Comprehensive Stock Comparison
Compare Fresenius Medical Care AG & Co. KGaA (FMS) vs HCA Healthcare, Inc. (HCA) Stock
Analyze side-by-side fundamentals, valuation, growth, and profitability to decide which stock is the better buy.
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Quick Verdict
| Category | Winner | Why |
|---|---|---|
| Growth | HCA | 7.1% revenue growth vs FMS's 1.5% |
| Value | FMS | Lower P/E (9.9x vs 17.5x) |
| Quality / Margins | HCA | 9.0% net margin vs FMS's 5.0% |
| Stability / Safety | HCA | Beta 0.29 vs FMS's 0.40 |
| Dividends | HCA | 0.6% yield; 5-year raise streak; FMS pays no meaningful dividend |
| Momentum (1Y) | HCA | +73.9% vs FMS's +0.2% |
| Efficiency (ROA) | HCA | 11.2% ROA vs FMS's 3.2%, ROIC 19.9% vs 5.6% |
Who Each Stock Is For
Income & stability
Growth exposure
Long-term compounding (10Y)
Sleep-well-at-night portfolio
Valuation efficiency (growth/$)
Defensive / Recession hedge
Business Model
What each company does and how it makes money
Fresenius Medical Care is a global leader in dialysis care and products for patients with chronic kidney failure. It generates revenue through two main segments: dialysis services (about 75% of revenue) from its network of outpatient clinics and hospital contracts, and dialysis products (about 25%) including machines, dialyzers, and related supplies. The company's key advantage is its vertically integrated model—combining clinics, products, and services—which creates patient stickiness and economies of scale in the capital-intensive dialysis industry.
HCA Healthcare is one of the largest for-profit hospital operators in the United States, providing comprehensive medical and surgical services through its network of acute care hospitals and outpatient facilities. It generates revenue primarily from patient services — including inpatient hospital stays, outpatient procedures, and emergency care — with the vast majority coming from government programs like Medicare and Medicaid alongside private insurance reimbursements. The company's scale advantage — operating over 180 hospitals concentrated in high-growth markets — creates significant purchasing power with suppliers and negotiating leverage with payers.
Revenue Breakdown by Segment
How each company's revenue is distributed across its business units
Financial Metrics Comparison
Side-by-side fundamentals across 2 stocks. BestLagging
Financial Scorecard
HCA leads in 5 of 6 categories (Financial Metrics, Profitability & Efficiency). FMS leads in 1 (Valuation Metrics).
Financial Metrics (TTM)
HCA is the larger business by revenue, generating $75.6B annually — 3.9x FMS's $19.6B. Profitability is closely matched — net margins range from 9.0% (HCA) to 5.0% (FMS). On growth, HCA holds the edge at +6.7% YoY revenue growth, suggesting stronger near-term business momentum.
| Metric | FMSFresenius Medical… | HCAHCA Healthcare, I… |
|---|---|---|
| RevenueTrailing 12 months | $19.6B | $75.6B |
| EBITDAEarnings before interest/tax | $3.3B | $15.5B |
| Net IncomeAfter-tax profit | $978M | $6.8B |
| Free Cash FlowCash after capex | $1.2B | $7.7B |
| Gross MarginGross profit ÷ Revenue | +25.6% | +41.5% |
| Operating MarginEBIT ÷ Revenue | +9.3% | +15.8% |
| Net MarginNet income ÷ Revenue | +5.0% | +9.0% |
| FCF MarginFCF ÷ Revenue | +6.0% | +10.2% |
| Rev. Growth (YoY)Latest quarter vs prior year | -0.3% | +6.7% |
| EPS Growth (YoY)Latest quarter vs prior year | +8.5% | +44.6% |
Valuation Metrics
At 11.8x trailing earnings, FMS trades at a 37% valuation discount to HCA's 18.7x P/E. Adjusting for growth (PEG ratio), HCA offers better value at 0.89x vs FMS's 2.32x — a lower PEG means you pay less per unit of expected earnings growth.
