Medical - Care Facilities
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HCA vs ENSG vs THC vs NHC
Revenue, margins, valuation, and 5-year total return — side by side.
Medical - Care Facilities
Medical - Care Facilities
Medical - Care Facilities
HCA vs ENSG vs THC vs NHC — Key Financials
Market cap, revenue, margins, and valuation side-by-side.
| Company Snapshot | ||||
|---|---|---|---|---|
| Industry | Medical - Care Facilities | Medical - Care Facilities | Medical - Care Facilities | Medical - Care Facilities |
| Market Cap | $95.95B | $10.18B | $17.01B | $2.66B |
| Revenue (TTM) | $75.60B | $5.27B | $21.45B | $1.50B |
| Net Income (TTM) | $6.78B | $363M | $1.70B | $101M |
| Gross Margin | 41.5% | 15.2% | 42.8% | 38.5% |
| Operating Margin | 15.8% | 8.5% | 16.1% | 8.1% |
| Forward P/E | 14.2x | 23.2x | 10.9x | 21.5x |
| Total Debt | $50.20B | $4.15B | $13.17B | $87M |
| Cash & Equiv. | $1.04B | $504M | $2.88B | — |
HCA vs ENSG vs THC vs NHC — Long-Term Stock Performance
Price return indexed to 100 at period start. Dividends excluded.
| Stock | May 20 | May 26 | Return |
|---|---|---|---|
| HCA Healthcare, Inc. (HCA) | 100 | 401.5 | +301.5% |
| The Ensign Group, I… (ENSG) | 100 | 398.7 | +298.7% |
| Tenet Healthcare Co… (THC) | 100 | 892.1 | +792.1% |
| National HealthCare… (NHC) | 100 | 255.6 | +155.6% |
Price return only. Dividends and distributions are not included.
Quick Verdict: HCA vs ENSG vs THC vs NHC
Each card shows where this stock fits in a portfolio — not just who wins on paper.
HCA carries the broadest edge in this set and is the clearest fit for defensive.
- Beta 0.29, yield 0.7%, current ratio 0.83x
- 9.0% margin vs NHC's 6.7%
- Beta 0.29 vs THC's 0.71
- 11.3% ROA vs THC's 5.7%, ROIC 19.9% vs 13.2%
ENSG is the clearest fit if your priority is growth exposure and sleep-well-at-night.
- Rev growth 18.7%, EPS growth 14.1%, 3Y rev CAGR 18.7%
- Lower volatility, beta 0.42, current ratio 1.42x
- 18.7% revenue growth vs THC's 3.1%
THC is the clearest fit if your priority is long-term compounding and valuation efficiency.
- 5.2% 10Y total return vs ENSG's 7.5%
- PEG 0.33 vs ENSG's 1.68
- Lower P/E (10.9x vs 21.5x), PEG 0.33 vs 0.93
NHC is the #2 pick in this set and the best alternative if income & stability is your priority.
- Dividend streak 12 yrs, beta 0.60, yield 1.4%
- 1.4% yield, 12-year raise streak, vs HCA's 0.7%, (1 stock pays no dividend)
- +81.9% vs HCA's +19.7%
See the full category breakdown
| Category | Winner | Why |
|---|---|---|
| Growth | 18.7% revenue growth vs THC's 3.1% | |
| Value | Lower P/E (10.9x vs 21.5x), PEG 0.33 vs 0.93 | |
| Quality / Margins | 9.0% margin vs NHC's 6.7% | |
| Stability / Safety | Beta 0.29 vs THC's 0.71 | |
| Dividends | 1.4% yield, 12-year raise streak, vs HCA's 0.7%, (1 stock pays no dividend) | |
| Momentum (1Y) | +81.9% vs HCA's +19.7% | |
| Efficiency (ROA) | 11.3% ROA vs THC's 5.7%, ROIC 19.9% vs 13.2% |
HCA vs ENSG vs THC vs NHC — Revenue Breakdown by Segment
How each company's revenue is distributed across its business units
HCA vs ENSG vs THC vs NHC — Financial Metrics
Side-by-side numbers across 4 stocks — who leads on profitability, valuation, growth, and risk.
