Comprehensive Stock Comparison
Compare Healthcare Services Group, Inc. (HCSG) vs American Shared Hospital Services (AMS) 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 | AMS | 32.9% revenue growth vs HCSG's 7.1% |
| Value | AMS | Lower P/E (6.4x vs 22.5x) |
| Quality / Margins | HCSG | 2.2% net margin vs AMS's -7.6% |
| Stability / Safety | HCSG | Lower D/E ratio (3.1% vs 77.4%) |
| Dividends | Tie | Neither pays a meaningful dividend |
| Momentum (1Y) | HCSG | +107.3% vs AMS's -28.0% |
| Efficiency (ROA) | HCSG | 4.9% ROA vs AMS's -3.8%, ROIC 7.7% vs -5.8% |
Who Each Stock Is For
Income & stability
Growth exposure
Long-term compounding (10Y)
Sleep-well-at-night portfolio
Defensive / Recession hedge
Business Model
What each company does and how it makes money
Healthcare Services Group provides outsourced housekeeping, laundry, and dietary services to nursing homes, retirement communities, and hospitals across the United States. It generates revenue through service contracts with healthcare facilities—primarily from its Housekeeping segment (~70% of revenue) and Dietary segment (~30%)—where it manages entire departments for clients. The company's moat lies in its specialized expertise in healthcare facility operations and its scale as a national provider, which creates switching costs for clients who rely on its integrated service model.
American Shared Hospital Services is a specialized medical equipment leasing company that provides Gamma Knife radiosurgery systems and proton beam radiation therapy equipment to healthcare providers. It generates revenue primarily through equipment leasing arrangements — typically taking a percentage of procedure fees — and also offers financing, installation, and support services. The company's moat lies in its specialized focus on high-cost, technologically advanced radiation therapy equipment that requires significant capital investment, creating barriers to entry for smaller competitors.
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
HCSG leads in 4 of 6 categories (Financial Metrics, Profitability & Efficiency). AMS leads in 1 (Valuation Metrics). 1 tied.
Financial Metrics (TTM)
HCSG is the larger business by revenue, generating $1.8B annually — 61.5x AMS's $29M. HCSG is the more profitable business, keeping 2.2% of every revenue dollar as net income compared to AMS's -7.6%. On growth, HCSG holds the edge at +8.5% YoY revenue growth, suggesting stronger near-term business momentum.
| Metric | HCSGHealthcare Servic… | AMSAmerican Shared H… |
|---|---|---|
| RevenueTrailing 12 months | $1.8B | $29M |
| EBITDAEarnings before interest/tax | $60M | $2M |
| Net IncomeAfter-tax profit | $40M | -$2M |
| Free Cash FlowCash after capex | $158M | -$10M |
| Gross MarginGross profit ÷ Revenue | +12.5% | +25.0% |
| Operating MarginEBIT ÷ Revenue | +2.4% | -12.3% |
| Net MarginNet income ÷ Revenue | +2.2% | -7.6% |
| FCF MarginFCF ÷ Revenue | +8.7% | -34.7% |
| Rev. Growth (YoY)Latest quarter vs prior year | +8.5% | +2.5% |
| EPS Growth (YoY)Latest quarter vs prior year | +2.1% | -56.7% |
Valuation Metrics
At 6.4x trailing earnings, AMS trades at a 76% valuation discount to HCSG's 26.9x P/E. On an enterprise value basis, AMS's 7.7x EV/EBITDA is more attractive than HCSG's 24.0x.
| Metric | HCSGHealthcare Servic… | AMSAmerican Shared H… |
|---|---|---|
| Market CapShares × price | $1.7B | $14M |
| Enterprise ValueMkt cap + debt − cash | $1.6B | $26M |
| Trailing P/EPrice ÷ TTM EPS | 26.88x | 6.39x |
| Forward P/EPrice ÷ next-FY EPS est. | 22.54x | — |
| PEG RatioP/E ÷ EPS growth rate | — | 0.97x |
| EV / EBITDAEnterprise value multiple | 23.98x | 7.70x |
| Price / SalesMarket cap ÷ Revenue | 0.91x | 0.48x |
| Price / BookPrice ÷ Book value/share | 2.59x | 0.47x |
| Price / FCFMarket cap ÷ FCF | 12.02x | — |
Profitability & Efficiency
HCSG delivers a 8.0% return on equity — every $100 of shareholder capital generates $8 in annual profit, vs $-8 for AMS. HCSG carries lower financial leverage with a 0.03x debt-to-equity ratio, signaling a more conservative balance sheet compared to AMS's 0.77x. On the Piotroski fundamental quality scale (0–9), HCSG scores 7/9 vs AMS's 5/9, reflecting strong financial health.