| Metric | FMSFresenius Medical… | HCAHCA Healthcare, I… |
|---|---|---|
| Market CapShares × price | $13.6B | $118.5B |
| Enterprise ValueMkt cap + debt − cash | $24.4B | $167.6B |
| Trailing P/EPrice ÷ TTM EPS | 11.84x | 18.66x |
| Forward P/EPrice ÷ next-FY EPS est. | 9.89x | 17.50x |
| PEG RatioP/E ÷ EPS growth rate | 2.32x | 0.89x |
| EV / EBITDAEnterprise value multiple | 6.33x | 10.82x |
| Price / SalesMarket cap ÷ Revenue | 0.59x | 1.57x |
| Price / BookPrice ÷ Book value/share | 0.81x | — |
| Price / FCFMarket cap ÷ FCF | — | 15.40x |
Profitability & Efficiency
On the Piotroski fundamental quality scale (0–9), HCA scores 7/9 vs FMS's 5/9, reflecting strong financial health.
| Metric | FMSFresenius Medical… | HCAHCA Healthcare, I… |
|---|---|---|
| ROE (TTM)Return on equity | +6.8% | — |
| ROA (TTM)Return on assets | +3.2% | +11.2% |
| ROICReturn on invested capital | +5.6% | +19.9% |
| ROCEReturn on capital employed | +6.9% | +27.0% |
| Piotroski ScoreFundamental quality 0–9 | 5 | 7 |
| Debt / EquityFinancial leverage | 0.76x | — |
| Net DebtTotal debt minus cash | $9.2B | $49.2B |
| Cash & Equiv.Liquid assets | $1.6B | $1.0B |
| Total DebtShort + long-term debt | $10.8B | $50.2B |
| Interest CoverageEBIT ÷ Interest expense | 6.84x | 5.37x |
Total Returns (with DRIP)
A $10,000 investment in HCA five years ago would be worth $30,878 today (with dividends reinvested), compared to $7,718 for FMS. Over the past 12 months, HCA leads with a +73.9% total return vs FMS's +0.2%. The 3-year compound annual growth rate (CAGR) favors HCA at 30.2% vs FMS's 9.1% — a key indicator of consistent wealth creation.
| Metric | FMSFresenius Medical… | HCAHCA Healthcare, I… |
|---|---|---|
| YTD ReturnYear-to-date | -0.2% | +12.6% |
| 1-Year ReturnPast 12 months | +0.2% | +73.9% |
| 3-Year ReturnCumulative with dividends | +29.7% | +120.8% |
| 5-Year ReturnCumulative with dividends | -22.8% | +208.8% |
| 10-Year ReturnCumulative with dividends | -28.5% | +688.3% |
| CAGR (3Y)Annualised 3-year return | +9.1% | +30.2% |
Risk & Volatility
HCA is the less volatile stock with a 0.29 beta — it tends to amplify market swings less than FMS's 0.40 beta. A beta below 1.0 means the stock typically moves less than the S&P 500. HCA currently trades 95.8% from its 52-week high vs FMS's 77.0% drawdown — a narrower gap to the peak suggests stronger recent price momentum.
| Metric | FMSFresenius Medical… | HCAHCA Healthcare, I… |
|---|---|---|
| Beta (5Y)Sensitivity to S&P 500 | 0.40x | 0.29x |
| 52-Week HighHighest price in past year | $30.46 | $552.90 |
| 52-Week LowLowest price in past year | $20.95 | $295.00 |
| % of 52W HighCurrent price vs 52-week peak | +77.0% | +95.8% |
| RSI (14)Momentum oscillator 0–100 | 49.0 | 56.0 |
| Avg Volume (50D)Average daily shares traded | 518K | 879K |
Analyst Outlook
Wall Street rates FMS as "Hold" and HCA as "Buy". Consensus price targets imply 19.4% upside for FMS (target: $28) vs -1.1% for HCA (target: $524). HCA is the only dividend payer here at 0.56% yield — a key consideration for income-focused portfolios.
