Comprehensive Stock Comparison
Compare The Ensign Group, Inc. (ENSG) 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 |  ENSG | 18.7% revenue growth vs HCA's 7.1% |
| Value |  HCA | Lower P/E (18.0x vs 28.2x), PEG 0.86 vs 2.04 |
| Quality / Margins | HCA | 9.0% net margin vs ENSG's 6.8% |
| Stability / Safety | HCA | Beta 0.29 vs ENSG's 0.43 |
| Dividends | HCA | 0.5% yield, 5-year raise streak, vs ENSG's 0.1% |
| Momentum (1Y) | HCA | +71.2% vs ENSG's +61.4% |
| Efficiency (ROA) | HCA | 11.2% ROA vs ENSG's 6.3%, ROIC 19.9% vs 8.9% |
Who Each Stock Is For
Income & stability
HCADividend streak 5 yrs, beta 0.29, yield 0.5%
Growth exposure
ENSGRev growth 18.7%, EPS growth 14.1%, 3Y rev CAGR 18.7%
Long-term compounding (10Y)
ENSG9.5% 10Y total return vs HCA's 6.7%
Sleep-well-at-night portfolio
HCALower volatility, beta 0.29, current ratio 0.83x
Valuation efficiency (growth/$)
HCAPEG 0.86 vs ENSG's 2.04
Defensive / Recession hedge
HCABeta 0.29, yield 0.5%, current ratio 0.83x
Business Model
What each company does and how it makes money
The Ensign Group operates a network of skilled nursing facilities and senior living communities across multiple states. It generates revenue primarily from patient care reimbursements—mainly Medicare and Medicaid—along with private pay services and ancillary offerings like therapy and diagnostics. The company's competitive advantage lies in its decentralized operational model that empowers local leaders and its disciplined acquisition strategy for underperforming facilities.
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 3ENSG 1HCA5/6 metricsHCA6/6 metricsENSG4/6 metricsHCA2/2 metricsHCA leads in 3 of 6 categories (Financial Metrics, Valuation Metrics). ENSG leads in 1 (Total Returns). 2 tied.
Financial Metrics (TTM)
HCA is the larger business by revenue, generating $75.6B annually — 15.7x ENSG's $4.8B. Profitability is closely matched — net margins range from 9.0% (HCA) to 6.8% (ENSG). On growth, ENSG holds the edge at +19.8% YoY revenue growth, suggesting stronger near-term business momentum.
| Metric | ENSGThe Ensign Group,… | HCAHCA Healthcare, I… |
|---|---|---|
| RevenueTrailing 12 months | $4.8B | $75.6B |
| EBITDAEarnings before interest/tax | $501M | $15.5B |
| Net IncomeAfter-tax profit | $328M | $6.8B |
| Free Cash FlowCash after capex | $290M | $7.7B |
| Gross MarginGross profit ÷ Revenue | +15.7% | +41.5% |
| Operating MarginEBIT ÷ Revenue | +8.3% | +15.8% |
| Net MarginNet income ÷ Revenue | +6.8% | +9.0% |
| FCF MarginFCF ÷ Revenue | +6.0% | +10.2% |
| Rev. Growth (YoY)Latest quarter vs prior year | +19.8% | +6.7% |
| EPS Growth (YoY)Latest quarter vs prior year | +6.0% | +44.6% |
Valuation Metrics
At 19.2x trailing earnings, HCA trades at a 47% valuation discount to ENSG's 36.3x P/E. Adjusting for growth (PEG ratio), HCA offers better value at 0.91x vs ENSG's 2.63x — a lower PEG means you pay less per unit of expected earnings growth.
