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BTSG vs ADUS vs HCSG vs ACHC vs ENSG

Revenue, margins, valuation, and 5-year total return — side by side.

Live fundamentals10-year financials5-year price chart
BTSG
BrightSpring Health Services, Inc. Common Stock

Medical - Healthcare Information Services

HealthcareNASDAQ • US
Market Cap$10.23B
5Y Perf.+380.4%
ADUS
Addus HomeCare Corporation

Medical - Care Facilities

HealthcareNASDAQ • US
Market Cap$1.81B
5Y Perf.+12.3%
HCSG
Healthcare Services Group, Inc.

Medical - Care Facilities

HealthcareNASDAQ • US
Market Cap$1.60B
5Y Perf.+136.3%
ACHC
Acadia Healthcare Company, Inc.

Medical - Care Facilities

HealthcareNASDAQ • US
Market Cap$2.25B
5Y Perf.-70.2%
ENSG
The Ensign Group, Inc.

Medical - Care Facilities

HealthcareNASDAQ • US
Market Cap$10.18B
5Y Perf.+53.9%

BTSG vs ADUS vs HCSG vs ACHC vs ENSG — Key Financials

Market cap, revenue, margins, and valuation side-by-side.

Company Snapshot
BTSG logoBTSG
ADUS logoADUS
HCSG logoHCSG
ACHC logoACHC
ENSG logoENSG
IndustryMedical - Healthcare Information ServicesMedical - Care FacilitiesMedical - Care FacilitiesMedical - Care FacilitiesMedical - Care Facilities
Market Cap$10.23B$1.81B$1.60B$2.25B$10.18B
Revenue (TTM)$13.65B$1.45B$1.84B$3.37B$5.27B
Net Income (TTM)$310M$100M$59M$-1.11B$363M
Gross Margin12.2%32.5%13.3%56.2%15.2%
Operating Margin3.3%9.8%3.0%11.7%8.5%
Forward P/E34.0x14.1x20.8x16.4x23.2x
Total Debt$2.84B$209M$25M$2.65B$4.15B
Cash & Equiv.$88M$82M$161M$133M$504M

BTSG vs ADUS vs HCSG vs ACHC vs ENSGLong-Term Stock Performance

Price return indexed to 100 at period start. Dividends excluded.

BTSG
ADUS
HCSG
ACHC
ENSG
StockJan 24May 26Return
BrightSpring Health… (BTSG)100480.4+380.4%
Addus HomeCare Corp… (ADUS)100112.3+12.3%
Healthcare Services… (HCSG)100236.3+136.3%
Acadia Healthcare C… (ACHC)10029.8-70.2%
The Ensign Group, I… (ENSG)100153.9+53.9%

Price return only. Dividends and distributions are not included.

Quick Verdict: BTSG vs ADUS vs HCSG vs ACHC vs ENSG

Each card shows where this stock fits in a portfolio — not just who wins on paper.

Bottom line: ENSG leads in 3 of 7 categories (5-stock set), making it the strongest pick for profitability and margin quality and capital preservation and lower volatility. BrightSpring Health Services, Inc. Common Stock is the stronger pick specifically for valuation and capital efficiency and recent price momentum and sentiment. ADUS and HCSG also each lead in at least one category. As sector peers, any of these can serve as alternatives in the same allocation.
BTSG
BrightSpring Health Services, Inc. Common Stock
The Growth Play

BTSG is the #2 pick in this set and the best alternative if growth exposure and valuation efficiency is your priority.

  • Rev growth 14.6%, EPS growth 10.3%, 3Y rev CAGR 18.7%
  • PEG 0.70 vs ENSG's 1.68
  • PEG 0.70 vs 1.68
  • +129.8% vs ADUS's -13.4%
Best for: growth exposure and valuation efficiency
ADUS
Addus HomeCare Corporation
The Defensive Pick

ADUS ranks third and is worth considering specifically for sleep-well-at-night and defensive.

  • Lower volatility, beta 0.58, Low D/E 19.2%, current ratio 1.80x
  • Beta 0.58, current ratio 1.80x
  • 23.2% revenue growth vs ACHC's 5.0%
Best for: sleep-well-at-night and defensive
HCSG
Healthcare Services Group, Inc.
The Niche Pick

HCSG is the clearest fit if your priority is efficiency.

