Astrana Health, Inc. (ASTH) 2025 Q3 法說會逐字稿

Good day, everyone, and welcome to Astrana Health third-quarter 2025 earnings call. (Operator Instructions) Today's speakers will be Brandon Sim, President and Chief Executive Officer of Astrana Health; and Chan Basho, Chief Operating and Financial Officer.

大家好，歡迎參加 Astrana Health 2025 年第三季財報電話會議。（操作員說明）今天的演講嘉賓是 Astrana Health 總裁兼執行長 Brandon Sim；以及營運長兼財務長 Chan Basho。

This press release announcing Astrana Health's results for the third quarter ended September 30, 2025, is available at the Investors section of the company's website at www.astranahealth.com. The company will discuss certain non-GAAP measures during this call. Reconciliations to the most comparable GAAP measures are included in the press release. To provide some additional background on its results, the company has made a supplemental deck available on its website. A replay of this broadcast will also be available at Astrana Health's website after the conclusion of this call.

本新聞稿公佈了Astrana Health截至2025年9月30日的第三季業績，可在本公司網站www.astranahealth.com的投資人關係欄位查閱。本公司將在本次電話會議中討論某些非GAAP財務指標。新聞稿中包含與最可比較的 GAAP 指標的調整表。為了提供更多關於其業績的背景信息，該公司在其網站上提供了一份補充資料。本次電話會議結束後，您也可以在 Astrana Health 的網站上觀看本次廣播的重播。

Before we get started, I would like to remind everyone that this conference call and any accompanying information discussed herein contains certain forward-looking statements within the meaning of the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These forward-looking statements can be identified by terms such as anticipate, believe, expect, future, plan, outlook and will and conclude, among other things, statements regarding the company's guidance, continued growth, acquisition strategy, ability to deliver sustainable long-term value, ability to respond to the changing environment, liquidity, operational focus, strategic growth plans and acquisition integration efforts.

在會議開始前，我想提醒大家，本次電話會議及本文討論的任何相關資訊包含1995年《私人證券訴訟改革法案》安全港條款所界定的某些前瞻性陳述。這些前瞻性陳述可以透過諸如預期、相信、期望、未來、計劃、展望和將等詞語來識別，並得出結論，其中包括有關公司指導、持續增長、收購戰略、提供可持續長期價值的能力、應對不斷變化的環境的能力、流動性、運營重點、戰略增長計劃和收購整合工作的陳述。

Although, the company believes that the expectations reflected in the forward-looking statements today are reasonable as of today, those statements are subject to risks and uncertainties that could cause the actual results to differ materially from those projected. These can be no assurance that those expectations will prove to be correct.

儘管公司認為，截至目前，前瞻性聲明中反映的預期是合理的，但這些聲明受到風險和不確定性的影響，可能導致實際結果與預測結果有重大差異。這並不能保證這些預期最終會實現。

Information about the risk associations with the investing in Astrana Health is included in the filings with the Securities and Exchange Commission, which we encourage you to review before making any investment decisions. The company does not assume any obligation to update any forward-looking statements as a result of the new information, future events, change in market conditions or otherwise, except as required by law. Regarding the disclaimer language, I would like you to refer to you to slide 2 of the conference call presentation for further information.

有關投資 Astrana Health 的風險資訊已包含在提交給美國證券交易委員會的文件中，我們建議您在做出任何投資決定之前仔細閱讀這些文件。除法律另有規定外，本公司不承擔因新資訊、未來事件、市場狀況變化或其他原因而更新任何前瞻性聲明的義務。關於免責聲明部分，請參閱電話會議簡報的第 2 頁以獲取更多資訊。

With that, I'll turn the call over to Astrana Health President and Chief Executive Officer, Brandon Sim. Please go ahead, Brandon.

接下來，我將把電話交給 Astrana Health 總裁兼執行長 Brandon Sim。請繼續，布蘭登。

Good afternoon, and thank you for joining us on Astrana Health's Third Quarter 2025 Earnings Call. Today, I'll start with an overview of our third quarter performance, highlight several exciting developments across our AI-enabled technology platform and discuss our new strategic partnerships. I'll then review our updated 2025 guidance and share some early perspective on how we're approaching 2026. After that, I'll turn it over to Chan for the financial review, and we'll open the call for your questions.

下午好，感謝各位參加阿斯特拉納健康公司2025年第三季財報電話會議。今天，我將首先概述我們第三季的業績，重點介紹我們人工智慧技術平台的一些令人興奮的發展，並討論我們新的策略合作夥伴關係。接下來，我將回顧我們更新後的 2025 年指導方針，並分享我們對 2026 年的一些初步看法。之後，我會把報告交給 Chan 進行財務審核，然後我們會開放提問環節。

Astrana delivered another strong quarter of financial and operational results in the third quarter as we continue to execute on our strategy of building the nation's leading health care delivery platform. This was an especially important quarter for all of us here at Astrana as we welcomed new providers, patients and team members after the close of our acquisition of Prospect Health in July.

阿斯特拉納在第三季度再次取得了強勁的財務和營運業績，我們繼續執行打造全國領先的醫療保健服務平台的策略。對於我們 Astrana 的所有人來說，這是一個特別重要的季度，因為在 7 月完成對 Prospect Health 的收購後，我們迎來了新的供應商、患者和團隊成員。

Our strategy remains grounded in four pillars that define how we have built a durable and profitable enterprise, one that consistently does right by providers and patients. These are smart growth, disciplined risk progression, quality and cost excellence and operating leverage through our technology platform. First, our model allows us to grow markets with strong physician leadership, payer partnerships and performance visibility, thus delivering consistent quality and financial outcomes at scale.

我們的策略仍然以四大支柱為基礎，這四大支柱定義了我們如何建立一個持久盈利的企業，一個始終為醫療服務提供者和患者提供良好服務的企業。這些目標包括：透過我們的技術平台實現智慧成長、有紀律的風險控制、卓越的品質和成本控制以及營運槓桿。首先，我們的模式使我們能夠透過強大的醫生領導、支付方合作關係和績效可見性來拓展市場，從而大規模地提供一致的品質和財務成果。

Next, we take on greater levels of risk in a disciplined fashion, supported by the data, infrastructure and clinical programs needed to manage that risk responsibly. We've built Astrana to be efficient and accountable in both quality and cost. And as we integrate new partners and scale our automation and AI capabilities, we continue to unlock operating leverage where each incremental member, physician and market contributes more to the enterprise than the one before it.

接下來，我們將以嚴謹的方式承擔更大程度的風險，並依靠資料、基礎設施和臨床專案來負責任地管理這些風險。我們打造 Astrana 的目標是在品質和成本方面都做到有效率和負責。隨著我們整合新的合作夥伴並擴大自動化和人工智慧能力，我們不斷釋放營運槓桿，使每個新增成員、醫生和市場對企業的貢獻都比之前更大。

It's in these periods of industry disruption that the Astrana model has continued to differentiate itself in terms of the superior outcomes we're delivering to both our patients and our payer partners. This has allowed us to consistently deliver differentiated financial results as well, and this quarter is no different.

正是在產業動盪時期，阿斯特拉納模式憑藉其為患者和支付方合作夥伴帶來的卓越成果，不斷脫穎而出。這也使我們能夠持續取得差異化的財務業績，本季也不例外。

For the third quarter of 2025, we delivered another strong performance across the business with total revenues of $956 million, up 100% year-over-year and 46% sequentially, driven by both the integration of Prospect Health into the company as well as solid organic growth across the core business.

2025 年第三季度，公司整體業績表現強勁，總收入達 9.56 億美元，年增 100%，環比增長 46%，這主要得益於 Prospect Health 併入公司以及核心業務的穩健內生增長。

Adjusted EBITDA for the quarter was $68.5 million, up 52% year-over-year and 42% sequentially as we continue to prioritize sustainable industry-leading profitability even as we scale aggressively. Medical cost trends across both Prospect and Astrana's core business remained firmly within expectations during the third quarter, underscoring the consistency and predictability of our operating model. In both the legacy Astrana and legacy Prospect businesses, medical cost trend was stable and well controlled with no meaningful deviation relative to the assumptions embedded in our guidance. First, in our legacy Astrana core business, Medicare once again trended favorably below our aggregate 4.5% trend expectation for the year. Importantly, Medicaid trend decelerated relative to the second quarter.

