TBRG vs. Waystar: Which Healthcare RCM Stock Is the Better Bet Now?

With healthcare providers grappling with increasingly complex reimbursement models and labor shortages, the adoption of advanced software has become a strategic need. Against this backdrop, Technavio projects the global healthcare revenue cycle management (RCM) software market to expand at a CAGR of 12.1% from 2026 to 2035, valued at $200.5 billion in 2025. TruBridge Inc. TBRG and Waystar Holding Corp. WAY are well-known players in this space. 

TruBridge (formerly, Computer Programs and Systems, Inc.) connects providers and patients in its target market of rural and community hospitals through RCM and electronic health record solutions. In the first quarter of 2026, the company surpassed the Zacks Consensus Estimate for earnings but missed revenues.

On the other hand, Waystar offers end-to-end RCM solutions through its cloud-based software, simplifying healthcare payments for providers across the continuum of care. The company’s first-quarter results reflected both top and bottom lines beating the consensus mark.

Let’s dive deeper to assess which one of them is the better investment pick today.  

The Case for TBRG

With the rapid maturity of the EHR industry and rising demand for outsourced RCM services and complementary solutions, TruBridge has steadily shifted its strategy, operations and financial results toward RCM. Following its early 2024 corporate rebranding, the company operates through Financial Health (previously, RCM business segment) and Patient Care (formerly HER).

Financially, TruBridge’s first-quarter 2026 revenues declined 1% year over year. Within this, Patient Care revenues increased 6%, driven by revenue growth from new SaaS contracts, migrations to SaaS arrangements and the timing of annual licenses. The strength was partially offset by the impact of the discontinuation of Centriq, its web-based acute-care EHR platform. In contrast, Financial Health revenues fell 5.1% due to customer attrition, though it still benefited from higher revenues generated from previous-period bookings.

Adjusted earnings per share (EPS) came in at 59 cents in the quarter, 63.9% higher than the prior-year quarter’s figure, supported by the company’s ongoing cost optimization and savings efforts. Trubridge also holds a solid earnings surprise track record, as the data shows.

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In a key development, in April 2026, Inventurus Knowledge Solutions, Inc. — the U.S. subsidiary of Inventurus Knowledge Solutions Limited (IKS Health) — entered into a definitive agreement to acquire TruBridge. Under the terms of the deal, TBRG shareholders are set to receive $26.25 in cash for each share of common stock, with closing expected in the third calendar quarter of 2026. TBRG stock closed yesterday’s session at $25.94, implying about 1.2% upside to the offer price.

The Case for WAY

The company was recently named to the TIME100 Most Influential Companies list and recognized as the TIME Impact in AI award winner, highlighting the success of its proprietary AltitudeAI engine. The platform has prevented more than $15 billion in denied claims in less than a year and reduced 90% of the time spent on denial appeal and recovery.  Waystar is also advancing its vision for the industry's first autonomous revenue cycle by introducing new AI-powered capabilities to the platform, led by agentic AI. Its expanded partnership with Google Cloud further strengthens these efforts via deeper integration of Gemini models and data infrastructure.

In 2025, the company crossed $1 billion in revenues. Continuing the momentum, first-quarter 2026 sales rose 22% year over year, supported by net revenue retention of roughly 111% and nearly 99% first pass acceptance rates across its AI platform. AI-powered capabilities contributed nearly 40% of new bookings in the quarter. Entering the second quarter, TruBridge boasts the largest qualified sales pipeline of new and cross-sell upsell opportunities in its history.

Adjusted EBITDA for the quarter increased 26% year over year, with a margin of 43%, mainly driven by a shift to higher-margin solutions. Waystar delivered adjusted EPS of 42 cents, up 23.5% year over year.

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The company ended the quarter with $159 million in cash, equivalents and short-term investments. Unlevered free cash flow was $90 million, including 67% of adjusted EBITDA conversion, while net leverage improved to 2.7X compared to 3X at the end of 2025.

However, Waystar saw modest offsets in volume-based revenues, primarily in patient payment solutions, reflecting a mix of external and client-driven dynamics. The company reaffirmed its 2026 revenue guidance range of $1.274-$1.294 billion, with the midpoint representing a 17% year-over-year increase. It now anticipates second-quarter revenue growth to be flat to 1% sequentially, versus the previous expectation of 1% to 3%. 

TBRG & WAY: Stock Price Performance

Year to date, TruBridge shares have climbed 17.5%, surpassing the Zacks-Medical Info Systems industry’s 23.9% decline and the sector’s 5.8% fall.  

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Waystar shares have plunged 40.8% so far this year compared with the Zacks Internet-Software industry’s 10.5% decline and the sector’s 19.1% growth.

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Endnote

Waystar demonstrated strong execution and continued innovation momentum in its first-quarter 2026 results. The company’s AI-powered capabilities drove substantial new bookings, reflecting the growing value of embedded intelligence across the revenue cycle. While management acknowledged near-term impacts from some offsets in its volume-based revenues, it reaffirmed the full-year revenue growth targets. We believe existing WAY stockholders should continue to retain their position as AI traction continues to accelerate.

Meanwhile, TruBridge is in the middle of a sell-off process to IKS Health. Its latest quarterly performance demonstrated strength in the Patient Care segment and favorable impacts from cost optimization efforts. With its shares currently trading close to the buyout price, the pending transaction continues to set a clear valuation floor and limited downside risk. Existing holders may benefit from retaining TBRG stock through the deal closure to capture the guaranteed gains.

TBRG sports a Zacks Rank #1 (Strong Buy), while WAY has a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank stocks here.

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