  • 7.3% ROA vs ACHC's -18.6%, ROIC 9.0% vs 5.9%
Best for: efficiency
ACHC
Acadia Healthcare Company, Inc.
The Healthcare Pick

Among these 5 stocks, ACHC doesn't own a clear edge in any measured category.

Best for: healthcare exposure
ENSG
The Ensign Group, Inc.
The Income Pick

ENSG carries the broadest edge in this set and is the clearest fit for income & stability and long-term compounding.

  • Dividend streak 12 yrs, beta 0.42, yield 0.1%
  • 7.5% 10Y total return vs BTSG's 381.3%
  • 6.9% margin vs ACHC's -32.8%
  • Beta 0.42 vs BTSG's 1.46
Best for: income & stability and long-term compounding
See the full category breakdown
CategoryWinnerWhy
GrowthADUS logoADUS23.2% revenue growth vs ACHC's 5.0%
ValueBTSG logoBTSGPEG 0.70 vs 1.68
Quality / MarginsENSG logoENSG6.9% margin vs ACHC's -32.8%
Stability / SafetyENSG logoENSGBeta 0.42 vs BTSG's 1.46
DividendsENSG logoENSG0.1% yield; 12-year raise streak; the other 4 pay no meaningful dividend
Momentum (1Y)BTSG logoBTSG+129.8% vs ADUS's -13.4%
Efficiency (ROA)HCSG logoHCSG7.3% ROA vs ACHC's -18.6%, ROIC 9.0% vs 5.9%

BTSG vs ADUS vs HCSG vs ACHC vs ENSG — Revenue Breakdown by Segment

How each company's revenue is distributed across its business units

BTSGBrightSpring Health Services, Inc. Common Stock
FY 2025
Commercial Insurance
68.8%$3.3B
Medicaid
31.2%$1.5B
ADUSAddus HomeCare Corporation
FY 2025
Personal Care
76.6%$1.1B
Hospice
18.5%$263M
Home Health
5.0%$71M
HCSGHealthcare Services Group, Inc.
FY 2025
Dietary Services
55.1%$1.0B
Environmental Services
44.9%$825M
ACHCAcadia Healthcare Company, Inc.
FY 2025
United States Facilities
100.0%$3.3B
ENSGThe Ensign Group, Inc.
FY 2025
Skilled Services Segment
97.4%$4.8B
Standard Bearer Segment
2.6%$127M

BTSG vs ADUS vs HCSG vs ACHC vs ENSG — Financial Metrics

Side-by-side numbers across 5 stocks — who leads on profitability, valuation, growth, and risk.

BEST OVERALLHCSGLAGGINGENSG

Income & Cash Flow (Last 12 Months)

ACHC leads this category, winning 2 of 6 comparable metrics.

BTSG is the larger business by revenue, generating $13.6B annually — 9.4x ADUS's $1.4B. ENSG is the more profitable business, keeping 6.9% of every revenue dollar as net income compared to ACHC's -32.8%. On growth, BTSG holds the edge at +25.6% YoY revenue growth, suggesting stronger near-term business momentum.

MetricBTSG logoBTSGBrightSpring Heal…ADUS logoADUSAddus HomeCare Co…HCSG logoHCSGHealthcare Servic…ACHC logoACHCAcadia Healthcare…ENSG logoENSGThe Ensign Group,…
RevenueTrailing 12 months$13.6B$1.4B$1.8B$3.4B$5.3B
EBITDAEarnings before interest/tax$572M$159M$72M$588M$558M
Net IncomeAfter-tax profit$310M$100M$59M-$1.1B$363M
Free Cash FlowCash after capex$508M$137M$139M-$215M$406M
Gross MarginGross profit ÷ Revenue+12.2%+32.5%+13.3%+56.2%+15.2%
Operating MarginEBIT ÷ Revenue+3.3%+9.8%+3.0%+11.7%+8.5%
Net MarginNet income ÷ Revenue+2.3%+6.9%+3.2%-32.8%+6.9%
FCF MarginFCF ÷ Revenue+3.7%+9.5%+7.6%-6.4%+7.7%
Rev. Growth (YoY)Latest quarter vs prior year+25.6%+7.7%+6.6%+7.6%+18.4%
EPS Growth (YoY)Latest quarter vs prior year+142.9%+17.2%+175.0%-49.8%+21.9%
ACHC leads this category, winning 2 of 6 comparable metrics.

Valuation Metrics

ACHC leads this category, winning 4 of 7 comparable metrics.

