Comprehensive Stock Comparison
Compare Healthcare Services Group, Inc. (HCSG) 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 | HCSG | 7.1% revenue growth vs HCA's 7.1% |
| Value | HCA | Lower P/E (17.5x vs 22.5x) |
| Quality / Margins | HCA | 9.0% net margin vs HCSG's 2.2% |
| Stability / Safety | HCA | Beta 0.29 vs HCSG's 0.74 |
| Dividends | HCA | 0.6% yield; 5-year raise streak; HCSG pays no meaningful dividend |
| Momentum (1Y) | HCSG | +107.3% vs HCA's +73.9% |
| Efficiency (ROA) | HCA | 11.2% ROA vs HCSG's 4.9%, ROIC 19.9% vs 7.7% |
Who Each Stock Is For
Income & stability
Growth exposure
Long-term compounding (10Y)
Sleep-well-at-night portfolio
Defensive / Recession hedge
Business Model
What each company does and how it makes money
Healthcare Services Group provides outsourced housekeeping, laundry, and dietary services to nursing homes, retirement communities, and hospitals across the United States. It generates revenue through service contracts with healthcare facilities—primarily from its Housekeeping segment (~70% of revenue) and Dietary segment (~30%)—where it manages entire departments for clients. The company's moat lies in its specialized expertise in healthcare facility operations and its scale as a national provider, which creates switching costs for clients who rely on its integrated service model.
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 4 of 6 categories (Financial Metrics, Valuation Metrics). HCSG leads in 1 (Analyst Outlook). 1 tied.
Financial Metrics (TTM)
HCA is the larger business by revenue, generating $75.6B annually — 41.8x HCSG's $1.8B. HCA is the more profitable business, keeping 9.0% of every revenue dollar as net income compared to HCSG's 2.2%.
| Metric | HCSGHealthcare Servic… | HCAHCA Healthcare, I… |
|---|---|---|
| RevenueTrailing 12 months | $1.8B | $75.6B |
| EBITDAEarnings before interest/tax | $60M | $15.5B |
| Net IncomeAfter-tax profit | $40M | $6.8B |
| Free Cash FlowCash after capex | $158M | $7.7B |
| Gross MarginGross profit ÷ Revenue | +12.5% | +41.5% |
| Operating MarginEBIT ÷ Revenue | +2.4% | +15.8% |
| Net MarginNet income ÷ Revenue | +2.2% | +9.0% |
| FCF MarginFCF ÷ Revenue | +8.7% | +10.2% |
| Rev. Growth (YoY)Latest quarter vs prior year | +8.5% | +6.7% |
| EPS Growth (YoY)Latest quarter vs prior year | +2.1% | +44.6% |
Valuation Metrics
At 18.7x trailing earnings, HCA trades at a 31% valuation discount to HCSG's 26.9x P/E. On an enterprise value basis, HCA's 10.8x EV/EBITDA is more attractive than HCSG's 24.0x.
| Metric | HCSGHealthcare Servic… | HCAHCA Healthcare, I… |
|---|---|---|
| Market CapShares × price | $1.7B | $118.5B |
| Enterprise ValueMkt cap + debt − cash | $1.6B | $167.6B |
| Trailing P/EPrice ÷ TTM EPS | 26.88x | 18.66x |
| Forward P/EPrice ÷ next-FY EPS est. | 22.54x | 17.50x |
| PEG RatioP/E ÷ EPS growth rate | — | 0.89x |
| EV / EBITDAEnterprise value multiple | 23.98x | 10.82x |
| Price / SalesMarket cap ÷ Revenue | 0.91x | 1.57x |
| Price / BookPrice ÷ Book value/share | 2.59x | — |
| Price / FCFMarket cap ÷ FCF | 12.02x | 15.40x |
Profitability & Efficiency
| Metric | HCSGHealthcare Servic… | HCAHCA Healthcare, I… |
|---|---|---|
| ROE (TTM)Return on equity | +8.0% | — |
| ROA (TTM)Return on assets | +4.9% | +11.2% |
| ROICReturn on invested capital | +7.7% | +19.9% |
| ROCEReturn on capital employed | +7.8% | +27.0% |
| Piotroski ScoreFundamental quality 0–9 | 7 | 7 |
| Debt / EquityFinancial leverage | 0.03x | — |
| Net DebtTotal debt minus cash | -$116M | $49.2B |
| Cash & Equiv.Liquid assets | $125M | $1.0B |
| Total DebtShort + long-term debt | $19M | $50.2B |
| Interest CoverageEBIT ÷ Interest expense | 20.15x | 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 $7,774 for HCSG. Over the past 12 months, HCSG leads with a +107.3% total return vs HCA's +73.9%. The 3-year compound annual growth rate (CAGR) favors HCA at 30.2% vs HCSG's 17.9% — a key indicator of consistent wealth creation.
| Metric | HCSGHealthcare Servic… | HCAHCA Healthcare, I… |
|---|---|---|
| YTD ReturnYear-to-date | +25.5% | +12.6% |
| 1-Year ReturnPast 12 months | +107.3% | +73.9% |
| 3-Year ReturnCumulative with dividends | +64.1% | +120.8% |
| 5-Year ReturnCumulative with dividends | -22.3% | +208.8% |
| 10-Year ReturnCumulative with dividends | -23.5% | +688.3% |
| CAGR (3Y)Annualised 3-year return | +17.9% | +30.2% |
Risk & Volatility
HCA is the less volatile stock with a 0.29 beta — it tends to amplify market swings less than HCSG's 0.74 beta. A beta below 1.0 means the stock typically moves less than the S&P 500.