本季調整後 EBITDA 為 6,850 萬美元，年增 52%，環比增長 42%，我們將繼續優先考慮可持續的行業領先盈利能力，即使我們正在積極擴大規模。第三季度，Prospect 和 Astrana 核心業務的醫療成本趨勢都維持在預期之內，凸顯了我們營運模式的一致性和可預測性。在原有的阿斯特拉納業務和原有的普羅斯佩克特業務中，醫療成本趨勢穩定且控制良好，與我們的指導意見中隱含的假設相比，沒有出現任何實質偏差。首先，在我們傳統的阿斯特拉納核心業務中，Medicare 再次呈現優於我們全年 4.5% 整體趨勢預期的良好趨勢。值得注意的是，與第二季相比，醫療補助計劃的成長趨勢有所放緩。

Inpatient costs continue to trend favorably, and we continue to expect a full year blended cost trend of approximately 4.5% in the legacy Astrana business. Moving over to Prospect. Prospect also performed ahead of our expectations during the third quarter, and we remain very excited about the scale, capabilities and talent this acquisition brings to the Astrana platform. We are reiterating our synergy targets of $12 million to $15 million over the coming quarters.

住院費用持續呈現良好趨勢，我們繼續預期阿斯特拉納傳統業務全年綜合成本趨勢約為 4.5%。移步至展望鎮。Prospect 在第三季也表現出色，超越了我們的預期，我們對此次收購為 Astrana 平台帶來的規模、能力和人才感到非常興奮。我們重申未來幾季實現 1,200 萬至 1,500 萬美元綜效的目標。

Since closing the acquisition in early July, our teams have been focused on three key integration priorities: first, aligning and enhancing the provider and patient experience across both organizations; second, standardizing operating systems and financial reporting to enable consistent execution; and third, implementing the Astrana technology platform, which provides real-time visibility into utilization and outcomes and will drive meaningful synergy capture over time.

自 7 月初完成收購以來，我們的團隊一直專注於三個關鍵的整合優先事項：首先，協調和提升兩個組織內的醫護人員和病患體驗；其次，標準化營運系統和財務報告，以實現一致的執行；第三，實施 Astrana 技術平台，該平台可提供對利用率和結果的即時可見性，並將隨著時間的執行有意義的協同效應的推移。

Much of this work is already complete. We already have live visibility into utilization and performance metrics, and we remain on track to fully onboard prospects physician groups and care teams to the Astrana platform by mid-2026. Equally as important, we are advancing the cultural integration that underpins long-term success, ensuring that our combined teams are unified around a shared mission, values and operating playbook. As we've always said, Prospect meaningfully expands our scale across Southern California and strengthens our ability to serve patients and payers with a single integrated delivery model.

這項工作的大部分已經完成。我們已經能夠即時了解利用率和績效指標，我們仍有望在 2026 年年中之前將潛在的醫生團體和護理團隊全面納入 Astrana 平台。同樣重要的是，我們正在推動文化融合，這是長期成功的基礎，確保我們合併後的團隊圍繞著共同的使命、價值觀和營運準則團結一致。正如我們一直所說，Prospect 顯著擴大了我們在南加州的規模，並增強了我們透過單一的綜合交付模式為患者和支付方提供服務的能力。

We remain confident that the integration will position Astrana for even stronger performance heading into 2026. As we continue integrating Prospect, we are also increasingly excited about the opportunity to leverage AI across our combined enterprise to drive meaningful improvements in both efficiency and care quality. A few examples. Our predictive models identify patients at high medical risk and surface actionable insights to physicians and care teams directly within Astrana's proprietary software, enabling earlier interventions and more coordinated care. We're also deploying AI-driven tools across claims analytics and clinical documentation to reduce administrative friction and help prevent fraud, waste and abuse.

我們仍然相信，此次整合將使阿斯特拉納在 2026 年取得更強勁的業績。隨著我們不斷整合 Prospect，我們也越來越興奮地期待在合併後的企業中利用人工智慧來推動效率和護理品質的顯著提高。舉幾個例子。我們的預測模型能夠識別高醫療風險患者，並在 Astrana 的專有軟體中直接向醫生和護理團隊提供可操作的見解，從而實現更早的干預和更協調的護理。我們也在理賠分析和臨床文件中部署人工智慧驅動的工具，以減少管理摩擦，並幫助防止詐欺、浪費和濫用。

Recently, we introduced a large language model integrated directly into our platform that allows clinicians and care teams to query a patient's longitudinal medical record and receive cited source-based responses. As a payer-agnostic platform serving all lines of business, Astrana is uniquely positioned with one of the most comprehensive data sets in the industry to power this kind of innovation. Over time, we expect these AI-enabled efficiencies to compound, expanding operating leverage, supporting consistent margin growth and most importantly, improving outcomes for the patients we serve. It's a very exciting time here at Astrana. The third quarter was also an active period of growth for Astrana, underscoring the strong market demand for our high-quality technology-enabled solutions.

最近，我們推出了一種大型語言模型，該模型直接整合到我們的平台中，使臨床醫生和護理團隊能夠查詢患者的縱向醫療記錄並收到基於引用來源的回應。作為一家服務於所有業務線的、與支付方無關的平台，Astrana 擁有業內最全面的數據集之一，這使其在推動此類創新方面具有獨特的優勢。隨著時間的推移，我們預計這些人工智慧帶來的效率提升將會不斷累積，擴大營運槓桿，支持持續的利潤成長，最重要的是，改善我們所服務患者的治療效果。阿斯特拉納現在正處於一個非常令人興奮的時刻。第三季也是阿斯特拉納的活躍成長期，凸顯了市場對我們高品質技術解決方案的強勁需求。

We expanded our strategic partnership with Intermountain Health in Nevada, further strengthening Astrana's presence in one of our fastest-growing markets. This collaboration combines Intermountain's leading clinical infrastructure with Astrana's value-based care management capabilities and care delivery presence to enhance coordination, quality and affordability for patients across Southern Nevada. It reinforces Astrana's position as a trusted partner to major health systems seeking to deliver integrated patient-centered care tailored to local communities. And in our Care Enablement business, we also entered a new partnership with a provider group in Southern California. The group serves more than 40,000 members in value-based care arrangements across all lines of business and will begin onboarding to the Astrana platform in the first half of 2026.

我們擴大了與內華達州 Intermountain Health 的策略合作夥伴關係，進一步加強了 Astrana 在我們成長最快的市場之一的地位。此次合作將 Intermountain 的領先臨床基礎設施與 Astrana 的基於價值的護理管理能力和護理服務能力相結合，旨在提高內華達州南部患者的協調性、品質和可負擔性。這鞏固了阿斯特拉納作為值得信賴的合作夥伴的地位，該合作夥伴致力於為尋求提供以患者為中心、量身定制當地社區服務的大型醫療系統提供支持。在我們的護理賦能業務方面，我們也與南加州的一家醫療服務提供者集團建立了新的合作關係。該集團為超過 40,000 名會員提供基於價值的醫療保健服務，業務涵蓋所有領域，並將於 2026 年上半年開始加入 Astrana 平台。

Next, I would like to address the adjustments we've made to our 2025 guidance, which are detailed in today's press release. To be clear, these updates do not reflect any change in the underlying performance, cost trend or fundamentals of either Prospect or our legacy Astrana operations. Rather, they reflect timing considerations. Specifically, we now expect several payer contracts to transition from partial risk to full risk arrangements in the first quarter of 2026 instead of in mid-2025 as originally anticipated.

接下來，我想談談我們對 2025 年業績指引所做的調整，這些調整已在今天的新聞稿中詳細說明。需要明確的是，這些更新並不反映 Prospect 或我們原有的 Astrana 業務的潛在績效、成本趨勢或基本面的任何變化。相反，它們反映的是時機的考慮。具體而言，我們現在預計，一些支付方合約將在 2026 年第一季從部分風險安排過渡到完全風險安排，而不是像最初預期的那樣在 2025 年年中過渡。

At Astrana, we take a disciplined and collaborative approach to growth. We work closely with our payer partners to structure arrangements that are aligned, economically sound and built for long-term success for both parties. We have not and will not enter into full risk contracts simply to accelerate the top line. We do so only when the data, infrastructure and financial alignment are in place to manage that risk responsibly and sustainably. Accordingly, we are now updating our full year 2025 revenue guidance to a range of $3.1 billion to $3.18 billion and adjusted EBITDA to a range of $200 million to $210 million. The key takeaway is that this is purely a matter of timing.