At 18.7x trailing earnings, ADUS trades at a 69% valuation discount to BTSG's 60.9x P/E. Adjusting for growth (PEG ratio), ADUS offers better value at 0.93x vs ENSG's 2.16x — a lower PEG means you pay less per unit of expected earnings growth.

MetricBTSG logoBTSGBrightSpring Heal…ADUS logoADUSAddus HomeCare Co…HCSG logoHCSGHealthcare Servic…ACHC logoACHCAcadia Healthcare…ENSG logoENSGThe Ensign Group,…
Market CapShares × price$10.2B$1.8B$1.6B$2.3B$10.2B
Enterprise ValueMkt cap + debt − cash$13.0B$1.9B$1.5B$4.8B$13.8B
Trailing P/EPrice ÷ TTM EPS60.85x18.67x27.54x-2.01x29.85x
Forward P/EPrice ÷ next-FY EPS est.34.00x14.12x20.83x16.42x23.19x
PEG RatioP/E ÷ EPS growth rate1.25x0.93x2.16x
EV / EBITDAEnterprise value multiple22.68x12.52x22.38x8.27x25.71x
Price / SalesMarket cap ÷ Revenue0.79x1.28x0.87x0.68x2.01x
Price / BookPrice ÷ Book value/share6.17x1.65x3.19x1.04x4.59x
Price / FCFMarket cap ÷ FCF25.91x17.48x11.49x27.46x
ACHC leads this category, winning 4 of 7 comparable metrics.

Profitability & Efficiency

HCSG leads this category, winning 6 of 9 comparable metrics.

BTSG delivers a 16.7% return on equity — every $100 of shareholder capital generates $17 in annual profit, vs $-41 for ACHC. HCSG carries lower financial leverage with a 0.05x debt-to-equity ratio, signaling a more conservative balance sheet compared to ENSG's 1.86x. On the Piotroski fundamental quality scale (0–9), BTSG scores 7/9 vs ENSG's 5/9, reflecting strong financial health.

MetricBTSG logoBTSGBrightSpring Heal…ADUS logoADUSAddus HomeCare Co…HCSG logoHCSGHealthcare Servic…ACHC logoACHCAcadia Healthcare…ENSG logoENSGThe Ensign Group,…
ROE (TTM)Return on equity+16.7%+9.3%+11.8%-40.9%+16.6%
ROA (TTM)Return on assets+5.0%+7.0%+7.3%-18.6%+6.8%
ROICReturn on invested capital+6.7%+8.8%+9.0%+5.9%+7.0%
ROCEReturn on capital employed+9.0%+10.9%+7.7%+7.5%+10.2%
Piotroski ScoreFundamental quality 0–977755
Debt / EquityFinancial leverage1.51x0.19x0.05x1.24x1.86x
Net DebtTotal debt minus cash$2.8B$127M-$136M$2.5B$3.7B
Cash & Equiv.Liquid assets$88M$82M$161M$133M$504M
Total DebtShort + long-term debt$2.8B$209M$25M$2.7B$4.2B
Interest CoverageEBIT ÷ Interest expense2.13x14.45x33.02x-5.99x88.33x
HCSG leads this category, winning 6 of 9 comparable metrics.

Total Returns (Dividends Reinvested)

BTSG leads this category, winning 4 of 6 comparable metrics.

A $10,000 investment in BTSG five years ago would be worth $48,127 today (with dividends reinvested), compared to $3,823 for ACHC. Over the past 12 months, BTSG leads with a +129.8% total return vs ADUS's -13.4%. The 3-year compound annual growth rate (CAGR) favors BTSG at 68.8% vs ACHC's -29.2% — a key indicator of consistent wealth creation.

MetricBTSG logoBTSGBrightSpring Heal…ADUS logoADUSAddus HomeCare Co…HCSG logoHCSGHealthcare Servic…ACHC logoACHCAcadia Healthcare…ENSG logoENSGThe Ensign Group,…
YTD ReturnYear-to-date+37.9%-8.7%+28.6%+71.2%+0.3%
1-Year ReturnPast 12 months+129.8%-13.4%+55.8%+1.2%+27.5%
3-Year ReturnCumulative with dividends+381.3%+16.3%+48.6%-64.5%+88.9%
5-Year ReturnCumulative with dividends+381.3%+0.0%-21.1%-61.8%+103.2%
10-Year ReturnCumulative with dividends+381.3%+399.9%-26.8%-58.5%+752.0%
CAGR (3Y)Annualised 3-year return+68.8%+5.2%+14.1%-29.2%+23.6%
BTSG leads this category, winning 4 of 6 comparable metrics.

