topics 740): Improvements to Income Tax Disclosures” to expand the disclosure requirements for income taxes, specifically related to the rate reconciliation and income taxes paid. ASU 2023-09 is effective for the Company’s annual periods beginning January 1, 2025, with early adoption permitted. The Company does not expect the adoption of ASU 2023-09 to have a significant impact on its consolidated financial statements and related disclosures.
Derivative Financial Instruments	Derivative Financial Instruments Interest Rate Collar Agreements The Company’s collar agreement is designed to limit the interest rate risk associated with the Company’s Revolver Loan. The principal objective of the collar agreement is to eliminate or reduce the variability of the cash flows in interest payments associated with the Company’s floating-rate debt, thus reducing the impact of interest rate changes on future interest payment cash flows. Refer to Note 9 — “Credit Facility, Promissory Notes Payable, Bank Loans, and Lines of Credit” for further information on the Company’s debt. Under the terms of the agreement, the ceiling is 5.0 % and the floor is 2.34 %. The collar agreement is not designated as a hedging instrument. Changes in the fair value of this contract are recognized as unrealized gain or loss on investments in the accompanying condensed consolidated statements of income and reflected in the accompanying condensed consolidated statements of cash flows as unrealized (gain) loss on investments. The estimated fair value of the collar was determined using Level 2. As of September 30, 2024 and December 31, 2023, the fair value of the collar was $ 0.2 million and $ 0.3 million , respectively, and presented within other long-term liabilities, in the accompanying condensed consolidated balance sheets.
Investments in Marketable Securities	Investments in Marketable Securities Certificates of deposit are reported at par value, plus accrued interest, with maturity dates greater than ninety days . As of September 30, 2024 and December 31, 2023, certificates of deposit amounted to approximately $ 2.3 million and $ 2.2 million , respectively. Investments in certificates of deposit are classified as Level 1 investments in the fair value hierarchy. Equity securities are reported at fair value. These securities are classified as Level 1 in the valuation hierarchy, where quoted market prices from reputable third-party brokers are available in an active market and unadjusted.

Basis of Presentation and Sum_3

Basis of Presentation and Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Schedule of Disaggregated Revenue by Each Payor Type	The following table presents disaggregated revenue generated by payer type for the three and nine months ended September 30, 2024 and 2023 (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Commercial $ 52,961 $ 43,495 $ 142,667 $ 122,421 Medicare 258,377 222,387 747,418 660,855 Medicaid 151,943 65,469 414,453 201,920 Other third parties 15,429 16,822 64,793 48,429 Revenue $ 478,710 $ 348,173 $ 1,369,331 $ 1,033,625
Schedule of Contributions to Revenue and Receivables by Payor	The Company had major payers that contributed the following percentages of net revenue for the three and nine months ended September 30, 2024 and 2023: Three Months Ended Nine Months Ended 2024 2023 2024 2023 Payer A 27.7 % 37.4 % 30.0 % 39.0 % Payer B 15.4 % 12.4 % 14.8 % * Payer D 12.0 % * * * *Less than 10% of total net revenues The Company had major payers that contributed to the following percentages of receivables and receivables – related parties: As of September 30, As of December 31, Payer A 31.3 % 36.0 % Payer C 36.0 % 41.0 %

Business Combinations and Goo_2

Business Combinations and Goodwill (Tables)	9 Months Ended
	Sep. 30, 2024
Business Combination and Asset Acquisition [Abstract]
Schedule of Business Acquisitions, by Acquisition	The following table summarizes the purchase price allocation of the fair value of assets acquired and liabilities assumed related to each acquisition at the acquisition date for acquisitions that closed during the nine months ended September 30, 2024 (in thousands): CFC AHMS Others* Net Total Total purchase consideration: Cash paid $ 90,998 $ 63,935 $ 15,000 $ 169,933 Contingent consideration 8,026 — 6,161 14,187 Common stock issued 21,952 — — 21,952 $ 120,976 $ 63,935 $ 21,161 $ 206,072 Assets: Cash and cash equivalents $ 16,674 $ 33,950 $ 3,515 $ 54,139 Investment in marketable securities — — 30 30 Receivables 6,530 11,007 — 17,537 Other receivables 472 — — 472 Prepaid expenses and other current assets — 36 11 47 Amount due from affiliates 2,902 — — 2,902 Land, property, and equipment — — 823 823 Intangible assets 28,000 23,600 3,900 55,500 Goodwill 83,602 31,048 13,621 128,271 Income tax receivable — — 1 1 Restricted cash — 300 — 300 Total assets acquired $ 138,180 $ 99,941 $ 21,901 $ 260,022 Liabilities: Accounts payable and accrued expenses $ 2,487 $ 7,111 $ 250 $ 9,848 Medical liabilities 14,693 14,942 — 29,635 Amount due from affiliates — 5,890 54 5,944 Income taxes payable 24 1,689 — 1,713 Deferred tax liability — 6,374 8 6,382 Non-controlling interest — — 428 428 Total liabilities assumed $ 17,204 $ 36,006 $ 740 $ 53,950 Total net assets acquired $ 120,976 $ 63,935 $ 21,161 $ 206,072 *Others consist of estimated fair values of the assets acquired, net of cash acquired, related to ADSC, PCCCV, and Airline Complete. Unaudited Pro Forma Financial Information The pro forma financial information in the table below presents the combined results of the Company and CFC, AHMS, ADSC, PCCCV, and Airline Complete as if the acquisitions had occurred on January 1, 2023. The pro forma information presented is shown for illustrative purposes only and is not necessarily indicative of future results of operations of the Company or results of operations of the Company that would have actually occurred had the transactions been in effect for the periods presented. Three Months Ended Nine Months Ended (in thousands, except per share amounts) 2024 2023 2024 2023 Total revenue $ 478,710 $ 430,399 $ 1,434,813 $ 1,207,867 Net income attributable to Astrana Health, Inc. $ 16,094 $ 26,215 $ 54,148 $ 64,875 Net income per share – basic $ 0.34 $ 0.56 $ 1.14 $ 1.39 Net income per share – diluted $ 0.33 $ 0.56 $ 1.13 $ 1.38
Schedule of Change in Carrying Value of Goodwill	The change in the carrying value of goodwill for the nine months ended September 30, 2024 was as follows (in thousands): Amount Balance, January 1, 2024 $ 278,831 Acquisitions 128,271 Adjustments 2,609 Balance, September 30, 2024 $ 409,711

Intangible Assets, Net (Tables)

Intangible Assets, Net (Tables)	9 Months Ended
	Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets, Net	At September 30, 2024, the Company’s intangible assets, net, consisted of the following (in thousands): Useful Gross Accumulated Net Indefinite lived assets: Trademarks N/A $ 2,150 $ — $ 2,150 Licenses N/A 1,900 — 1,900 Amortized intangible assets: Network relationships 11 - 21 156,779 ( 111,626 ) 45,153 Management contracts 15 22,832 ( 17,647 ) 5,185 Member relationships 7 - 14 71,577 ( 17,582 ) 53,995 Patient management platform 5 2,060 ( 2,060 ) — Tradename/trademarks 20 1,011 ( 345 ) 666 Developed technology 6 107 ( 48 ) 59 $ 258,416 $ ( 149,308 ) $ 109,108 At December 31, 2023, the Company’s intangible assets, net, consisted of the following (in thousands): Useful Gross Accumulated Net Indefinite lived assets: Trademarks N/A $ 2,150 $ — $ 2,150 Amortized intangible assets: Network relationships 11 - 21 150,679 ( 104,859 ) 45,820 Management contracts 15 22,832 ( 16,662 ) 6,170 Member relationships 10 - 14 24,077 ( 7,345 ) 16,732 Patient management platform 5 2,060 ( 2,060 ) — Tradename/trademarks 20 1,011 ( 308 ) 703 Developed technology 6 107 ( 34 ) 73 $ 202,916 $ ( 131,268 ) $ 71,648
Schedule of Future Amortization Expense	Future amortization expense is estimated to be as follows for the following years ending December 31 (in thousands): Amount 2024 (excluding the nine months ended September 30, 2024) $ 6,630 2025 22,856 2026 18,642 2027 15,170 2028 12,459 Thereafter 29,301 Total $ 105,058

Investments in Other Entities (

Investments in Other Entities (Tables)	9 Months Ended
	Sep. 30, 2024
Equity Method Investments and Joint Ventures [Abstract]
Schedule of Equity Method Investments	For the nine months ended September 30, 2024 and 2023, the Company’s equity method investment balance consisted of the following (in thousands): % of December 31, Initial Allocation September 30, 2024 LaSalle Medical Associates – IPA line of business 25 % $ 9,866 $ — $ 2,225 $ 12,091 Pacific Medical Imaging & Oncology Center, Inc. 40 % 1,691 — ( 72 ) 1,619 CAIPA MSO, LLC 30 % 13,660 — 643 14,303 I Health, Inc. 25 % — 5,968 20 5,988 Other* 25 % 557 — 71 628 $ 25,774 $ 5,968 $ 2,887 $ 34,629 % of December 31, Initial Allocation Funding September 30, 2023 LaSalle Medical Associates – IPA line of business 25 % $ 5,684 $ — $ 2,642 $ — $ 8,326 Pacific Medical Imaging & Oncology Center, Inc. 40 % 1,878 — ( 219 ) — 1,659 531 W. College, LLC ** 50 % 17,281 — ( 387 ) 700 17,594 One MSO, LLC ** 50 % 2,718 — 330 — 3,048 CAIPA MSO, LLC 30 % 12,738 — 575 — 13,313 Other* 25 % — 325 163 — 488 $ 40,299 $ 325 $ 3,104 $ 700 $ 44,428 *Other consists of smaller equity method investments. ** Investments were solely for the benefit of APC and its shareholders. For three months ended September 30, 2024 and 2023, the Company’s equity method investment balance consisted of the following (in thousands): % of June 30, Initial Allocation September 30, 2024 LaSalle Medical Associates – IPA line of business 25 % $ 11,027 $ — $ 1,064 $ 12,091 Pacific Medical Imaging & Oncology Center, Inc. 40 % 1,648 — ( 29 ) 1,619 CAIPA MSO, LLC 30 % 14,100 — 203 14,303 I Health, Inc. 25 % 5,923 — 65 5,988 Other* 25 % 578 — 50 628 $ 33,276 $ — $ 1,353 $ 34,629 % of June 30, Initial Allocation Funding September 30, 2023 LaSalle Medical Associates – IPA line of business 25 % $ 10,537 $ — $ ( 2,211 ) $ — $ 8,326 Pacific Medical Imaging & Oncology Center, Inc. 40 % 1,655 — 4 — 1,659 531 W. College, LLC ** 50 % 17,070 — ( 176 ) 700 17,594 One MSO, LLC ** 50 % 2,960 — 88 — 3,048 CAIPA MSO, LLC 30 % 13,190 — 123 — 13,313 Other* 25 % 420 — 68 — 488 $ 45,832 $ — $ ( 2,104 ) $ 700 $ 44,428 * Other consists of smaller equity method investments. ** Investments were solely for the benefit of APC and its shareholders.