| Metric | FMSFresenius Medical… | HCAHCA Healthcare, I… |
|---|---|---|
| Analyst RatingConsensus buy/hold/sell | Hold | Buy |
| Price TargetConsensus 12-month target | $28.00 | $523.92 |
| # AnalystsCovering analysts | 18 | 46 |
| Dividend YieldAnnual dividend ÷ price | — | +0.6% |
| Dividend StreakConsecutive years of raises | 3 | 5 |
| Dividend / ShareAnnual DPS | — | $2.94 |
| Buyback YieldShare repurchases ÷ mkt cap | 0.0% | +8.5% |
Historical Charts
Charts are rendered on first load. Hover for details.
Chart 1Total Return — 5 Years (Rebased to 100)
| Stock | Mar 20 | Feb 26 | Change |
|---|---|---|---|
| Fresenius Medical C… (FMS) | 100 | 56.36 | -43.6% |
| HCA Healthcare, Inc. (HCA) | 100 | 367.9 | +267.9% |
HCA Healthcare, Inc. (HCA) returned +209% over 5 years vs Fresenius Medical C… (FMS)'s -23%. A $10,000 investment in HCA 5 years ago would be worth $30,878 today (including dividends reinvested).
Chart 2Revenue Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Fresenius Medical C… (FMS) | $17.0B | $19.6B | +15.3% |
| HCA Healthcare, Inc. (HCA) | $41.5B | $75.6B | +82.2% |
Fresenius Medical Care AG & Co. KGaA's revenue grew from $17.0B (2016) to $19.6B (2025) — a 1.6% CAGR. HCA Healthcare, Inc.'s revenue grew from $41.5B (2016) to $75.6B (2025) — a 6.9% CAGR.
Chart 3Net Margin Trend — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Fresenius Medical C… (FMS) | 6.9% | 5.0% | -28.2% |
| HCA Healthcare, Inc. (HCA) | 7.0% | 9.0% | +28.8% |
Fresenius Medical Care AG & Co. KGaA's net margin went from 7% (2016) to 5% (2025). HCA Healthcare, Inc.'s net margin went from 7% (2016) to 9% (2025).
Chart 4P/E Ratio History — 9 Years
| Stock | 2017 | 2025 | Change |
|---|---|---|---|
| Fresenius Medical C… (FMS) | 25.3 | 14.2 | -43.9% |
| HCA Healthcare, Inc. (HCA) | 14.8 | 16.5 | +11.5% |
Fresenius Medical Care AG & Co. KGaA has traded in a 10x–39x P/E range over 9 years; current trailing P/E is ~12x. HCA Healthcare, Inc. has traded in a 12x–17x P/E range over 9 years; current trailing P/E is ~19x.
Chart 5EPS Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Fresenius Medical C… (FMS) | 1.87 | 1.68 | -10.2% |
| HCA Healthcare, Inc. (HCA) | 7.3 | 28.38 | +288.8% |
Fresenius Medical Care AG & Co. KGaA's EPS grew from $1.87 (2016) to $1.68 (2025) — a -1% CAGR. HCA Healthcare, Inc.'s EPS grew from $7.30 (2016) to $28.38 (2025) — a 16% CAGR.
Chart 6Free Cash Flow — 5 Years
Fresenius Medical Care AG & Co. KGaA generated $0M FCF in 2025 (-100% vs 2021). HCA Healthcare, Inc. generated $8B FCF in 2025 (+43% vs 2021).
FMS vs HCA: Frequently Asked Questions
9 questions · data-driven answers · updated daily
01Is FMS or HCA a better buy right now?
Fresenius Medical Care AG & Co. KGaA (FMS) offers the better valuation at 11.8x trailing P/E (9.9x forward), making it the more compelling value choice. Analysts rate HCA Healthcare, Inc. (HCA) a "Buy" — based on 46 analyst ratings — the highest consensus in this comparison. The "better buy" depends entirely on your goals: growth investors should weight revenue trajectory, value investors should weight P/E and PEG, and income investors should weight dividend yield and streak.
02Which has the better valuation — FMS or HCA?
