XML 20 R11.htm IDEA: XBRL DOCUMENT v3.24.3
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
September 30,

 

 

Nine Months Ended
September 30,

 

(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 impairment 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