Accounts Payable and Accrued _2

Accounts Payable and Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2024
Payables and Accruals [Abstract]
Schedule of Accounts Payable and Accrued Expenses	The Company’s accounts payable and accrued expenses consisted of the following (in thousands): September 30, December 31, Accounts payable and other accruals $ 36,908 $ 9,075 Capitation payable 13,317 4,503 Subcontractor IPA payable 2,440 2,529 Professional fees 4,152 4,407 Due to related parties 3,785 9,271 Contract liabilities 2,246 744 Accrued compensation 17,498 20,098 Other provider payable 14,465 9,322 Total accounts payable and accrued expenses $ 94,811 $ 59,949

Medical Liabilities (Tables)

Medical Liabilities (Tables)	9 Months Ended
	Sep. 30, 2024
Liability for Unpaid Claims and Claims Adjustment Expense, Activity in Liability [Abstract]
Schedule of Medical Liabilities	The Company’s medical liabilities consisted of the following (in thousands): September 30, September 30, Medical liabilities, beginning of period $ 106,657 $ 81,255 Acquired* (see Note 3) 32,106 6,157 Components of medical care costs related to claims incurred: Current period 797,906 642,880 Prior periods ( 7,890 ) ( 13,251 ) Total medical care costs 790,016 629,629 Payments for medical care costs related to claims incurred: Current period ( 654,625 ) ( 547,212 ) Prior periods ( 112,847 ) ( 74,966 ) Total paid ( 767,472 ) ( 622,178 ) Adjustments ( 1,028 ) 2,656 Medical liabilities, end of period $ 160,279 $ 97,519 *The acquired balance includes medical liabilities from current and prior periods.

Credit Facility, Promissory N_2

Credit Facility, Promissory Notes Payable, Bank Loans, and Lines of Credit (Tables)	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Schedule of Credit Facility	The Company’s debt balance consisted of the following (in thousands): September 30, December 31, Term Loan $ 285,250 $ 280,000 Revolver Loan 146,732 — Promissory Note Payable 9,875 2,000 Total debt 441,857 282,000 Less: Current portion of debt ( 15,000 ) ( 19,500 ) Less: Unamortized financing costs ( 3,738 ) ( 3,561 ) Long-term debt $ 423,119 $ 258,939
Schedule of Future Commitments of Credit Facility	The following are the future commitments of the Company’s debt for the years ending December 31 (in thousands): Amount 2024 (excluding the nine months ended September 30, 2024) $ 3,750 2025 16,875 2026 169,232 2027 34,250 2028 217,750 Total $ 441,857

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2024
Share-Based Payment Arrangement [Abstract]
Schedule of Share-Based Compensation Expense	The following table summarizes the stock-based compensation expense recognized under all of the Company’s stock plans for the three and nine months ended September 30, 2024 and 2023, and associated with the issuance of restricted stock awards and units and vesting of stock options that are included in general and administrative expenses in the accompanying condensed consolidated statements of income (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Stock options and ESPP $ 349 $ 406 $ 1,125 $ 1,393 Restricted stock awards and units 5,814 5,300 18,176 11,971 Total stock-based compensation expense $ 6,163 $ 5,706 $ 19,301 $ 13,364
Schedule of Stock Option Transactions Under Stock Option Plans	The Company’s outstanding stock options consisted of the following: Shares Weighted Weighted Aggregate Options outstanding at January 1, 2024 504,241 $ 34.03 2.10 $ 4.7 Options granted — — — — Options exercised ( 75,455 ) 16.71 — 2.3 Options forfeited ( 7,271 ) 50.56 — — Options outstanding at September 30, 2024 421,515 $ 36.84 1.28 $ 10.9 Options exercisable at September 30, 2024 383,685 $ 30.06 1.10 $ 10.9

Related-Party Transactions (Tab

Related-Party Transactions (Tables)	9 Months Ended
	Sep. 30, 2024
Related Party Transactions [Abstract]
Schedule of Fees Incurred and Revenue Earned from Related Party Transactions	The following tables set forth revenue recognized and fees incurred related to AHMC, HSMSO, and Aurion for the three and nine months ended September 30, 2024 and 2023 (in thousands): Three Months Ended September 30, 2024 Three Months Ended September 30, 2023 AHMC HSMSO Aurion AHMC HSMSO Aurion Revenue $ 11,167 $ 626 $ — $ 5,619 $ 326 $ — Expenses 9,169 — 50 6,445 ( 200 ) 75 Net $ 1,998 $ 626 $ ( 50 ) $ ( 826 ) $ 526 $ ( 75 ) Nine Months Ended September 30, 2024 Nine Months Ended September 30, 2023 AHMC HSMSO Aurion AHMC HSMSO Aurion Revenue $ 33,944 $ 1,239 $ — $ 37,337 $ 950 $ — Expenses 24,134 — 200 18,505 35 225 Net $ 9,810 $ 1,239 $ ( 200 ) $ 18,832 $ 915 $ ( 225 )

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Schedule of Earnings Per Share Computations	Below is a summary of the earnings per share computations: Three months ended September 30, 2024 2023 Earnings per share – basic $ 0.34 $ 0.47 Earnings per share – diluted $ 0.33 $ 0.47 Weighted average shares of common stock outstanding – basic 47,686,841 46,547,502 Weighted average shares of common stock outstanding – diluted 48,223,788 46,920,607 Nine months ended September 30, 2024 2023 Earnings per share – basic $ 1.05 $ 1.04 Earnings per share – diluted $ 1.04 $ 1.03 Weighted average shares of common stock outstanding – basic 47,521,368 46,527,350 Weighted average shares of common stock outstanding – diluted 47,960,686 46,881,567
Schedule of Shares Included in the Diluted Earnings Per Share Computations	Below is a summary of the shares included in the diluted earnings per share computations: Three months ended September 30, 2024 2023 Weighted average shares of common stock outstanding – basic 47,686,841 46,547,502 Stock options 169,785 253,767 Restricted stock awards and units 321,348 88,450 Contingently issuable shares 45,814 30,888 Weighted average shares of common stock outstanding – diluted 48,223,788 46,920,607 Nine months ended September 30, 2024 2023 Weighted average shares of common stock outstanding – basic 47,521,368 46,527,350 Stock options 155,309 254,399 Restricted stock awards and units 243,806 89,409 Contingently issuable shares 40,203 10,409 Weighted average shares of common stock outstanding – diluted 47,960,686 46,881,567

Variable Interest Entities (V_2

Variable Interest Entities (VIEs) (Tables)	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Assets and Liabilities, Variable Interest Entities	The following table includes assets that can only be used to settle the liabilities of the Company’s VIEs, and to which the creditors of Astrana have no recourse, and liabilities to which the creditors of the Company’s VIEs have no recourse to the general credit of Astrana, as the primary beneficiary of the VIEs. These assets and liabilities, with the exception of investments in affiliates and amounts due to, or from, affiliates, which are eliminated upon consolida tion, are included in the accompanying condensed consolidated balance sheets (in thousands). September 30, 2024 December 31, 2023 Assets Current assets Cash and cash equivalents $ 181,340 $ 184,078 Investment in marketable securities 2,233 — Receivables, net 54,356 21,120 Receivables, net – related party 76,010 58,707 Income taxes receivable — 1,600 Other receivables 385 454 Prepaid expenses and other current assets 9,763 9,991 Total current assets 324,087 275,950 Non-current assets Land, property and equipment, net 5,619 5,306 Intangible assets, net 82,264 60,906 Goodwill 235,638 140,157 Income taxes receivable, non-current 15,943 15,943 Investments in other entities – equity method 14,338 12,114 Investment in affiliates* 413,269 273,182 Investment in a privately held entity 405 405 Restricted cash 40 40 Operating lease right-of-use assets 21,648 28,796 Other assets 1,147 1,149 Total non-current assets 790,311 537,998 Total assets $ 1,114,398 $ 813,948 Current liabilities Accounts payable and accrued expenses $ 41,416 $ 32,707 Fiduciary accounts payable 6,041 7,737 Medical liabilities 75,648 55,157 Dividend payable 638 638 Income tax payable 26,105 — Finance lease liabilities 520 646 Operating lease liabilities 3,434 3,305 Amount due to affiliates* 76,294 107,340 Other liabilities 11,139 8,542 Total current liabilities 241,235 216,072 Non-current liabilities Finance lease liabilities, net of current portion 649 1,033 Operating lease liabilities, net of current portion 21,054 28,675 Deferred tax liability 7,198 7,284 Other long-term liabilities 299 230 Total non-current liabilities 29,200 37,222 Total liabilities $ 270,435 $ 253,294 *Investment in affiliates includes the Company’s VIEs’ investment in Astrana, which is reflected as treasury shares and eliminated upon consolidation. Amounts due to, or from, affiliates are receivables with Astrana’s subsidiaries. As a result, these balances are eliminated upon consolidation and are not reflected on Astrana’s condensed consolidated balance sheets as of September 30, 2024 and December 31, 2023 .

