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AUNA vs. THC: Which Ambulatory Care Stock Is the Smarter Bet Now?
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Key Takeaways
Auna S.A. leads in Latin America with strong Peru results and Mexico revenue recovery.
Colombia risk-sharing models support stable margins and consistent cash cycles for AUNA.
AUNA's $825M debt refinancing strengthened its capital structure and boosted cash by 42%.
Auna S.A. (AUNA - Free Report) and Tenet Healthcare (THC - Free Report) are two well-established players in the ambulatory care space. AUNA’s healthcare network provides a range of in-person services through medium to high-complexity focused hospitals, clinics and outpatient facilities across Mexico, Peru and Colombia, alongside complementary virtual care and at-home care. THC’s Ambulatory Care segment includes the operations of USPI Holding Company, Inc. (“USPI”), which held ownership interests in 533 ambulatory surgery centers (ASC) and 26 surgical hospitals in 37 states as of 2025-end, spanning specialties, including orthopedics, gastroenterology, pain management and urology.
According to Coherent Market Insights, the global ambulatory healthcare service market is projected to witness a CAGR of 5.7% through 2026-2033. The expansion is supported by increasing demand for outpatient care, advancements in medical technologies and a worldwide shift toward cost-effective healthcare delivery models. Against this backdrop, let’s assess how each company stacks up.
The Case for Auna S.A.
The company operates through ‘The Auna Way’, a differentiated model aimed at transforming health care in Spanish-speaking Latin America, where private health care remains fragmented, inefficient and underpenetrated. In Peru, the vertical integration of healthcare plans into healthcare operations continues to generate value. In the fourth quarter of 2025, Peru’s performance was driven by a strong pricing mix in Healthcare Services and a record low medical loss ratio in Oncosalud. Auna S.A. also signed an agreement with EsSalud under a public-private partnership to begin the construction of Torre Trecca in Lima, broadening its addressable market in the country.
Meanwhile, the Mexico operations have stabilized and are moving toward sustained top-line and EBITDA growth in 2026. With a new leadership team in place, the focus remains on expanding reach into larger segments of privately insured families and furthering alignment with certain physician groups. The high-margin, Out-of-Pocket segment contributed 12% of Mexico revenues in December, up from 8% in the third quarter, driven by targeted pricing initiatives and pre-negotiated physician rates. At the same time, Auna S.A. is acting on its corporate and government agencies opportunity.
The company is scaling its oncology capabilities in Mexico, such as the new OncoCenter at Doctors Hospital, and the signing of an exclusive five-year agreement with the leading oncology group, Opción Oncología.
In Colombia, measures implemented to manage risks and improve cash flows are yielding promising results. The company continues to expand risk-sharing models such as Prospective Global Payments (“PGP”), supporting stable margins, high occupancy and a consistent cash cycle.
On the capital structure front, Auna completed $825 million debt refinancing, which improved its maturity profile and reduced interest expenses. Despite refinancing-related costs, leverage remained at 3.6X, supported by a strong free cash flow generation that increased cash position by 42%.
Earnings estimates for Auna are also showing an upward trend.
Image Source: Zacks Investment Research
The Case for Tenet Healthcare
In 2025, Tenet Healthcare reported net operating revenues of $21.3 billion, up 14% from the prior year, while the adjusted EBITDA margin improved 200 basis points to 21.4%. USPI’s same facility revenues grew 7.5%, highlighted by double-digit same-store volume growth in total joint replacements across ASCs. Results came in above the company’s long-term organic growth target of 3%-6%.
M&A and de novo activity also remained robust, with nearly $350 million invested in 2025 and 35 facilities added to the portfolio. Tenet Healthcare sees a strong pipeline to support its $250 million annual target for USPI M&A in 2026. The phase-out of the inpatient-only list in 2026 is expected to further the shift of services toward lower-cost sites of care, creating a gradual tailwind for USPI over several years.
