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Variable Interest Entities (VIEs) - Schedule of Assets and Liabilities, Variable Interest Entities (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Current assets      
Cash and cash equivalents $ 429,474 $ 288,455 $ 293,807
Receivables, net (including amounts with related parties) 374,465 275,990  
Other receivables 26,385 29,496  
Prepaid expenses and other current assets 26,264 25,239  
Loans receivable 4,926 0  
Total current assets 863,313 638,496  
Non-current assets      
Property and equipment, net 57,332 14,274  
Intangible assets, net 270,968 118,179  
Goodwill 865,305 419,253 278,831
Income taxes receivable, net of current portion 26,220 15,943  
Loans receivable, net of current portion 48,724 51,266  
Investments in other entities – equity method 25,637 39,319  
Operating lease right-of-use assets 35,738 32,601  
Other assets 22,528 16,667  
Total non-current assets 1,355,348 716,398  
Total assets [1] 2,218,661 1,354,894  
Current liabilities      
Accounts payable and accrued expenses 195,912 106,142  
Fiduciary accounts payable 3,524 8,223  
Medical liabilities 335,705 209,039 $ 106,657
Operating lease liabilities 7,809 5,350  
Other liabilities 24,458 27,479  
Total current liabilities 615,273 365,608  
Non-current liabilities      
Deferred tax liability 5,491 4,555  
Operating lease liabilities, net of current portion 31,552 30,654  
Other long-term liabilities 17,107 14,610  
Total non-current liabilities 1,045,054 475,118  
Total liabilities [1] 1,660,327 840,726  
Variable Interest Entity, Primary Beneficiary      
Current assets      
Cash and cash equivalents 202,164 158,922  
Receivables, net (including amounts with related parties) 208,929 132,228  
Other receivables 8,907 15,303  
Prepaid expenses and other current assets 12,946 12,420  
Loans receivable 753 0  
Amount due from affiliates [2] 58,265 0  
Total current assets 491,964 318,873  
Non-current assets      
Property and equipment, net 41,646 5,875  
Intangible assets, net 216,594 87,840  
Goodwill 524,751 243,283  
Income taxes receivable, net of current portion 12,405 15,943  
Loans receivable, net of current portion 194 0  
Investments in other entities – equity method 17,069 15,442  
Investment in a privately held entity 405 405  
Investment in affiliates [2] 152,155 224,894  
Operating lease right-of-use assets 26,499 21,585  
Other assets 3,287 3,059  
Total non-current assets 995,005 618,326  
Total assets 1,486,969 937,199  
Current liabilities      
Accounts payable and accrued expenses 108,309 43,800  
Fiduciary accounts payable 3,524 8,223  
Medical liabilities 198,919 105,486  
Income taxes payable 15,007 11,041  
Operating lease liabilities 5,473 3,487  
Other liabilities 6,505 2,509  
Amount due to affiliate [2] 0 48,142  
Total current liabilities 337,737 222,688  
Non-current liabilities      
Deferred tax liability 7,159 11,237  
Operating lease liabilities, net of current portion 24,241 21,012  
Other long-term liabilities 6,855 1,139  
Total non-current liabilities 38,255 33,388  
Total liabilities $ 375,992 $ 256,076  
[1] The Company’s consolidated balance sheets include the assets and liabilities of its consolidated VIEs. The consolidated balance sheets include total assets that can be used only to settle obligations of the Company’s consolidated VIEs totaling $1,276.5 million and $712.3 million as of December 31, 2025 and 2024, respectively, and total liabilities of the Company’s consolidated VIEs for which creditors do not have recourse to the general credit of the primary beneficiary of $376.0 million and $207.9 million as of December 31, 2025 and 2024, respectively. These VIE balances do not include $152.2 million of investment in affiliates and $58.3 million of amounts due from affiliates as of December 31, 2025, and $224.9 million of investment in affiliates and $48.1 million of amounts due to affiliates as of December 31, 2024, as these are eliminated upon consolidation and not presented within the consolidated balance sheets. See Note 18 — “Variable Interest Entities (VIEs)” for further detail.
[2] Investment in affiliates includes APC’s investment in Astrana. While such shares of Astrana’s common stock are legally issued to APC and outstanding, they are treated as treasury shares for accounting purposes and excluded from shares of common stock outstanding in the consolidated financial statements. Amounts due to, or from, affiliates are receivables or payables with Astrana’s subsidiaries. As a result, these balances are eliminated upon consolidation and are not reflected on Astrana’s consolidated balance sheet as of December 31, 2025 and 2024, respectively.