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2024
Leases [Abstract]
Schedule of Information Related to Lease Costs	The components of lease expense were as follows (dollars in thousands): Three Months Ended September 30, 2024 2023 Operating lease cost $ 3,205 $ 2,187 Finance lease cost Amortization of lease expense 172 202 Interest on lease liabilities 20 35 Sublease income ( 3 ) ( 307 ) Total lease cost, net $ 3,394 $ 2,117 Nine Months Ended September 30, 2024 2023 Operating lease cost $ 9,438 $ 5,570 Finance lease cost Amortization of lease expense 534 505 Interest on lease liabilities 66 80 Sublease income ( 246 ) ( 806 ) Total lease cost, net $ 9,792 $ 5,349 Other information related to leases was as follows (in thousands): Three Months Ended September 30, 2024 2023 Supplemental Cash Flow Information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 3,089 $ 2,016 Operating cash flows from finance leases 20 35 Financing cash flows from finance leases 172 202 Nine Months Ended September 30, 2024 2023 Supplemental Cash Flow Information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 8,684 $ 5,636 Operating cash flows from finance leases 66 80 Financing cash flows from finance leases 534 505 Nine Months Ended September 30, 2024 2023 Weighted Average Remaining Lease Term Operating leases 6.93 years 6.84 years Finance leases 2.69 years 3.18 years Weighted Average Discount Rate Operating leases 6.68 % 5.75 % Finance leases 5.70 % 5.19 %
Schedule of Future Minimum Lease Payments Under Non-cancelable Leases	The following are future minimum lease payments under non-cancellable leases for the years ending December 31 (in thousands) below: Operating Finance 2024 (excluding the nine months ended September 30, 2024) $ 1,855 $ 160 2025 7,523 599 2026 7,213 345 2027 6,729 267 2028 6,472 27 Thereafter 16,902 9 Total future minimum lease payments 46,694 1,407 Less: imputed interest 10,291 110 Total lease liabilities 36,403 1,297 Less: current portion 5,241 554 Long-term lease liabilities $ 31,162 $ 743

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 30, 2024
Segment Reporting [Abstract]
Schedule of Information about our Segments	Certain amounts disclosed in the prior period have been recast to conform to the current period presentation. Specifically, reclassifications were made between cost of services and general and administrative expenses in the accompanying segment table for the three and nine months ended September 30, 2023, and the segments are presented net of intrasegment eliminations. The following table presents information about our segments (in thousands): Three Months Ended September 30, 2024 Care Care Care Other Intersegment Corporate Consolidated Third-Party $ 455,760 $ 20,083 $ 2,867 $ — $ — $ — $ 478,710 Intersegment — 14,645 38,063 — ( 52,708 ) — — Total revenues 455,760 34,728 40,930 — ( 52,708 ) — 478,710 Cost of services 369,835 29,114 19,604 — ( 13,335 ) — 405,218 General and administrative (1) 47,139 6,971 15,012 — ( 39,370 ) 15,315 45,067 Total expenses 416,974 36,085 34,616 — ( 52,705 ) 15,315 450,285 Income (loss) from operations $ 38,786 $ ( 1,357 ) $ 6,314 $ — $ ( 3 ) (2) $ ( 15,315 ) $ 28,425 Three Months Ended September 30, 2023 Care Care Care Other Intersegment Corporate Consolidated Third-Party $ 320,885 $ 16,737 $ 10,306 $ 245 $ — $ — $ 348,173 Intersegment — 12,234 26,604 49 ( 38,887 ) — — Total revenues 320,885 28,971 36,910 294 ( 38,887 ) — 348,173 Cost of services 249,917 23,060 13,658 76 ( 11,336 ) — 275,375 General and administrative (1) 30,628 6,946 16,804 875 ( 28,621 ) 7,083 33,715 Total expenses 280,545 30,006 30,462 951 ( 39,957 ) 7,083 309,090 Income (loss) from operations $ 40,340 $ ( 1,035 ) $ 6,448 $ ( 657 ) $ 1,070 (2) $ ( 7,083 ) $ 39,083 Nine Months Ended September 30, 2024 Care Care Care Other Intersegment Corporate Consolidated Third-Party $ 1,301,355 $ 59,179 $ 8,797 $ — $ — $ — $ 1,369,331 Intersegment — 41,125 101,579 — ( 142,704 ) — — Total revenues 1,301,355 100,304 110,376 — ( 142,704 ) — 1,369,331 Cost of services 1,049,437 80,160 56,916 — ( 38,091 ) — 1,148,422 General and administrative (1) 129,613 19,914 36,724 — ( 104,692 ) 50,720 132,279 Total expenses 1,179,050 100,074 93,640 — ( 142,783 ) 50,720 1,280,701 Income (loss) from operations $ 122,305 $ 230 $ 16,736 $ — $ 79 (2) $ ( 50,720 ) $ 88,630 Nine Months Ended September 30, 2023 Care Care Care Other Intersegment Corporate Consolidated Third-Party $ 957,297 $ 42,603 $ 33,164 $ 561 $ — $ — $ 1,033,625 Intersegment — 37,228 69,287 131 ( 106,646 ) — — Total revenues 957,297 79,831 102,451 692 ( 106,646 ) — 1,033,625 Cost of services 783,333 65,187 44,441 209 ( 35,522 ) — 857,648 General and administrative (1) 83,475 16,076 38,181 2,459 ( 74,401 ) 21,704 87,494 Total expenses 866,808 81,263 82,622 2,668 ( 109,923 ) 21,704 945,142 Income (loss) from operations $ 90,489 $ ( 1,432 ) $ 19,829 $ ( 1,976 ) $ 3,277 (2) $ ( 21,704 ) $ 88,483 (1) Balance includes general and administrative expenses, and depreciation and amortization. (2) Income from operations for the intersegment elimination represents rental income from segments renting from other segments. Rental income is presented within other income that is not presented in the table.

Fair Value Measurements of Fi_2

Fair Value Measurements of Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2024
Fair Value Disclosures [Abstract]
Schedule of Carrying Amounts and Fair Values of Financial Instruments	The carrying amounts and fair values of the Company’s financial instruments as of September 30, 2024, are presented below (in thousands): Fair Value Measurements Level 1 Level 2 Level 3 Total Assets Money market accounts* $ 28,044 $ — $ — $ 28,044 Marketable securities – certificates of deposit 2,263 — — 2,263 Marketable securities – equity securities 91 — — 91 I Health call option — — 3,907 3,907 Total assets $ 30,398 $ — $ 3,907 $ 34,305 Liabilities Interest rate collar $ — $ 154 $ — $ 154 AAMG contingent consideration — — 3,876 3,876 VOMG contingent consideration — — 15 15 DMG remaining equity interest purchase — — 8,542 8,542 Sun Labs remaining equity interest purchase — — 7,352 7,352 ADSC contingent considerations — — 4,138 4,138 CFC contingent considerations — — 9,138 9,138 PCCCV contingent considerations — — 2,597 2,597 Total liabilities $ — $ 154 $ 35,658 $ 35,812 * Included in cash and cash equivalents The carrying amounts and fair values of the Company’s financial instruments as of December 31, 2023, are presented below (in thousands): Fair Value Measurements Level 1 Level 2 Level 3 Total Assets Money market accounts* $ 4,842 $ — $ — $ 4,842 Marketable securities – certificates of deposit 2,150 — — 2,150 Marketable securities – equity securities 348 — — 348 Total assets $ 7,340 $ — $ — $ 7,340 Liabilities AAMG contingent consideration $ — $ — $ 5,475 $ 5,475 VOMG contingent consideration — — 17 17 DMG remaining equity interest purchase — — 8,542 8,542 Sun Labs remaining equity interest purchase — — 7,802 7,802 Interest rate collar — 252 — 252 Total liabilities $ — $ 252 $ 21,836 $ 22,088 * Included in cash and cash equivalents
Schedule of Change in Fair Value of Level 3 Liabilities	The change in the fair value of Level 3 liabilities for the nine months ended September 30, 2024, was as follows (in thousands): Amount Balance at January 1, 2024 $ 21,836 Additions 14,202 Change in fair value of existing Level 3 liabilities 3,643 Settlements ( 4,023 ) Balance at September 30, 2024 $ 35,658
Schedule of Gain (Loss) on Equity Securities	The components comprising total gains and losses on equity securities are as follows (in thousands) for the periods listed below: Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Total gains (losses) recognized on equity securities $ 68 $ ( 870 ) $ ( 133 ) $ ( 6,571 ) Gains (losses) recognized on equity securities sold 65 — ( 146 ) — Unrealized gains (losses) recognized on equity securities held at end of period $ 3 $ ( 870 ) $ 13 $ ( 6,571 )

Description of Business (Detail

Description of Business (Details)	9 Months Ended
	Sep. 30, 2024 Segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of reportable segments	3

Basis of Presentation and Sum_4

Basis of Presentation and Summary of Significant Accounting Policies - Additional Information (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($) Segment	Dec. 31, 2023 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of reportable segments | Segment	3
Amount deposit accounts exceeded FDIC insured limit	$ 359,300	$ 318,900
Risk pool surplus or deficits, settlement period after risk pool performance year	18 months
Contract liabilities	$ 2,246	744
Accounts Payable and Accrued Expenses
Summary Of Significant Accounting Policies [Line Items]
Contract liabilities		$ 700

Basis of Presentation and Sum_5

Basis of Presentation and Summary of Significant Accounting Policies - Schedule of Disaggregated Revenue by Each Payer Type (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Disaggregation of Revenue [Line Items]
Revenue	$ 478,710	$ 348,173	$ 1,369,331	$ 1,033,625
Commercial
Disaggregation of Revenue [Line Items]
Revenue	52,961	43,495	142,667	122,421
Medicare
Disaggregation of Revenue [Line Items]
Revenue	258,377	222,387	747,418	660,855
Medicaid
Disaggregation of Revenue [Line Items]
Revenue	151,943	65,469	414,453	201,920
Other third parties
Disaggregation of Revenue [Line Items]
Revenue	$ 15,429	$ 16,822	$ 64,793	$ 48,429

Basis of Presentation and Sum_6

Basis of Presentation and Summary of Significant Accounting Policies - Schedule of Contributions to Revenue and Receivables by Payer (Details) - Customer Concentration Risk	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Net Revenue | Payer A
Accounts Receivable And Net Revenue [Line Items]
Concentration risk	27.70%	37.40%	30%	39%
Net Revenue | Payer B
Accounts Receivable And Net Revenue [Line Items]
Concentration risk	15.40%	12.40%	14.80%
Net Revenue | Payer D
Accounts Receivable And Net Revenue [Line Items]
Concentration risk	12%
Receivables and Receivables-Related Parties | Payer A
Accounts Receivable And Net Revenue [Line Items]
Concentration risk			31.30%		36%
Receivables and Receivables-Related Parties | Payer C
Accounts Receivable And Net Revenue [Line Items]
Concentration risk			36%		41%

