Astrana Health Inc. (NASDAQ:ASTH) saw its stock value decline sharply on Tuesday, closing at $21.48, a decrease of approximately 22%. This drop followed the Centers for Medicare & Medicaid Services (CMS) announcement on Monday regarding proposed updates to Medicare Advantage payment methodologies and policies for the 2027 performance year. The proposal underscored objectives of payment sustainability, accuracy, and simplification of administrative procedures while projecting only minimal payment growth.
CMS outlined a tentative net average payment increase of 0.09% year over year. While this increment translates to over $700 million in additional Medicare Advantage payments, it was notably far less than the 4% to 6% rate increase some market analysts had anticipated for 2027. This suggestion of restrained payment growth contributed to substantial investor unease.
Within this context, Astrana Health’s stock movement was disproportionately pronounced compared to its Medicare Advantage-focused peers. Price declines of roughly 10% and 12% were recorded for Agilon Health Inc. (NYSE:AGL) and Alignment Healthcare Inc. (NASDAQ:ALHC), respectively, contrasting with the approximately 22% slide seen in Astrana Health shares.
Business Overview and Revenue Exposure
Astrana Health functions as a Management Services Organization (MSO), supporting Independent Physicians Associations and Medical Groups by providing comprehensive administrative and auxiliary healthcare services. The company’s operational model heavily involves direct patient care, distinguishing it notably from certain market participants.
Approximately 61% of Astrana Health’s revenue derives from Medicare-related business, highlighting significant exposure to policy changes in the Medicare Advantage program. However, under scrutiny is how the company’s particular approach to risk adjustment interacts with CMS’s evolving regulatory stance.
Distinctive Risk Adjustment Methodology
One key point in the evaluation is Astrana Health’s risk adjustment practices. Unlike many large payers, the organization does not rely on audio-only clinical visits or standalone chart review methods to establish risk scores. Instead, its risk assessments are fundamentally based on direct, encounter-centric patient care. This care delivery approach is integral to its business model and potentially mitigates exposure to negative impacts related to CMS’s disallowance of certain diagnosis sources.
CMS estimates that the disallowed diagnosis sources represent approximately a 1.53% adverse effect on risk scores across the Medicare Advantage market. Analysts note, however, that Astrana Health faces a minimal exposure to this headwind due to its avoidance of those particular methodologies.
Implications of CMS Proposed Changes and Strategic Outlook
While the immediate market reaction to the CMS proposal was negative, specified analysts consider that, over the long term, the policy shifts may actually enhance Astrana Health’s strategic value. As payers aim to better control patient management costs and more accurately document clinical diagnoses based on encounter data, partners with effective and fully delegated care delivery models become vital.
In this regard, Astrana Health’s goal-aligned partnership model may facilitate increased delegated contract agreements with Medicare Advantage plans beyond 2027. This perspective underlies an optimistic outlook, contrasting with the short-term stock price volatility.
Valuation and Analyst Recommendations
Following the share price downturn, Astrana Health’s stock now trades at approximately 0.4 times estimated 2027 sales and around six times enterprise value to adjusted EBITDA projections for that year. This valuation multiple range is interpreted by some analysts as an attractive entry point for a company acknowledged for profitability, a robust operating framework, and a seasoned leadership team.
William Blair, providing coverage on the stock, expressed surprise at the intensity of selling pressure on Astrana Health shares. Nonetheless, the firm maintains an Outperform rating, endorsing confidence in the company’s medium- to long-term prospects.
Recent Stock Activity and Market Sentiment
In after-hours trading on Tuesday, Astrana Health’s stock posted a gain of 3.86%, reaching $22.31 according to market data sources. This uptick following the initial decline indicates investor reassessment and suggests potential stabilization or recovery.
Alongside Astrana Health’s developments, peer companies Agilon Health and Alignment Healthcare exhibited price declines of 2.81% and 3.58%, respectively, during the same trading session, reflecting broader market sensitivity to CMS proposals but less severe than that observed with Astrana Health.
Key Points
- Astrana Health’s 22% stock price drop followed CMS’s release of 2027 Medicare Advantage payment policy proposals indicating marginal payment growth.
- The company’s revenue is significantly Medicare-dependent, with about 61% of income linked to this sector.
- Astrana Health’s unique risk adjustment model focuses on direct patient encounters, avoiding audio-only visits or chart-only reviews, which minimizes negative payment adjustments.
- Analysts suggest the policy changes could increase the value of delegated care delivery models, potentially favoring companies like Astrana Health.
Risks and Uncertainties
- The limited suggested Medicare Advantage payment growth may constrain revenue expansion for companies dependent on Medicare funding.
- Changes in CMS’s risk adjustment and documentation policies carry regulatory uncertainty, potentially impacting future payments.
- The disproportionate stock price reaction indicates investor sensitivity, which may lead to volatility unrelated to fundamental performance.
- Dependence on Medicare Advantage contracts exposes Astrana Health to policy and reimbursement fluctuations inherent in government healthcare programs.