Risk & Volatility

Evenly matched — BTSG and ENSG each lead in 1 of 2 comparable metrics.

ENSG is the less volatile stock with a 0.42 beta — it tends to amplify market swings less than BTSG's 1.46 beta. A beta below 1.0 means the stock typically moves less than the S&P 500. BTSG currently trades 96.8% from its 52-week high vs ADUS's 78.2% drawdown — a narrower gap to the peak suggests stronger recent price momentum.

MetricBTSG logoBTSGBrightSpring Heal…ADUS logoADUSAddus HomeCare Co…HCSG logoHCSGHealthcare Servic…ACHC logoACHCAcadia Healthcare…ENSG logoENSGThe Ensign Group,…
Beta (5Y)Sensitivity to S&P 5001.46x0.58x1.12x0.84x0.42x
52-Week HighHighest price in past year$54.68$124.44$24.39$30.20$218.00
52-Week LowLowest price in past year$19.01$90.89$12.66$11.43$133.81
% of 52W HighCurrent price vs 52-week peak+96.8%+78.2%+91.5%+81.0%+80.0%
RSI (14)Momentum oscillator 0–10067.949.361.846.223.3
Avg Volume (50D)Average daily shares traded3.0M236K676K3.1M358K
Evenly matched — BTSG and ENSG each lead in 1 of 2 comparable metrics.

Analyst Outlook

HCSG leads this category, winning 1 of 1 comparable metric.

Analyst consensus: BTSG as "Buy", ADUS as "Buy", HCSG as "Hold", ACHC as "Buy", ENSG as "Buy". Consensus price targets imply 32.3% upside for ADUS (target: $129) vs -7.9% for BTSG (target: $49). ENSG is the only dividend payer here at 0.14% yield — a key consideration for income-focused portfolios.

MetricBTSG logoBTSGBrightSpring Heal…ADUS logoADUSAddus HomeCare Co…HCSG logoHCSGHealthcare Servic…ACHC logoACHCAcadia Healthcare…ENSG logoENSGThe Ensign Group,…
Analyst RatingConsensus buy/hold/sellBuyBuyHoldBuyBuy
Price TargetConsensus 12-month target$48.75$128.67$24.50$23.50$222.33
# AnalystsCovering analysts915152513
Dividend YieldAnnual dividend ÷ price+0.1%
Dividend StreakConsecutive years of raises220112
Dividend / ShareAnnual DPS$0.24
Buyback YieldShare repurchases ÷ mkt cap+0.4%0.0%+3.9%+2.2%+0.2%
HCSG leads this category, winning 1 of 1 comparable metric.
Key Takeaway

ACHC leads in 2 of 6 categories (Income & Cash Flow, Valuation Metrics). HCSG leads in 2 (Profitability & Efficiency, Analyst Outlook). 1 tied.

Best OverallHealthcare Services Group, … (HCSG)Leads 2 of 6 categories
Loading custom metrics...

BTSG vs ADUS vs HCSG vs ACHC vs ENSG: Key Questions Answered

10 questions · data-driven answers · updated daily

01

Is BTSG or ADUS or HCSG or ACHC or ENSG a better buy right now?

For growth investors, Addus HomeCare Corporation (ADUS) is the stronger pick with 23.

2% revenue growth year-over-year, versus 5. 0% for Acadia Healthcare Company, Inc. (ACHC). Addus HomeCare Corporation (ADUS) offers the better valuation at 18. 7x trailing P/E (14. 1x forward), making it the more compelling value choice. Analysts rate BrightSpring Health Services, Inc. Common Stock (BTSG) a "Buy" — based on 9 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.

02

Which has the better valuation — BTSG or ADUS or HCSG or ACHC or ENSG?

On trailing P/E, Addus HomeCare Corporation (ADUS) is the cheapest at 18.

7x versus BrightSpring Health Services, Inc. Common Stock at 60. 9x. On forward P/E, Addus HomeCare Corporation is actually cheaper at 14. 1x. The PEG ratio (P/E divided by earnings growth rate) is the most growth-adjusted single valuation metric: BrightSpring Health Services, Inc. Common Stock wins at 0. 70x versus The Ensign Group, Inc. 's 1. 68x — a PEG below 1. 0 traditionally signals the market is underpricing earnings growth.