| Metric | ENSGThe Ensign Group,… | HCAHCA Healthcare, I… |
|---|---|---|
| Market CapShares × price | $12.3B | $121.7B |
| Enterprise ValueMkt cap + debt − cash | $13.8B | $170.9B |
| Trailing P/EPrice ÷ TTM EPS | 36.31x | 19.18x |
| Forward P/EPrice ÷ next-FY EPS est. | 28.21x | 17.99x |
| PEG RatioP/E ÷ EPS growth rate | 2.63x | 0.91x |
| EV / EBITDAEnterprise value multiple | 26.13x | 11.03x |
| Price / SalesMarket cap ÷ Revenue | 2.43x | 1.61x |
| Price / BookPrice ÷ Book value/share | 5.59x | — |
| Price / FCFMarket cap ÷ FCF | 33.12x | 15.83x |
Profitability & Efficiency
| Metric | ENSGThe Ensign Group,… | HCAHCA Healthcare, I… |
|---|---|---|
| ROE (TTM)Return on equity | +15.5% | — |
| ROA (TTM)Return on assets | +6.3% | +11.2% |
| ROICReturn on invested capital | +8.9% | +19.9% |
| ROCEReturn on capital employed | +10.0% | +27.0% |
| Piotroski ScoreFundamental quality 0–9 | 7 | 7 |
| Debt / EquityFinancial leverage | 0.93x | — |
| Net DebtTotal debt minus cash | $1.6B | $49.2B |
| Cash & Equiv.Liquid assets | $504M | $1.0B |
| Total DebtShort + long-term debt | $2.1B | $50.2B |
| Interest CoverageEBIT ÷ Interest expense | 53.02x | 5.37x |
Total Returns (with DRIP)
A $10,000 investment in HCA five years ago would be worth $30,319 today (with dividends reinvested), compared to $26,368 for ENSG. Over the past 12 months, HCA leads with a +71.2% total return vs ENSG's +61.4%. The 3-year compound annual growth rate (CAGR) favors ENSG at 33.1% vs HCA's 29.9% — a key indicator of consistent wealth creation.
| Metric | ENSGThe Ensign Group,… | HCAHCA Healthcare, I… |
|---|---|---|
| YTD ReturnYear-to-date | +21.9% | +15.7% |
| 1-Year ReturnPast 12 months | +61.4% | +71.2% |
| 3-Year ReturnCumulative with dividends | +135.7% | +119.4% |
| 5-Year ReturnCumulative with dividends | +163.7% | +203.2% |
| 10-Year ReturnCumulative with dividends | +952.4% | +668.1% |
| CAGR (3Y)Annualised 3-year return | +33.1% | +29.9% |
Risk & Volatility
HCA is the less volatile stock with a 0.29 beta — it tends to amplify market swings less than ENSG's 0.43 beta. A beta below 1.0 means the stock typically moves less than the S&P 500.
| Metric | ENSGThe Ensign Group,… | HCAHCA Healthcare, I… |
|---|---|---|
| Beta (5Y)Sensitivity to S&P 500 | 0.43x | 0.29x |
| 52-Week HighHighest price in past year | $218.00 | $552.90 |
| 52-Week LowLowest price in past year | $118.73 | $310.18 |
| % of 52W HighCurrent price vs 52-week peak | +97.3% | +98.5% |
| RSI (14)Momentum oscillator 0–100 | 65.6 | 62.3 |
| Avg Volume (50D)Average daily shares traded | 369K | 1.0M |
Analyst Outlook
Wall Street rates ENSG as "Buy" and HCA as "Buy". Consensus price targets imply 4.8% upside for ENSG (target: $222) vs -3.8% for HCA (target: $524). For income investors, HCA offers the higher dividend yield at 0.54% vs ENSG's 0.12%.
| Metric | ENSGThe Ensign Group,… | HCAHCA Healthcare, I… |
|---|---|---|
| Analyst RatingConsensus buy/hold/sell | Buy | Buy |
| Price TargetConsensus 12-month target | $222.33 | $523.92 |
| # AnalystsCovering analysts | 13 | 46 |
| Dividend YieldAnnual dividend ÷ price | +0.1% | +0.5% |
| Dividend StreakConsecutive years of raises | 12 | 5 |
| Dividend / ShareAnnual DPS | $0.24 | $2.94 |
| Buyback YieldShare repurchases ÷ mkt cap | +0.0% | +8.3% |
Historical Charts
Charts are rendered on first load. Hover for details.
Chart 1Total Return — 5 Years (Rebased to 100)
| Stock | Mar 20 | Mar 26 | Change |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | 100 | 480.26 | +380.3% |
| HCA Healthcare, Inc. (HCA) | 100 | 416.9 | +316.9% |
HCA Healthcare, Inc. (HCA) returned +203% over 5 years vs The Ensign Group, I… (ENSG)'s +164%. A $10,000 investment in HCA 5 years ago would be worth $30,319 today (including dividends reinvested).
