AGL vs ASTH: Which Is the Better Buy in 2026?

Same yardstick, side by side (as of August 2026). Valuation lined up like this is most meaningful for two names in the same corner of the market, which these are. Figures are approximate; verify before investing.

The metrics above tell you which is the marginally better business. The bigger risk for most people is not picking the slightly worse stock, it is over-concentrating. AGL and ASTH share themes, so owning both, or adding either to what you already hold, can quietly push a large share of your portfolio into one bet.

This is the part a generic comparison page cannot answer, because it depends on what you own. Connect your brokerage and Walnut shows your real, combined AGL and ASTH exposure, flags overlap with your existing positions, and tells you if adding one would tip you past a concentration you are comfortable with, read-only by default, with your login staying at your broker. Walnut is not an investment adviser.

agilon health provides a platform, capital, and technology that let community primary-care physician groups take on full financial risk for their senior patients, mostly Medicare Advantage members plus ACO REACH beneficiaries. Instead of fee-for-service billing, agilon and its partner doctors are paid a fixed amount per member and keep the difference if they keep patients healthy and out of the hospital. The model scales through long-term partnerships in individual markets, and the company reports total platform membership around 536,000, including roughly 426,000 Medicare Advantage members and 110,000 in the ACO model.

Full AGL guide

Astrana Health trades on Nasdaq under ASTH and was known as Apollo Medical Holdings (AMEH) until the 2024 rebrand. The company organizes independent physicians into risk-bearing networks and then contracts with health plans on a capitated basis, meaning it accepts a fixed per-member payment and keeps the difference if it can manage care for less. The business reports in three segments: Care Partners, the risk-bearing network arm that produces the large majority of revenue; Care Delivery, the owned and affiliated clinics; and Care Enablement, the technology and management-services platform that the networks run on. The membership base skews heavily toward Medicare Advantage, with Medicaid, commercial and ACO REACH or Medicare Shared Savings lives filling out the rest, and the geographic footprint is still concentrated in California even after expansion into Nevada, Texas and other states.

Full ASTH guide

Both fit overlapping themes, but they are not interchangeable. The useful comparison is which set of drivers and risks you want exposure to.

• AGL drivers: Margin-over-growth reset; Improving risk-adjustment and contracting.
• ASTH drivers: The shift toward full-risk contracts; Membership growth through acquisition and network additions.

A faster-growing, richer-valued name usually swings harder, so it suits a longer horizon and a higher tolerance for volatility; a steadier, more cash-generative business suits a more conservative or income-minded investor. The honest test is which set of risks you could hold through a drawdown: agilon carries meaningful medical-cost-trend risk: because it is paid a fixed amount per member, an unexpected rise in senior utilization or unit costs can swing it back to losses, which is what drove heavy prior-year losses. For ASTH, the core risk is structural: with operating margin under 3%, a modest increase in medical cost trend or utilization can erase profitability across the capitated book, and 2023 through 2025 already showed net income falling from ~$60.7 million to ~$22.5 million even as revenue more than doubled.

Pick AGL if you believe its drivers more; ASTH if you believe its. Many investors hold both, but since they share themes, that is a concentrated bet, not diversification. Decide deliberately and check overlap. For the full detail, see the AGL and ASTH guides.

AGL. agilon generates billions in revenue but has historically run at a loss, posting a full-year 2025 net loss of roughly $391 million before turning to positive net income in Q1 2026. Because the company is in an early turnaround with thin projected EBITDA margins, valuation is driven more by revenue scale and the credibility of the profitability path than by current earnings multiples. Investors typically watch medical margin and membership trends rather than headline revenue growth, which is declining by design.

ASTH. The valuation gap between a ~44x trailing multiple and a ~22x forward multiple is the whole debate in one number: it prices in the raised full-year 2026 adjusted EBITDA guidance of ~$255 million to ~$280 million actually landing. Note also that market cap of ~$1.76 billion sits at less than half of trailing revenue, which is normal for capitated healthcare because the company books the full premium dollar as revenue while keeping only a thin slice. Comparing ASTH on price-to-sales against a software or device company is therefore misleading; margin and cash conversion are the relevant lenses.

Headline figures (approximate, July 2026): AGL shows revenue (ttm) ~$5.8B, 2026 revenue guidance ~$5.68B to $5.81B, q1 2026 revenue ~$1.42B (down ~7% YoY), q1 2026 net income ~$49M (vs ~$12M a year earlier); ASTH shows market cap ~$1.76B, revenue (ttm) ~$3.84B, up ~59% year over year, net income (ttm) ~$40.6M, EPS ~$0.82, trailing p/e ~44x, forward P/E ~22x.

AGL and ASTH are related but distinct: same themes, different businesses and risks. Neither wins in the abstract; the right pick is whichever thesis you actually believe, sized so you are not over-concentrated in one theme. Walnut can show your combined AGL and ASTH exposure against your real portfolio. It is not an investment adviser.