Astrana Health (ASTH) Cash Flow: Operating & Free Cash Flow

Astrana Health (ASTH) Cash Flow Statement

In fiscal 2025 (fiscal year ended Dec 31, 2025), Astrana Health generated $114.60M of operating cash flow and spent $10.11M on capital expenditures. That left free cash flow of $104.49M, up 136.6% from $44.17M a year earlier, or 3.3% of revenue. It returned $23.31M to shareholders through $7.88M in dividends and $15.43M in share buybacks.

Astrana Health Cash Flow Statement Analysis

Values in millions USD

Income Statement Balance Sheet Cash Flow Ratios

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Cash flow statement showing operating, investing, and financing activities for Astrana Health, Inc. (ASTH) - Annual data in millions USD
Breakdown	FY 2025	FY 2024	FY 2023	FY 2022	FY 2021	FY 2020	FY 2019	FY 2018	FY 2017
Period ending	Dec 2025	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020	Dec 2019	Dec 2018	Dec 2017
Operating Activities
Net Income	24.08	49.93	57.85	45.74	46.06	37.69	17.67	10.84	25.80
Depreciation & Amortization	45.75	27.93	17.75	17.54	17.52	18.35	18.28	19.30	19.08
Deferred Income Tax	-4.29	-4.25	-12.44	-14.28	7.67	0.40	-6.80	-8.35	-20.68
Stock Based Compensation	38.60	34.54	22.04	16.10	6.75	3.38	1.55	0.00	0.00
Change in Working Capital	-3.10	-63.61	-23.39	-1.96	-33.64	4.04	-22.77	-63.05	15.98
Change in Accounts Receivable	-7.16	-35.77	-20.57	-33.97	-21.63	4.13	-5.80	-28.63	10.70
Change in Inventory	0.00	0.00	12.16	27.61	-2.11	-7.71	0.00	0.00	0.00
Change in Accounts Payable	-11.69	-30.92	-0.50	-0.05	3.22	8.20	-4.40	-22.67	-1.81
Change in Other Working Capital	15.76	11.69	6.42	25.14	-1.22	-1.22	-12.58	-11.75	7.09
Other Operating Activities	13.56	3.42	6.42	4.70	33.66	84.79	5.75	157.26	42.15
Net Cash from Operating Activities	114.60	52.20	68.23	82.13	70.34	46.16	13.67	26.10	53.07
Investing Activities
Capital Expenditures	-10.11	-8.03	-28.53	-22.94	-19.22	-1.16	-1.04	-1.17	-2.08
Acquisitions	-548.60	-146.26	-6.84	-16.35	-2.59	-11.35	-53.00	-16.68	0.00
Purchases of Investments	0.00	-9.88	-6.15	-1.85	-41.62	91.61	-115.40	-0.41	-18.01
Sales/Maturities of Investments	15.10	0.12	0.49	32.07	73.99	50.63	0.00	0.00	0.03
Other Investing Activities	4.61	-28.23	-23.80	1.96	5.98	16.50	-11.19	-7.50	26.80
Net Cash from Investing Activities	-539.00	-192.40	-65.52	-7.11	16.54	95.49	-180.63	-25.76	6.73
Financing Activities
Debt Repayment	604.81	-18.50	-204.68	-3.87	-238.33	-9.61	234.48	7.41	4.90
Common Stock Issued	0.00	1.03	0.00	8.63	49.20	10.80	0.76	0.20	2.16
Common Stock Repurchased	-15.43	-5.60	-10.19	-9.25	-5.74	-0.54	-7.57	-5.05	-3.18
Dividends Paid	-7.89	-4.04	-62.07	-14.03	-31.09	-51.32	-61.72	-17.76	-10.45
Other Financing Activities	-12.15	-4.09	-4.16	-4.61	37.98	-1.04	-2.62	4.00	-8.41
Net Cash from Financing Activities	569.35	135.15	3.42	-20.09	-47.75	-51.70	163.33	-11.20	-14.98
Summary
Net Change in Cash	144.94	-5.05	6.13	54.93	39.13	89.96	-3.63	-12.88	110.50
Cash at Beginning of Period	289.10	294.15	288.03	233.10	193.97	104.01	107.64	119.77	9.27
Cash at End of Period	434.05	289.10	294.15	288.03	233.10	193.97	104.01	106.89	119.77
Free Cash Flow	104.49	44.17	39.70	59.19	51.11	45.00	12.63	24.93	50.99
Supplemental Disclosures
Interest Paid	-	30.42	14.25	6.67	4.16	8.51	-	-	-
Income Taxes Paid	-	43.94	56.57	47.31	37.20	62.00	-	-	-

Source: Company financial statements from annual and quarterly filings. Data as of Jun 30, 2026. Data sources and methodology

Frequently Asked Questions About Astrana Health Cash Flow

What is Astrana Health's free cash flow?

Astrana Health generated free cash flow of $104.49M in fiscal 2025 (fiscal year ended Dec 31, 2025), operating cash flow of $114.60M minus $10.11M of capital expenditures. That was up 136.6% from $44.17M a year earlier. Free cash flow equaled 3.3% of revenue.

How much does Astrana Health spend on capital expenditures?

Astrana Health spent $10.11M on capital expenditures in fiscal 2025, compared with $8.03M a year earlier. That equals 8.8% of operating cash flow.

Does Astrana Health pay dividends or buy back shares?

Yes. In fiscal 2025 Astrana Health returned $7.88M in dividends and $15.43M in share buybacks to shareholders, according to its cash flow statement.

What is free cash flow?

Free cash flow is operating cash flow minus capital expenditures. It is the cash a company has left for dividends, buybacks, debt repayment or acquisitions after funding its operations and investment. Full definition