DVA vs FMS: 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: FMS 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. DVA and FMS 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 DVA and FMS 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.

DaVita Inc. (NYSE: DVA) is a Denver, Colorado based kidney care company and the largest provider of dialysis services in the United States. As of June 30, 2026 it treated approximately 298,500 patients across 3,266 outpatient dialysis centers, of which 2,671 are in the US and 595 are spread across 14 other countries. The core business is straightforward and repetitive: patients with end stage renal disease come in roughly three times a week for a treatment that keeps them alive, and DaVita bills a payer for each treatment. Around that base the company runs two smaller segments, an international dialysis business and Integrated Kidney Care (IKC), a value-based care arm that took risk on roughly 62,600 patients and about $5.4 billion of annualized medical spend as of early 2026.

Full DVA guide

Fresenius Medical Care treats end-stage kidney disease, the point at which a patient's kidneys have failed and dialysis or a transplant is the only option. It runs the largest network of outpatient dialysis clinics in the world, with the large majority of revenue coming from the United States, and it also manufactures the machines, dialyzers, bloodlines and water-treatment systems those clinics use, selling that equipment to third parties including its own competitors. Since a 2023 reorganisation the company reports in two segments: Care Delivery, the clinic network, and Care Enablement, the products business. Demand is close to non-discretionary, since a patient on hemodialysis typically needs three sessions a week indefinitely, but the price of each session in the US is set largely by Medicare rather than negotiated.

Full FMS guide

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

• DVA drivers: The buyback is the growth engine; Volume trends turned less bad.
• FMS drivers: The FME25+ cost program; US reimbursement and the TDAPA roll-off.

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: Payer mix is the dominant risk and it is currently moving the wrong way: the expiration of enhanced ACA premium subsidies is pushing patients out of commercial plans and into government coverage, which management sized as roughly a $40 million headwind in 2026 with a larger one expected in 2027. For FMS, the long-term structural worry is that GLP-1 drugs and SGLT2 inhibitors slow the progression of chronic kidney disease enough to shrink the future dialysis population, a thesis the company disputes on the grounds that better survival can also increase treatment years.

Pick DVA if you believe its drivers more; FMS 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 DVA and FMS guides.

DVA. DVA trades at a visible discount to the broader healthcare sector, roughly 16x trailing and 12x forward earnings versus a healthcare industry average in the mid 20s, and that gap is the argument in both directions. Bulls read it as a cheap, defensive, non-discretionary cash machine with a shrinking share count. Bears read it as an appropriate multiple for a business with sub-1% volume growth, negative revenue-per-treatment guidance for the second half of 2026, roughly 3.4x leverage, and a profit pool concentrated in a thin commercially insured minority of patients that is actively eroding. The stock fell sharply in early August 2026 after Q2 results beat on both revenue and adjusted EPS but management reaffirmed rather than raised full-year guidance at a midpoint below consensus, which is a reminder that the multiple is doing very little cushioning work when the mix narrative turns.

FMS. A sub-one-times-sales multiple is unusual for a healthcare services business with near non-discretionary demand, and it prices in the flat volumes and reimbursement ceiling rather than any doubt about the need for the service. Because the company reports in euros and earns most of its revenue in dollars, the reported and constant-currency growth rates can differ by several percentage points, and screeners that convert figures at a spot rate will not match the company's own release. The valuation case rests on margin, since operating income is growing at a double-digit rate off a revenue line management itself guides to broadly flat.

Headline figures (approximate, August 2026): DVA shows revenue (ttm) ~$14.0 billion (up ~6.4% year over year), revenue (q2 2026) ~$3.55 billion, with adjusted operating income of ~$579 million, net income (ttm) ~$847 million, with trailing EPS of ~$12.11, fy 2026 adjusted eps guidance ~$14.10 to ~$15.20 (midpoint ~$14.65), reaffirmed not raised; FMS shows revenue (ttm) ~$19.4B (reported in euros), market cap ~$12.7B, ads price ~$23.77, price / sales (ttm) ~0.65x.

DVA and FMS 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 DVA and FMS exposure against your real portfolio. It is not an investment adviser.