Business Combinations and Goo_3

Business Combinations and Goodwill - Additional Information (Details) - USD ($)				3 Months Ended		9 Months Ended
	Mar. 31, 2024	Mar. 29, 2024	Jan. 31, 2024	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Jul. 01, 2024	Jan. 01, 2024
Business Acquisition [Line Items]
Impairment of goodwill				$ 0	$ 0	$ 0	$ 0
Revenue since acquisition						235,900,000
Net income since acquisition						$ 26,400,000
Airline
Business Acquisition [Line Items]
Interest acquired								100%
AHMS
Business Acquisition [Line Items]
Consideration transferred	$ 63,935,000
Prime Community Care of Central Valley, Inc
Business Acquisition [Line Items]
Consideration transferred		$ 10,500,000
Fair value of contingent consideration		$ 2,500,000
Community Family Care Medical Group IPA, Inc.
Business Acquisition [Line Items]
Consideration transferred			$ 120,976,000
Consideration of acquisition in cash funded			91,000,000
Business acquisition of common stock			$ 22,000,000
Equity interest issued, number of shares (shares)			631,712
Fair value of contingent consideration			$ 8,000,000
Advanced Diagnostic and Surgical Center, Inc
Business Acquisition [Line Items]
Interest acquired									95%
Fair value of contingent consideration									$ 3,600,000

Business Combinations and Goo_4

Business Combinations and Goodwill - Summary of Purchase Price Allocation (Details) - USD ($) $ in Thousands				9 Months Ended
		Mar. 31, 2024	Jan. 31, 2024	Sep. 30, 2024	Dec. 31, 2023
Assets:
Goodwill				$ 409,711	$ 278,831
CFC
Total purchase consideration:
Cash paid			$ 90,998
Contingent consideration			8,026
Common stock issued			21,952
Consideration transferred			120,976
Assets:
Cash and cash equivalents			16,674
Investment in marketable securities			0
Receivables			6,530
Other receivables			472
Prepaid expenses and other current assets			0
Amounts due from affiliates			2,902
Land, property and equipment			0
Intangible assets			28,000
Goodwill			83,602
Income tax receivable			0
Restricted cash			0
Total assets acquired			138,180
Liabilities:
Accounts payable and accrued expenses			2,487
Medical liabilities			14,693
Amounts due to affiliates			0
Income taxes payable			24
Deferred tax liability			0
Non-controlling interest			0
Total liabilities assumed			17,204
Total net assets acquired			$ 120,976
AHMS
Total purchase consideration:
Cash paid		$ 63,935
Contingent consideration		0
Common stock issued		0
Consideration transferred		63,935
Assets:
Cash and cash equivalents		33,950
Investment in marketable securities		0
Receivables		11,007
Other receivables		0
Prepaid expenses and other current assets		36
Amounts due from affiliates		0
Land, property and equipment		0
Intangible assets		23,600
Goodwill		31,048
Income tax receivable		0
Restricted cash		300
Total assets acquired		99,941
Liabilities:
Accounts payable and accrued expenses		7,111
Medical liabilities		14,942
Amounts due to affiliates		5,890
Income taxes payable		1,689
Deferred tax liability		6,374
Non-controlling interest		0
Total liabilities assumed		36,006
Total net assets acquired		$ 63,935
Other Acquisitions
Total purchase consideration:
Cash paid	[1]			15,000
Contingent consideration	[1]			6,161
Common stock issued	[1]			0
Consideration transferred	[1]			21,161
Assets:
Cash and cash equivalents	[1]			3,515
Investment in marketable securities	[1]			30
Receivables	[1]			0
Other receivables	[1]			0
Prepaid expenses and other current assets	[1]			11
Amounts due from affiliates	[1]			0
Land, property and equipment	[1]			823
Intangible assets	[1]			3,900
Goodwill	[1]			13,621
Income tax receivable	[1]			1
Restricted cash	[1]			0
Total assets acquired	[1]			21,901
Liabilities:
Accounts payable and accrued expenses	[1]			250
Medical liabilities	[1]			0
Amounts due to affiliates	[1]			54
Income taxes payable	[1]			0
Deferred tax liability	[1]			8
Non-controlling interest	[1]			428
Total liabilities assumed	[1]			740
Total net assets acquired	[1]			21,161
Total Acquisitions
Total purchase consideration:
Cash paid				169,933
Contingent consideration				14,187
Common stock issued				21,952
Consideration transferred				206,072
Assets:
Cash and cash equivalents				54,139
Investment in marketable securities				30
Receivables				17,537
Other receivables				472
Prepaid expenses and other current assets				47
Amounts due from affiliates				2,902
Land, property and equipment				823
Intangible assets				55,500
Goodwill				128,271
Income tax receivable				1
Restricted cash				300
Total assets acquired				260,022
Liabilities:
Accounts payable and accrued expenses				9,848
Medical liabilities				29,635
Amounts due to affiliates				5,944
Income taxes payable				1,713
Deferred tax liability				6,382
Non-controlling interest				428
Total liabilities assumed				53,950
Total net assets acquired				$ 206,072
[1] *Others consist of estimated fair values of the assets acquired, net of cash acquired, related to ADSC, PCCCV, and Airline Complete.

Business Combinations and Goo_5

Business Combinations and Goodwill - Schedule of Business Acquisition, Pro Forma Information, Nonrecurring Adjustments (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Business Combination and Asset Acquisition [Abstract]
Business Acquisition, Pro Forma Revenue	$ 478,710	$ 430,399	$ 1,434,813	$ 1,207,867
Net income attributable to Astrana Health, Inc.	$ 16,094	$ 26,215	$ 54,148	$ 64,875
Net income per share - basic (in dollars per share)	$ 0.34	$ 0.56	$ 1.14	$ 1.39
Net income per share - diluted (in dollars per share)	$ 0.33	$ 0.56	$ 1.13	$ 1.38

Business Combinations and Goo_6

Business Combinations and Goodwill - Schedule of Goodwill (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 278,831
Acquisitions	128,271
Adjustments	2,609
Ending balance	$ 409,711

Intangible Assets, Net - Schedu

Intangible Assets, Net - Schedule of Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Accumulated Amortization	$ (149,308)	$ (131,268)
Total	105,058
Intangible Assets, Gross	258,416	202,916
Intangible Assets, Net	109,108	71,648
Trademarks
Finite-Lived Intangible Assets [Line Items]
Indefinite lived assets:	2,150	2,150
Licenses
Finite-Lived Intangible Assets [Line Items]
Indefinite lived assets:	1,900
Network relationships
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets, Gross	156,779	150,679
Accumulated Amortization	(111,626)	(104,859)
Total	$ 45,153	$ 45,820
Network relationships | Minimum
Finite-Lived Intangible Assets [Line Items]
Useful Life	11 years	11 years
Network relationships | Maximum
Finite-Lived Intangible Assets [Line Items]
Useful Life	21 years	21 years
Management contracts
Finite-Lived Intangible Assets [Line Items]
Useful Life	15 years	15 years
Amortized intangible assets, Gross	$ 22,832	$ 22,832
Accumulated Amortization	(17,647)	(16,662)
Total	5,185	6,170
Member relationships
Finite-Lived Intangible Assets [Line Items]
Amortized intangible assets, Gross	71,577	24,077
Accumulated Amortization	(17,582)	(7,345)
Total	$ 53,995	$ 16,732
Member relationships | Minimum
Finite-Lived Intangible Assets [Line Items]
Useful Life	7 years	10 years
Member relationships | Maximum
Finite-Lived Intangible Assets [Line Items]
Useful Life	14 years	14 years
Patient management platform
Finite-Lived Intangible Assets [Line Items]
Useful Life	5 years	5 years
Amortized intangible assets, Gross	$ 2,060	$ 2,060
Accumulated Amortization	$ (2,060)	$ (2,060)
Tradename/trademarks
Finite-Lived Intangible Assets [Line Items]
Useful Life	20 years	20 years
Amortized intangible assets, Gross	$ 1,011	$ 1,011
Accumulated Amortization	(345)	(308)
Total	$ 666	$ 703
Developed technology
Finite-Lived Intangible Assets [Line Items]
Useful Life	6 years	6 years
Amortized intangible assets, Gross	$ 107	$ 107
Accumulated Amortization	(48)	(34)
Total	$ 59	$ 73

Intangible Assets, Net - Additi

Intangible Assets, Net - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 6,700,000	$ 3,200,000	$ 18,000,000	$ 9,500,000
Impairment of finite-lived intangible assets			$ 0	$ 0

Intangible Assets, Net - Sche_2

Intangible Assets, Net - Schedule of Future Amortization Expense (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2024 (excluding the nine months ended September 30, 2024)	$ 6,630
2025	22,856
2026	18,642
2027	15,170
2028	12,459
Thereafter	29,301
Total	$ 105,058

