Related-Party Transactions

6 Months Ended

Jun. 30, 2025

Related Party Transactions [Abstract]

Related-Party Transactions

12.Related-Party Transactions

Equity Method Investments

During the three months ended June 30, 2025 and 2024, the Company paid approximately $2.2 million and $1.4 million, respectively, to our equity method investments, for management fee services, provider services, and interest expense. During the six months ended June 30, 2025 and 2024, the Company paid approximately $3.8 million and $2.5 million, respectively, to our equity method investments, for management fee services, provider services, and interest expense. During the six months ended June 30, 2025, the Company received $0.9 million from our equity method investments in management fees.

Astrana Board Members and Officers

During the three months ended June 30, 2025 and 2024, 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 six months ended June 30, 2025 and 2024, the Company recognized approximately $2.5 million and $1.7 million, respectively, in rent expense from the same properties. As of June 30, 2025, and December 31, 2024, the Company’s operating right-of-use asset balance included $6.9 million and $2.7 million, respectively, and the Company’s operating lease liabilities included $7.2 million and $2.7 million, respectively, for certain properties that are managed by Allied Pacific Holdings Investment Management, LLC. The chief executive officer of Allied Pacific Holdings Investment Management, LLC is a member of the Company’s board of directors.

The Company has a Simple Agreement for Future Equity ("SAFE") with Third Way Health. As of June 30, 2025, and December 31, 2024, the investment was $6.0 million, respectively, and presented within investments in privately held entities on the condensed consolidated balance sheets. During the three months ended June 30, 2025 and 2024, the Company incurred approximately $3.0 million and $1.2 million, respectively, in expenses payable to Third Way Health for call center and credentialing services. During the six months ended June 30, 2025 and 2024, the Company incurred approximately $5.2 million and $1.7 million, respectively, in expenses for call center services. One of Astrana’s officers is a board member of Third Way Health.

The Company has an agreement with AHMC Healthcare Inc. (“AHMC”) for services provided to the Company. Revenue with AHMC consists of capitation, risk pool, and miscellaneous fees, and expenses consist of claims expense. One of the Company’s directors is an officer of AHMC and two of the Company’s directors serve on AHMC’s board of directors.

The following tables set forth revenue recognized and fees incurred related to AHMC for the three and six months ended June 30, 2025 and 2024 (in thousands):

	Three Months Ended June 30,					Six Months Ended June 30,
	2025			2024		2025			2024
Revenue	$	4,574		$	12,857	$	11,345		$	22,777
Expenses		46,320			7,408		78,000			14,965
Net	$	(41,746	)	$	5,449	$	(66,655	)	$	7,812

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 June 30, 2025 and 2024, the Company had recognized risk pool revenues of $2.8 million and $11.0 million, respectively. During the six months ended June 30, 2025 and 2024, the Company had recognized risk pool revenues of $7.8 million and $19.1 million, respectively. As of June 30, 2025 and December 31, 2024, $55.1 million and $47.7 million remained in outstanding risk pool receivables, respectively.

APC Board Members

During the three months ended June 30, 2025 and 2024, the Company paid an aggregate of approximately $4.7 million and $4.9 million, respectively, to board members for provider services, which included approximately $0.6 million and $0.6 million, respectively, to Astrana board members and officers who are also board members and officers of APC. During the six months ended June 30, 2025 and 2024, the Company paid an aggregate of approximately $9.2 million and $9.6 million, respectively, to board members for provider services, which included approximately $1.2 million and $1.4 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 and promissory note payable with related parties, see Note 5 — “Investments in Other Entities — Equity Method” and Note 8 — “Credit Facility and Bank Loans,” respectively.