The Hospital segment’s adjusted EBITDA grew 16% in 2025, with same-store revenues per adjusted admission benefiting from payer mix and strong acuity. In September, Tenet Healthcare opened its newest hospital facility in Port St. Lucie, FL, expanding capacity in one of the fastest-growing markets and offering comprehensive emergency and specialty care with advanced technology.
Management expects a $250 million impact on its 2026 adjusted EBITDA, primarily in the Hospital segment, due to the expiration of enhanced exchange tax credits, which will result in lower volume growth and a less favorable payer mix. The company is also shifting away from the traditional annual expense management to greater deployment of technology to drive more expense reduction opportunities, including within the global business center.
Speaking of the balance sheet, Tenet Healthcare held $2.88 billion of cash on hand as of Dec. 31, with no outstanding borrowings under its line of credit facility. Free cash flow for the year reached $2.53 billion, while leverage stood at 2.25X EBITDA.
Analysts continue to project a positive outlook on the company’s earnings estimates.
Image Source: Zacks Investment Research
AUNA vs. THC: Price Performance & Valuation
Year to date, Auna shares have risen 7.4%, whereas Tenet Healthcare has dipped 5.4%.
Image Source: Zacks Investment Research
AUNA trades at a forward, five-year price/sales of 0.31X, lower than its median of 0.41X. THC is trading at a sales multiple of 0.75X, higher than its median.
Image Source: Zacks Investment Research
Conclusion
Operating within the ambulatory care space, both Auna S.A. and Tenet Healthcare are well-positioned to benefit from industry trends. Auna S.A.’s Peru operations remain a key performance driver, and Mexico is set for a strong recovery, while Colombia’s risk mitigation measures protect its cash flow. A stronger capital structure is another plus.
Tenet Healthcare continues to deliver steady performance across the USPI and Hospitals segments, though the expiration of enhanced exchange tax credits is projected to have a financial impact on its operational metrics. Both AUNA and THC demonstrate upward revisions in earnings estimates. That said, based on its valuation and year-to-date performance, AUNA stands out as the more compelling investment option for now.
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AUNA vs. THC: Which Ambulatory Care Stock Is the Smarter Bet Now?
Key Takeaways
Auna S.A. (AUNA - Free Report) and Tenet Healthcare (THC - Free Report) are two well-established players in the ambulatory care space. AUNA’s healthcare network provides a range of in-person services through medium to high-complexity focused hospitals, clinics and outpatient facilities across Mexico, Peru and Colombia, alongside complementary virtual care and at-home care. THC’s Ambulatory Care segment includes the operations of USPI Holding Company, Inc. (“USPI”), which held ownership interests in 533 ambulatory surgery centers (ASC) and 26 surgical hospitals in 37 states as of 2025-end, spanning specialties, including orthopedics, gastroenterology, pain management and urology.
According to Coherent Market Insights, the global ambulatory healthcare service market is projected to witness a CAGR of 5.7% through 2026-2033. The expansion is supported by increasing demand for outpatient care, advancements in medical technologies and a worldwide shift toward cost-effective healthcare delivery models. Against this backdrop, let’s assess how each company stacks up.
The Case for Auna S.A.
The company operates through ‘The Auna Way’, a differentiated model aimed at transforming health care in Spanish-speaking Latin America, where private health care remains fragmented, inefficient and underpenetrated. In Peru, the vertical integration of healthcare plans into healthcare operations continues to generate value. In the fourth quarter of 2025, Peru’s performance was driven by a strong pricing mix in Healthcare Services and a record low medical loss ratio in Oncosalud. Auna S.A. also signed an agreement with EsSalud under a public-private partnership to begin the construction of Torre Trecca in Lima, broadening its addressable market in the country.