Who Leads Where
THC leads in 2 of 6 categories
NHC leads 2 • HCA leads 1 • ENSG leads 0 • 1 tied
Explore the data ↓Income & Cash Flow (Last 12 Months)
THC leads this category, winning 4 of 6 comparable metrics.
Income & Cash Flow (Last 12 Months)
HCA is the larger business by revenue, generating $75.6B annually — 50.4x NHC's $1.5B. Profitability is closely matched — net margins range from 9.0% (HCA) to 6.7% (NHC). On growth, ENSG holds the edge at +18.4% YoY revenue growth, suggesting stronger near-term business momentum.
| Metric | ||||
|---|---|---|---|---|
| RevenueTrailing 12 months | $75.6B | $5.3B | $21.5B | $1.5B |
| EBITDAEarnings before interest/tax | $15.5B | $558M | $4.3B | $166M |
| Net IncomeAfter-tax profit | $6.8B | $363M | $1.7B | $101M |
| Free Cash FlowCash after capex | $7.7B | $406M | $3.3B | $147M |
| Gross MarginGross profit ÷ Revenue | +41.5% | +15.2% | +42.8% | +38.5% |
| Operating MarginEBIT ÷ Revenue | +15.8% | +8.5% | +16.1% | +8.1% |
| Net MarginNet income ÷ Revenue | +9.0% | +6.9% | +7.9% | +6.7% |
| FCF MarginFCF ÷ Revenue | +10.2% | +7.7% | +15.6% | +9.8% |
| Rev. Growth (YoY)Latest quarter vs prior year | +6.7% | +18.4% | +2.8% | +12.5% |
| EPS Growth (YoY)Latest quarter vs prior year | +44.6% | +21.9% | +87.6% | -8.4% |
Valuation Metrics
THC leads this category, winning 7 of 7 comparable metrics.
Valuation Metrics
At 12.5x trailing earnings, THC trades at a 58% valuation discount to ENSG's 29.8x P/E. Adjusting for growth (PEG ratio), THC offers better value at 0.38x vs ENSG's 2.16x — a lower PEG means you pay less per unit of expected earnings growth.
| Metric | ||||
|---|---|---|---|---|
| Market CapShares × price | $95.9B | $10.2B | $17.0B | $2.7B |
| Enterprise ValueMkt cap + debt − cash | $145.1B | $13.8B | $27.3B | $2.7B |
| Trailing P/EPrice ÷ TTM EPS | 15.12x | 29.85x | 12.53x | 22.35x |
| Forward P/EPrice ÷ next-FY EPS est. | 14.19x | 23.19x | 10.94x | 21.51x |
| PEG RatioP/E ÷ EPS growth rate | 0.72x | 2.16x | 0.38x | 0.97x |
| EV / EBITDAEnterprise value multiple | 9.37x | 25.71x | 6.34x | 15.85x |
| Price / SalesMarket cap ÷ Revenue | 1.27x | 2.01x | 0.80x | 1.81x |
| Price / BookPrice ÷ Book value/share | — | 4.59x | 1.97x | 2.50x |
| Price / FCFMarket cap ÷ FCF | 12.47x | 27.46x | 6.72x | 17.89x |
Profitability & Efficiency
HCA leads this category, winning 4 of 9 comparable metrics.
Profitability & Efficiency
THC delivers a 19.6% return on equity — every $100 of shareholder capital generates $20 in annual profit, vs $10 for NHC. NHC carries lower financial leverage with a 0.08x debt-to-equity ratio, signaling a more conservative balance sheet compared to ENSG's 1.86x. On the Piotroski fundamental quality scale (0–9), HCA scores 7/9 vs NHC's 2/9, reflecting strong financial health.
