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ASTHAstrana Health, Inc.
$47.04$2.3B
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  4. Financial Ratios

Astrana Health, Inc. (ASTH) Financial Ratios

Latest Ratios: P/E Ratio 102.3x · EV/EBITDA 24.0x · ROE 4.2%. (2015–2025 historical series)

Income StatementBalance SheetCash FlowRatios
AnnualQuarterly

ASTH Valuation Multiples

Price-based multiples — how expensive the stock is relative to earnings, sales, book value, and cash flow

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2015
Market Cap$2.3B$1.2B$1.5B$1.8B$1.3B$3.3B$684M$670M$753M$688M$31M
Enterprise Value$3.0B$1.9B$1.7B$1.8B$1.3B$3.3B$751M$824M$659M$574M$22M
P/E Ratio →102.2653.9335.0329.6929.8948.3418.0947.2168.4526.67—
P/S Ratio0.730.380.751.301.184.311.851.201.451.920.70
P/B Ratio4.162.192.964.392.426.531.541.861.852.053.61
P/FCF22.3211.7234.4345.4122.8065.2715.2053.0630.1813.49—
P/OCF20.3510.6929.1326.4216.4347.4314.8249.0228.8312.96—

P/E links to full P/E history page with 30-year chart

ASTH EV Ratios

Enterprise-value multiples — capital-structure-neutral measures of total business value

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2015
EV / Revenue—0.590.841.321.134.272.031.471.271.610.50
EV / EBITDA23.9915.0814.5317.8810.6028.5630.7416.245.9110.14—
EV / EBIT37.9623.8614.9617.2713.6539.7465.9426.947.9311.54—
EV / FCF—17.9338.5846.1021.8164.6416.7065.2026.4511.26—

ASTH Profitability

Margins and return-on-capital ratios measuring operating efficiency

Margins

Full margin charts and quarterly trend are on the Earnings History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2015
Gross Margin9.3%9.3%13.3%15.5%17.4%23.0%5.9%16.6%26.8%17.9%22.0%
Operating Margin2.5%2.5%4.4%6.1%9.1%12.7%1.6%5.8%17.7%10.5%-14.9%
Net Profit Margin0.7%0.7%2.1%4.4%3.9%8.9%-6.4%2.5%2.1%7.2%-21.2%

Return on Capital

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2015
ROE4.2%4.2%9.3%12.5%8.4%14.4%-5.9%3.7%2.9%15.0%-109.3%
ROA1.3%1.3%3.8%6.4%4.9%8.2%-3.1%2.3%2.2%10.1%-47.8%
ROIC6.2%6.2%11.8%13.5%16.0%14.9%0.9%5.9%25.8%25.4%—
ROCE6.1%6.1%10.5%11.0%13.3%13.5%0.9%6.1%22.4%19.1%-54.2%

ASTH Leverage & Debt

Solvency and debt-coverage ratios — lower is generally safer

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2015
Debt / Equity1.931.930.920.780.410.390.590.710.030.020.02
Debt / EBITDA8.688.684.023.141.881.7410.665.060.120.11—
Net Debt / Equity—1.160.360.07-0.11-0.060.150.42-0.23-0.34-1.06
Net Debt / EBITDA5.225.221.560.27-0.48-0.282.753.02-0.84-2.00—
Debt / FCF—6.214.150.69-0.99-0.631.4912.14-3.74-2.23—
Interest Coverage1.571.573.446.5811.9415.414.516.46148.41624.81-14.20

ASTH Liquidity & Efficiency

Short-term solvency ratios and asset-utilisation metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2015
Current Ratio1.401.401.752.112.883.532.943.122.401.321.82
Quick Ratio1.401.401.752.112.883.532.943.122.401.321.82
Cash Ratio0.700.700.801.361.982.502.272.081.501.101.25
Asset Turnover—1.431.501.491.180.890.450.771.010.732.25
Inventory Turnover———————————
Days Sales Outstanding—46.7658.2738.8938.2046.8459.7664.4240.3420.5333.10

ASTH Shareholder Yields

Earnings, FCF, buyback, and dividend yields — total returns to shareholders

Dividends

Full dividend history and growth charts are on the Dividend History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2015
Dividend Yield0.3%0.6%0.3%3.4%1.0%0.9%7.5%9.2%2.4%1.5%—
Payout Ratio35.1%35.1%9.4%102.2%31.1%45.1%—437.2%163.9%40.5%—

Total Shareholder Return Metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2015
Earnings Yield1.0%1.9%2.9%3.4%3.3%2.1%5.5%2.1%1.5%3.8%—
FCF Yield4.5%8.5%2.9%2.2%4.4%1.5%6.6%1.9%3.3%7.4%—
Buyback Yield0.7%1.3%0.1%0.6%0.7%0.2%0.1%1.1%0.7%0.5%0.0%
Total Shareholder Yield1.0%1.9%0.3%4.0%1.7%1.1%7.6%10.3%3.0%2.0%0.0%
Shares Outstanding—$49M$48M$47M$46M$45M$37M$36M$38M$29M$5M

Key Metrics

Growth RegimeAccelerating
ProfitabilityStrained
Balance SheetMixed
Cash FlowMixed
Top Statement Risk

Margin compression from scaling

Verified Source

Metrics are mathematically derived from official filings.