在阿斯特拉納，我們採取嚴謹的協作方式來實現成長。我們與支付方合作夥伴緊密合作，建構雙方利益一致、經濟合理且有利於雙方長期成功的安排。我們過去沒有、將來也不會為了加速營收成長而簽訂全風險合約。只有當資料、基礎設施和財務條件到位，能夠負責任且永續地管理風險時，我們才會這樣做。因此，我們現在將 2025 年全年營收預期更新為 31 億美元至 31.8 億美元，調整後 EBITDA 預期更新為 2 億美元至 2.1 億美元。關鍵在於，這完全是時機問題。

Cost trends and clinical outcomes remain steady across both legacy Astrana and Prospect. Demand from our partners continues to be strong as reflected in several of the partnerships I just mentioned, and our pipeline continues to expand. We remain confident that the contribution from these contracts will be realized in 2026 and will further reinforce the strength and durability of our long-term growth trajectory.

無論是傳統阿斯特拉納或普羅斯佩克，成本趨勢和臨床結果都保持穩定。正如我剛才提到的幾個合作關係所反映的那樣，我們合作夥伴的需求依然強勁，我們的專案儲備也在擴大。我們仍然相信，這些合約的貢獻將在 2026 年實現，並將進一步鞏固我們長期成長軌蹟的實力和持久性。

Before I hand it over to Chan for his financial review, I want to share a bit of our perspective on the factors that will shape performance in 2026. While we're not yet providing formal guidance, there are several dynamics already coming into focus. On the positive side, we expect tailwinds from improved Medicare Advantage rates, the realization of prospect-related synergies and the continued maturation of our full risk cohorts, all of which should support steady revenue growth and margin expansion.

在將報告交給 Chan 進行財務審查之前，我想分享我們對 2026 年業績影響因素的一些看法。雖然我們尚未提供正式指導，但一些動態因素已經逐漸顯現。積極的一面是，我們預計 Medicare Advantage 費率的提高、與潛在客戶相關的協同效應的實現以及我們所有風險群體的持續成熟都將帶來利好，所有這些都將支持穩定的收入增長和利潤率的擴大。

Offsetting these, we do anticipate some headwinds in our Medicaid and exchange businesses, where evolving regulatory dynamics may create pressure on membership and rates in certain markets. We're working proactively with our plan partners and state agencies to navigate these transitions thoughtfully and to position Astrana for sustained performance across all lines of business.

儘管如此，我們預計在醫療補助和交易所業務方面會遇到一些不利因素，不斷變化的監管動態可能會對某些市場的會員人數和費率造成壓力。我們正積極與我們的計劃合作夥伴和州政府機構合作，以周全的方式應對這些轉變，並使 Astrana 在所有業務領域都能保持持續的業績。

We remain confident that our focus on being a high-quality, responsibly managed care delivery platform will continue to differentiate Astrana and enable growth even in and especially in a more uncertain environment. Our 2026 planning reflects a balanced view that incorporates both the opportunities and the challenges ahead, and we look forward to sharing more detail when we report our fourth quarter results early next year.

我們仍然堅信，我們專注於成為高品質、負責任的醫療服務平台，將繼續使 Astrana 脫穎而出，並使其即使在更不確定的環境中也能實現成長，尤其是在這種環境中。我們的 2026 年規劃體現了一種平衡的觀點，既包括未來的機遇，也包括挑戰。我們期待在明年初公佈第四季業績時分享更多細節。

Moving over to a personal note. My family recently welcomed our first child, and we had the great privilege of doing so through the Astrana network. It was incredibly meaningful to experience firsthand the level of coordination and care our physicians, providers and teams deliver each and every day. It reminds me of why we do what we do, building a health care system that truly supports physicians and patients through some of life's most important moments.

接下來是一些個人感想。我家最近迎來了我們的第一個孩子，我們非常榮幸能夠透過 Astrana 網路實現這一願望。親身體驗到我們的醫生、醫護人員和團隊每天展現出的協調和關懷水平，讓我感到無比榮幸。這讓我想起了我們做這一切的意義所在：建立一個真正能在人生中一些最重要的時刻為醫生和病人提供支持的醫療保健系統。

In closing, I'm so proud of how our team continues to execute in a complex and evolving environment. Astrana's mission remains clear: to build a sustainable, coordinated health care platform that empowers physicians, improves outcomes and lowers cost for patients and their communities. And we are delivering on that vision, building a health care system that truly works while driving industry-leading growth and profitability, one community at a time.

最後，我為我們的團隊能夠在複雜多變的環境中持續有效率地完成任務而感到無比自豪。Astrana 的使命仍然明確：建立一個可持續的、協調的醫療保健平台，賦予醫生權力，改善患者及其社區的治療效果，並降低治療成本。我們正在逐步實現這一願景，建立一個真正有效的醫療保健系統，同時推動行業領先的成長和獲利能力，一次服務一個社區。

With that, I'll turn it over to Chan to discuss our financials.

接下來，我將把發言權交給陳，讓他來討論我們的財務狀況。

Thanks, Brandon, and good afternoon, everyone. Our third quarter results reflect strong execution and continued consistency across the business. We successfully integrated Prospect into our consolidated financials while maintaining solid performance across legacy Astrana operations. These results demonstrate the scalability of our platform and the discipline with which we continue to manage growth, risk and capital deployment. Total revenue for the quarter was $956 million, representing growth of approximately 100% year-over-year and 46% sequentially.

謝謝你，布蘭登，大家下午好。第三季業績反映了公司各業務部門的強勁執行力和持續穩定性。我們已成功將 Prospect 整合到我們的合併財務報表中，同時保持了 Astrana 原有業務的穩健表現。這些結果證明了我們平台的可擴展性，以及我們在管理成長、風險和資本部署方面所秉持的嚴謹態度。本季總營收為 9.56 億美元，年增約 100%，季增 46%。

This increase reflects the addition of Prospect Health as well as steady organic growth across our Care Partners segment. Within our Care Enablement segment, we added material scale this quarter, more than doubling revenue quarter-over-quarter as Prospect brings more provider group clients for us to serve with our technology-enabled offerings. Adjusted EBITDA was $68.5 million, up 52% year-over-year and 42% sequentially, reflecting strong profitability even as the company grew rapidly. Medical cost trend performance in the quarter was stable and in line with our expectations across both legacy Astrana and Prospect. As we continue to bring these companies together over the coming quarters, there remains a material opportunity to bring Prospect's trend performance more in line with that of legacy Astrana.

這一成長反映了 Prospect Health 的加入，以及我們 Care Partners 業務部門的穩定自然成長。在我們的護理賦能部門，本季度我們實現了實質性的規模增長，收入環比增長超過一倍，因為 Prospect 為我們帶來了更多醫療服務提供商客戶，以便我們能夠透過技術賦能的產品為他們提供服務。調整後的 EBITDA 為 6,850 萬美元，年增 52%，季增 42%，反映出即使公司快速成長，獲利能力依然強勁。本季醫療成本趨勢表現穩定，符合我們對原 Astrana 和 Prospect 的預期。隨著我們在接下來的幾季繼續整合這些公司，我們仍然有機會讓 Prospect 的趨勢表現更接近原始 Astrana 的趨勢表現。

Operating expenses as a percentage of revenue declined modestly with the integration of Prospect and the continued automation of core administrative workflows. We remain on track to achieve our previously communicated synergy target of $12 million to $15 million of savings through 2026. We ended the quarter with approximately $463 million of cash and short-term investments and net debt of approximately $624 million, ahead of expectations following the close of the Prospect transaction.

隨著 Prospect 的整合和核心管理工作流程的持續自動化，營運費用佔收入的百分比略有下降。我們仍有望實現先前公佈的協同效應目標，即在 2026 年節省 1,200 萬至 1,500 萬美元。本季末，我們擁有約 4.63 億美元的現金和短期投資，淨債務約為 6.24 億美元，這超出了 Prospect 交易完成後的預期。

Our net leverage ratio at quarter end was approximately 2.5x on a pro forma trailing 12-month adjusted EBITDA basis, and we continue to expect to reduce leverage within the next 12 months through a combination of EBITDA growth and free cash flow generation. Cash flow from operations for the quarter was approximately $10 million, bringing our nine-month total to $118 million. We continue to expect full year free cash flow conversion of approximately 40% to 45% of adjusted EBITDA, in line with prior commentary.

