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Related-Party Transactions
 3 Months Ended
Mar. 31, 2024
Related Party Transactions [Abstract]  
Related-Party Transactions Related-Party Transactions
Equity Method Investments
During the three months ended March 31, 2023, AHM recognized approximately $5.0 million in management fees from LMA. On August 31, 2023, the management service agreement between LMA’s IPA and AHM was terminated. LMA is accounted for under the equity method based on the 25% equity ownership interest held by APC in LMA’s IPA line of business (see Note 5 — “Investments in Other Entities - Equity Method”).
During the three months ended March 31, 2024 and 2023, APC paid approximately $0.8 million and $0.6 million, respectively, to PMIOC for provider services. APC and PMIOC have an Ancillary Service Contract together whereby PMIOC provides covered services on behalf of APC to enrollees of the plans of APC. PMIOC is accounted for under the equity method based on the 40% equity ownership interest held by APC (see Note 5 — “Investments in Other Entities — Equity Method”).
During the three months ended March 31, 2024 and 2023, the Company paid approximately $0.2 million and $0.2 million, respectively, to James Song, M.D., a Professional Corporation (“Song PC”) for provider services. Song PC is accounted for
under the equity method based on the 25% equity ownership interest held by Astrana, as Astrana has the ability to exercise significant influence, but not control over, Song PC’s operations.
Astrana Board Members and Officers
During the three months ended March 31, 2024 and 2023, AHM recognized approximately $0.5 million and $0.5 million, respectively, in management fees from Arroyo Vista Family Health Center (“Arroyo Vista”). The Company has a managed service agreement with Arroyo Vista. Arroyo Vista’s chief executive officer is a member of the Company’s board of directors.
During the three months ended March 31, 2024 and 2023, the Company paid approximately $0.1 million and $64,000, respectively, to Arroyo Vista for services as a provider. The Company has provider contracts with Arroyo Vista.
During the three months ended March 31, 2024 , the Company incurred rent expenses of approximately $0.9 million from certain properties that are managed by Allied Pacific Holdings Investment Management, LLC. During the three months ended March 31, 2023, the Company incurred $0.9 million in rent expense from the same properties, but it was eliminated upon consolidation. These properties were previously consolidated by Astrana until they were spun off on December 26, 2023. The chief executive officer of the real estate business managing these properties is also a member of the Company’s board of directors.
As of March 31, 2024 and December 31, 2023, the Company’s operating right-of-use asset balance included $12.7 million and $14.1 million, respectively, and the Company’s operating lease liabilities included $13.2 million and $14.5 million, respectively, for certain properties that are managed by Allied Pacific Holdings Investment Management, LLC.
During the three months ended March 31, 2024 and 2023, the Company incurred approximately $0.6 million and $0.4 million in expenses payable to Third Way Health for call center services. One of Astrana’s officers is a board member of Third Way Health.
During the three months ended March 31, 2024 and 2023, the Company paid approximately $45,000 and $0.2 million, respectively, to Sunny Village Care Center for services as a provider. The Company has provider contracts with Sunny Village Care Center. Sunny Village Care Center shares common ownership with certain Astrana board members.
During the three months ended March 31, 2023, Astrana paid approximately $9.5 million to purchase Astrana’s stock from a board member. The Company did not make any similar purchases during the three months ended March 31, 2024.
During the three months ended March 31, 2024, the Company incurred rent expenses of approximately $38,000 to First Commonwealth Property, LLC for an office lease. First Commonwealth Property, LLC shares common ownership with certain board members of APC and AHM.
The Company has agreements with Health Source MSO Inc., a California corporation (“HSMSO”), Aurion Corporation (“Aurion”), and AHMC for services provided to the Company. One of the Company’s board members is an officer of AHMC, HSMSO, and Aurion. Aurion is also partially owned by one of the Company’s board members. Revenue with AHMC and HSMSO consists of capitation, risk pool, and miscellaneous fees and expenses consisting of claims expenses, management fees, and consulting fees.
The following table sets forth revenue recognized and fees incurred related to AHMC, HSMSO, and Aurion for the three months ended March 31, 2024 and 2023 (in thousands):
Three months ended March 31, 2024Three months ended March 31, 2023
AHMCHSMSOAurionAHMCHSMSOAurion
Revenue$9,920 $301 $— $14,484 $315 $— 
Expenses7,557 — 50 6,400 169 50 
Net$2,363 $301 $(50)$8,084 $146 $(50)
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 March 31, 2024 and 2023, the Company has recognized risk pool revenues of $8.1 million and $13.0 million, respectively. The Company has a risk pool receivable balance of $58.8 million and $54.0 million as of March 31, 2024 and December 31, 2023, respectively.
APC Board Members
During the three months ended March 31, 2024 and 2023, the Company paid an aggregate of approximately $4.7 million and $9.4 million, respectively, to board members for provider services which included approximately $0.8 million and $0.9 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, see Note 5 — “Investment in Other Entities — Equity Method”