Investments in Other Entities -

Investments in Other Entities - Schedule of Equity Method Investments (Details) - USD ($) $ in Thousands	3 Months Ended			9 Months Ended
	Sep. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Equity Method Investments [Roll Forward]
Beginning Balance	$ 33,276	$ 25,774	$ 45,832	$ 25,774	$ 40,299
Initial Investment	0		0	5,968	325
Allocation of Net Income (Loss)	1,353		(2,104)	2,887	3,104
Funding			700		700
Ending Balance	$ 34,629		$ 44,428	$ 34,629	$ 44,428
LaSalle Medical Associates – IPA line of business
Schedule of Equity Method Investments [Line Items]
% of Ownership	25%		25%	25%	25%
Equity Method Investments [Roll Forward]
Beginning Balance	$ 11,027	9,866	$ 10,537	$ 9,866	$ 5,684
Initial Investment	0		0	0	0
Allocation of Net Income (Loss)	1,064		(2,211)	2,225	2,642
Funding			0		0
Ending Balance	$ 12,091		$ 8,326	$ 12,091	$ 8,326
Pacific Medical Imaging & Oncology Center, Inc.
Schedule of Equity Method Investments [Line Items]
% of Ownership	40%		40%	40%	40%
Equity Method Investments [Roll Forward]
Beginning Balance	$ 1,648	1,691	$ 1,655	$ 1,691	$ 1,878
Initial Investment	0		0	0	0
Allocation of Net Income (Loss)	(29)		4	(72)	(219)
Funding			0		0
Ending Balance	$ 1,619		$ 1,659	$ 1,619	$ 1,659
531 W. College, LLC
Schedule of Equity Method Investments [Line Items]
% of Ownership			50%		50%
Equity Method Investments [Roll Forward]
Beginning Balance			$ 17,070		$ 17,281
Initial Investment			0		0
Allocation of Net Income (Loss)			(176)		(387)
Funding			700		700
Ending Balance			$ 17,594		$ 17,594
One MSO, LLC
Schedule of Equity Method Investments [Line Items]
% of Ownership			50%		50%
Equity Method Investments [Roll Forward]
Beginning Balance			$ 2,960		$ 2,718
Initial Investment			0		0
Allocation of Net Income (Loss)			88		330
Funding			0		0
Ending Balance			$ 3,048		$ 3,048
CAIPA MSO, LLC
Schedule of Equity Method Investments [Line Items]
% of Ownership	30%		30%	30%	30%
Equity Method Investments [Roll Forward]
Beginning Balance	$ 14,100	$ 13,660	$ 13,190	$ 13,660	$ 12,738
Initial Investment	0		0	0	0
Allocation of Net Income (Loss)	203		123	643	575
Funding			0		0
Ending Balance	$ 14,303		$ 13,313	$ 14,303	$ 13,313
I Health, Inc.
Schedule of Equity Method Investments [Line Items]
% of Ownership	25%	25%		25%
Equity Method Investments [Roll Forward]
Beginning Balance	$ 5,923	$ 0		$ 0
Initial Investment	0			5,968
Allocation of Net Income (Loss)	65			20
Ending Balance	$ 5,988			$ 5,988
Other
Schedule of Equity Method Investments [Line Items]
% of Ownership	25%		25%	25%	25%
Equity Method Investments [Roll Forward]
Beginning Balance	$ 578	$ 557	$ 420	$ 557	$ 0
Initial Investment	0		0	0	325
Allocation of Net Income (Loss)	50		68	71	163
Funding			0		0
Ending Balance	$ 628		$ 488	$ 628	$ 488

Investments in Other Entities_2

Investments in Other Entities - Additional Information (Details) - USD ($)	3 Months Ended			9 Months Ended
	Sep. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Jun. 30, 2024	Dec. 31, 2023	Jun. 30, 2023	Dec. 31, 2022
Schedule of Equity Method Investments [Line Items]
Purchase price of equity investment	$ 34,629,000		$ 44,428,000	$ 34,629,000	$ 44,428,000	$ 33,276,000	$ 25,774,000	$ 45,832,000	$ 40,299,000
Initial Investment	0		0	5,968,000	325,000
Impairment of investments	$ 0		$ 0	$ 0	$ 0
I Health, Inc.
Schedule of Equity Method Investments [Line Items]
Equity interest (as a percent)	25%	25%		25%
Purchase price of equity investment	$ 5,988,000			$ 5,988,000		$ 5,923,000	$ 0
Initial Investment	0			5,968,000
I Health, Inc. | Call Option
Schedule of Equity Method Investments [Line Items]
Equity interest (as a percent)		25%
Purchase price of equity investment		$ 9,900,000
Initial Investment		6,000,000
Call option	$ 3,900,000	$ 3,900,000		$ 3,900,000

Loans Receivable (Details)

Loans Receivable (Details) - USD ($) $ in Millions			1 Months Ended
	Jul. 17, 2024	Jan. 29, 2024	Jul. 31, 2023
IntraCare Convertible Promissory Note Receivable | Convertible Secured Promissory Note
Accounts, Notes, Loans and Financing Receivable [Line Items]
Revolving credit facility term			5 years
Debt, principal sum			$ 25
Interest rate (as a percent)			8.81%
Mature Date			Jul. 27, 2028
BASS Medical Group | Senior Secured Promissory Note
Accounts, Notes, Loans and Financing Receivable [Line Items]
Debt, principal sum		$ 20
Interest rate (as a percent)		8.21%
Mature Date		Jan. 11, 2031
DWGAS Convertible Promissory Note Receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Revolving credit facility term	5 years
Debt, principal sum	$ 5
Interest rate (as a percent)	7.50%
Management service organization's equity interest conversion option	80%
Mature Date	Jul. 17, 2029

Accounts Payable and Accrued _3

Accounts Payable and Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Accounts payable and other accruals	$ 36,908	$ 9,075
Capitation payable	13,317	4,503
Subcontractor IPA payable	2,440	2,529
Professional fees	4,152	4,407
Due to related parties	3,785	9,271
Contract liabilities	2,246	744
Accrued compensation	17,498	20,098
Other provider payable	14,465	9,322
Total accounts payable and accrued expenses	$ 94,811	$ 59,949

Medical Liabilities (Details)

Medical Liabilities (Details) - USD ($) $ in Thousands		9 Months Ended
		Sep. 30, 2024	Sep. 30, 2023
Medical Liabilities [Roll Forward]
Medical liabilities, beginning of period		$ 106,657	$ 81,255
Acquired* (see Note 3)	[1]	32,106	6,157
Components of medical care costs related to claims incurred:
Current period		797,906	642,880
Prior periods		(7,890)	(13,251)
Total medical care costs		790,016	629,629
Payments for medical care costs related to claims incurred:
Current period		(654,625)	(547,212)
Prior periods		(112,847)	(74,966)
Total paid		(767,472)	(622,178)
Adjustments		(1,028)	2,656
Medical liabilities, end of period		$ 160,279	$ 97,519
[1] *The acquired balance includes medical liabilities from current and prior periods.

Credit Facility, Promissory N_3

Credit Facility, Promissory Notes Payable, Bank Loans, and Lines of Credit - Schedule of Credit Facility (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Line of Credit Facility [Line Items]
Total debt	$ 441,857	$ 282,000
Less: Current portion of debt	(15,000)	(19,500)
Less: Unamortized financing costs	(3,738)	(3,561)
Long-term debt	423,119	258,939
Revolver Loan
Line of Credit Facility [Line Items]
Total debt	146,732	0
Term Loan
Line of Credit Facility [Line Items]
Total debt	285,250	280,000
Promissory Note Payable
Line of Credit Facility [Line Items]
Total debt	$ 9,875	$ 2,000

Credit Facility, Promissory N_4

Credit Facility, Promissory Notes Payable, Bank Loans, and Lines of Credit - Schedule of Maturities (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Debt Disclosure [Abstract]
2024 (excluding the nine months ended September 30, 2024)	$ 3,750
2025	16,875
2026	169,232
2027	34,250
2028	217,750
Total	$ 441,857

Credit Facility, Bank Loans, an

Credit Facility, Bank Loans, and Lines of Credit - Additional Information (Details)

1 Months Ended

6 Months Ended

9 Months Ended

Apr. 01, 2024 USD ($)

Nov. 03, 2023 USD ($)

Jun. 16, 2021 USD ($)

May 31, 2021

Jun. 30, 2024 USD ($)

Sep. 30, 2024 USD ($) FinancialRatio

Sep. 30, 2023

Jul. 01, 2024 USD ($)

Mar. 31, 2024

Dec. 31, 2023 USD ($)

Sep. 08, 2023 USD ($)

May 01, 2023 USD ($)

Sep. 10, 2019 USD ($)

Debt Instrument [Line Items]

Amount outstsnding

$ 441,857,000

$ 282,000,000

Average effective interest rate

7.08%

6.07%

Loan from company

$ 441,857,000

Deferred financing costs

4,800,000

6,100,000

Unamortized deferred financing costs

3,738,000

3,561,000

FYB

Debt Instrument [Line Items]

Interest acquired

100%

Minimum | Secured Overnight Financing Rate

Debt Instrument [Line Items]

Basis spread on variable rate

1.50%

Minimum | Base Rate

Debt Instrument [Line Items]

Basis spread on variable rate

0.50%

Maximum | Secured Overnight Financing Rate

Debt Instrument [Line Items]

Basis spread on variable rate

2.75%

Maximum | Base Rate

Debt Instrument [Line Items]

Basis spread on variable rate

1.75%

Revolver Loan

Debt Instrument [Line Items]

Amount outstsnding

$ 146,700,000

Repayments

$ 180,000,000

Proceeds from (repayments of) bank overdrafts

$ 120,000,000

I Health, Inc.

Debt Instrument [Line Items]

% of Ownership

25%

25%

Amended Credit Agreement | Minimum | Secured Overnight Financing Rate

Debt Instrument [Line Items]

Basis spread on variable rate

1.25%

Amended Credit Agreement | Minimum | Base Rate

Debt Instrument [Line Items]

Basis spread on variable rate

0.25%

Amended Credit Agreement | Maximum | Secured Overnight Financing Rate

Debt Instrument [Line Items]

Basis spread on variable rate

2.50%

Amended Credit Agreement | Maximum | Base Rate

Debt Instrument [Line Items]

Basis spread on variable rate

1.50%

Amended Credit Agreement | Revolver Loan

Debt Instrument [Line Items]

Revolving credit facility term

5 years

Maximum loan availability

$ 400,000,000

Interest rate

7.20%

Credit Agreement Amendment | Secured Debt | Truist Bank | Debt Instrument, Redemption, Period One

Debt Instrument [Line Items]

Interest rate (as a percent)

5%

Credit Agreement Amendment | Secured Debt | Truist Bank | Debt Instrument, Redemption, Period Two

Debt Instrument [Line Items]

Interest rate (as a percent)

7.50%

Credit Agreement Amendment | Secured Debt | Truist Bank | Debt Instrument, Redemption, Period Three

Debt Instrument [Line Items]

Interest rate (as a percent)

10%

Credit Agreement

Debt Instrument [Line Items]

Amount outstsnding

$ 285,300,000

Average effective interest rate

7.20%

Number of key financial ratios | FinancialRatio

2

Maximum consolidated leverage ratio (not greater than)

3.75

Debt covenant, aggregate purchase price, maximum

$ 75,000,000

Consolidated leverage ratio, annual decrease

0.25

Debt instrument, covenant, leverage ratio, adjusted maximum

4

Minimum consolidated interest coverage ratio (not less than)

3.25

Subordinated Loan Agreement | Subordinated Debt

Debt Instrument [Line Items]