以過去 12 個月調整後的 EBITDA 計算，我們季度末的淨槓桿率約為 2.5 倍，我們繼續預期在未來 12 個月內透過 EBITDA 成長和自由現金流的產生來降低槓桿率。本季經營活動產生的現金流約為 1,000 萬美元，使我們前九個月的總現金流達到 1.18 億美元。我們仍預期全年自由現金流轉換率約為調整後 EBITDA 的 40% 至 45%，與先前的評論一致。

Turning to guidance. We are updating our 2025 outlook to reflect the timing of full risk contracts with certain payer partners that have shifted from a 2025 start to a first quarter 2026 start date. As Brandon mentioned, this update does not reflect any change in the underlying operating performance of either Prospect or legacy Astrana. For full year 2025, we now expect total revenue in the range of $3.1 billion to $3.18 billion and adjusted EBITDA in the range of $200 million to $210 million.

尋求指導。我們正在更新 2025 年的展望，以反映與某些支付方合作夥伴簽訂的全風險合約的時間安排，這些合約的開始日期已從 2025 年改為 2026 年第一季。正如 Brandon 所提到的，此更新並未反映 Prospect 或原 Astrana 的任何潛在營運績效變化。我們現在預計 2025 年全年總營收將在 31 億美元至 31.8 億美元之間，調整後 EBITDA 將在 2 億美元至 2.1 億美元之間。

With that, we'll now open the call for questions.

接下來，我們將開始接受提問。

(Operator Instructions) Jailendra Singh, Truist Securities.

（操作員指示）Jailendra Singh，Truist Securities。

Congratulations, Brandon, for the new addition to your family. My question is on the revenue guidance update driven by full risk transition timing delay. Were they related to one payer or multiple payers? You called out tech and data integration. Can you be more specific there?

恭喜布蘭登，家裡又添新成員！我的問題是關於由於全面風險過渡時間延遲而導致的收入預期更新。它們與一個付款方有關，還是與多個付款方有關？你提到了技術和數據整合。能說得更具體些嗎？

Were these contracts on the Prospect side or legacy Astrana? And do you have enough clarity at this point that this will affect definitely go live 1/1? Or is there a chance of delay further? And related to that, does this delay impact in terms of how you are approaching your other partial risk to full risk transitions?

這些合約是Prospect一方的還是原Astrana一方的？目前您是否已充分了解情況，這一定會影響到 1 月 1 日的上線？或者還有可能進一步延誤嗎？與此相關的是，這種延遲是否會影響您處理其他部分風險轉向完全風險的方式？

Jailendra, thank you for the question. Thanks for the warm message. So on the delay, the delay was strictly a timing issue. We remain committed to completing the transitions in the first quarter of 2026. It does relate to both legacy Astrana and the Prospect businesses as we're ensuring contract standardization across both of those businesses and consolidating them into one.

賈倫德拉，謝謝你的提問。謝謝你的熱情留言。所以，關於延誤的問題，那完全是一個時間問題。我們仍致力於在 2026 年第一季完成過渡工作。這確實與原始 Astrana 業務和 Prospect 業務都有關聯，因為我們正在確保這兩個業務的合約標準化，並將它們合併為一個。

The delay was not due to technical or technology or data issues. In fact, as I described in my prepared remarks, we are making significant progress in integrating Prospect's team and onboarding teams onto our AI-enabled platform, including the capability to have real-time utilization information and data on our population. Rather, around half of the delay, to dive a little deeper, is procedural in nature, such as regulatory filings and making sure that there is a bidirectional data and operational feed. Half of that delay, we expect to be finalized on 1/1. The other half were in late-stage conversations and do anticipate finalization in Q1 of 2026.

延誤並非由於技術、製程或資料問題造成的。事實上，正如我在準備好的演講稿中所描述的那樣，我們在將 Prospect 團隊和新團隊整合到我們的人工智慧平台上方面取得了重大進展，包括能夠獲取我們人口的即時利用資訊和數據。更深入地分析一下，大約一半的延誤是程序性的，例如監管文件和確保雙向資料和營運回饋。其中一半的延誤預計將於 1 月 1 日完成。另一半談判已進入後期階段，預計 2026 年第一季完成。

And this is across several payer partners, not just a single entity. And I just want to remind everyone that we are very collaborative partners with our payers. We think that these contracts will mutually benefit both parties given our unique high-quality networks that are differentially well managed. And we're confident again that these contracts will commence in the first quarter of 2026. On the revenue item, a bit of seasonality on Prospect, but we're not expecting necessarily a step down in the core revenue of the business other than from these full risk delays.

而且這種情況涉及多個支付方合作夥伴，並非僅限於單一實體。我只想提醒大家，我們與支付方是非常合作的夥伴。我們認為，鑑於我們獨特的高品質網路以及我們卓越的管理水平，這些合約將使雙方互惠互利。我們再次有信心，這些合約將於 2026 年第一季開始生效。關於收入方面，Prospect 的表現會受到一些季節性因素的影響，但除了這些全風險延遲之外，我們預期公司的核心收入不一定會下降。

Thanks, Jailendra.

謝謝你，賈倫德拉。

And before I actually ask my follow-up quickly, just to make sure that EBITDA reduction of $10 million also all because of this timing delay, right?

在我正式提問之前，我快速跟進一下，確認一下 EBITDA 減少 1000 萬美元是否也是由於時間延誤造成的，對嗎？

That's right. Core trend, medical cost trend in both legacy Astrana and Prospect businesses continue to come in line to slightly better than expected.

這是正確的。核心趨勢，無論是傳統Astrana業務或Prospect業務的醫療成本趨勢，都持續略優於預期。

Okay. And then my follow-up is on the kind of congrats on the high-profile Intermountain Health partnership. Can you provide any more details around the economics there, level of engagement? What does this open up for you guys in terms of new market, new opportunities?

好的。然後，我要就備受矚目的 Intermountain Health 合作關係表示祝賀。您能否提供更多關於當地經濟狀況和參與程度的細節？這為你們帶來了哪些新市場、新機會？

Does this provide an opportunity down the road for Astrana to enter additional states where Intermountain has presence? Maybe spend some time there.

這是否為 Astrana 未來進入 Intermountain 已開展業務的其他州提供了機會？或許可以在那裡待一段時間。

Sure. At the moment, we're very excited about the partnership. Intermountain is obviously a huge presence in Nevada as well as other states in that region. Our partnership today is about utilizing Intermountain's very established and large clinical infrastructure and network and combining that with Astrana's unique presence in our care delivery model in Las Vegas and in other parts of Southern Nevada in order to deliver a more coordinated and accessible approach to members in Nevada. So we're excited to expand our network to have Intermountain be a part of that network, and we think it's going to drive great outcomes in AEP as we speak and into next year.

當然。目前，我們對此次合作感到非常興奮。Intermountain 在內華達州以及該地區的其他州顯然擁有巨大的影響力。我們今天的合作旨在利用 Intermountain 非常成熟且龐大的臨床基礎設施和網絡，並將其與 Astrana 在拉斯維加斯和內華達州南部其他地區的醫療服務模式中的獨特地位相結合，從而為內華達州的會員提供更加協調和便捷的醫療服務。因此，我們很高興能夠擴展我們的網絡，讓 Intermountain 成為該網絡的一部分，我們認為這將在當前和明年為 AEP 帶來巨大的成果。

Going forward, we haven't had those discussions yet, but I do think that there are opportunities to continue expanding on that partnership and other partnerships with health systems. So, we're excited about that as well.

展望未來，我們還沒有進行過這方面的討論，但我認為有機會繼續擴大這種合作關係以及與醫療系統的其他合作關係。所以，我們也對此感到興奮。

Ryan Daniels, William Blair.

瑞安·丹尼爾斯，威廉·布萊爾。

This is Matthew Mardula on for Ryan Daniels. First, Brandon, congratulations on your child. And it's great to hear that, cost trends were reiterated for Astrana's full year. And in your prepared remarks, you mentioned higher Medicaid cost trends continuing to be above trend, although improvement from Q2. When do you expect kind of Medicaid cost trends to come closer to that 4.5%?

這裡是馬修馬杜拉，替瑞安丹尼爾斯為您報道。首先，布蘭登，恭喜你喜得貴子。很高興聽到阿斯特拉納全年的成本趨勢再次得到證實。在您事先準備好的演講稿中，您提到醫療補助成本趨勢持續高於趨勢水平，儘管比第二季度有所改善。您預期醫療補助計畫的成本趨勢何時會接近 4.5% 這個數值？

And we've just been hearing a bunch of different time frames. So curious to hear what you think. And then given the fourth quarter seasonality, what gives you that confidence that you have enough factored into the guide to account for it?

