Astrana Health's second quarter is the first report that runs against a clean year-over-year comparison since the July 2025 close of the Prospect Health acquisition, and the print is the most direct evidence yet that the company is executing on the bet that brought it to $4 billion of revenue: capitation scale, integrated risk-bearing infrastructure, and the secular migration of Medicare Advantage and Medicaid lives into full-risk arrangements. Revenue of $972.5 million was up 49% year over year, net income rose 81% to $18.5 million, adjusted EBITDA climbed 43% to $68.9 million, and adjusted diluted earnings per share reached $0.80 - a 45% jump. Management raised the full-year adjusted EBITDA guide to $255–$280 million, even after raising the lower end of the range, while reaffirming revenue and free cash flow. The raise is the only signal a value-based-care operator can really deliver at this stage of integration: organic trajectory, plus an integration running ahead of plan.
The market reaction is the test that has not yet come. Shares trade at $37.79, down about 24% from a 52-week high of $49.81 on July 1, 2026, but up roughly 108% from the $18.16 low on February 12, 2026. Analyst consensus is a Strong Buy with a $51.50 target, implying 36% upside. The forward price-to-earnings multiple sits near 23x - generous for a 49%-top-line, 43%-EBITDA growth print - and the EV/forward adjusted EBITDA of 9.3x against the raised guide is roughly in line with value-based-care peers. The asymmetry is this: the company is in the first full year of a major acquisition, the integration is delivering, and the guide raise came inside the report. The risk is that Prospect synergies and organic Knox-Keene full-risk conversion both have to land for the back half of the year to clear the guide. This is the company raising on the way up; the question is whether the back-half cadence can match.