| Metric | ||||
|---|---|---|---|---|
| ROE (TTM)Return on equity | — | +16.6% | +19.6% | +9.6% |
| ROA (TTM)Return on assets | +11.3% | +6.8% | +5.7% | +6.4% |
| ROICReturn on invested capital | +19.9% | +7.0% | +13.2% | +8.4% |
| ROCEReturn on capital employed | +27.0% | +10.2% | +13.8% | — |
| Piotroski ScoreFundamental quality 0–9 | 7 | 5 | 7 | 2 |
| Debt / EquityFinancial leverage | — | 1.86x | 1.47x | 0.08x |
| Net DebtTotal debt minus cash | $49.2B | $3.7B | $10.3B | $87M |
| Cash & Equiv.Liquid assets | $1.0B | $504M | $2.9B | — |
| Total DebtShort + long-term debt | $50.2B | $4.2B | $13.2B | $87M |
| Interest CoverageEBIT ÷ Interest expense | 5.37x | 88.33x | 4.28x | 24.41x |
Total Returns (Dividends Reinvested)
NHC leads this category, winning 4 of 6 comparable metrics.
Total Returns (Dividends Reinvested)
A $10,000 investment in THC five years ago would be worth $29,044 today (with dividends reinvested), compared to $20,324 for ENSG. Over the past 12 months, NHC leads with a +81.9% total return vs HCA's +19.7%. The 3-year compound annual growth rate (CAGR) favors NHC at 46.5% vs HCA's 16.3% — a key indicator of consistent wealth creation.
| Metric | ||||
|---|---|---|---|---|
| YTD ReturnYear-to-date | -8.6% | +0.3% | -2.7% | +31.9% |
| 1-Year ReturnPast 12 months | +19.7% | +27.5% | +27.4% | +81.9% |
| 3-Year ReturnCumulative with dividends | +57.4% | +88.9% | +178.5% | +214.6% |
| 5-Year ReturnCumulative with dividends | +109.7% | +103.2% | +190.4% | +162.1% |
| 10-Year ReturnCumulative with dividends | +450.5% | +752.0% | +523.4% | +198.2% |
| CAGR (3Y)Annualised 3-year return | +16.3% | +23.6% | +40.7% | +46.5% |
Risk & Volatility
Evenly matched — HCA and NHC each lead in 1 of 2 comparable metrics.
Risk & Volatility
HCA is the less volatile stock with a 0.29 beta — it tends to amplify market swings less than THC's 0.71 beta. A beta below 1.0 means the stock typically moves less than the S&P 500. NHC currently trades 93.1% from its 52-week high vs HCA's 77.1% drawdown — a narrower gap to the peak suggests stronger recent price momentum.
| Metric | ||||
|---|---|---|---|---|
| Beta (5Y)Sensitivity to S&P 500 | 0.29x | 0.42x | 0.71x | 0.60x |
| 52-Week HighHighest price in past year | $556.52 | $218.00 | $247.21 | $184.08 |
| 52-Week LowLowest price in past year | $330.00 | $133.81 | $146.60 | $93.54 |
| % of 52W HighCurrent price vs 52-week peak | +77.1% | +80.0% | +78.5% | +93.1% |
| RSI (14)Momentum oscillator 0–100 | 30.8 | 23.3 | 52.9 | 51.2 |
| Avg Volume (50D)Average daily shares traded | 1000K | 358K | 1.2M | 117K |
Analyst Outlook
NHC leads this category, winning 2 of 2 comparable metrics.
Analyst Outlook
Analyst consensus: HCA as "Buy", ENSG as "Buy", THC as "Buy". Consensus price targets imply 38.1% upside for THC (target: $268) vs 22.9% for HCA (target: $527). For income investors, NHC offers the higher dividend yield at 1.44% vs ENSG's 0.14%.
| Metric | ||||
|---|---|---|---|---|
| Analyst RatingConsensus buy/hold/sell | Buy | Buy | Buy | — |
| Price TargetConsensus 12-month target | $527.45 | $222.33 | $268.00 | — |
| # AnalystsCovering analysts | 46 | 13 | 32 | — |
| Dividend YieldAnnual dividend ÷ price | +0.7% | +0.1% | — | +1.4% |
| Dividend StreakConsecutive years of raises | 5 | 12 | 0 | 12 |
| Dividend / ShareAnnual DPS | $2.94 | $0.24 | — | $2.47 |
| Buyback YieldShare repurchases ÷ mkt cap | +10.5% | +0.2% | +8.4% | +0.6% |
THC leads in 2 of 6 categories (Income & Cash Flow, Valuation Metrics). NHC leads in 2 (Total Returns, Analyst Outlook). 1 tied.
