Can Waystar Still Stand Up to Rising Competition?

Key Points

• 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 built a reputation for its powerful software-as-a-service (SaaS), helping to integrate payer networks with electronic health records. However, as the AI and cloud field has become increasingly crowded overall in recent years, Waystar faces increasing competition from companies offering similar or related tools, such as Phreesia Inc. NYSE: PHR and Doximity Inc. NYSE: DOCS.

Waystar shares are down some 40% in the last 12 months, but analysts are still predicting growth across multiple metrics, including earnings and share price. A closer comparison of Waystar against these rivals—one larger and one smaller, by market capitalization—may help investors to determine how best to capitalize on the rush to bring AI and cloud technology into the healthcare software space.

Waystar's AI Developments and Growth Are Exciting, But Balance Sheet Risks Linger

Fresh off a January agentic AI update to its AltitudeAI system, which is already responsible for preventing billions of denials each year, Waystar has leaned into AI technology in its products. The company has successfully used AI to drive further adoption, expanding its capabilities and aiding with pricing—in this way, Waystar is a key example of a company utilizing AI for its potential benefits, rather than risking being displaced by AI technology.

AI has also helped Waystar to retain customers and build its network. The company reported net revenue retention of 113% for the latest quarter and sports more than 1,300 clients generating at least $100,000 in revenue over the prior 12 months. This helped overall revenue for the quarter grow by 12% year-over-year (YOY) to $269 million and adjusted EBITDA margin to reach 42%.

Waystar has also been growing via acquisitions, including its recent purchase of Iodine Software in the fall of 2025. This move should boost Waystar's addressable market by 15%. At the same time, though, investors may be cautious about Waystar's balance sheet following the purchase. As of the end of the third quarter 2025, Waystar had $421 million in cash compared to gross debt of $1.2 billion. This may be one reason shares have fallen in recent months.

Phreesia Reaches a Pivotal Growth Milestone

Phreesia's patient intake management system serves a somewhat different function than Waystar's products, but similarly utilizes cloud technology to improve efficiency and accuracy. Like Waystar, Phreesia shares have plunged in the last year, but by an even wider margin of about 55%. As a smaller firm with a market capitalization of just $768 million, Phreesia has recently achieved GAAP profitability with earnings per share (EPS) of 11 cents in the latest reported quarter.

New product initiatives and the recent acquisition of AccessOne in November are helping the company to continue to expand its footprint. In particular, AccessOne should provide about $7.5 million in revenue through the end of the 2026 fiscal year on January 31 by facilitating the addition of provider financing to Phreesia's offerings.

Analysts are excited about Phreesia's growth trajectory, with 17 out of 19 taking a bullish view of the stock. Wall Street seems to think it will also reverse course following its recent decline, predicting upside potential of almost 134%.

Doximity's Balance Sheet and Revenue Performance Stand Out, But Broader Sector Concerns Weigh On Shares

With another unique niche in the healthcare tech space, Doximity offers a secure medical network for healthcare providers. The company stands out amongst peers for its strong revenue growth of 23% YOY for the latest quarter, the result of high adoption rates thanks to its AI integration.

Doximity also offers attractive adjusted EBITDA and free cash flow margins, which have helped it to maintain a healthy cash position. However, despite its balance sheet strengths, investors may be concerned about whether healthcare customers will be able to continue to utilize Doximity's services amid large-scale policy and budget changes. This may have contributed to the company's share price decline of about 41% in the last year.

Nonetheless, like both companies above, analysts generally view DOCS shares positively, assigning a Moderate Buy rating overall and predicting some 89% in upside possible over the year to come, should the external situation become more navigable.