Comprehensive Stock Comparison
Compare Acadia Healthcare Company, Inc. (ACHC) vs Fresenius Medical Care AG & Co. KGaA (FMS) 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 | ACHC | 5.0% revenue growth vs FMS's 1.5% |
| Value | FMS | Lower P/E (9.9x vs 15.7x) |
| Quality / Margins | FMS | 5.0% net margin vs ACHC's -33.3% |
| Stability / Safety | FMS | Beta 0.40 vs ACHC's 0.75, lower leverage |
| Dividends | Tie | Neither pays a meaningful dividend |
| Momentum (1Y) | FMS | +0.2% vs ACHC's -21.8% |
| Efficiency (ROA) | FMS | 3.2% ROA vs ACHC's -20.0%, ROIC 5.6% vs 5.9% |
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
Acadia Healthcare operates a network of behavioral healthcare facilities — including psychiatric hospitals, residential treatment centers, and outpatient clinics — across the United States and Puerto Rico. It generates revenue primarily from patient services reimbursed by government payers like Medicaid and Medicare (roughly 50-60%) and commercial insurance (roughly 30-40%). The company's competitive advantage lies in its scale as one of the largest pure-play behavioral health providers, creating operational efficiencies and a broad geographic footprint that supports patient access and referral networks.
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.
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
FMS leads in 4 of 6 categories — strongest in Valuation Metrics and Total Returns. 2 categories are tied.
Financial Metrics (TTM)
FMS is the larger business by revenue, generating $19.6B annually — 5.9x ACHC's $3.3B. FMS is the more profitable business, keeping 5.0% of every revenue dollar as net income compared to ACHC's -33.3%. On growth, ACHC holds the edge at +6.1% YoY revenue growth, suggesting stronger near-term business momentum.
| Metric | ACHCAcadia Healthcare… | FMSFresenius Medical… |
|---|---|---|
| RevenueTrailing 12 months | $3.3B | $19.6B |
| EBITDAEarnings before interest/tax | $513M | $3.3B |
| Net IncomeAfter-tax profit | -$1.1B | $978M |
| Free Cash FlowCash after capex | -$440M | $1.2B |
| Gross MarginGross profit ÷ Revenue | +60.6% | +25.6% |
| Operating MarginEBIT ÷ Revenue | +9.7% | +9.3% |
| Net MarginNet income ÷ Revenue | -33.3% | +5.0% |
| FCF MarginFCF ÷ Revenue | -13.3% | +6.0% |
| Rev. Growth (YoY)Latest quarter vs prior year | +6.1% | -0.3% |
| EPS Growth (YoY)Latest quarter vs prior year | -38.2% | +8.5% |
Valuation Metrics
On an enterprise value basis, FMS's 6.3x EV/EBITDA is more attractive than ACHC's 8.0x.
| Metric | ACHCAcadia Healthcare… | FMSFresenius Medical… |
|---|---|---|
| Market CapShares × price | $2.1B | $13.6B |
| Enterprise ValueMkt cap + debt − cash | $4.6B | $24.4B |
| Trailing P/EPrice ÷ TTM EPS | -1.93x | 11.84x |
| Forward P/EPrice ÷ next-FY EPS est. | 15.68x | 9.89x |
| PEG RatioP/E ÷ EPS growth rate | — | 2.32x |
| EV / EBITDAEnterprise value multiple | 8.02x | 6.33x |
| Price / SalesMarket cap ÷ Revenue | 0.64x | 0.59x |
| Price / BookPrice ÷ Book value/share | 0.99x | 0.81x |
| Price / FCFMarket cap ÷ FCF | — | — |
Profitability & Efficiency
FMS delivers a 6.8% return on equity — every $100 of shareholder capital generates $7 in annual profit, vs $-52 for ACHC. FMS carries lower financial leverage with a 0.76x debt-to-equity ratio, signaling a more conservative balance sheet compared to ACHC's 1.23x.