我們聽到的都是不同的時間說法。很想聽聽你的想法。考慮到第四季的季節性因素，是什麼讓你確信你已經在預測中充分考慮了這些因素？

Thanks, Matthew. We continue to be encouraged by the trend that we're seeing the trend of the trend that is in Medicaid. Look, we do anticipate further continued headwinds in Medicaid as we have some instability in the regulatory environment at this moment. We do think that sometime in '26, perhaps late '26, we expect margins in Medicaid to stabilize. But at this moment, we're encouraged by the trend that we're seeing in terms of the improvement in Medicaid. So, we'll certainly update the market if anything changes there.

謝謝你，馬修。我們對醫療補助計劃的發展趨勢感到持續鼓舞。你看，我們預期醫療補助計畫將繼續面臨更多阻力，因為目前監管環境存在一些不穩定因素。我們認為，在 2026 年的某個時候，或許是 2026 年末，醫療補助的利潤率可望趨於穩定。但就目前而言，我們對醫療補助計劃改善的趨勢感到鼓舞。所以，如果市場情況有任何變化，我們一定會及時更新資訊。

Great. And then with the new partnership group in Southern California that serves over 40,000 members across all lines of business, could you kind of provide a breakdown of the payer type of these 40,000 lives? Do they have a similar split as you? And then what's the kind of percentage of full risk lives? And then the kind of last one is, so do you believe this will be profitable from day 1 when you onboard them in the first half of 2026?

偉大的。那麼，對於南加州這個為超過 40,000 名會員提供全方位服務的全新合作組織，您能否提供一下這 40,000 名會員的付款類型細分情況？他們的分成比例和你們的類似嗎？那麼，完全面臨風險的生命佔比是多少呢？最後一個問題是，您是否認為從 2026 年上半年他們加入的第一天起就能獲利？

Sure thing. It is a similar mix in terms of Medicare, Medicaid and commercial as our business today. It is mostly -- it is actually all shared risk members, not full risk members, and we'll help them manage similar to the rest of the Care Enablement business by charging a fee as a percentage of revenues for that business. We do anticipate it to be additive to EBITDA very early on since our Care Enablement operating leverage allows us to add new members into that business effectively.

當然可以。就聯邦醫療保險、醫療補助和商業保險而言，它與我們目前的業務組成類似。實際上，大部分都是風險共擔成員，而不是完全風險成員，我們將透過以該業務收入的一定比例收取費用來幫助他們進行類似於其他 Care Enablement 業務的管理。我們預計它將很快對 EBITDA 產生積極影響，因為我們的護理賦能營運槓桿使我們能夠有效地將新成員納入該業務。

Jack Silvan, Jefferies.

傑克西爾萬，傑富瑞集團。

Congrats on the quarter. This is Meghan Holtz on for Jack Slevin. Can you discuss the margins by segment in the quarter? Enablement looks very high, while Care Partners lagged a little bit. So, what's driving that?

恭喜你本季取得佳績。這裡是梅根·霍爾茨，替傑克·斯萊文為您報道。能否分析一下本季各業務區的利潤率？賦能水準非常高，而護理夥伴的賦能水準則略有落後。那麼，是什麼原因導致這種情況發生呢？

Meghan, thanks for joining for the question. On Enablement, you'll notice, as Chan also mentioned in the prepared remarks, that the enablement business grew rapidly in Q3. Part of that is that Prospect, the legacy Prospect business had quite a large enablement business and clients that we have now onboarded.

梅根，感謝你參與提問。關於賦能，你會注意到，正如 Chan 在準備好的演講稿中也提到的那樣，賦能業務在第三季度迅速增長。部分原因是，Prospect（原Prospect公司）擁有相當龐大的賦能業務和客戶群，我們現在已經將這些客戶納入麾下。

We're excited by the potential of the Care Enablement business as these are members that we are managing well with our AI-enabled technology platform, and we're driving a very strong EBITDA margin in that business, and we expect that to continue to grow in the future. We are adding to the Care Enablement pipeline, as I mentioned, with a new client, and there are several other clients that were -- the pipeline is quite strong in that business.

我們對護理賦能業務的潛力感到興奮，因為我們利用人工智慧技術平台對這些成員進行了良好的管理，並且該業務的 EBITDA 利潤率非常強勁，我們預計未來將繼續成長。正如我之前提到的，我們正在為護理賦能業務拓展新客戶，此外還有其他幾位客戶——該業務的管道非常強勁。

On the Care Partners side, Care Partners margin we expect it to look a little lower this quarter because as I guided to before, the legacy Prospect business does run at a slightly higher trend than the core business. Again, all of this was contemplated in our guidance and when we did the deal. So, the blended number is going to be a little higher.

就 Care Partners 而言，我們預計本季 Care Partners 的利潤率會略低一些，因為正如我之前所預測的那樣，傳統的 Prospect 業務的營運趨勢確實比核心業務略高。再次強調，所有這些因素都在我們的指導意見中以及我們進行交易時考慮到了。所以，綜合起來的數字會稍微高一點。

However, we do see opportunity in the future to bring that business more in line with the legacy Astrana Care Partners MLR. There is also a bit of seasonality in there. But overall, those are the drivers for the strong Care Enablement performance growth and margin-wise as well as the in line to slightly better-than-expected Care Partners margin.

不過，我們看到未來有機會讓這項業務與傳統的 Astrana Care Partners MLR 更一致。其中也包含一些季節性因素。但總體而言，這些因素推動了 Care Enablement 業務的強勁成長和利潤率提升，以及 Care Partners 業務利潤率達到預期或略高於預期。

Michael Ha, Baird.

Michael Ha，貝爾德。

Congrats, Brendan. Maybe another one on Medicaid. And I know your cost trend guidance is tracking well. You decelerated from 2Q. But if we double-click into it a bit more, nationally, we're seeing elevated member disenrollment trends.

恭喜你，布倫丹。或許還有一位是靠醫療補助計劃（Medicaid）過活的。我知道你們的成本趨勢預測進展順利。你從第二季開始減速。但如果我們更深入地研究一下，從全國範圍來看，我們發現會員退會率呈上升趨勢。

And then on a state-specific basis, California is something that I've noticed recent monthly disenrollment trends have really spiked into July and August. And the composition of that disenrollment is a bit alarming too. I'm seeing it at roughly 90% procedural disenrollment. So, I wanted to ask if you're seeing any recent signs of this attrition in California, if you're seeing any emerging acuity mix shift?

然後，就各州而言，我注意到加州最近的月度退學趨勢在 7 月和 8 月出現了大幅增長。而且，退學人員的組成也有些令人擔憂。我看到大約有 90% 的人取消了手術資格。所以我想問，您最近在加州是否看到任何這種人員流失的跡象，或者是否看到任何新興的病情嚴重程度組合變化？

And then with Elevance and United also -- not also, but both assuming negative Medicaid margins into next year. Just wondering how you're digesting that all these payer developments and how it might be factoring into your early thinking on '26? I know you called Medicaid out as a headwind, but I would love to hear some expanded thoughts on at all.

此外，Elevance 和 United 也——不，不是也，而是兩家公司都假設明年的 Medicaid 利潤率為負。我想知道您是如何看待所有這些支付方發展動態的，以及這些動態會如何影響您對2026年的早期思考？我知道你曾指出醫療補助計劃是一個阻礙因素，但我很想聽聽你對此的更詳細的看法。

Thanks so much, Michael, for the question. We're tracking those numbers closely, too, from California that I think you're referencing. Overall, disenrollment from Medicaid year-to-date has not been as severe as our initial expectations, nor as high as you're probably seeing in the California DHCS reports in aggregate. Things are still early. So, we'll see how 2026 progresses.

非常感謝你的提問，麥可。我們也密切關注加州的這些數據，我想你指的是這些數據。總體而言，今年迄今為止，退出 Medicaid 的情況沒有我們最初的預期那麼嚴重，也沒有您在加州 DHCS 報告中看到的總體情況那麼高。現在還為時過早。所以，讓我們拭目以待2026年的發展。

But year-to-date in 2025, we're seeing an annualized mid- to high single-digit attrition rate in Medicaid in terms of eligibility and enrollment. Part of this, I think there are two reasons: one, really that these are real Medal Medicaid members that we have built a longitudinal relationship with. We've worked with them over time, whether through line of business change or through as they get older, we really know these members, and we have known them for a long time. It's part of the strength of our model. So, we think that there's a lot of work that we're doing in order to ensure that those who are qualified legitimately continue to be enrolled in Medicaid even in the face of regulatory headwinds.

