HCA vs SEM

For growth investors, HCA Healthcare, Inc.

(HCA) is the stronger pick with 7. 1% revenue growth year-over-year, versus 5. 1% for Select Medical Holdings Corporation (SEM). Select Medical Holdings Corporation (SEM) offers the better valuation at 13. 9x trailing P/E (13. 1x 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.

On trailing P/E, Select Medical Holdings Corporation (SEM) is the cheapest at 13.

9x versus HCA Healthcare, Inc. at 15. 1x. On forward P/E, Select Medical Holdings Corporation is actually cheaper at 13. 1x.

Over the past 5 years, HCA Healthcare, Inc.

(HCA) delivered a total return of +111. 1%, compared to -15. 1% for Select Medical Holdings Corporation (SEM). Over 10 years, the gap is even starker: HCA returned +451. 4% versus SEM's +163. 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), HCA Healthcare, Inc.

(HCA) is the lower-risk stock at 0. 29β versus Select Medical Holdings Corporation's 0. 46β — meaning SEM is approximately 61% more volatile than HCA relative to the S&P 500.

By revenue growth (latest reported year), HCA Healthcare, Inc.

(HCA) is pulling ahead at 7. 1% versus 5. 1% for Select Medical Holdings Corporation (SEM). On earnings-per-share growth, the picture is similar: HCA Healthcare, Inc. grew EPS 29. 0% year-over-year, compared to -28. 9% for Select Medical Holdings Corporation. Over a 3-year CAGR, HCA leads at 7. 9% 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.

HCA Healthcare, Inc.

(HCA) is the more profitable company, earning 9. 0% net margin versus 2. 7% for Select Medical Holdings Corporation — 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 6. 1% for SEM. 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.

On forward earnings alone, Select Medical Holdings Corporation (SEM) trades at 13.

1x forward P/E versus 14. 2x for HCA Healthcare, Inc. — 1. 1x cheaper on a one-year earnings basis. Analyst consensus price targets imply the most upside for HCA: 22. 8% to $527. 45.

All stocks in this comparison pay dividends.

Select Medical Holdings Corporation (SEM) offers the highest yield at 1. 5%, versus 0. 7% for HCA Healthcare, Inc. (HCA).

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, +451. 4% 10Y return). Both have compounded well over 10 years (HCA: +451. 4%, SEM: +163. 0%), 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.

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.