On trailing P/E, Fresenius Medical Care AG & Co. KGaA (FMS) is the cheapest at 11.8x versus HCA Healthcare, Inc. at 18.7x. On forward P/E, Fresenius Medical Care AG & Co. KGaA is actually cheaper at 9.9x. The PEG ratio (P/E divided by earnings growth rate) is the most growth-adjusted single valuation metric: HCA Healthcare, Inc. wins at 0.83x versus Fresenius Medical Care AG & Co. KGaA's 1.94x — a PEG below 1.0 traditionally signals the market is underpricing earnings growth.
03Which is the better long-term investment — FMS or HCA?
Over the past 5 years, HCA Healthcare, Inc. (HCA) delivered a total return of +208.8%, compared to -22.8% for Fresenius Medical Care AG & Co. KGaA (FMS). A $10,000 investment in HCA five years ago would be worth approximately $31K today (assuming dividends reinvested). Over 10 years, the gap is even starker: HCA returned +688.3% versus FMS's -28.5%. Past returns do not guarantee future results, and the stock with the higher historical return may already have its best growth priced in.
04Which is safer — FMS or HCA?
By beta (market sensitivity over 5 years), HCA Healthcare, Inc. (HCA) is the lower-risk stock at 0.29β versus Fresenius Medical Care AG & Co. KGaA's 0.40β — meaning FMS is approximately 37% more volatile than HCA relative to the S&P 500.
05Which has better profit margins — FMS or HCA?
HCA Healthcare, Inc. (HCA) is the more profitable company, earning 9.0% net margin versus 5.0% for Fresenius Medical Care AG & Co. KGaA — meaning it keeps 9.0% of every revenue dollar as bottom-line profit. Operating margin tells a similar story: HCA leads at 15.8% versus 9.3% for FMS. At the gross margin level — before operating expenses — HCA leads at 41.5%, reflecting greater pricing power or product mix advantage. Stronger margins indicate durable pricing power, lower cost of revenue, or higher mix of software/services. They are one of the clearest signs of business quality.
06Is FMS or HCA more undervalued right now?
The PEG ratio (forward P/E divided by expected earnings growth rate) is the most precise measure of undervaluation relative to growth potential. By this metric, HCA Healthcare, Inc. (HCA) is the more undervalued stock at a PEG of 0.83x versus Fresenius Medical Care AG & Co. KGaA's 1.94x. A PEG below 1.0 is traditionally considered the threshold for growth-adjusted undervaluation. On forward earnings alone, Fresenius Medical Care AG & Co. KGaA (FMS) trades at 9.9x forward P/E versus 17.5x for HCA Healthcare, Inc. — 7.6x cheaper on a one-year earnings basis. Analyst consensus price targets imply the most upside for FMS: 19.4% to $28.00.
07Which pays a better dividend — FMS or HCA?
In this comparison, HCA (0.6% yield) pays a dividend. FMS does not pay a meaningful dividend and should not be held primarily for income.
08Is FMS or HCA better for a retirement portfolio?
For long-horizon retirement investors, HCA Healthcare, Inc. (HCA) is the stronger choice — it scores higher on the combination of lower volatility, dividend reliability, and long-term compounding (low volatility (β 0.29), 0.6% yield, +688.3% 10Y return). Both have compounded well over 10 years (HCA: +688.3%, FMS: -28.5%), confirming both are viable long-term holds — but the lower-volatility option typically results in less emotional selling during corrections. Retirement portfolios generally favour predictability over maximum returns. Consult a financial advisor before making allocation decisions.
09What are the main differences between FMS and HCA?
Both stocks operate in the Healthcare sector, making this a peer-level intra-sector comparison — the same macro tailwinds and headwinds will affect both. In terms of investment character: FMS is a mid-cap deep-value stock; HCA is a mid-cap quality compounder stock. HCA pays a dividend while FMS does not, making them suitable for different income and tax situations. These fundamental differences mean investors should not choose between them on a single metric — the "better stock" depends entirely on which of these characteristics aligns with your investment strategy.
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