BACK vs ENSG vs ACHC vs SGRY

For growth investors, The Ensign Group, Inc.

(ENSG) is the stronger pick with 18. 7% revenue growth year-over-year, versus -98. 6% for IMAC Holdings, Inc. (BACK). The Ensign Group, Inc. (ENSG) offers the better valuation at 29. 4x trailing P/E (22. 7x forward), making it the more compelling value choice. Analysts rate The Ensign Group, Inc. (ENSG) a "Buy" — based on 13 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.

On forward P/E, Acadia Healthcare Company, Inc.

is actually cheaper at 16. 7x — notably different from the trailing picture, reflecting expected earnings growth.

Over the past 5 years, The Ensign Group, Inc.

(ENSG) delivered a total return of +105. 6%, compared to -99. 9% for IMAC Holdings, Inc. (BACK). Over 10 years, the gap is even starker: ENSG returned +738. 2% versus BACK's -100. 0%. Past returns do not guarantee future results, and the stock with the higher historical return may already have its best growth priced in.

By beta (market sensitivity over 5 years), IMAC Holdings, Inc.

(BACK) is the lower-risk stock at -0. 04β versus Surgery Partners, Inc. 's 1. 06β — meaning SGRY is approximately -2570% more volatile than BACK relative to the S&P 500. On balance sheet safety, Surgery Partners, Inc. (SGRY) carries a lower debt/equity ratio of 114% versus 186% for The Ensign Group, Inc. — giving it more financial flexibility in a downturn.

By revenue growth (latest reported year), The Ensign Group, Inc.

(ENSG) is pulling ahead at 18. 7% versus -98. 6% for IMAC Holdings, Inc. (BACK). On earnings-per-share growth, the picture is similar: Surgery Partners, Inc. grew EPS 54. 1% year-over-year, compared to -537. 4% for Acadia Healthcare Company, Inc.. Over a 3-year CAGR, ENSG leads at 18. 7% annualised revenue growth. Higher growth typically commands a higher valuation multiple — check whether the premium P/E or P/S is justified by the growth rate using the PEG ratio.

The Ensign Group, Inc.

(ENSG) is the more profitable company, earning 6. 8% net margin versus -125. 5% for IMAC Holdings, Inc. — meaning it keeps 6. 8% of every revenue dollar as bottom-line profit. Operating margin tells a similar story: SGRY leads at 11. 8% versus -78. 0% for BACK. At the gross margin level — before operating expenses — SGRY leads at 23. 1%, 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.

On forward earnings alone, Acadia Healthcare Company, Inc.

(ACHC) trades at 16. 7x forward P/E versus 37. 4x for Surgery Partners, Inc. — 20. 6x cheaper on a one-year earnings basis. Analyst consensus price targets imply the most upside for SGRY: 31. 7% to $19. 00.

In this comparison, BACK (100.

0% yield), ENSG (0. 1% yield) pay a dividend. ACHC, SGRY do not pay a meaningful dividend and should not be held primarily for income.

For long-horizon retirement investors, IMAC Holdings, Inc.

(BACK) is the stronger choice — it scores higher on the combination of lower volatility, dividend reliability, and long-term compounding (low volatility (β -0. 04), 100. 0% yield). Both have compounded well over 10 years (BACK: -100. 0%, SGRY: +0. 3%), 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.

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: BACK is a small-cap income-oriented stock; ENSG is a mid-cap high-growth stock; ACHC is a small-cap quality compounder stock; SGRY is a small-cap quality compounder stock. BACK pays a dividend while ENSG, ACHC, SGRY do 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.