Basis spread on variable rate

1%

Debt, principal sum

$ 2,000,000

I Health Promissiory Note

Debt Instrument [Line Items]

Proceeds from promissory note

$ 8,300,000

Interest rate (as a percent)

4.30%

Additional Principal Amount

$ 1,600,000

Notes payable

$ 9,900,000

FYB Promissory Note

Debt Instrument [Line Items]

Amount outstsnding

$ 2,000,000

Letter of Credit | Astrana Medical

Debt Instrument [Line Items]

Loan from company

545,000,000

Letter of Credit | Amended Credit Agreement

Debt Instrument [Line Items]

Maximum loan availability

$ 25,000,000

$ 50,000,000

Letter of Credit | Credit Agreement Amendment | Truist Bank

Debt Instrument [Line Items]

Amount funded at closing

$ 300,000,000

New Term Loan

Debt Instrument [Line Items]

Unamortized deferred financing costs

1,000,000

$ 2,600,000

Line of Credit | APC Business Loan Agreement | Preferred Bank | Allied Pacific Of California IPA

Debt Instrument [Line Items]

Maximum loan availability

$ 4,100,000

Standby Letters of Credit | Allied Pacific Of California IPA

Debt Instrument [Line Items]

Maximum loan availability

$ 3,900,000

Term of facility

1 year

Standby Letters of Credit | Amended Credit Agreement | Truist Bank

Debt Instrument [Line Items]

Maximum loan availability

$ 25,000,000

Term of facility

1 year

Mezzanine and Stockholders' E_2

Mezzanine and Stockholders' Equity (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended		3 Months Ended		9 Months Ended		12 Months Ended
	Mar. 31, 2016	Oct. 31, 2015	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Class of Stock [Line Items]
Holdback shares not issued to former shareholders (in shares)					41,048
Preferred stock, shares authorized (in shares)			5,000,000		5,000,000		5,000,000
Treasury shares (in shares)			10,598,749		10,598,749		10,584,340
Treasury stock repurchased (in shares)					3,466,051		3,451,642
Payments of ordinary dividends common stock					$ 2,114	$ 2,266
APC
Class of Stock [Line Items]
Treasury shares (in shares)			7,132,698		7,132,698		7,132,698
APC | Apollo Medical Holdings, Inc
Class of Stock [Line Items]
Equity interest (as a percent)			13%		13%		13.22%
CDSC
Class of Stock [Line Items]
Payments of ordinary dividends common stock			$ 200	$ 1,400	$ 2,100	$ 1,600
Company And APC
Class of Stock [Line Items]
Treasury shares (in shares)			10,598,749		10,598,749		10,584,340
Series A Preferred Stock
Class of Stock [Line Items]
Preferred stock, shares authorized (in shares)			0		0		1,111,111
Preferred stock, shares outstanding (in shares)			0		0		0
Series B Preferred Stock
Class of Stock [Line Items]
Class of warrant, number of securities called by each warrant (in shares)	1
Exercise price per share (in dollars per share)	$ 10
Preferred stock, shares authorized (in shares)			0		0		555,555
Preferred stock, shares outstanding (in shares)			0		0		0
Number of shares purchased by related party (in shares)	555,555
Private Placement
Class of Stock [Line Items]
Class of warrant, number of securities called by each warrant (in shares)		1
Exercise price per share (in dollars per share)		$ 9
Number of shares purchased by related party (in shares)		1,111,111

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Share-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	$ 6,163	$ 5,706	$ 19,301	$ 13,364
Stock options and ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	349	406	1,125	1,393
Restricted stock awards and units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	$ 5,814	$ 5,300	$ 18,176	$ 11,971

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Details) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024 USD ($) shares	Sep. 30, 2023 shares	Sep. 30, 2024 USD ($) $ / shares shares	Sep. 30, 2023 USD ($) shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation expense | $	$ 31,700		$ 31,700
Shares issued for exercise of options and warrants (in shares)	75,455		75,455	125,000
Purchase price adjustment from merger | $	$ 232
Number of shares issued under stock purchase plan			7,789
Options granted	0		0
Shares withheld from issuance upon exercise of options	21,655	0	21,655	0
Restricted Stock Awards and Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted stock awards granted (in shares)			519,696
Contingent on performance (in shares)			405,164
Weighted average grant date fair value (in dollars per share) | $ / shares			$ 41.31
Performance Based Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average grant date fair value (in dollars per share) | $ / shares			$ 43.01
Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock, discounted price, percentage	85		85
Common stock, discounted price, percentage (up to)	90		90
Number of shares authorized for issuance (in shares)	5,000,000		5,000,000
APC Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Purchase price adjustment from merger | $	$ 200		$ 200	$ 1,300

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of Stock Option Transactions Under Stock Option Plans (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended	9 Months Ended		12 Months Ended
	Sep. 30, 2024	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Shares
Beginning balance (in shares)	421,515	421,515		504,241
Options granted (in shares)		0
Options exercised (in shares)	(75,455)	(75,455)	(125,000)
Options forfeited (in shares)		(7,271)
Options outstanding, ending balance (in shares)	421,515	421,515		504,241
Options exercisable (in shares)	383,685	383,685
Weighted Average Exercise Price
Options outstanding, beginning balance (in dollars per share)		$ 34.03
Options granted (in dollars per share)		0
Options exercised (in dollars per share)		16.71
Options forfeited (in dollars per share)		50.56
Options outstanding, ending balance (in dollars per share)	$ 36.84	36.84		$ 34.03
Options exercisable (in dollars per share)	$ 30.06	$ 30.06
Weighted Average Remaining Contractual Term (Years)
Options outstanding		1 year 3 months 10 days		2 years 1 month 6 days
Options exercisable		1 year 1 month 6 days
Aggregate Intrinsic Value (in millions)
Options outstanding	$ 10.9	$ 10.9		$ 4.7
Options exercised		2.3
Options exercisable	$ 10.9	$ 10.9

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Commitments And Contingencies [Line Items]
Amount outstanding	$ 441,857
Amended Credit Agreement | Truist Bank | Standby Letters of Credit
Commitments And Contingencies [Line Items]
Maximum loan availability	25,000
APC | Standby Letters of Credit
Commitments And Contingencies [Line Items]
Maximum loan availability	$ 3,900

Related-Party Transactions - Ad

Related-Party Transactions - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Mar. 31, 2024	Dec. 31, 2023
Related Party Transaction [Line Items]
Revenue	$ 478,710	$ 348,173	$ 1,369,331	$ 1,033,625
Operating lease right-of-use assets	33,119		33,119			$ 37,396
Expenses payable	400	500	2,100	900
Investments in privately held entities	8,896		8,896			6,396
Operating lease liabilities	5,241		5,241			4,607
Third Way Health | Agreement for Future Equity Fund
Related Party Transaction [Line Items]
Investments in privately held entities	6,000		6,000			3,500
Risk pool settlements and incentives
Related Party Transaction [Line Items]
Revenue	21,779	15,022	57,564	48,605
LMA | Related Party
Related Party Transaction [Line Items]
Revenue		4,300		16,200
First Commonwealth Property, LLC
Related Party Transaction [Line Items]
Operating lease right-of-use assets	700		700			800
Operating lease liabilities	800		800			800
Allied Pacific Holdings Investment Management, LLC | Chief Executive Officer
Related Party Transaction [Line Items]
Operating lease right-of-use assets	2,000		2,000			14,100
Operating lease liabilities	2,000		2,000			14,500
AHMC
Related Party Transaction [Line Items]
Amount outstanding under agreement	74,700		74,700			$ 54,000
AHMC | Related Party | Risk pool settlements and incentives
Related Party Transaction [Line Items]
Revenue	9,400	4,200	28,500	33,000
AHMC | Arroyo Vista | Related Party
Related Party Transaction [Line Items]
Revenue	400	500	1,500	1,300
APC | Board [Member]
Related Party Transaction [Line Items]
Payments for repurchase of shares	700		700	9,500
APC | Sunny Village Care Center | Provider Services
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	100	200	300	1,000
APC | Board Members | Provider Services
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	4,600	11,600	14,100	30,500
APC | Board Members Who Are Also Officers | Provider Services
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	800	700	2,200	2,300
APC | Allied Pacific Holdings Investment Management, LLC | Taxes Associated with Excluded Assets Spin-off
Related Party Transaction [Line Items]
Related party transaction, amount of transaction			5,300
AMG | First Commonwealth Property, LLC | Office Lease
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	100	100	100	100
AMG | Allied Pacific Holdings Investment Management, LLC | Office Lease
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	$ 1,300	800	$ 3,000	2,500
I Health, Inc.
Related Party Transaction [Line Items]
Equity interest (as a percent)	25%		25%		25%
I Health, Inc. | Related Party
Related Party Transaction [Line Items]
Incurred expenses	$ 600		$ 1,200
PMIOC
Related Party Transaction [Line Items]
Equity interest (as a percent)	40%		40%
PMIOC | Provider Services
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	$ 800	800	$ 2,200	1,900
Song PC
Related Party Transaction [Line Items]
Equity interest (as a percent)	25%		25%
Song PC | Provider Services
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	$ 300	$ 300	$ 700	$ 800

Related-Party Transactions - Sc

Related-Party Transactions - Schedule of Fees Incurred and Revenue Earned from Related Party Transactions (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
AHMC | Revenue
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	$ 11,167	$ 5,619	$ 33,944	$ 37,337
AHMC | Expenses
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	9,169	6,445	24,134	18,505
AHMC | Net
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	1,998	(826)	9,810	18,832
HSMSO | Revenue
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	626	326	1,239	950
HSMSO | Expenses
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	0	(200)	0	35
HSMSO | Net
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	626	526	1,239	915
Aurion | Revenue
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	0	0	0	0
Aurion | Expenses
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	50	75	200	225
Aurion | Net
Related Party Transaction [Line Items]
Related party transaction, amount of transaction	$ (50)	$ (75)	$ (200)	$ (225)

Income Taxes (Details)

Income Taxes (Details) - USD ($)	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Effective income tax rate	30.20%	34.80%
Unrecognized tax benefits related to various federal and state income tax matters	$ 0