但截至 2025 年，我們看到 Medicaid 在資格和註冊方面出現了年化中高個位數流失率。我認為這其中有兩個原因：第一，這些都是真正的 Medal Medicaid 會員，我們已經與他們建立了長期的合作關係。隨著時間的推移，無論是業務線的變化還是他們年齡的增長，我們都與他們保持著合作關係，我們非常了解這些成員，而且我們認識他們已經很久了。這是我們模式優勢的一部分。因此，我們認為我們正在做很多工作，以確保那些符合資格的人即使面臨監管阻力也能繼續合法地加入醫療補助計劃。

In addition, as members have been disenrolled, we do believe also that plans are retaining members with us at a disproportionate rate because they want to keep members enrolled in our high-quality network and our well-managed network. So, with all that being said, we'll continue to observe what happens in 2026, have done some scenario planning internally to deal with these potential headwinds in '26. But disenrollment in that mid- to high single-digit range, not as bad as we think some of the data from the statewide reports are showing, Michael.

此外，由於有些會員已經退會，我們也相信，各計畫之所以能以不成比例的速度留住會員，是因為他們希望讓會員繼續留在我們高品質、管理完善的網路中。綜上所述，我們將繼續觀察 2026 年的情況，並在內部進行了一些情境規劃，以因應 2026 年可能出現的這些不利因素。但退學率在個位數中高段位，並沒有我們認為從一些全州報告數據中顯示的那麼糟糕，邁克爾。

Perfect. And just one more question. As we look into '27, I know it's a bit early, but the rate notice, my early thinking on the effective growth rate is -- I mean, I think it could be very strong. Elevated '25 fee-for-service trends seems to be tracking very high. I'm thinking high single-digit effective growth rate might even be possible for '27.

完美的。最後一個問題。展望 2027 年，我知道現在還為時過早，但根據利率通知，我對有效成長率的初步想法是——我的意思是，我認為它可能會非常強勁。2025 年按服務收費的趨勢似乎持續高位成長。我認為2027年實現個位數高位有效成長率甚至有可能。

So, when I consider that, I consider how MA is tracking to be almost two-thirds of your total revenue. And then I consider how your MA cost trend is less than 4.5%. The immediate thing that pops into my head is significant margin tailwind across most of your company, all those hundreds of basis points of excess rates on top of your trend. So, a few parts to this question. Firstly, where are you right now in terms of your MA margins?

所以，考慮到這一點，我認為 MA 的表現幾乎占到你們總收入的三分之二。然後我注意到您的 MA 成本趨勢低於 4.5%。我腦海中立刻浮現出的是，貴公司大部分業務都獲得了顯著的利潤增長，所有這些數百個基點的超額利率都疊加在了你們的趨勢之上。這個問題包含幾個部分。首先，您目前的移動平均線利潤率處於什麼水準？

Second, how should we think about margins tracking into next year? I'm thinking margin expansion because rates are good, trend steady, benefits should cut again. And then when you think about '27, just would love to hear your thoughts on how a strong rate notice could drive better margins and help out the overall achievability of your '27 EBITDA target of $350 million.

其次，我們該如何看待明年的利潤率走勢？我認為利潤率會擴大，因為利率不錯，趨勢穩定，福利可能會再次削減。那麼，當您考慮 2027 年時，我很想聽聽您對強有力的利率通知如何推動更高的利潤率並幫助實現 2027 年 3.5 億美元的 EBITDA 目標的看法。

Thanks for the question, Michael. And you know that I believe you're a leader in thinking about how MA rates are going to evolve in or how they have evolved in '26 and how they might evolve in '27. So, to answer your question in a couple of parts: one, '26 was a nice increase in MA rates, but we don't believe that they fully accounted for the increasing trend. As a benchmark, for example, it's not fully apples-to-apples, but via the ACO REACH RTA report, we're seeing an 8% to 10% trend nationwide.

謝謝你的提問，麥可。你知道，我相信你是思考 MA 利率在 2026 年將如何演變，以及在 2027 年將如何演變的領導者。所以，分兩部分回答你的問題：第一，26 年 MA 利率確實有所提高，但我們認為這並沒有完全解釋成長趨勢。例如，作為基準，雖然並不完全可比，但透過 ACO REACH RTA 報告，我們看到全國範圍內的趨勢是 8% 到 10%。

So good report, but we still believe slightly underfunded, and we think there's more room for growth in the '27 rate announcement, which I think you also mentioned in your question. We're not sharing per line of business margin at this moment, but we do think that there is room for margin to stabilize and potentially start expanding in '26 and '27 because of these strong rate increases that we're seeing.

這份報告不錯，但我們仍然認為資金略有不足，而且我們認為 2027 年的利率公告還有更大的成長空間，我想您在問題中也提到了這一點。目前我們不會公佈各業務線的利潤率，但我們認為，由於我們看到的強勁利率增長，利潤率在 2026 年和 2027 年有穩定下來並可能開始擴張的空間。

As I've talked about a lot before, we don't have a strong -- we don't have a strong or any headwind really at all around V28. So, we feel confident that there is room to grow if the rates come in -- continue to come in as expected. It's a bit early for us to exactly quantify what that looks like now as we're still in the middle of AEP, and we're looking at how we're growing as well as the shift in distribution across Stars in our plan partners.

正如我之前多次提到的，V28 附近並沒有強勁的逆風，或者說根本沒有逆風。因此，我們相信，如果利率繼續按預期增長，那麼還有成長空間。現在要準確量化其發展還為時過早，因為我們仍處於年度計劃實施期間，我們正在觀察我們的增長情況以及我們計劃合作夥伴中星級分佈的變化。

But we do think there's a potential headwind there, as I called out in the prepared remarks. We continue to hope and anticipate that the 27-rate notice, as you mentioned, is going to be strong as well, hopefully, in the mid- to high single digits. So that is our expectation at the moment.

但我們認為那裡可能存在一些不利因素，正如我在準備好的演講稿中提到的那樣。我們仍然希望並預計，正如您所提到的，27 級利率通知也將表現強勁，希望利率能達到個位數中高段。這就是我們目前的預期。

Ryan Langston, TD Cowen.

Ryan Langston，TD Cowen。

Cool news on the kiddo, Brandon. Just I want to make sure about these contracts, I understand it. So, you lowered the full year revenue guidance by $60 million at the midpoint, but you also lowered the EBITDA by $15 million. And assuming that's all from these contracts, that implies like a 25% margin assumption and like a run rate $60 million EBITDA on these contracts. So, is there just other pieces kind of moving parts that are included in the guidance change? Or are those kind of the right numbers to think about?

布蘭登這孩子有好消息。我只是想確認一下，我是否理解這些合約的內容。所以，你們將全年營收預期中位數下調了 6,000 萬美元，但同時也將 EBITDA 下調了 1,500 萬美元。假設這些合約全部如此，那就意味著利潤率約為 25%，這些合約的 EBITDA 運作率為 6,000 萬美元。那麼，指導方針的變更中是否還包含其他一些變動因素？或者說，這些數字是值得考慮的嗎？

Thanks for the question. Thanks for the warm message. We believe the run rate is close to $15 million -- around $15 million for the latter half of the year. So closer to a $30 million run rate really. And the revenue was frankly, anticipated to be frankly, a beat.

謝謝你的提問。謝謝你的熱情留言。我們認為年收入接近 1500 萬美元——下半年約為 1500 萬美元。所以實際年收入應該更接近3000萬美元。坦白說，收入原本預計會低於預期。

So, the magnitude of the drop is not as severe perhaps as you may expect on the margin assumption there. So, those are really the two items around the full risk delay. We're talking about a $15 million over a half year item that we expect to be fully resolved in the first quarter of 2026. And we -- there's not quite the margin that necessarily that you think there is on that business.

因此，實際跌幅可能沒有您根據邊際假設所預期的那麼嚴重。所以，以上就是關於全面風險延遲的兩個主要面向。我們說的是一個為期半年、金額達 1500 萬美元的項目，預計將在 2026 年第一季完全解決。而且，我們——這個產業的利潤空間並沒有你想像的那麼大。

Okay. And then just one more thing. On the Prospect commentary, I think you said it kind of beat stand-alone expectations. I'm sorry if I missed this, you already said it, but does that include any of the $12 million to $15 million synergies that you called out that you're reiterating? Or is that just like literally as a stand-alone entity, it exceeded expectations? And maybe just a sense on how much it exceeded, if you could.

