Value
7.2/10data confidence 100%| Component | Sub-score |
|---|---|
| P/E | 2.6 |
| P/S | 10.0 |
| EV/EBITDA | 3.8 |
| Fwd P/E | 9.2 |
| PEG | 10.0 |
| Analyst target | 6.0 |
- ▸Forward P/E: 10.9x
- ▸PEG: 0.10
- ▸Attractively valued
ASTH · Why this verdict
Why Astrana Health (ASTH) is rated SELL
Updated
Model-generated analysis — not investment advice. Not a registered investment advisor. Past performance does not guarantee future results. How we score · Editorial policy
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VerdictSELL
Overall score6.4/10
ConfidenceMEDIUM
MacroNEUTRAL
TrendMatrix Research · core thesis
Engine thesis — one sentence
Astrana Health is an industry growth leader (48% YoY) with a perfect 4-quarter earnings beat streak and a 10.0x forward P/E, trading 23.0% below its $44.95 analyst target, but razor-thin margins and heavy leverage keep quality below the minimum bar.
Falsifiable statement — pillar-level invalidators below. Engine-derived; not personalized advice.
Thesis pillars
| Pillar | Expectation | Trend |
|---|---|---|
The business has razor-thin margins and heavy leverage, with operating margin at 1.7% and debt-to-equity of 27.9 flagged as value-trap signals, and quality at 3.7/10 is below the 4.0 floor. Bear case | Operating margin should expand above 3% and quality should recover above 4.0/10 over the next 12 months. | ↑Improving |
| CounterCash conversion is excellent at 570% FCF/net income, and thin margins are normal for managed-care services, so leverage may be manageable. | ||
Astrana is growing 48% YoY and ranks as an industry growth leader, with quarterly revenue of about $973M in June 2026 versus $655M a year earlier. Growth breakdown | Quarterly revenue should keep rising toward the $1.02B next-quarter estimate and stay above 20% YoY growth. | →Stable |
| CounterRevenue stepped up sharply from $655M to $956M between June and September 2025 and has been nearly flat since ($951M-$973M), so the headline growth rate may come from an acquisition that is about to lap. | ||
Astrana beat EPS estimates in all of the last 4 quarters with an average surprise of 15.7% (June 2026: 0.80 vs 0.73), and has beaten in 11 of the last 12. Catalyst breakdown | EPS should keep beating estimates at the report due 2026-11-05. | →Stable |
| CounterThe 4-quarter streak raises the bar for each new report, and small-base EPS beats can reverse into a miss, as in August 2024 (-19.6%). | ||
Price is 23.0% below the $44.95 analyst target while downside to the stop is 8.0%, a reward-to-risk of 2.9, at a forward P/E of 10.0x. Estimated upside | The analyst target should hold near $44.95 while price recovers from $36.53. | →Stable |
| CounterAnalyst coverage is light and momentum is weak at 3.4/10 with falling on-balance volume, so the target may lag a deteriorating trend. | ||
Cash conversion is excellent, with free cash flow at 570% of net income and a 6.7 Piotroski component score despite thin accounting profits. Quality breakdown | Free cash flow should stay above 100% of net income over the next 12 months. | →Stable |
| CounterA 570% ratio on a tiny net income base (net margin score 0.5) may reflect working-capital timing, not durable cash generation. | ||
The business has razor-thin margins and heavy leverage, with operating margin at 1.7% and debt-to-equity of 27.9 flagged as value-trap signals, and quality at 3.7/10 is below the 4.0 floor.
↑ImprovingBear case
- Expectation
- Operating margin should expand above 3% and quality should recover above 4.0/10 over the next 12 months.
CounterCash conversion is excellent at 570% FCF/net income, and thin margins are normal for managed-care services, so leverage may be manageable.
Astrana is growing 48% YoY and ranks as an industry growth leader, with quarterly revenue of about $973M in June 2026 versus $655M a year earlier.
→StableGrowth breakdown
- Expectation
- Quarterly revenue should keep rising toward the $1.02B next-quarter estimate and stay above 20% YoY growth.
CounterRevenue stepped up sharply from $655M to $956M between June and September 2025 and has been nearly flat since ($951M-$973M), so the headline growth rate may come from an acquisition that is about to lap.
Astrana beat EPS estimates in all of the last 4 quarters with an average surprise of 15.7% (June 2026: 0.80 vs 0.73), and has beaten in 11 of the last 12.
→StableCatalyst breakdown
- Expectation
- EPS should keep beating estimates at the report due 2026-11-05.
CounterThe 4-quarter streak raises the bar for each new report, and small-base EPS beats can reverse into a miss, as in August 2024 (-19.6%).
Price is 23.0% below the $44.95 analyst target while downside to the stop is 8.0%, a reward-to-risk of 2.9, at a forward P/E of 10.0x.
→StableEstimated upside
- Expectation
- The analyst target should hold near $44.95 while price recovers from $36.53.
CounterAnalyst coverage is light and momentum is weak at 3.4/10 with falling on-balance volume, so the target may lag a deteriorating trend.