Chart 2Revenue Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | $1.7B | $5.1B | +205.6% |
| HCA Healthcare, Inc. (HCA) | $41.5B | $75.6B | +82.2% |
The Ensign Group, Inc.'s revenue grew from $1.7B (2016) to $5.1B (2025) — a 13.2% 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 |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | 3.0% | 6.8% | +125.1% |
| HCA Healthcare, Inc. (HCA) | 7.0% | 9.0% | +28.8% |
The Ensign Group, Inc.'s net margin went from 3% (2016) to 7% (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 |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | 27 | 29.8 | +10.4% |
| HCA Healthcare, Inc. (HCA) | 14.8 | 16.5 | +11.5% |
The Ensign Group, Inc. has traded in a 21x–31x P/E range over 9 years; current trailing P/E is ~36x. 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 |
|---|---|---|---|
| The Ensign Group, I… (ENSG) | 0.96 | 5.84 | +508.3% |
| HCA Healthcare, Inc. (HCA) | 7.3 | 28.38 | +288.8% |
The Ensign Group, Inc.'s EPS grew from $0.96 (2016) to $5.84 (2025) — a 22% CAGR. HCA Healthcare, Inc.'s EPS grew from $7.30 (2016) to $28.38 (2025) — a 16% CAGR.
Chart 6Free Cash Flow — 5 Years
The Ensign Group, Inc. generated $371M FCF in 2025 (+80% vs 2021). HCA Healthcare, Inc. generated $8B FCF in 2025 (+43% vs 2021).
ENSG vs HCA: Frequently Asked Questions
9 questions · data-driven answers · updated daily
01Is ENSG or HCA a better buy right now?
HCA Healthcare, Inc. (HCA) offers the better valuation at 19.2x trailing P/E (18.0x 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.
02Which has the better valuation — ENSG or HCA?
On trailing P/E, HCA Healthcare, Inc. (HCA) is the cheapest at 19.2x versus The Ensign Group, Inc. at 36.3x. On forward P/E, HCA Healthcare, Inc. is actually cheaper at 18.0x. The PEG ratio (P/E divided by earnings growth rate) is the most growth-adjusted single valuation metric: HCA Healthcare, Inc. wins at 0.86x versus The Ensign Group, Inc.'s 2.04x — a PEG below 1.0 traditionally signals the market is underpricing earnings growth.
03Which is the better long-term investment — ENSG or HCA?
Over the past 5 years, HCA Healthcare, Inc. (HCA) delivered a total return of +203.2%, compared to +163.7% for The Ensign Group, Inc. (ENSG). A $10,000 investment in HCA five years ago would be worth approximately $30K today (assuming dividends reinvested). Over 10 years, the gap is even starker: ENSG returned +952.4% versus HCA's +668.1%. 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 — ENSG or HCA?
By beta (market sensitivity over 5 years), HCA Healthcare, Inc. (HCA) is the lower-risk stock at 0.29β versus The Ensign Group, Inc.'s 0.43β — meaning ENSG is approximately 45% more volatile than HCA relative to the S&P 500.
05Which has better profit margins — ENSG or HCA?
HCA Healthcare, Inc. (HCA) is the more profitable company, earning 9.0% net margin versus 6.8% for The Ensign 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 8.4% for ENSG. 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 ENSG or HCA 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, HCA Healthcare, Inc. (HCA) is the more undervalued stock at a PEG of 0.86x versus The Ensign Group, Inc.'s 2.04x. A PEG below 1.0 is traditionally considered the threshold for growth-adjusted undervaluation. On forward earnings alone, HCA Healthcare, Inc. (HCA) trades at 18.0x forward P/E versus 28.2x for The Ensign Group, Inc. — 10.2x cheaper on a one-year earnings basis. Analyst consensus price targets imply the most upside for ENSG: 4.8% to $222.33.
07Which pays a better dividend — ENSG or HCA?
All stocks in this comparison pay dividends. HCA Healthcare, Inc. (HCA) offers the highest yield at 0.5%, versus 0.1% for The Ensign Group, Inc. (ENSG).
08Is ENSG 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), 0.5% yield, +668.1% 10Y return). Both have compounded well over 10 years (HCA: +668.1%, ENSG: +952.4%), 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 ENSG 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 ENSG 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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