好的。還有一件事。關於前景展望的評論，我想你說過它有點超出了人們對獨立賽事的預期。如果我錯過了，我很抱歉，您已經說過了，但其中是否包括您之前提到的、現在再次重申的 1200 萬至 1500 萬美元的協同效應？或者說，就其本身而言，它超出了預期？如果可以的話，或許還可以感受它超出了多少。

Sure thing. No, I'm not yet talking about the synergies in that comment. The comment was simply about the medical cost trend, utilization trends and the financial performance of the stand-alone Prospect business. It wasn't -- it was a slightly better-than-expected number, which was in line with what we did diligence on. And so, we're very pleased to see that, that has continued, and we expect that there are further synergies on both the top and the bottom line as well as opportunities to improve MLR and performance going forward into '26 and '27. But to answer your question, it's really about the stand-alone business for Prospect that the comment was about.

當然可以。不，我那條評論裡還沒談到協同效應。該評論僅涉及醫療成本趨勢、利用率趨勢以及獨立運營的 Prospect 業務的財務表現。並非如此——這個數字略好於預期，與我們盡職調查的結果一致。因此，我們非常高興地看到這種情況持續下去，我們預計在 2026 年和 2027 年，無論在收入還是利潤方面，都會有進一步的協同效應，並且有機會提高 MLR 和業績。但要回答你的問題，這條評論實際上是關於 Prospect 的獨立業務的。

Andrew Mok, Barclays.

Andrew Mok，巴克萊銀行。

This is Thomas Walsh on for Andrew. I believe you just quoted the legacy Astrana blended cost trend figure. Could you share the relevant Prospect figure? And is the delta between those due to any structural difference between the member populations?

這裡是托馬斯·沃爾什，他代替安德魯發言。我認為你剛才引用的是阿斯特拉納集團以往的混合成本趨勢數據。能否提供一下相關的潛在客戶資料？兩者之間的差異是否是由於成員群體之間的結構性差異所造成的？

We haven't shared the cost trend number for the stand-alone Prospect business. Part of that is that the integration is combining some of the businesses. Part of the acquisition was an asset purchase. We continue to expect it to be several points higher on trend than the legacy Astrana business. We don't think that necessarily this is something structural in nature.

我們尚未公佈獨立營運的Prospect業務的成本趨勢數據。部分原因是整合將一些業務合併在一起。此次收購的一部分是資產購買。我們仍預期其趨勢將比傳統的阿斯特拉納業務高出幾個百分點。我們認為這未必是結構性問題。

We believe that over time, as we combine the contracts, which we're doing now, as we continue to combine and onboard the team into our clinical pathways and our technology platform, there is opportunity to move that margin to look more similar to the legacy Astrana business. And again, the Prospect business did perform in line with our expectations, both as a result of the diligence as well as expectations after we've gotten our hands around it. So everything in line, and we continue to look forward to improving the performance of both businesses as a combined entity in Q4 and into 2026.

我們相信，隨著時間的推移，隨著我們合併合約（我們現在正在這樣做），隨著我們繼續合併團隊並將其納入我們的臨床路徑和技術平台，有機會讓利潤率看起來更像傳統的阿斯特拉納業務。再次證明，Prospect 業務的表現符合我們的預期，這既得益於我們先前的盡職調查，也得益於我們接手後的預期。所以一切進展順利，我們期待在第四季以及2026年繼續提升兩家公司合併後的表現。

David Larsen, BTIG.

David Larsen，BTIG。

I'm sorry, if I missed this, but what was your medical trend in the quarter? And how does that compare to expectations? Just any color between the commercial, Medicaid and Medicare for that trend? And then what are your expectations for trend in '26?

抱歉，如果我錯過了，請問您本季的醫療趨勢是什麼？與預期相比如何？符合這種趨勢的，商業保險、醫療補助和醫療保險之間的任何顏色都可以嗎？那麼，您對2026年的趨勢有何預期呢？

Thanks for the question. The trend across all lines of business, blended weighted average was just under 4.5%, continues to be in line with our expectations for the legacy strata business. Medicare continues to be better. Medical Medicaid, as I mentioned, has sequentially improved. So, trend decelerated versus Q2 and continues to be going in the right direction and commercial is stable as well.

謝謝你的提問。所有業務線的趨勢，綜合加權平均值略低於 4.5%，繼續符合我們對傳統分層物業業務的預期。聯邦醫療保險制度持續改善。正如我之前提到的，醫療補助計劃（Medicaid）已經逐步改善。因此，與第二季度相比，成長趨勢有所放緩，但仍朝著正確的方向發展，商業狀況也保持穩定。

So, we're very pleased with the ability -- the continuing ability to manage cost trend effectively for our population. Going forward into 2026, we're not sharing our trend expectations specifically yet. I do think that we're going to be conservative just in the face of some of the regulatory potential headwinds that are coming down the line for Medicaid and exchange, but it's a bit early to share the exact trend assumption at this time. We certainly will do that on our Q4 earnings call.

因此，我們對持續有效控製成本趨勢的能力感到非常滿意，這有利於我們的人口。展望 2026 年，我們目前暫不分享具體的趨勢預期。我認為，面對醫療補助和醫療保險交易市場即將面臨的一些監管潛在阻力，我們將採取保守的做法，但現在分享確切的趨勢假設還為時過早。我們肯定會在第四季財報電話會議上討論這個問題。

That's very helpful. And then do you have any exposure to the exchanges? Another value-based care company this evening who reported indicated that exchanges could be very material to their '26 earnings. Is there any exposure there or not? I don't think so.

那很有幫助。那麼，您是否持有任何交易所相關股份？今晚另一家以價值為導向的醫療保健公司發布報告稱，交易所可能會對其 2026 年的收益產生重大影響。那裡是否存在輻射暴露？我不這麼認為。

Thanks, Dave. There is some exposure. We do have exchange membership, but it's a fairly small part of the business, around 3% of revenue. So, there's -- we think it's a manageable exposure to the exchange.

謝謝你，戴夫。存在一定程度的暴露。我們確實有會員交換業務，但這只佔業務的一小部分，約佔收入的 3%。所以，我們認為這是可以控制的交易所風險敞口。

Great. And then what percent of claims are complete so we can have confidence that there's not going to be any sort of negative surprise in terms of claims costs in the fourth quarter?

偉大的。那麼，索賠完成的百分比是多少，才能讓我們確信第四季度的索賠成本不會出現任何負面意外？

Our completion rates are pretty consistent quarter-over-quarter, over 85%. As a reminder, we haven't had negative prior period development for many quarters in a row now. I can't even count how many, and we continue to be consistent in terms of our medical cost trend forecasting and our ability to actually manage those costs. Notably, we also don't have any negative prior period developments on risk adjustment either. And again, we think that's a reflection of our consistent and conservative approach in terms of risk adjustment.

我們的完成率每季都相當穩定，超過 85%。需要提醒的是，我們已經連續多個季度沒有出現負的前期發展趨勢了。我什至都數不清有多少了，而且我們在醫療成本趨勢預測和實際控制這些成本的能力方面一直保持穩定。值得注意的是，我們在風險調整上也沒有任何負面的前期發展趨勢。我們再次認為，這反映了我們在風險調整上一貫的保守做法。

Congratulations on becoming a father.

恭喜你榮升父親。

Craig Jones, Stifel.

克雷格瓊斯，斯蒂費爾。

Congrats, Brandon. So, I wanted to ask about the implications of the reconciliation bill around work requirements. I'd assume California will be one of the slower there to adopt that. But have you heard anything about how they plan to implement it or the speed that they plan to implement?

恭喜你，布蘭登。所以，我想問和解法案對工作要求的影響。我估計加州在採用這項技術方面會比較慢。但你有沒有聽說過他們計劃如何實施，或計劃以多快的速度實施？

Thank you. What we've been hearing as probably similar to all of you is that this is probably a 2027 item as currently constructed. So, we're not necessarily seeing the impacts of that yet. We are anticipating potential headwinds next year if there are other related items such as the UIS status members. But at this moment, we're anticipating this to be a 2027 item.

謝謝。我們聽到的消息可能和大家聽到的差不多，以目前的建造方式來看，這可能是 2027 年才能完成的項目。所以，我們目前可能還沒有看到這些影響。我們預計明年可能會遇到一些不利因素，例如 UIS 成員地位等其他相關事項。但目前我們預計這將是 2027 年的產品。

Got it. And then maybe on Medicare. So, entering the third year of V28, I wanted to ask you any thoughts on potential for V29 soon and maybe how the potential use of nCounter data may impact Astrana.