HCA vs ENSG vs THC vs NHC: Key Questions Answered
10 questions · data-driven answers · updated daily
01Is HCA or ENSG or THC or NHC a better buy right now?
For growth investors, The Ensign Group, Inc.
(ENSG) is the stronger pick with 18. 7% revenue growth year-over-year, versus 3. 1% for Tenet Healthcare Corporation (THC). Tenet Healthcare Corporation (THC) offers the better valuation at 12. 5x trailing P/E (10. 9x forward), making it the more compelling value choice. Analysts rate HCA Healthcare, Inc. (HCA) a "Buy" — based on 46 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 — HCA or ENSG or THC or NHC?
On trailing P/E, Tenet Healthcare Corporation (THC) is the cheapest at 12.
5x versus The Ensign Group, Inc. at 29. 8x. On forward P/E, Tenet Healthcare Corporation is actually cheaper at 10. 9x. The PEG ratio (P/E divided by earnings growth rate) is the most growth-adjusted single valuation metric: Tenet Healthcare Corporation wins at 0. 33x versus The Ensign Group, Inc. 's 1. 68x — a PEG below 1. 0 traditionally signals the market is underpricing earnings growth.
03Which is the better long-term investment — HCA or ENSG or THC or NHC?
Over the past 5 years, Tenet Healthcare Corporation (THC) delivered a total return of +190.
4%, compared to +103. 2% for The Ensign Group, Inc. (ENSG). Over 10 years, the gap is even starker: ENSG returned +752. 0% versus NHC's +198. 2%. 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 — HCA or ENSG or THC or NHC?
By beta (market sensitivity over 5 years), HCA Healthcare, Inc.
(HCA) is the lower-risk stock at 0. 29β versus Tenet Healthcare Corporation's 0. 71β — meaning THC is approximately 147% more volatile than HCA relative to the S&P 500. On balance sheet safety, National HealthCare Corporation (NHC) carries a lower debt/equity ratio of 8% versus 186% for The Ensign Group, Inc. — giving it more financial flexibility in a downturn.
05Which is growing faster — HCA or ENSG or THC or NHC?
By revenue growth (latest reported year), The Ensign Group, Inc.
(ENSG) is pulling ahead at 18. 7% versus 3. 1% for Tenet Healthcare Corporation (THC). On earnings-per-share growth, the picture is similar: HCA Healthcare, Inc. grew EPS 29. 0% year-over-year, compared to -52. 6% for Tenet Healthcare Corporation. 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.
06Which has better profit margins — HCA or ENSG or THC or NHC?
HCA Healthcare, Inc.
(HCA) is the more profitable company, earning 9. 0% net margin versus 6. 6% for Tenet Healthcare Corporation — meaning it keeps 9. 0% of every revenue dollar as bottom-line profit. Operating margin tells a similar story: THC leads at 16. 1% versus 8. 6% for ENSG. At the gross margin level — before operating expenses — THC leads at 82. 3%, 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.
07Is HCA or ENSG or THC or NHC 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, Tenet Healthcare Corporation (THC) is the more undervalued stock at a PEG of 0. 33x 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, Tenet Healthcare Corporation (THC) trades at 10. 9x forward P/E versus 23. 2x for The Ensign Group, Inc. — 12. 2x cheaper on a one-year earnings basis. Analyst consensus price targets imply the most upside for THC: 38. 1% to $268. 00.
08Which pays a better dividend — HCA or ENSG or THC or NHC?
In this comparison, NHC (1.
4% yield), HCA (0. 7% yield), ENSG (0. 1% yield) pay a dividend. THC does not pay a meaningful dividend and should not be held primarily for income.
09Is HCA or ENSG or THC or NHC 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. 7% yield, +450. 5% 10Y return). Both have compounded well over 10 years (HCA: +450. 5%, THC: +523. 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.
10What are the main differences between HCA and ENSG and THC and NHC?
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: HCA is a mid-cap deep-value stock; ENSG is a mid-cap high-growth stock; THC is a mid-cap deep-value stock; NHC is a small-cap quality compounder stock. HCA, NHC pay a dividend while ENSG, THC 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.
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