ASTH vs PRVA: 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.

Reading it: ASTH is the cheaper of the two on forward earnings, but cheaper is not the same as better. Pair the valuation with growth (how far the forward P/E sits below the trailing P/E) and risk (beta) before you decide.

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. ASTH and PRVA 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 ASTH and PRVA 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.

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

Privia Health Group is a national physician-enablement company headquartered in Arlington, Virginia, and its structure is unusual enough that it drives everything about the financials. Physicians keep owning their own Affiliated Practices and the buildings, staff and equipment inside them, and they join a single large Privia Medical Group in their market as owners of it. Privia holds the payer contracts, negotiates reimbursement, maintains the patient records and supplies the Privia Platform (technology plus revenue-cycle, population-health and administrative services) through a local management services organization, and in states where corporate ownership of medical practice is restricted the Medical Group is a Non-Owned or Friendly entity that Privia manages but does not own. As of June 30, 2026 that network covered ~5,644 implemented providers, ~1,300 practices, ~6.1 million patients and ~1,647,000 attributed lives in value-based arrangements. Revenue arrives in three shapes: fee-for-service patient care (~$803.8 million in the first half of 2026, about ~65% of the total) plus administrative fees from Non-Owned groups, value-based revenue split across capitation (~$181.3 million), shared savings (~$143.9 million) and per-member-per-month care management fees (~$38.6 million), and a small amount of other services. Of every dollar of revenue, roughly ~79% goes straight back out as provider expense to the physicians who earned it.

Full PRVA guide

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

• ASTH drivers: The shift toward full-risk contracts; Membership growth through acquisition and network additions.
• PRVA drivers: Provider adds and new-market entry drive the top line; The mix is shifting toward value-based care, which carries more margin and more risk.

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: 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. For PRVA, payer concentration is the sharpest exposure: three payers accounted for ~27%, ~18% and ~17% of first-half revenue, and a single payer represented ~55% of net receivables at June 30, 2026, so one contract renegotiation or slow settlement moves both the income statement and the cash cycle.

Growth-minded investors who believe the theme has years to run tend to accept the richer multiple for more upside; value-minded investors lean toward the cheaper forward earnings and steadier profile. Pick ASTH if you believe its drivers more; PRVA 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 ASTH and PRVA guides.

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.

PRVA. Figures are approximate, stamped to August 2026 and drawn from the Q2 2026 earnings release, the Form 10-Q filed August 6, 2026 and the full-year 2025 release, so verify live data before acting on any of them. The reason PRVA screens at ~1.1x sales and ~96x earnings simultaneously is that the sales figure includes the ~79% of revenue paid straight to physicians while the earnings figure is after ~$71 million of annual stock compensation, so neither multiple describes the business on its own. The cleanest single comparison is enterprise value against adjusted EBITDA at roughly ~16x trailing and ~15x guided, held next to ~24% revenue growth, ~19% attributed-lives growth and a debt-free balance sheet.

Headline figures (approximate, August 2026): 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; PRVA shows practice collections vs revenue (ttm) Practice Collections ~$3.69 billion flowed through the platform, of which ~$2.36 billion was recognized as GAAP revenue; the difference is collections at Non-Owned Medical Groups that Privia manages but does not consolidate. Full-year 2026 guidance was raised to the high end at ~$3.65 to ~$3.75 billion of collections and ~$2.35 to ~$2.45 billion of revenue, revenue growth GAAP revenue ~$2.36 billion for the twelve months ended June 30, 2026, up ~24%; Q2 2026 revenue ~$632.6 million, up ~21.4%; first-half revenue ~$1.24 billion, up ~23.5%, split ~65% fee-for-service patient care and ~29% value-based (capitation, shared savings, care management fees), what privia keeps Provider expense consumed ~79% of Q2 revenue (~$500.5 million of ~$632.6 million). Trailing Care Margin ~$503 million (~13.6% of Practice Collections, ~21% of revenue), platform contribution ~$69.0 million in Q2 at a ~52.2% margin, and trailing adjusted EBITDA ~$144 million, roughly ~3.9% of the money flowing across the platform, earnings, gaap versus adjusted Trailing net income attributable to stockholders ~$28.1 million (~$0.22 per share) against trailing adjusted net income of ~$136 million (~$1.04 per diluted share). The bridge is ~$71.1 million of annualized stock compensation plus intangible amortization and non-recurring items; Q2 2026 net income was ~$9.0 million with ~$19.4 million of stock compensation inside it.

ASTH and PRVA 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 ASTH and PRVA exposure against your real portfolio. It is not an investment adviser.