Can Waystar Still Stand Up to Rising Competition?By Nathan Reiff. Published: 2/4/2026.
Article Highlights- As Waystar's shares have fallen by 40% over the last year, investors may be questioning how the company stacks up against rivals like Phreesia and Doximity.
- All three companies have faced share price challenges recently, but each has a case for future growth based on acquisitions, product expansion, and other factors.
- Waystar may stand out for its successful integration of AI through its AltitudeAI system and its recent agentic AI launch.
At the intersection of healthcare and cloud computing, Waystar Holding Corp. (NASDAQ: WAY) has developed powerful software-as-a-service (SaaS) solutions that integrate payer networks with electronic health records. But as the AI and cloud fields have become increasingly crowded in recent years, Waystar faces mounting competition from companies offering similar or adjacent tools, such as Phreesia Inc. (NYSE: PHR) and Doximity Inc. (NYSE: DOCS).
Waystar shares are down roughly 40% over the past 12 months, yet analysts still forecast growth across multiple metrics, including earnings and share price. A side-by-side look at Waystar and these rivals—one larger and one smaller by market capitalization—can help investors evaluate how to capitalize on the rush to bring AI and cloud technology into healthcare software.
Waystar's AI Developments and Growth Are Exciting, But Balance Sheet Risks Linger
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Fresh off a January agentic AI update to its AltitudeAI system—already credited with preventing billions of claim denials each year—Waystar has leaned into AI across its product lineup. The company has used AI to drive adoption, expand capabilities and refine pricing, making it an example of a business leveraging AI for competitive advantage rather than being displaced by it.
AI has also helped Waystar retain customers and expand its network. The company reported net revenue retention of 113% for the latest quarter and has more than 1,300 clients generating at least $100,000 in revenue over the prior 12 months. Those dynamics supported 12% year-over-year (YOY) revenue growth to $269 million for the quarter and an adjusted EBITDA margin of 42%.
Waystar has pursued growth through acquisitions as well, including its purchase of Iodine Software in fall 2025, a deal expected to expand its addressable market by about 15%. At the same time, investors may be cautious about the company’s leverage: as of the end of the third quarter of 2025, Waystar held $421 million in cash against roughly $1.2 billion in gross debt. That capital structure risk is likely a factor in the recent share decline.
Phreesia Reaches a Pivotal Growth Milestone Phreesia’s patient intake management system serves a somewhat different role than Waystar’s offerings but similarly relies on cloud technology to improve efficiency and accuracy. Like Waystar, Phreesia shares have plunged over the past year—by about 55%—but the smaller company (market capitalization roughly $768 million) recently achieved GAAP profitability, reporting earnings per share (EPS) of $0.11 in the latest quarter.
New product initiatives and the November acquisition of AccessOne are helping Phreesia expand its footprint. AccessOne is expected to contribute about $7.5 million in revenue through the end of Phreesia’s 2026 fiscal year (Jan. 31, 2026) by enabling provider financing as part of Phreesia’s offerings.
Analysts appear optimistic: 17 of 19 analysts rate the stock bullishly, and Wall Street projects nearly 134% upside from current levels if the company can sustain its recovery.
Doximity's Balance Sheet and Revenue Performance Stand Out, But Broader Sector Concerns Weigh On Shares Doximity occupies another distinct niche in healthcare tech by operating a secure professional network for clinicians. The company reported robust revenue growth of 23% YOY in the latest quarter, driven in part by high adoption of its AI-enabled features.
Strong adjusted EBITDA and free cash flow margins have helped Doximity maintain a healthy cash position and solid balance sheet. Yet investors remain wary about whether healthcare customers will sustain spending amid large-scale policy and budget changes, a concern that likely contributed to the stock’s roughly 41% decline over the past year.
Still, analysts generally view DOCS favorably— assigning an overall Moderate Buy rating—and project approximately 89% upside over the coming year if broader sector headwinds ease. |