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Details) - shares	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Restricted Stock Awards and Units
Earnings Per Share [Line Items]
Antidilutive securities not included in the calculation of earnings per share (in shares)	0	243,689	0	243,689
Employee Stock Option
Earnings Per Share [Line Items]
Antidilutive securities not included in the calculation of earnings per share (in shares)	155,990	200,978	155,990	200,978
Performance Shares
Earnings Per Share [Line Items]
Antidilutive securities not included in the calculation of earnings per share (in shares)	1,085,808	925,558	1,085,808	925,558
APC
Earnings Per Share [Line Items]
Antidilutive securities not included in the calculation of earnings per share (in shares)			7,132,698		7,132,698

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Earnings Per Share Computations (Details) - $ / shares	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Earnings Per Share [Abstract]
Earnings per share – basic (in dollars per share)	$ 0.34	$ 0.47	$ 1.05	$ 1.04
Earnings per share – diluted (in dollars per share)	$ 0.33	$ 0.47	$ 1.04	$ 1.03
Weighted average shares of common stock outstanding – basic (in shares)	47,686,841	46,547,502	47,521,368	46,527,350
Weighted average shares of common stock outstanding – diluted (in shares)	48,223,788	46,920,607	47,960,686	46,881,567

Earnings Per Share - Schedule_2

Earnings Per Share - Schedule of Shares Included in the Diluted Earnings Per Share Computations (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Earnings Per Share [Line Items]
Weighted average shares of common stock outstanding – basic (in shares)	47,686,841	46,547,502	47,521,368	46,527,350
Contingently issuable shares (in shares)	45,814	30,888	40,203	10,409
Weighted average shares of common stock outstanding – diluted (in shares)	48,223,788	46,920,607	47,960,686	46,881,567
Employee Stock Option
Earnings Per Share [Line Items]
Adjustments to weighted average shares of common stock (in shares)	169,785	253,767	155,309	254,399
Restricted stock awards and units
Earnings Per Share [Line Items]
Adjustments to weighted average shares of common stock (in shares)	321,348	88,450	243,806	89,409

Variable Interest Entities (V_3

Variable Interest Entities (VIEs)- Additional Information (Details)		9 Months Ended
	Jan. 01, 2024	Sep. 30, 2024
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Variable interest entity, ownership percentage	25%	100%

Variable Interest Entities (V_4

Variable Interest Entities (VIEs) (Details) - USD ($) $ in Thousands		Sep. 30, 2024	Jun. 30, 2024	Dec. 31, 2023		Sep. 30, 2023	Jun. 30, 2023	Dec. 31, 2022
Current assets
Cash and cash equivalents		$ 347,994		$ 293,807		$ 273,941
Investment in marketable securities		2,354		2,498
Income taxes receivable		16,211		10,657
Other receivables		1,120		1,335
Prepaid expenses and other current assets		20,506		17,450
Total current assets		596,990		461,507
Non-current assets
Intangible assets, net		109,108		71,648
Goodwill		409,711		278,831
Income taxes receivable, non-current		15,943		15,943
Investments in other entities – equity method		34,629	$ 33,276	25,774		44,428	$ 45,832	$ 40,299
Operating lease right-of-use assets		33,119		37,396
Other assets		8,878		1,877
Total non-current assets		688,386		471,854
Total assets		1,285,376		933,361	[1]
Current liabilities
Accounts payable and accrued expenses		94,811		59,949
Fiduciary accounts payable		6,041		7,737
Medical liabilities		160,279		106,657		$ 97,519		$ 81,255
Dividend payable		638		638
Finance lease liabilities		554		646
Operating lease liabilities		5,241		4,607
Current portion of long-term debt		15,000		19,500
Other liabilities		30,364		18,940
Total current liabilities		312,928		218,674
Non-current liabilities
Finance lease liabilities, net of current portion		743		1,033
Operating lease liabilities, net of current portion		31,162		36,289
Deferred tax liability		2,857		4,072
Other long-term liabilities		7,460		3,586
Total non-current liabilities		465,341		303,919
Total liabilities	[1]	778,269		522,593
Nonrelated Party
Current assets
Receivables, net		132,237		76,780
Related Party
Current assets
Receivables, net		76,568		58,980
Variable Interest Entity, Primary Beneficiary
Current assets
Cash and cash equivalents		181,340		184,078
Investment in marketable securities		2,233		0
Income taxes receivable		0		1,600
Other receivables		385		454
Prepaid expenses and other current assets		9,763		9,991
Total current assets		324,087		275,950
Non-current assets
Land, property and equipment, net		5,619		5,306
Intangible assets, net		82,264		60,906
Goodwill		235,638		140,157
Income taxes receivable, non-current		15,943		15,943
Investments in other entities – equity method		14,338		12,114
Investment in affiliates		413,269		273,182
Investment in a privately held entity		405		405
Restricted cash		40		40
Operating lease right-of-use assets		21,648		28,796
Other assets		1,147		1,149
Total non-current assets		790,311		537,998
Total assets		1,114,398		813,948
Current liabilities
Accounts payable and accrued expenses		41,416		32,707
Fiduciary accounts payable		6,041		7,737
Medical liabilities		75,648		55,157
Dividend payable		638		638
Income tax payable		26,105		0
Finance lease liabilities		520		646
Operating lease liabilities		3,434		3,305
Amount due to affiliates		76,294		107,340
Other liabilities		11,139		8,542
Total current liabilities		241,235		216,072
Non-current liabilities
Finance lease liabilities, net of current portion		649		1,033
Operating lease liabilities, net of current portion		21,054		28,675
Deferred tax liability		7,198		7,284
Other long-term liabilities		299		230
Total non-current liabilities		29,200		37,222
Total liabilities		270,435		253,294
Variable Interest Entity, Primary Beneficiary | Nonrelated Party
Current assets
Receivables, net		54,356		21,120
Variable Interest Entity, Primary Beneficiary | Related Party
Current assets
Receivables, net		$ 76,010		$ 58,707
[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 $ 701.1 million and $ 540.8 million as of September 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 $ 194.1 million and $ 146.0 million as of September 30, 2024 and December 31, 2023, respectively. These VIE balances do not include $ 413.3 million of investment in affiliates and $ 76.3 million of amounts due to affiliates as of September 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.

Leases - Additional information

Leases - Additional information (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Lessee, Lease, Description [Line Items]
Lease option to extend (up to)	10 years
Lease, termination period, if applicable	1 year
Assets recorded under finance leases	$ 1.4	$ 1.7
Accumulated depreciation associated with finance leases	$ 2	$ 1.6
Minimum
Lessee, Lease, Description [Line Items]
Remaining lease term, finance	1 month
Maximum
Lessee, Lease, Description [Line Items]
Remaining lease term, finance	16 years

Leases - Schedule of Components

Leases - Schedule of Components of Lease Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Leases [Abstract]
Operating lease cost	$ 3,205	$ 2,187	$ 9,438	$ 5,570
Finance lease cost
Amortization of lease expense	172	202	534	505
Interest on lease liabilities	20	35	66	80
Sublease income	(3)	(307)	(246)	(806)
Total lease cost, net	$ 3,394	$ 2,117	$ 9,792	$ 5,349

Leases - Schedule of Other Info

Leases - Schedule of Other Information Related to Leases (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 3,089	$ 2,016	$ 8,684	$ 5,636
Operating cash flows from finance leases	20	35	66	80
Financing cash flows from finance leases	$ 172	$ 202	$ 534	$ 505
Weighted Average Remaining Lease Term
Operating leases	6 years 11 months 4 days	6 years 10 months 2 days	6 years 11 months 4 days	6 years 10 months 2 days
Finance leases	2 years 8 months 8 days	3 years 2 months 4 days	2 years 8 months 8 days	3 years 2 months 4 days
Weighted Average Discount Rate
Operating leases	6.68%	5.75%	6.68%	5.75%
Finance leases	5.70%	5.19%	5.70%	5.19%

Leases - Schedule of Future Min

Leases - Schedule of Future Minimum Lease Payments Under Non-cancelable Leases (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Operating Leases
Operating leases, 2024 (excluding the nine months ended September 30, 2024)	$ 1,855
Operating leases, 2025	7,523
Operating leases, 2026	7,213
Operating leases, 2027	6,729
Operating leases, 2028	6,472
Operating leases, Thereafter	16,902
Operating leases, Total future minimum lease payments	46,694
Operating leases, Less: imputed interest	10,291
Operating leases, Total lease liabilities	36,403
Operating leases, Less: current portion	5,241	$ 4,607
Operating leases, Long-term lease liabilities	31,162	36,289
Finance Leases
Finance leases, 2024 (excluding the nine months ended September 30, 2024)	160
Finance leases, 2025	599
Finance leases, 2026	345
Finance leases, 2027	267
Finance leases, 2028	27
Finance leases, Thereafter	9
Finance leases, Total future minimum lease payments	1,407
Finance leases, Less: imputed interest	110
Finance leases, Total lease liabilities	1,297
Finance leases, Less: current portion	554	646
Finance leases, Long-term lease liabilities	$ 743	$ 1,033

Segments (Details)

