BACK vs ENSG vs ACHC vs SGRY vs UHS

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). Universal Health Services, Inc. (UHS) offers the better valuation at 7. 4x trailing P/E (7. 3x 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 trailing P/E, Universal Health Services, Inc.

(UHS) is the cheapest at 7. 4x versus The Ensign Group, Inc. at 29. 4x. On forward P/E, Universal Health Services, Inc. is actually cheaper at 7. 3x. The PEG ratio (P/E divided by earnings growth rate) is the most growth-adjusted single valuation metric: Universal Health Services, Inc. wins at 0. 45x versus The Ensign Group, Inc. 's 1. 64x — a PEG below 1. 0 traditionally signals the market is underpricing 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, Universal Health Services, Inc. (UHS) carries a lower debt/equity ratio of 74% 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.

Universal Health Services, Inc.

(UHS) is the more profitable company, earning 8. 6% net margin versus -125. 5% for IMAC Holdings, Inc. — meaning it keeps 8. 6% 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 — UHS leads at 90. 4%, 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.

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, Universal Health Services, Inc. (UHS) is the more undervalued stock at a PEG of 0. 45x versus The Ensign Group, Inc. 's 1. 64x. A PEG below 1. 0 is traditionally considered the threshold for growth-adjusted undervaluation. On forward earnings alone, Universal Health Services, Inc. (UHS) trades at 7. 3x forward P/E versus 37. 4x for Surgery Partners, Inc. — 30. 1x cheaper on a one-year earnings basis. Analyst consensus price targets imply the most upside for UHS: 33. 0% to $226. 00.

In this comparison, BACK (100.

0% yield), UHS (0. 5% 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; UHS is a mid-cap deep-value stock. BACK pays a dividend while ENSG, ACHC, SGRY, UHS 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.