| Metric | HCSGHealthcare Servic… | HCAHCA Healthcare, I… |
|---|---|---|
| Beta (5Y)Sensitivity to S&P 500 | 0.74x | 0.29x |
| 52-Week HighHighest price in past year | $22.98 | $552.90 |
| 52-Week LowLowest price in past year | $9.13 | $295.00 |
| % of 52W HighCurrent price vs 52-week peak | +94.7% | +95.8% |
| RSI (14)Momentum oscillator 0–100 | 64.3 | 56.0 |
| Avg Volume (50D)Average daily shares traded | 627K | 879K |
Analyst Outlook
Wall Street rates HCSG as "Buy" and HCA as "Buy". Consensus price targets imply 7.2% upside for HCSG (target: $23) 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 | HCSGHealthcare Servic… | HCAHCA Healthcare, I… |
|---|---|---|
| Analyst RatingConsensus buy/hold/sell | Buy | Buy |
| Price TargetConsensus 12-month target | $23.33 | $523.92 |
| # AnalystsCovering analysts | 14 | 46 |
| Dividend YieldAnnual dividend ÷ price | — | +0.6% |
| Dividend StreakConsecutive years of raises | 20 | 5 |
| Dividend / ShareAnnual DPS | — | $2.94 |
| Buyback YieldShare repurchases ÷ mkt cap | +3.7% | +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 |
|---|---|---|---|
| Healthcare Services… (HCSG) | 100 | 69.75 | -30.3% |
| HCA Healthcare, Inc. (HCA) | 100 | 367.9 | +267.9% |
HCA Healthcare, Inc. (HCA) returned +209% over 5 years vs Healthcare Services… (HCSG)'s -22%. 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 |
|---|---|---|---|
| Healthcare Services… (HCSG) | $1.6B | $1.8B | +17.6% |
| HCA Healthcare, Inc. (HCA) | $41.5B | $75.6B | +82.2% |
Healthcare Services Group, Inc.'s revenue grew from $1.6B (2016) to $1.8B (2025) — a 1.8% 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 |
|---|---|---|---|
| Healthcare Services… (HCSG) | 5.0% | 3.2% | -35.1% |
| HCA Healthcare, Inc. (HCA) | 7.0% | 9.0% | +28.8% |
Healthcare Services Group, Inc.'s net margin went from 5% (2016) to 3% (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 |
|---|---|---|---|
| Healthcare Services… (HCSG) | 44.3 | 23.6 | -46.7% |
| HCA Healthcare, Inc. (HCA) | 14.8 | 16.5 | +11.5% |
Healthcare Services Group, Inc. has traded in a 20x–44x P/E range over 9 years; current trailing P/E is ~27x. 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 |
|---|---|---|---|
| Healthcare Services… (HCSG) | 1.05 | 0.81 | -22.9% |
| HCA Healthcare, Inc. (HCA) | 7.3 | 28.38 | +288.8% |
Healthcare Services Group, Inc.'s EPS grew from $1.05 (2016) to $0.81 (2025) — a -3% CAGR. HCA Healthcare, Inc.'s EPS grew from $7.30 (2016) to $28.38 (2025) — a 16% CAGR.
Chart 6Free Cash Flow — 5 Years
Healthcare Services Group, Inc. generated $139M FCF in 2025 (+343% vs 2021). HCA Healthcare, Inc. generated $8B FCF in 2025 (+43% vs 2021).
HCSG vs HCA: Frequently Asked Questions
9 questions · data-driven answers · updated daily
01Is HCSG or HCA a better buy right now?
HCA Healthcare, Inc. (HCA) offers the better valuation at 18.7x trailing P/E (17.5x forward), making it the more compelling value choice. Analysts rate Healthcare Services Group, Inc. (HCSG) a "Buy" — based on 14 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 — HCSG or HCA?
On trailing P/E, HCA Healthcare, Inc. (HCA) is the cheapest at 18.7x versus Healthcare Services Group, Inc. at 26.9x. On forward P/E, HCA Healthcare, Inc. is actually cheaper at 17.5x.
03Which is the better long-term investment — HCSG or HCA?
Over the past 5 years, HCA Healthcare, Inc. (HCA) delivered a total return of +208.8%, compared to -22.3% for Healthcare Services Group, Inc. (HCSG). 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 HCSG's -23.5%. 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 — HCSG or HCA?
By beta (market sensitivity over 5 years), HCA Healthcare, Inc. (HCA) is the lower-risk stock at 0.29β versus Healthcare Services Group, Inc.'s 0.74β — meaning HCSG is approximately 152% more volatile than HCA relative to the S&P 500.
05Which has better profit margins — HCSG or HCA?
HCA Healthcare, Inc. (HCA) is the more profitable company, earning 9.0% net margin versus 3.2% for Healthcare Services Group, Inc. — 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 2.6% for HCSG. 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 HCSG or HCA more undervalued right now?
On forward earnings alone, HCA Healthcare, Inc. (HCA) trades at 17.5x forward P/E versus 22.5x for Healthcare Services Group, Inc. — 5.0x cheaper on a one-year earnings basis. Analyst consensus price targets imply the most upside for HCSG: 7.2% to $23.33.
07Which pays a better dividend — HCSG or HCA?
In this comparison, HCA (0.6% yield) pays a dividend. HCSG does not pay a meaningful dividend and should not be held primarily for income.
08Is HCSG 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%, HCSG: -23.5%), 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 HCSG 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. HCA pays a dividend while HCSG 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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