Segments (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Segment Reporting Information [Line Items]
Total revenue	$ 478,710	$ 348,173	$ 1,369,331	$ 1,033,625
Cost of services	405,218	275,375	1,148,422	857,648
General and administrative	45,067	33,715	132,279	87,494
Total expenses	450,285	309,090	1,280,701	945,142
Income from operations	28,425	39,083	88,630	88,483
Third-Party
Segment Reporting Information [Line Items]
Total revenue	478,710	348,173	1,369,331	1,033,625
Intersegment Elimination
Segment Reporting Information [Line Items]
Total revenue	(52,708)	(38,887)	(142,704)	(106,646)
Cost of services	(13,335)	(11,336)	(38,091)	(35,522)
General and administrative	(39,370)	(28,621)	(104,692)	(74,401)
Total expenses	(52,705)	(39,957)	(142,783)	(109,923)
Income from operations	(3)	1,070	79	3,277
Intersegment Elimination | Intersegment
Segment Reporting Information [Line Items]
Total revenue	(52,708)	(38,887)	(142,704)	(106,646)
Corporate Costs
Segment Reporting Information [Line Items]
General and administrative	15,315	7,083	50,720	21,704
Total expenses	15,315	7,083	50,720	21,704
Income from operations	(15,315)	(7,083)	(50,720)	(21,704)
Care Partners | Operating Segments
Segment Reporting Information [Line Items]
Total revenue	455,760	320,885	1,301,355	957,297
Cost of services	369,835	249,917	1,049,437	783,333
General and administrative	47,139	30,628	129,613	83,475
Total expenses	416,974	280,545	1,179,050	866,808
Income from operations	38,786	40,340	122,305	90,489
Care Partners | Operating Segments | Third-Party
Segment Reporting Information [Line Items]
Total revenue	455,760	320,885	1,301,355	957,297
Care Delivery | Operating Segments
Segment Reporting Information [Line Items]
Total revenue	34,728	28,971	100,304	79,831
Cost of services	29,114	23,060	80,160	65,187
General and administrative	6,971	6,946	19,914	16,076
Total expenses	36,085	30,006	100,074	81,263
Income from operations	(1,357)	(1,035)	230	(1,432)
Care Delivery | Operating Segments | Third-Party
Segment Reporting Information [Line Items]
Total revenue	20,083	16,737	59,179	42,603
Care Delivery | Operating Segments | Intersegment
Segment Reporting Information [Line Items]
Total revenue	14,645	12,234	41,125	37,228
Care Enablement | Operating Segments
Segment Reporting Information [Line Items]
Total revenue	40,930	36,910	110,376	102,451
Cost of services	19,604	13,658	56,916	44,441
General and administrative	15,012	16,804	36,724	38,181
Total expenses	34,616	30,462	93,640	82,622
Income from operations	6,314	6,448	16,736	19,829
Care Enablement | Operating Segments | Third-Party
Segment Reporting Information [Line Items]
Total revenue	2,867	10,306	8,797	33,164
Care Enablement | Operating Segments | Intersegment
Segment Reporting Information [Line Items]
Total revenue	$ 38,063	26,604	$ 101,579	69,287
Other | Operating Segments
Segment Reporting Information [Line Items]
Total revenue		294		692
Cost of services		76		209
General and administrative		875		2,459
Total expenses		951		2,668
Income from operations		(657)		(1,976)
Other | Operating Segments | Third-Party
Segment Reporting Information [Line Items]
Total revenue		245		561
Other | Operating Segments | Intersegment
Segment Reporting Information [Line Items]
Total revenue		$ 49		$ 131

Fair Value Measurements of Fi_3

Fair Value Measurements of Financial Instruments - Schedule of Carrying Amounts and Fair Values of Financial Instruments (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market accounts	$ 28,044	$ 4,842
Marketable securities – certificates of deposit	2,263	2,150
Marketable securities – equity securities	91	348
Total assets	34,305	7,340
Total liabilities	35,812	22,088
AAMG contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	3,876	5,475
VOMG contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	15	17
DMG remaining equity interest purchase
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining equity interest purchase	8,542	8,542
Sun Labs remaining equity interest purchase
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining equity interest purchase	7,352	7,802
ADSC contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	4,138
CFC contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	9,138
PCCCV contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	2,597
Interest Rate Collar
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative liability	154	252
I Health call option
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative assets	3,907
Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market accounts	28,044	4,842
Marketable securities – certificates of deposit	2,263	2,150
Marketable securities – equity securities	91	348
Total assets	30,398	7,340
Total liabilities	0	0
Level 1 | AAMG contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	0	0
Level 1 | VOMG contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	0	0
Level 1 | DMG remaining equity interest purchase
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining equity interest purchase	0	0
Level 1 | Sun Labs remaining equity interest purchase
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining equity interest purchase	0	0
Level 1 | ADSC contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	0
Level 1 | CFC contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	0
Level 1 | PCCCV contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	0
Level 1 | Interest Rate Collar
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative liability	0	0
Level 1 | I Health call option
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative assets	0
Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market accounts	0	0
Marketable securities – certificates of deposit	0	0
Marketable securities – equity securities	0	0
Total assets	0	0
Total liabilities	154	252
Level 2 | AAMG contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	0	0
Level 2 | VOMG contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	0	0
Level 2 | DMG remaining equity interest purchase
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining equity interest purchase	0	0
Level 2 | Sun Labs remaining equity interest purchase
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining equity interest purchase	0	0
Level 2 | ADSC contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	0
Level 2 | CFC contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	0
Level 2 | PCCCV contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	0
Level 2 | Interest Rate Collar
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative liability	154	252
Level 2 | I Health call option
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative assets	0
Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market accounts	0	0
Marketable securities – certificates of deposit	0	0
Marketable securities – equity securities	0	0
Total assets	3,907	0
Total liabilities	35,658	21,836
Level 3 | AAMG contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	3,876	5,475
Level 3 | VOMG contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	15	17
Level 3 | DMG remaining equity interest purchase
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining equity interest purchase	8,542	8,542
Level 3 | Sun Labs remaining equity interest purchase
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining equity interest purchase	7,352	7,802
Level 3 | ADSC contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	4,138
Level 3 | CFC contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	9,138
Level 3 | PCCCV contingent considerations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	2,597
Level 3 | Interest Rate Collar
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative liability	0	$ 0
Level 3 | I Health call option
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative assets	$ 3,907

Fair Value Measurements of Fi_4

Fair Value Measurements of Financial Instruments - Schedule of Change in Fair Value of Level 3 Liabilities (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 21,836
Additions	14,202
Change in fair value of existing Level 3 liabilities	3,643
Settlements	(4,023)
Ending balance	$ 35,658

Fair Value Measurements of Fi_5

Fair Value Measurements of Financial Instruments - Additional Information (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
	Jan. 31, 2024	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Jun. 30, 2024	Mar. 31, 2024	Jan. 01, 2024	Dec. 31, 2023	Jun. 30, 2023	Dec. 31, 2022	Oct. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities – certificates of deposit		$ 2,263		$ 2,263					$ 2,150
Equity securities		91		91					348
Unrealized (loss) gain on investments		(561)	$ (342)	415	$ (5,875)
Investments in other entities – equity method		34,629	44,428	34,629	44,428	$ 33,276			25,774	$ 45,832	$ 40,299
Apollo-Sun Labs Management, LLC
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity interest purchase obligation, noncurrent		7,400		7,400					7,800
Unrealized gain (loss) from change in fair value		(100)	(500)	$ 400	(2,300)
AAMG contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest acquired												100%
AAMG contingent consideration | 2023 Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity interest issued, number of shares (shares)				157,059
AAMG contingent consideration | Met 2023 Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity interest issued, number of shares (shares)				78,535
AAMG contingent consideration | 2024 Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity interest issued, number of shares (shares)				184,357
AAMG contingent consideration | Other Liabilities | 2023 Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration		4,000		$ 4,000					2,600
AAMG contingent consideration | Other Noncurrent Liabilities | 2023 Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity interest issued, number of shares (shares)				78,524
AAMG contingent consideration | Other Noncurrent Liabilities | 2024 Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration		3,900		$ 3,900					2,900
AAMG contingent consideration | Other Noncurrent Liabilities | 2023 and 2024 Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration		5,600		5,600					5,600
Advanced Diagnostic and Surgical Center, Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest acquired								95%
Fair value of contingent consideration								$ 3,600
Advanced Diagnostic and Surgical Center, Inc | Other Noncurrent Liabilities | 2023 Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration		2,100		2,100
Advanced Diagnostic and Surgical Center, Inc | Other Noncurrent Liabilities | 2024 Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration		2,100		2,100
Community Family Care Medical Group IPA, Inc.
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity interest issued, number of shares (shares)	631,712
Fair value of contingent consideration	$ 8,000
Community Family Care Medical Group IPA, Inc. | Other Noncurrent Liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration		15,000		15,000
Contingent consideration, liability, each measurement period		5,000		5,000
Community Family Care Medical Group IPA, Inc. | Other Noncurrent Liabilities | First Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration		3,700		3,700
Community Family Care Medical Group IPA, Inc. | Other Noncurrent Liabilities | Second and Third Metric
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration		5,400		5,400
PCCCV
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration		2,600		$ 2,600
DMG And Sun Labs
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity interest purchase obligation, period to purchase				3 years
DMG remaining equity interest purchase
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in other entities – equity method		8,500		$ 8,500					8,500
I Health, Inc.
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in other entities – equity method		$ 5,988		$ 5,988		$ 5,923			0
Equity interest (as a percent)		25%		25%			25%
I Health, Inc. | Call Option
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments in other entities – equity method							$ 9,900
Equity interest (as a percent)							25%
Call option		$ 3,900		$ 3,900			$ 3,900
Interest Rate Collar
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative, ceiling interest rate		5%		5%
Derivative, floor interest rate		2.34%		2.34%
Derivative asset, fair value		$ 200		$ 200					300
Unrealized (loss) gain on investments		(600)	$ 100	$ 100	$ 1,300
Certificates of Deposit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Short-term marketable securities, maturity period				90 days
Marketable securities – certificates of deposit		$ 2,300		$ 2,300					$ 2,200

Fair Value Measurements of Fi_6

Fair Value Measurements of Financial Instruments - Schedule of Gain (Loss) on Equity Securities (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Total gains (losses) recognized on equity securities	$ 68	$ (870)	$ (133)	$ (6,571)
Gains (losses) recognized on equity securities sold	65	0	(146)	0
Unrealized gains (losses) recognized on equity securities held at end of period	$ 3	$ (870)	$ 13	$ (6,571)

Subsequent Events (Additional I

Subsequent Events (Additional Information) (Details)	Nov. 08, 2024 USD ($)	Jul. 24, 2024 USD ($) State Member
Closing of Collaborative Health Systems, LLC Securities Purchase
Subsequent Event [Line Items]
Aggregate purchase price		$ 37,500,000
Number of medicare members | Member		129,000
Number of states | State		17
Maximum | Closing of Collaborative Health Systems, LLC Securities Purchase
Subsequent Event [Line Items]
Aggregate Earnout Payments		$ 21,500,000
Three Hundred Sixty Four Senior Secured Bridge Term Loan | Subsequent Event
Subsequent Event [Line Items]
Maximum loan availability	$ 1,095,000,000
Senior Secured Bridge Term Loan | Subsequent Event
Subsequent Event [Line Items]
Maximum loan availability	100,000,000
Asset and Equity Purchase Agreement | Subsequent Event
Subsequent Event [Line Items]
Aggregate purchase price	745,000,000
Escrow deposit in acquisition	$ 55,000,000