| Metric | ACHCAcadia Healthcare… | FMSFresenius Medical… |
|---|---|---|
| ROE (TTM)Return on equity | -51.5% | +6.8% |
| ROA (TTM)Return on assets | -20.0% | +3.2% |
| ROICReturn on invested capital | +5.9% | +5.6% |
| ROCEReturn on capital employed | +7.5% | +6.9% |
| Piotroski ScoreFundamental quality 0–9 | 5 | 5 |
| Debt / EquityFinancial leverage | 1.23x | 0.76x |
| Net DebtTotal debt minus cash | $2.5B | $9.2B |
| Cash & Equiv.Liquid assets | $133M | $1.6B |
| Total DebtShort + long-term debt | $2.6B | $10.8B |
| Interest CoverageEBIT ÷ Interest expense | 1.82x | 6.84x |
Total Returns (with DRIP)
A $10,000 investment in FMS five years ago would be worth $7,718 today (with dividends reinvested), compared to $4,183 for ACHC. Over the past 12 months, FMS leads with a +0.2% total return vs ACHC's -21.8%. The 3-year compound annual growth rate (CAGR) favors FMS at 9.1% vs ACHC's -31.4% — a key indicator of consistent wealth creation.
| Metric | ACHCAcadia Healthcare… | FMSFresenius Medical… |
|---|---|---|
| YTD ReturnYear-to-date | +64.0% | -0.2% |
| 1-Year ReturnPast 12 months | -21.8% | +0.2% |
| 3-Year ReturnCumulative with dividends | -67.7% | +29.7% |
| 5-Year ReturnCumulative with dividends | -58.2% | -22.8% |
| 10-Year ReturnCumulative with dividends | -57.7% | -28.5% |
| CAGR (3Y)Annualised 3-year return | -31.4% | +9.1% |
Risk & Volatility
FMS is the less volatile stock with a 0.40 beta — it tends to amplify market swings less than ACHC's 0.75 beta. A beta below 1.0 means the stock typically moves less than the S&P 500. FMS currently trades 77.0% from its 52-week high vs ACHC's 69.8% drawdown — a narrower gap to the peak suggests stronger recent price momentum.
| Metric | ACHCAcadia Healthcare… | FMSFresenius Medical… |
|---|---|---|
| Beta (5Y)Sensitivity to S&P 500 | 0.75x | 0.40x |
| 52-Week HighHighest price in past year | $33.58 | $30.46 |
| 52-Week LowLowest price in past year | $11.43 | $20.95 |
| % of 52W HighCurrent price vs 52-week peak | +69.8% | +77.0% |
| RSI (14)Momentum oscillator 0–100 | 84.4 | 49.0 |
| Avg Volume (50D)Average daily shares traded | 3.0M | 518K |
Analyst Outlook
Wall Street rates ACHC as "Buy" and FMS as "Hold". Consensus price targets imply 19.4% upside for FMS (target: $28) vs -15.4% for ACHC (target: $20).
| Metric | ACHCAcadia Healthcare… | FMSFresenius Medical… |
|---|---|---|
| Analyst RatingConsensus buy/hold/sell | Buy | Hold |
| Price TargetConsensus 12-month target | $19.82 | $28.00 |
| # AnalystsCovering analysts | 25 | 18 |
| Dividend YieldAnnual dividend ÷ price | — | — |
| Dividend StreakConsecutive years of raises | 1 | 3 |
| Dividend / ShareAnnual DPS | — | — |
| Buyback YieldShare repurchases ÷ mkt cap | +2.4% | 0.0% |
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 |
|---|---|---|---|
| Acadia Healthcare C… (ACHC) | 100 | 44.14 | -55.9% |
| Fresenius Medical C… (FMS) | 100 | 56.36 | -43.6% |
Fresenius Medical C… (FMS) returned -23% over 5 years vs Acadia Healthcare C… (ACHC)'s -58%.
Chart 2Revenue Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Acadia Healthcare C… (ACHC) | $2.8B | $3.3B | +17.9% |
| Fresenius Medical C… (FMS) | $17.0B | $19.6B | +15.3% |
Acadia Healthcare Company, Inc.'s revenue grew from $2.8B (2016) to $3.3B (2025) — a 1.8% CAGR. Fresenius Medical Care AG & Co. KGaA's revenue grew from $17.0B (2016) to $19.6B (2025) — a 1.6% CAGR.