SEC 10-K (2026Q1)

Premium Valuation Amidst Margin Uncertainty

Based on current market data, Astrana Health trades at a forward P/E of 35.05, which appears to price in significant future earnings growth that may be difficult to sustain given the company's historical net margin volatility as reported in recent quarterly financial statements.

The valuation premium relative to the company's thin net margins suggests that investors are pricing the entity as a high-growth technology platform rather than a traditional care provider. This multiple expansion warrants caution, as any failure to achieve operating leverage through the Care Enablement segment could lead to a sharp contraction in valuation multiples.

Capital Efficiency Decaying Under Expansion

According to historical financial data, Astrana Health's ROIC has trended downward from 4.6% in 2024Q1 to 1.8% in 2026Q1, indicating that the company's aggressive acquisition-led growth strategy is currently failing to generate returns that exceed the cost of capital required to fund such rapid expansion.

The decline in ROIC suggests that the capital deployed for inorganic growth is not yet yielding the expected operational synergies. Investors should monitor whether the integration of these assets can eventually drive higher returns or if the current capital allocation strategy will continue to dilute shareholder value.

Working Capital Volatility Hinders Efficiency

As reported in recent financial disclosures, the company's asset turnover ratio has remained stagnant near 0.42, reflecting the inherent difficulty in scaling a capital-intensive, integrated care delivery model without sacrificing the efficiency of its underlying administrative and clinical workflows.

The persistent fluctuation in DSO, which reached 42 days in 2026Q1, highlights the challenges in managing cash conversion cycles within a complex, multi-payer environment. This inefficiency suggests that the company's working capital management is highly sensitive to the timing of claims settlements and bonus payments from health plans.

Leverage Escalation Pressures Financial Flexibility

Based on the latest balance sheet, the debt-to-equity ratio has climbed significantly to 1.84 in 2026Q1, a sharp increase from 0.83 in 2025Q2, which indicates that the company is increasingly relying on debt to finance its aggressive market consolidation and infrastructure development.

While the current interest coverage ratio of 1.77 remains above critical levels, the rapid accumulation of debt relative to EBITDA suggests that the company's margin for error is narrowing. Any further deterioration in operating margins could severely limit the company's ability to service its debt obligations without seeking additional financing.

Misapplication of P/E Multiples

Investors frequently misapply the P/E ratio to Astrana Health, failing to account for the significant non-cash charges and acquisition-related accounting noise that often obscure the company's true underlying cash-generating capability in its current high-growth, low-margin phase of operations.

Because the company's GAAP earnings are heavily influenced by IBNR reserve adjustments and acquisition-related amortization, the P/E ratio provides a distorted view of profitability. A more appropriate metric for this business model would be EV/EBITDA or a cash-flow-based valuation, which better captures the operational performance of the core care enablement platform.

Download Financial Ratios Data

Includes 30+ ratios · 10 years · Updated daily

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ASTH — Frequently Asked Questions

Quick answers to the most common questions about buying ASTH stock.

What is Astrana Health, Inc.'s P/E ratio?

Astrana Health, Inc.'s current P/E ratio is 102.3x. The historical average is 39.7x. This places it at the 100th percentile of its historical range.

What is Astrana Health, Inc.'s EV/EBITDA?

Astrana Health, Inc.'s current EV/EBITDA is 24.0x. This enterprise value multiple compares the company's total value (equity + debt - cash) to its EBITDA. The historical average is 16.6x.

What is Astrana Health, Inc.'s ROE?

Astrana Health, Inc.'s return on equity (ROE) is 4.2%. The historical average is -4.5%.

Is ASTH stock overvalued?

Based on historical data, Astrana Health, Inc. is trading at a P/E of 102.3x. This is at the 100th percentile of its historical P/E range. Compare with industry peers and growth rates for a complete picture.

What is Astrana Health, Inc.'s dividend yield?

Astrana Health, Inc.'s current dividend yield is 0.34% with a payout ratio of 35.1%.

What are Astrana Health, Inc.'s profit margins?

Astrana Health, Inc. has 9.3% gross margin and 2.5% operating margin.

How much debt does Astrana Health, Inc. have?

Astrana Health, Inc.'s Debt/EBITDA ratio is 8.7x, indicating high leverage. A ratio above 4x may signal elevated financial risk.