Cash conversion is excellent, with free cash flow at 570% of net income and a 6.7 Piotroski component score despite thin accounting profits.
→StableQuality breakdown
- Expectation
- Free cash flow should stay above 100% of net income over the next 12 months.
CounterA 570% ratio on a tiny net income base (net margin score 0.5) may reflect working-capital timing, not durable cash generation.
Per-dimension breakdown
Quality
3.7/10data confidence 100%| Component | Sub-score |
|---|---|
| ROE | 2.3 |
| ROA | 2.5 |
| Gross margin | 0.0 |
| Op margin | 1.4 |
| Net margin | 0.5 |
| Current ratio | 4.7 |
| FCF quality | 10.0 |
| Moat | 4.9 |
| Piotroski F | 6.7 |
- ▸Excellent cash conversion: 570% FCF/NI
- ▸No competitive moat
Growth
10.0/10data confidence 67%| Component | Sub-score |
|---|---|
| Rev growth | 10.0 |
| EPS growth | 10.0 |
- ▸Strong growth: 48% YoY
Momentum
8.1/10data confidence 100%| Component | Sub-score |
|---|---|
| RSI | 5.5 |
| MACD | 8.6 |
| OBV | 10.0 |
| MA position | 9.0 |
| Volume | 7.3 |
- ▸Volume accumulation (rising OBV)
- ▸Above 200-day MA
Sentiment
6.2/10data confidence 100%| Component | Sub-score |
|---|---|
| Analyst rating | 5.0 |
| Price target | 8.6 |
| erm sentiment | 5.0 |
- ▸Analyst upside: 30%
Insider
6.2/10data confidence 75%| Component | Sub-score |
|---|---|
| materiality | 5.0 |
| holder change | 6.7 |
| notable moves | 7.0 |
- ▸No net insider activity — $0 (0.000% of mkt cap)
Peer rank
4.6/10data confidence 80%| Component | Sub-score |
|---|---|
| value rank | 5.0 |
| quality rank | 2.8 |
| growth rank | 9.1 |
- ▸Industry growth leader
Technical
2.9/10data confidence 100%| Component | Sub-score |
|---|---|
| bollinger | 0.0 |
| support resistance | 1.3 |
| 52w position | 5.4 |
| gap | 5.0 |
Risk (lower is worse)
4.3/10data confidence 100%| Component | Sub-score |
|---|---|
| short interest | 4.2 |
| days to cover | 3.4 |
| volatility | 2.5 |
| put call | 10.0 |
| implied vol | 0.0 |
| beta | 6.0 |
| debt equity | 3.7 |
- ▸High IV: 90%
Catalyst
7.5/10data confidence 100%| Component | Sub-score |
|---|---|
| erm | 5.0 |
| earnings history | 10.0 |
| earnings timing | 5.0 |
| surprise avg | 10.0 |
- ▸Perfect beat streak: 4Q
- ▸Earnings today
How the verdict was assembled
Engine trigger
Quality below minimum threshold.
Engine technical detail
verdict_path:
L1:HARD_BLOCK:QUALITY_FLOORPassed (5)
- MOMENTUM:8.1>=5.5
- INSIDER:OK
- NEWS_EVENTS:NONE_RECENT
- SEMI_CYCLE_PEAK:CLEAR
- MATERIALS_CYCLE_PEAK:CLEAR
Failed (2)
- ASYMMETRY:1.2<1.5@spot
- EARNINGS_PROXIMITY:0d<=7d
Warning (1)
- 8K_CSUITE_CHANGE:5.02 (officer departure/appointment)
Reward-to-Risk
1.23
Upside
+13.3%
Downside
10.8%
Sizing output
AVOID
SetupBreakout — Golden cross, above all MAs, RSI 58, MACD bullish
EdgeInst Constrain — Small cap ($2.0B) below institutional reach
SuitabilityAggressive — MCap $2.0B<$5B
Investment implication
The SELL_IF_HOLDING verdict reflects the ASYMMETRY gate's 1.2<1.5@spot outcome against Growth at 10.0 and asymmetric R:R of 1.23.
The strongest dimensions are Growth at 10.0, Momentum at 8.1, and Catalyst at 7.5; the weakest are Technical at 2.9, Quality at 3.7, and Risk (lower is worse) at 4.3. The V9 engine flagged 2 failed gates with 1 warning, producing an asymmetric reward-to-risk of 1.23 and an engine sizing output of AVOID.
What would invalidate the thesis
Falsifying conditions — when triggered, the corresponding pillar's thesis is invalidated.
- P1Industry Growth Leader
Trip ifRevenue growth falls below 15% YoY from current 48%.
- P2Perfect Earnings Beat Streak
Trip ifEPS surprise stays below 0% for 2 consecutive quarters.
- P3Thin Margins High Leverage
Trip ifQuality score rises above 5.0/10 from current 3.7.
- P4Large Analyst Upside
Trip ifAnalyst target falls below $38 from current $44.95.
- P5Strong Cash Conversion
Trip ifFree cash flow to net income falls below 100% from current 570%.