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Side-by-side financial comparison of Alignment Healthcare, Inc. (ALHC) and Astrana Health, Inc. (ASTH). Click either name above to swap in a different company.
Alignment Healthcare, Inc. is the larger business by last-quarter revenue ($1.0B vs $950.5M, roughly 1.1× Astrana Health, Inc.). Astrana Health, Inc. runs the higher net margin — 0.7% vs -1.1%, a 1.8% gap on every dollar of revenue. On growth, Alignment Healthcare, Inc. posted the faster year-over-year revenue change (44.4% vs 42.9%). Astrana Health, Inc. produced more free cash flow last quarter ($-6.0M vs $-55.4M). Over the past eight quarters, Astrana Health, Inc.'s revenue compounded faster (53.3% CAGR vs 26.9%).
Alignment Healthcare, Inc. is a U.S.-based healthcare provider offering Medicare Advantage plans for seniors. It adopts a value-based care model, partnering with local providers to deliver personalized coordinated medical services, prescription drug coverage and supplemental benefits to members across multiple U.S. states.
Astrana Health, Inc. is a U.S.-based value-based healthcare services provider that primarily serves Medicare-eligible senior populations across the United States. It offers in-home primary care, chronic disease management, and care coordination services, aiming to improve patient health outcomes and reduce unnecessary medical costs.
ALHC vs ASTH — Head-to-Head
Income Statement — Q4 FY2025 vs Q4 FY2025
| Metric | | |
|---|---|---|
| Revenue | $1.0B | $950.5M |
| Net Profit | $-11.0M | $6.6M |
| Gross Margin | — | — |
| Operating Margin | -1.0% | 1.9% |
| Net Margin | -1.1% | 0.7% |
| Revenue YoY | 44.4% | 42.9% |
| Net Profit YoY | 64.6% | 184.4% |
| EPS (diluted) | $-0.04 | $0.12 |
Green = leading value per metric. Periods may differ when fiscal calendars don't align.
8-Quarter Revenue & Profit Trend
Side-by-side quarterly history. Quarters aligned by calendar period so offset fiscal years line up.
| Q4 25 | $1.0B | $950.5M | ||
| Q3 25 | $993.7M | $956.0M | ||
| Q2 25 | $1.0B | $654.8M | ||
| Q1 25 | $926.9M | $620.4M | ||
| Q4 24 | $701.2M | $665.2M | ||
| Q3 24 | $692.4M | $478.7M | ||
| Q2 24 | $681.3M | $486.3M | ||
| Q1 24 | $628.6M | $404.4M |
| Q4 25 | $-11.0M | $6.6M | ||
| Q3 25 | $3.7M | $373.0K | ||
| Q2 25 | $15.7M | $9.4M | ||
| Q1 25 | $-9.1M | $6.7M | ||
| Q4 24 | $-31.1M | $-7.8M | ||
| Q3 24 | $-26.4M | $16.1M | ||
| Q2 24 | $-24.0M | $19.2M | ||
| Q1 24 | $-46.5M | $14.8M |
| Q4 25 | -1.0% | 1.9% | ||
| Q3 25 | 0.8% | 2.0% | ||
| Q2 25 | 2.2% | 3.1% | ||
| Q1 25 | -0.6% | 3.3% | ||
| Q4 24 | -3.2% | 0.1% | ||
| Q3 24 | -2.8% | 5.9% | ||
| Q2 24 | -2.7% | 6.2% | ||
| Q1 24 | -6.5% | 7.5% |
| Q4 25 | -1.1% | 0.7% | ||
| Q3 25 | 0.4% | 0.0% | ||
| Q2 25 | 1.5% | 1.4% | ||
| Q1 25 | -1.0% | 1.1% | ||
| Q4 24 | -4.4% | -1.2% | ||
| Q3 24 | -3.8% | 3.4% | ||
| Q2 24 | -3.5% | 3.9% | ||
| Q1 24 | -7.4% | 3.7% |
| Q4 25 | $-0.04 | $0.12 | ||
| Q3 25 | $0.02 | $0.01 | ||
| Q2 25 | $0.07 | $0.19 | ||
| Q1 25 | $-0.05 | $0.14 | ||
| Q4 24 | $-0.15 | $-0.14 | ||
| Q3 24 | $-0.14 | $0.33 | ||
| Q2 24 | $-0.13 | $0.40 | ||
| Q1 24 | $-0.25 | $0.31 |
Balance Sheet & Financial Strength
Snapshot of each company's liquidity, leverage and book value from the latest quarter.
| Metric | | |
|---|---|---|
| Cash + ST InvestmentsLiquidity on hand | $604.2M | $429.5M |
| Total DebtLower is stronger | $323.2M | — |
| Stockholders' EquityBook value | $179.3M | $779.3M |
| Total Assets | $1.1B | $2.2B |
| Debt / EquityLower = less leverage | 1.80× | — |
8-quarter trend — quarters aligned by calendar period.