03

Which is the better long-term investment — BTSG or ADUS or HCSG or ACHC or ENSG?

Over the past 5 years, BrightSpring Health Services, Inc.

Common Stock (BTSG) delivered a total return of +381. 3%, compared to -61. 8% for Acadia Healthcare Company, Inc. (ACHC). Over 10 years, the gap is even starker: ENSG returned +752. 0% versus ACHC's -58. 5%. Past returns do not guarantee future results, and the stock with the higher historical return may already have its best growth priced in.

04

Which is safer — BTSG or ADUS or HCSG or ACHC or ENSG?

By beta (market sensitivity over 5 years), The Ensign Group, Inc.

(ENSG) is the lower-risk stock at 0. 42β versus BrightSpring Health Services, Inc. Common Stock's 1. 46β — meaning BTSG is approximately 247% more volatile than ENSG relative to the S&P 500. On balance sheet safety, Healthcare Services Group, Inc. (HCSG) carries a lower debt/equity ratio of 5% versus 186% for The Ensign Group, Inc. — giving it more financial flexibility in a downturn.

05

Which is growing faster — BTSG or ADUS or HCSG or ACHC or ENSG?

By revenue growth (latest reported year), Addus HomeCare Corporation (ADUS) is pulling ahead at 23.

2% versus 5. 0% for Acadia Healthcare Company, Inc. (ACHC). On earnings-per-share growth, the picture is similar: BrightSpring Health Services, Inc. Common Stock grew EPS 1029% year-over-year, compared to -537. 4% for Acadia Healthcare Company, Inc.. Over a 3-year CAGR, BTSG 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.

06

Which has better profit margins — BTSG or ADUS or HCSG or ACHC or ENSG?

The Ensign Group, Inc.

(ENSG) is the more profitable company, earning 6. 8% net margin versus -33. 3% for Acadia Healthcare Company, Inc. — meaning it keeps 6. 8% of every revenue dollar as bottom-line profit. Operating margin tells a similar story: ACHC leads at 11. 7% versus 2. 6% for HCSG. At the gross margin level — before operating expenses — ADUS leads at 32. 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.

07

Is BTSG or ADUS or HCSG or ACHC or ENSG 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, BrightSpring Health Services, Inc. Common Stock (BTSG) is the more undervalued stock at a PEG of 0. 70x versus The Ensign Group, Inc. 's 1. 68x. A PEG below 1. 0 is traditionally considered the threshold for growth-adjusted undervaluation. On forward earnings alone, Addus HomeCare Corporation (ADUS) trades at 14. 1x forward P/E versus 34. 0x for BrightSpring Health Services, Inc. Common Stock — 19. 9x cheaper on a one-year earnings basis. Analyst consensus price targets imply the most upside for ADUS: 32. 3% to $128. 67.

08

Which pays a better dividend — BTSG or ADUS or HCSG or ACHC or ENSG?

In this comparison, ENSG (0.

1% yield) pays a dividend. BTSG, ADUS, HCSG, ACHC do not pay a meaningful dividend and should not be held primarily for income.

09

Is BTSG or ADUS or HCSG or ACHC or ENSG better for a retirement portfolio?

For long-horizon retirement investors, The Ensign Group, Inc.

(ENSG) is the stronger choice — it scores higher on the combination of lower volatility, dividend reliability, and long-term compounding (low volatility (β 0. 42), +752. 0% 10Y return). Both have compounded well over 10 years (ENSG: +752. 0%, BTSG: +381. 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.

10

What are the main differences between BTSG and ADUS and HCSG and ACHC and ENSG?

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: BTSG is a mid-cap quality compounder stock; ADUS is a small-cap high-growth stock; HCSG is a small-cap quality compounder stock; ACHC is a small-cap quality compounder stock; ENSG is a mid-cap high-growth 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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  • Market Cap > $100B
  • Revenue Growth > 5%
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ACHC

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ENSG

High-Growth Disruptor

  • Sector: Healthcare
  • Market Cap > $100B
  • Revenue Growth > 9%
  • Net Margin > 5%
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Beat Both

Find stocks that outperform BTSG and ADUS and HCSG and ACHC and ENSG on the metrics below

Revenue Growth>
%
(BTSG: 25.6% · ADUS: 7.7%)
Net Margin>
%
(BTSG: 2.3% · ADUS: 6.9%)
P/E Ratio<
x
(BTSG: 60.9x · ADUS: 18.7x)

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