知道了。然後或許還能透過聯邦醫療保險（Medicare）獲得報銷。因此，在 V28 進入第三年之際，我想問您對即將到來的 V29 的前景有何看法，以及 nCounter 資料的潛在用途可能會對 Astrana 產生怎樣的影響。

Sure thing. I know there's been discussion about a potential V29 or a further change to risk adjustment model. As I mentioned before, we feel very comfortable with our risk adjustment. If anything, we actually believe our RAF to be almost too low. So, we really don't think that V28 has hurt us.

當然可以。我知道有人討論過 V29 版本或對風險調整模型進行進一步修改的可能性。正如我之前提到的，我們對自身的風險調整非常有信心。如果非要說的話，我們其實認為我們的皇家空軍人數少得幾乎可以忽略不計。所以，我們真的不認為V28對我們造成了傷害。

And even a further V29, we're not extremely -- we're not very concerned about, frankly. We think that there remains to be opportunity to continue to correctly code our members and continue to improve the way that we take care of our patients over time, regardless of the risk adjustment model that's being implemented.

即使是進一步的 V29，我們也不是特別——坦白說，我們並不太擔心。我們認為，無論實施何種風險調整模型，我們仍然有機會繼續正確地對我們的成員進行編碼，並隨著時間的推移不斷改進我們照顧患者的方式。

Matthew Gilmore, KeyBanc Capital Markets.

Matthew Gilmore，KeyBanc Capital Markets。

This is Zach on for Matt. Congratulations, Brandon. Just wanted to touch on the transition to full risk. Based on the delays, I think that percentage ticks up in the first quarter. But do you have any guideposts or frameworks that you can provide in terms of how to think about that shift to full risk through the remainder of '26?

這裡是札克替馬特報道。恭喜你，布蘭登。我只想簡單談談向完全風險過渡的問題。根據延誤情況來看，我認為第一季這個比例會上升。但是，對於如何思考在 2026 年剩餘時間內向全面風險的轉變，您能否提供一些指導方針或框架？

Yes, thanks for the question. We're going to continue the transition to full risk as expected. These contracts, which we expected to turn on in mid-2025 ended up being delayed until the first quarter of 2026. But going forward, we do expect that high 70s percent of revenue coming from full risk to remain in that range going into '26.

是的，謝謝你的提問。我們將繼續按預期過渡到全面風險承擔。這些合約原計劃於 2025 年年中生效，但最終推遲到 2026 年第一季生效。但展望未來，我們預計到 2026 年，來自完全風險的收入佔比將維持在 70% 以上。

There are several forest contracts that we had anticipated going live in 2026, separate from the ones that we had discussed. And there's no danger or indication that, that's not going to happen. We're also seeing success in moving contracts to a delegated model even outside of California.

我們預計有幾份林業合約將於 2026 年生效，這些合約與我們之前討論過的合約不同。沒有任何跡象表明這種情況不會發生。我們也看到，即使在加州以外，將合約轉移到委託模式也取得了成功。

As I mentioned before, Texas is starting on fully delegated, which means we're paying claims, we're doing ops. We have full data visibility, very similar to the model we've successfully run in other parts of the country, starting 1/1 of '26 as well. So by and large, contractual movements are as expected. Unfortunately, a slight delay on these particular items this year.

正如我之前提到的，德克薩斯州已經開始全面授權，這意味著我們正在支付索賠，我們正在進行業務。我們擁有完整的資料可見性，與我們在全國其他地區成功運行的模型非常相似，也從 2026 年 1 月 1 日開始運行。所以總的來說，合約變動符合預期。遺憾的是，今年這些特定商品的到貨時間略有延遲。

Gene Mannheimer, Freedom Capital Markets.

吉恩‧曼海默，《自由資本市場》。

Congrats to the new dad, Brandon. My questions relate to, I guess, growth. So, you doubled revenue year-over-year. Much of that was Prospect. So, if we back out Prospect, what are we looking at for organic growth mid-single digit?

恭喜布蘭登榮升爸爸！我的問題大概都跟成長有關。所以，你們的收入比去年翻了一番。其中大部分是Prospect。那麼，如果我們剔除 Prospect 的影響，我們預期有機成長率會達到個位數中段嗎？

Gene, thanks for the question. I think if you really try to strip out every single part of the Prospect deal, which as I mentioned earlier, is a bit -- in some areas, it's challenging. I think the core Astrana business continues to grow in the mid-teens, low teens area.

吉恩，謝謝你的提問。我認為，如果你真的想把 Prospect 交易的每個部分都剝離出來，正如我之前提到的，這在某些方面有點——很有挑戰性。我認為阿斯特拉納的核心業務將繼續保持十幾到十幾的成長速度。

Prospect, I think we had guided to before, growing in the high single -- mid- to high single digits. But this is exclusive of some of the full risk movements and exclusive of AEP so far. So, we continue to be excited by the growth in all of these businesses and also, more importantly, managing the growth in an effective and stable manner in terms of EBITDA.

展望未來，我認為我們之前已經預測到，成長率將達到個位數高點至個位數中位數至高位。但這不包括部分完整的風險變動，也不包括迄今為止的AEP。因此，我們對所有這些業務的成長感到興奮，更重要的是，我們對以有效和穩定的方式管理 EBITDA 成長感到興奮。

Okay. No, that's encouraging. And then my follow-up is on your new group that you signed in Southern California, 40,000 lives. Was that an affiliate or an offshoot of Prospect? Or was Prospect instrumental in getting that win?

好的。不，這令人鼓舞。接下來我想問的是你在南加州簽約的新團隊，40000人。那是Prospect的附屬公司還是分公司？或者說，Prospect 在贏得那場勝利中發揮了關鍵作用？

Sure, Gene. No, not really. This is a separate client that had no relationship necessarily to us or to Prospect, just one of the clients in our pipeline. So that pipeline continues to be strong. We continue to expand our Care Enablement business.

當然可以，吉恩。不，其實不是。這是一個獨立的客戶，與我們或Prospect沒有任何必然聯繫，只是我們銷售管道中的一個客戶。所以這條輸送管道依然強勁。我們持續拓展護理賦能業務。

We're building a lot of technology around ensuring that, that offering is attractive and is well priced. And we think that's an area for growth as it has been in the past going forward as well.

我們正在圍繞這一點構建大量技術，以確保該產品或服務具有吸引力且價格合理。我們認為這是一個有成長潛力的領域，就像過去一樣，未來也將如此。

There are no further questions at this time. I'd like to pass the call back over to management for any closing remarks.

目前沒有其他問題了。我想把電話轉回給管理階層，請他們作總結發言。

Thank you so much. To conclude, I wanted to emphasize that Astrana continues to manage medical costs well. We continue to show that the value of Prospect is meaningful, and that integration is going smoothly. We do not believe that the transition to full risk is an ongoing issue. It's a onetime delay and does not reflect any of the -- any cost trend issues or medical cost issues in the core Astrana or the core Prospect businesses.

太感謝了。最後，我想強調的是，阿斯特拉納在醫療成本控制方面一直做得很好。我們不斷證明 Prospect 的價值是有意義的，並且整合工作進展順利。我們認為向全面風險過渡並非持續存在的問題。這是一次性的延遲，並不反映 Astrana 核心業務或 Prospect 核心業務的任何成本趨勢問題或醫療成本問題。

And we're very happy to share, as Chan mentioned in the prepared remarks, that we are now down to approximately 2.5 times net leverage on pro forma adjusted EBITDA, which is far ahead of what the timing was when we announced the deal. So we continue to focus on deleveraging, continue to focus on execution of the business, and we look forward to continued execution in future quarters in 2026. Thank you all for joining the conference call today, and I look forward to speaking to many of you in the coming months.

正如陳先生在準備好的發言稿中提到的那樣，我們非常高興地宣布，我們目前的淨槓桿率（按備考調整後的 EBITDA 計算）已降至約 2.5 倍，這遠遠優於我們宣布該交易時的預期。因此，我們將繼續專注於去槓桿化，繼續專注於業務執行，並期待在 2026 年的未來幾季繼續執行業務。感謝各位今天參加電話會議，我期待在接下來的幾個月與大家交流。

This concludes today's teleconference. You may now disconnect your lines at this time. Thank you for your participation.

今天的電話會議到此結束。現在您可以斷開線路了。感謝您的參與。