Equity Method Investments

During the three and six months ended June 30, 2026, the Company paid $3.6 million and $5.0 million, respectively, to its equity method investees for provider, call center, and credentialing services. During the three and six months ended June 30, 2025, the Company paid $2.2 million and $3.8 million, respectively to its equity method investees, for management fee services, provider services, and interest expense. For one of our equity method investments, Third Way Health, one of Astrana’s officers is also a board member. See Note 5 — “Investments in Other Entities – Equity Method.”

Astrana Board Members and Officers

During the three months ended June 30, 2026 and 2025, the Company incurred rent expenses of $1.2 million and $1.3 million, respectively, from certain properties that are managed by Allied Pacific Holdings Investment Management, LLC. During the six months ended June 30, 2026 and 2025, the Company incurred $2.5 million and $2.5 million, respectively, in rent expense from the same properties. As of June 30, 2026 and December 31, 2025, the Company’s operating lease right-of-use asset balance included $11.2 million and $10.1 million, respectively, and the Company’s operating lease liabilities included $11.9 million and $10.7 million, respectively, for certain properties that are managed by Allied Pacific Holdings Investment Management, LLC. Two of the Company’s directors own a portion of Allied Pacific Holdings Investment Management, LLC. One of these directors also serves as its chief executive officer and chief financial officer. A third director of the Company also serves as an officer of Allied Pacific Holdings Investment Management, LLC.

The Company has an agreement with AHMC for services provided to the Company, involving payment for hospital and other inpatient-related services, at rates similar to the Company’s other contracted hospitals. The Company and AHMC also have a risk-sharing agreement with certain AHMC hospitals to share the surplus and deficits of each of the hospital pools. Under the risk-sharing agreement, during the three months ended June 30, 2026 and 2025, the Company had recognized risk pool revenues of $1.9 million and $2.8 million, respectively. During the six months ended June 30, 2026 and 2025, the Company had recognized risk pool revenues of $4.0 million and $7.8 million, respectively. As of June 30, 2026 and December 31, 2025, $49.4 million and $40.5 million, respectively, remained in outstanding risk pool receivables. One of the Company’s directors is an officer of AHMC.

Revenue with AHMC consists of capitation, risk pool, and miscellaneous fees. Expenses with AHMC primarily include claims expenses. The following table sets forth revenue recognized and fees incurred with AHMC for the three and six months ended June 30, 2026 and 2025 (in thousands):

APC Board Members

During the three months ended June 30, 2026 and 2025, the Company paid an aggregate of $5.8 million and $4.7 million, respectively, to APC board members for provider services, which included $1.2 million and $0.6 million, respectively, paid to individuals who also serve as Astrana board members and/or officers. During the six months ended June 30, 2026 and 2025, the Company paid an aggregate of $10.8 million and $9.2 million, respectively, to APC board members for provider services, which included $2.1 million and $1.2 million, respectively, paid to individuals who also serve as Astrana board members and/or officers.

Intercompany Transactions

Because of corporate practice of medicine laws, the Company uses designated shareholder professional corporations, of which the sole shareholder is a member of the Company’s key personnel, to engage in certain transactions and make intercompany loans from time to time. These corporations are reported on a consolidated basis, together with the Company’s subsidiaries, and therefore, the Company does not separately disclose transactions between such affiliates and the Company’s subsidiaries as related-party transactions.