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0.36x Total Debt / Equity (Conservative)

Moderate exposure; ~$400M variable-rate debt means 200bps rate rise adds ~$8M annual interest cost, compressing thin margins by ~50-80bps

Medium intensity; US-China trade tariffs on metals and components disrupt supply chains.

Not applicable; Astrana is a domestic US value-based care operator with no significant physical goods supply chain or geopolitical chokepoints

Minimal; ~95%+ revenue is US-domestic; limited sovereign currency devaluation exposure with nascent Asia-Pacific (Philippines) operations representing <5% of revenue

Primarily California, Texas, Nevada; Philippines operations minimal; effectively no material sovereign currency devaluation risk given USD-denominated revenue base

Medium intensity; commodities: Steel, Aluminum, Copper, Crude Oil (fuel), Rare Earth Elements, Plastics/Resins; geopolitical: US-China trade tariffs on metals and components disrupt supply chains.

Moderate; CMS and state Medicaid programs as payer concentration risk; no single technology vendor >30% but Epic/athenahealth EHR dependency is operationally critical

Value-based care managed care organization; cloud disruption would impair care coordination platforms but core clinical operations would continue via on-premise and manual workflows

Fee-for-service medical billing secondary model; cloud termination disrupts billing cycles materially but paper-based claims submission remains viable fallback

High API coupling to CMS risk adjustment and quality reporting systems; switching EHR vendors carries 18-36 month migration risk and $20-50M estimated cost

Low Howey risk; revenue model is healthcare services delivery and capitation contracts, not investment contracts; no token or profit-sharing security characteristics

Medium

Moderate HIPAA exposure as primary risk; CCPA applicable given California base; GDPR minimal given limited EU operations; PHI breach liability is primary regulatory concern

Moderate; aggressive acquisition strategy in California IPA market could attract FTC scrutiny; market share in Southern California physician networks warrants monitoring

Medium burden; regimes: FAA, DOT, OSHA, EPA, ITAR, FTC; Export controls and defense procurement rules create contract concentration risk.

~70-75% recurring via capitation and value-based contracts; ~25-30% transactional fee-for-service; recurring capitation revenue provides strong cash flow predictability

Per-member-per-month capitation payments from Medicare Advantage, Medi-Cal, and commercial payers; supplemented by fee-for-service and management services fees

Capitation rates set by CMS/state contracts limiting direct pricing power; stress scenario: 5% capitation rate cut equals ~$60-80M revenue loss with limited offset ability

Low-to-moderate; rates largely government-determined; differentiation via quality bonuses and risk adjustment coding captures incremental upside but no direct price-setting authority

0.0% Gross Margin (Thin (<20%))

Low free-rider risk; capitation model aligns incentives; member churn tied to Medicare Advantage plan switching during AEP; annual churn estimated 10-15% of member panel

Sublinear but not highly scalable; clinical staffing grows ~0.6-0.7x revenue growth rate; management services infrastructure allows leveraging across acquired practices

Marginal cost of adding capitated members is moderate; each acquired IPA requires integration overhead but operating leverage improves at scale above 100K members per market

Not a franchise model; however, IPA network physician compliance with quality protocols and coding accuracy is a structural drift risk across 10,000+ affiliated providers

At 10x scale (~2M members), capitation economics improve via negotiating leverage; CAC equivalent (practice acquisition cost) likely compresses 20-30% with brand recognition

Weak direct network effects; larger provider network improves care coordination and payer contract leverage but not a classic platform network effect; durability is moderate

1.8% Return on Assets (Excellent)

Tier 1 recession resistant; Medicare and Medicaid revenue (~80%+ of mix) is government-funded and counter-cyclical; commercial segment (~20%) faces mild recession pressure

Medicare Advantage members (seniors 65+) representing ~50-60% of capitated revenue; concentration in CMS-regulated programs creates reimbursement policy dependency

Medi-Cal (California Medicaid) members and commercial insurance members; Medi-Cal expansion risk tied to California state budget cycles and managed care contract renewals

["11-0000 Management Occupations", "13-0000 Business and Financial Operations Occupations", "15-0000 Computer and Mathematical Occupations", "17-0000 Architecture and Engineering Occupations", "23-0000 Legal Occupations", "33-0000 Protective Service Occupations", "37-0000 Building and Grounds Cleaning and Maintenance Occupations", "41-0000 Sales and Related Occupations", "43-0000 Office and Administrative Support Occupations", "47-0000 Construction and Extraction Occupations", "49-0000 Installation, Maintenance, and Repair Occupations", "51-0000 Production Occupations", "53-0000 Transportation and Material Moving Occupations"]

0.3 (HIL — ~30% of characteristic roles agent-automatable)

0.3% CapEx / Revenue (Low-CapEx Asset-Light)

0001083446

ASTH