| Q4 25 | $604.2M | $429.5M | ||
| Q3 25 | $644.1M | $463.4M | ||
| Q2 25 | $503.8M | $342.1M | ||
| Q1 25 | $479.5M | $260.9M | ||
| Q4 24 | $470.6M | $290.8M | ||
| Q3 24 | $381.0M | $350.3M | ||
| Q2 24 | $363.7M | $327.7M | ||
| Q1 24 | $301.7M | $337.3M |
| Q4 25 | $323.2M | — | ||
| Q3 25 | $322.7M | — | ||
| Q2 25 | $322.3M | — | ||
| Q1 25 | $321.9M | — | ||
| Q4 24 | $321.4M | — | ||
| Q3 24 | $212.0M | — | ||
| Q2 24 | $211.7M | — | ||
| Q1 24 | $162.0M | — |
| Q4 25 | $179.3M | $779.3M | ||
| Q3 25 | $161.9M | $775.5M | ||
| Q2 25 | $141.0M | $765.5M | ||
| Q1 25 | $108.1M | $745.4M | ||
| Q4 24 | $99.9M | $712.7M | ||
| Q3 24 | $114.5M | $704.6M | ||
| Q2 24 | $123.7M | $678.9M | ||
| Q1 24 | $130.9M | $653.5M |
| Q4 25 | $1.1B | $2.2B | ||
| Q3 25 | $1.1B | $2.2B | ||
| Q2 25 | $1.0B | $1.4B | ||
| Q1 25 | $895.6M | $1.3B | ||
| Q4 24 | $782.1M | $1.4B | ||
| Q3 24 | $692.3M | $1.3B | ||
| Q2 24 | $716.3M | $1.3B | ||
| Q1 24 | $633.2M | $1.2B |
| Q4 25 | 1.80× | — | ||
| Q3 25 | 1.99× | — | ||
| Q2 25 | 2.29× | — | ||
| Q1 25 | 2.98× | — | ||
| Q4 24 | 3.22× | — | ||
| Q3 24 | 1.85× | — | ||
| Q2 24 | 1.71× | — | ||
| Q1 24 | 1.24× | — |
Cash Flow & Capital Efficiency
How much cash each business actually produces after reinvestment. Cash flow is harder to manipulate than net income.
| Metric | | |
|---|---|---|
| Operating Cash FlowLast quarter | $-50.4M | $-2.9M |
| Free Cash FlowOCF − Capex | $-55.4M | $-6.0M |
| FCF MarginFCF / Revenue | -5.5% | -0.6% |
| Capex IntensityCapex / Revenue | 0.5% | 0.3% |
| Cash ConversionOCF / Net Profit | — | -0.44× |
| TTM Free Cash FlowTrailing 4 quarters | $113.1M | $104.5M |
8-quarter trend — quarters aligned by calendar period.
| Q4 25 | $-50.4M | $-2.9M | ||
| Q3 25 | $144.6M | $10.0M | ||
| Q2 25 | $29.1M | $90.9M | ||
| Q1 25 | $16.6M | $16.6M | ||
| Q4 24 | $-8.7M | $-10.9M | ||
| Q3 24 | $26.2M | $34.0M | ||
| Q2 24 | $23.5M | $23.2M | ||
| Q1 24 | $-6.2M | $6.0M |
| Q4 25 | $-55.4M | $-6.0M | ||
| Q3 25 | $139.1M | $7.4M | ||
| Q2 25 | $21.1M | $89.5M | ||
| Q1 25 | $8.4M | $13.6M | ||
| Q4 24 | $-18.0M | $-13.5M | ||
| Q3 24 | $16.9M | $31.7M | ||
| Q2 24 | $11.8M | $20.4M | ||
| Q1 24 | $-17.4M | $5.6M |
| Q4 25 | -5.5% | -0.6% | ||
| Q3 25 | 14.0% | 0.8% | ||
| Q2 25 | 2.1% | 13.7% | ||
| Q1 25 | 0.9% | 2.2% | ||
| Q4 24 | -2.6% | -2.0% | ||
| Q3 24 | 2.4% | 6.6% | ||
| Q2 24 | 1.7% | 4.2% | ||
| Q1 24 | -2.8% | 1.4% |
| Q4 25 | 0.5% | 0.3% | ||
| Q3 25 | 0.6% | 0.3% | ||
| Q2 25 | 0.8% | 0.2% | ||
| Q1 25 | 0.9% | 0.5% | ||
| Q4 24 | 1.3% | 0.4% | ||
| Q3 24 | 1.3% | 0.5% | ||
| Q2 24 | 1.7% | 0.6% | ||
| Q1 24 | 1.8% | 0.1% |
| Q4 25 | — | -0.44× | ||
| Q3 25 | 38.77× | 26.69× | ||
| Q2 25 | 1.86× | 9.65× | ||
| Q1 25 | — | 2.48× | ||
| Q4 24 | — | — | ||
| Q3 24 | — | 2.11× | ||
| Q2 24 | — | 1.21× | ||
| Q1 24 | — | 0.40× |
Financial Flow Comparison
Revenue → gross profit → operating profit → net profit for each company.
Revenue Breakdown by Segment
ALHC
Segment breakdown not available.
ASTH
| Medicare | $542.4M | 57% |
| Commercial | $99.1M | 10% |
| Care Delivery | $92.1M | 10% |
| Care Enablement | $78.9M | 8% |
| Other Third Parties | $58.0M | 6% |
| Health Care Patient Service | $39.8M | 4% |
| Health Care Other | $25.5M | 3% |
| Other | $12.1M | 1% |
| Management Service | $10.3M | 1% |