Meanwhile, the Mexico operations have stabilized and are moving toward sustained top-line and EBITDA growth in 2026. With a new leadership team in place, the focus remains on expanding reach into larger segments of privately insured families and furthering alignment with certain physician groups. The high-margin, Out-of-Pocket segment contributed 12% of Mexico revenues in December, up from 8% in the third quarter, driven by targeted pricing initiatives and pre-negotiated physician rates. At the same time, Auna S.A. is acting on its corporate and government agencies opportunity.
The company is scaling its oncology capabilities in Mexico, such as the new OncoCenter at Doctors Hospital, and the signing of an exclusive five-year agreement with the leading oncology group, Opción Oncología.
In Colombia, measures implemented to manage risks and improve cash flows are yielding promising results. The company continues to expand risk-sharing models such as Prospective Global Payments (“PGP”), supporting stable margins, high occupancy and a consistent cash cycle.
On the capital structure front, Auna completed $825 million debt refinancing, which improved its maturity profile and reduced interest expenses. Despite refinancing-related costs, leverage remained at 3.6X, supported by a strong free cash flow generation that increased cash position by 42%.
Earnings estimates for Auna are also showing an upward trend.
Image Source: Zacks Investment Research
The Case for Tenet Healthcare
In 2025, Tenet Healthcare reported net operating revenues of $21.3 billion, up 14% from the prior year, while the adjusted EBITDA margin improved 200 basis points to 21.4%. USPI’s same facility revenues grew 7.5%, highlighted by double-digit same-store volume growth in total joint replacements across ASCs. Results came in above the company’s long-term organic growth target of 3%-6%.
M&A and de novo activity also remained robust, with nearly $350 million invested in 2025 and 35 facilities added to the portfolio. Tenet Healthcare sees a strong pipeline to support its $250 million annual target for USPI M&A in 2026. The phase-out of the inpatient-only list in 2026 is expected to further the shift of services toward lower-cost sites of care, creating a gradual tailwind for USPI over several years.
The Hospital segment’s adjusted EBITDA grew 16% in 2025, with same-store revenues per adjusted admission benefiting from payer mix and strong acuity. In September, Tenet Healthcare opened its newest hospital facility in Port St. Lucie, FL, expanding capacity in one of the fastest-growing markets and offering comprehensive emergency and specialty care with advanced technology.
Management expects a $250 million impact on its 2026 adjusted EBITDA, primarily in the Hospital segment, due to the expiration of enhanced exchange tax credits, which will result in lower volume growth and a less favorable payer mix. The company is also shifting away from the traditional annual expense management to greater deployment of technology to drive more expense reduction opportunities, including within the global business center.
Speaking of the balance sheet, Tenet Healthcare held $2.88 billion of cash on hand as of Dec. 31, with no outstanding borrowings under its line of credit facility. Free cash flow for the year reached $2.53 billion, while leverage stood at 2.25X EBITDA.
Analysts continue to project a positive outlook on the company’s earnings estimates.
Image Source: Zacks Investment Research
AUNA vs. THC: Price Performance & Valuation
Year to date, Auna shares have risen 7.4%, whereas Tenet Healthcare has dipped 5.4%.
Image Source: Zacks Investment Research
AUNA trades at a forward, five-year price/sales of 0.31X, lower than its median of 0.41X. THC is trading at a sales multiple of 0.75X, higher than its median.
Image Source: Zacks Investment Research
Conclusion
Operating within the ambulatory care space, both Auna S.A. and Tenet Healthcare are well-positioned to benefit from industry trends. Auna S.A.’s Peru operations remain a key performance driver, and Mexico is set for a strong recovery, while Colombia’s risk mitigation measures protect its cash flow. A stronger capital structure is another plus.
Tenet Healthcare continues to deliver steady performance across the USPI and Hospitals segments, though the expiration of enhanced exchange tax credits is projected to have a financial impact on its operational metrics. Both AUNA and THC demonstrate upward revisions in earnings estimates. That said, based on its valuation and year-to-date performance, AUNA stands out as the more compelling investment option for now.
AUNA sports a Zacks Rank #1 (Strong Buy) at present, while THC has a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank stocks here.