Chart 3Net Margin Trend — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Acadia Healthcare C… (ACHC) | 0.2% | -33.3% | -15335.0% |
| Fresenius Medical C… (FMS) | 6.9% | 5.0% | -28.2% |
Acadia Healthcare Company, Inc.'s net margin went from 0% (2016) to -33% (2025). Fresenius Medical Care AG & Co. KGaA's net margin went from 7% (2016) to 5% (2025).
Chart 4P/E Ratio History — 9 Years
| Stock | 2017 | 2025 | Change |
|---|---|---|---|
| Acadia Healthcare C… (ACHC) | 14.2 | 14.3 | +0.7% |
| Fresenius Medical C… (FMS) | 25.3 | 14.2 | -43.9% |
Acadia Healthcare Company, Inc. has traded in a 14x–29x P/E range over 5 years; current trailing P/E is ~-2x. Fresenius Medical Care AG & Co. KGaA has traded in a 10x–39x P/E range over 9 years; current trailing P/E is ~12x.
Chart 5EPS Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Acadia Healthcare C… (ACHC) | 0.07 | -12.16 | -17471.4% |
| Fresenius Medical C… (FMS) | 1.87 | 1.68 | -10.2% |
Acadia Healthcare Company, Inc.'s EPS grew from $0.07 (2016) to $-12.16 (2025) — a NaN% CAGR. Fresenius Medical Care AG & Co. KGaA's EPS grew from $1.87 (2016) to $1.68 (2025) — a -1% CAGR.
Chart 6Free Cash Flow — 5 Years
Acadia Healthcare Company, Inc. generated $-440M FCF in 2025 (-439% vs 2021). Fresenius Medical Care AG & Co. KGaA generated $0M FCF in 2025 (-100% vs 2021).
ACHC vs FMS: Frequently Asked Questions
9 questions · data-driven answers · updated daily
01Is ACHC or FMS 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 Acadia Healthcare Company, Inc. (ACHC) a "Buy" — based on 25 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 — ACHC or FMS?
On forward P/E, Fresenius Medical Care AG & Co. KGaA is actually cheaper at 9.9x.
03Which is the better long-term investment — ACHC or FMS?
Over the past 5 years, Fresenius Medical Care AG & Co. KGaA (FMS) delivered a total return of -22.8%, compared to -58.2% for Acadia Healthcare Company, Inc. (ACHC). A $10,000 investment in FMS five years ago would be worth approximately $8K today (assuming dividends reinvested). Over 10 years, the gap is even starker: FMS returned -28.5% versus ACHC's -57.7%. 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 — ACHC or FMS?
By beta (market sensitivity over 5 years), Fresenius Medical Care AG & Co. KGaA (FMS) is the lower-risk stock at 0.40β versus Acadia Healthcare Company, Inc.'s 0.75β — meaning ACHC is approximately 87% more volatile than FMS relative to the S&P 500. On balance sheet safety, Fresenius Medical Care AG & Co. KGaA (FMS) carries a lower debt/equity ratio of 76% versus 123% for Acadia Healthcare Company, Inc. — giving it more financial flexibility in a downturn.
05Which has better profit margins — ACHC or FMS?
Fresenius Medical Care AG & Co. KGaA (FMS) is the more profitable company, earning 5.0% net margin versus -33.3% for Acadia Healthcare Company, Inc. — meaning it keeps 5.0% of every revenue dollar as bottom-line profit. Operating margin tells a similar story: ACHC leads at 11.7% versus 9.3% for FMS. At the gross margin level — before operating expenses — FMS leads at 25.6%, 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 ACHC or FMS more undervalued right now?
On forward earnings alone, Fresenius Medical Care AG & Co. KGaA (FMS) trades at 9.9x forward P/E versus 15.7x for Acadia Healthcare Company, Inc. — 5.8x 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 — ACHC or FMS?
None of the stocks in this comparison currently pay a material dividend. All are effectively zero-yield and should be held for capital appreciation rather than income.
08Is ACHC or FMS better for a retirement portfolio?
For long-horizon retirement investors, Fresenius Medical Care AG & Co. KGaA (FMS) is the stronger choice — it scores higher on the combination of lower volatility, dividend reliability, and long-term compounding (low volatility (β 0.40)). Both have compounded well over 10 years (FMS: -28.5%, ACHC: -57.7%), 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 ACHC and FMS?
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: ACHC is a small-cap quality compounder stock; FMS is a mid-cap deep-value stock. 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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