| Metric | HCSGHealthcare Servic… | AMSAmerican Shared H… |
|---|---|---|
| ROE (TTM)Return on equity | +8.0% | -7.9% |
| ROA (TTM)Return on assets | +4.9% | -3.8% |
| ROICReturn on invested capital | +7.7% | -5.8% |
| ROCEReturn on capital employed | +7.8% | -6.4% |
| Piotroski ScoreFundamental quality 0–9 | 7 | 5 |
| Debt / EquityFinancial leverage | 0.03x | 0.77x |
| Net DebtTotal debt minus cash | -$116M | $12M |
| Cash & Equiv.Liquid assets | $125M | $11M |
| Total DebtShort + long-term debt | $19M | $23M |
| Interest CoverageEBIT ÷ Interest expense | 20.15x | -1.35x |
Total Returns (with DRIP)
A $10,000 investment in AMS five years ago would be worth $8,115 today (with dividends reinvested), compared to $7,774 for HCSG. Over the past 12 months, HCSG leads with a +107.3% total return vs AMS's -28.0%. The 3-year compound annual growth rate (CAGR) favors HCSG at 17.9% vs AMS's -16.9% — a key indicator of consistent wealth creation.
| Metric | HCSGHealthcare Servic… | AMSAmerican Shared H… |
|---|---|---|
| YTD ReturnYear-to-date | +25.5% | +0.5% |
| 1-Year ReturnPast 12 months | +107.3% | -28.0% |
| 3-Year ReturnCumulative with dividends | +64.1% | -42.7% |
| 5-Year ReturnCumulative with dividends | -22.3% | -18.8% |
| 10-Year ReturnCumulative with dividends | -23.5% | +15.3% |
| CAGR (3Y)Annualised 3-year return | +17.9% | -16.9% |
Risk & Volatility
AMS is the less volatile stock with a -0.01 beta — it tends to amplify market swings less than HCSG's 0.74 beta. A beta below 1.0 means the stock typically moves less than the S&P 500. HCSG currently trades 94.7% from its 52-week high vs AMS's 67.8% drawdown — a narrower gap to the peak suggests stronger recent price momentum.
| Metric | HCSGHealthcare Servic… | AMSAmerican Shared H… |
|---|---|---|
| Beta (5Y)Sensitivity to S&P 500 | 0.74x | -0.01x |
| 52-Week HighHighest price in past year | $22.98 | $3.11 |
| 52-Week LowLowest price in past year | $9.13 | $2.01 |
| % of 52W HighCurrent price vs 52-week peak | +94.7% | +67.8% |
| RSI (14)Momentum oscillator 0–100 | 64.3 | 48.1 |
| Avg Volume (50D)Average daily shares traded | 627K | 7K |
Analyst Outlook
| Metric | HCSGHealthcare Servic… | AMSAmerican Shared H… |
|---|---|---|
| Analyst RatingConsensus buy/hold/sell | Buy | — |
| Price TargetConsensus 12-month target | $23.33 | — |
| # AnalystsCovering analysts | 14 | — |
| Dividend YieldAnnual dividend ÷ price | — | — |
| Dividend StreakConsecutive years of raises | 20 | 0 |
| Dividend / ShareAnnual DPS | — | — |
| Buyback YieldShare repurchases ÷ mkt cap | +3.7% | 0.0% |
Historical Charts
Charts are rendered on first load. Hover for details.
Chart 1Total Return — 5 Years (Rebased to 100)
| Stock | Mar 20 | Feb 26 | Change |
|---|---|---|---|
| Healthcare Services… (HCSG) | 100 | 69.75 | -30.3% |
| American Shared Hos… (AMS) | 100 | 96.38 | -3.6% |
American Shared Hos… (AMS) returned -19% over 5 years vs Healthcare Services… (HCSG)'s -22%.
Chart 2Revenue Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Healthcare Services… (HCSG) | $1.6B | $1.8B | +17.6% |
| American Shared Hos… (AMS) | $19M | $28M | +51.6% |
Healthcare Services Group, Inc.'s revenue grew from $1.6B (2016) to $1.8B (2025) — a 1.8% CAGR.
Chart 3Net Margin Trend — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Healthcare Services… (HCSG) | 5.0% | 3.2% | -35.1% |
| American Shared Hos… (AMS) | 5.0% | 7.7% | +55.1% |
Healthcare Services Group, Inc.'s net margin went from 5% (2016) to 3% (2025).
Chart 4P/E Ratio History — 9 Years
| Stock | 2017 | 2025 | Change |
|---|---|---|---|
| Healthcare Services… (HCSG) | 44.3 | 23.6 | -46.7% |
| American Shared Hos… (AMS) | 7.9 | 9.7 | +22.8% |
Healthcare Services Group, Inc. has traded in a 20x–44x P/E range over 9 years; current trailing P/E is ~27x. American Shared Hospital Services has traded in a 8x–74x P/E range over 7 years; current trailing P/E is ~6x.
Chart 5EPS Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Healthcare Services… (HCSG) | 1.05 | 0.81 | -22.9% |
| American Shared Hos… (AMS) | 0.17 | 0.33 | +94.1% |
Healthcare Services Group, Inc.'s EPS grew from $1.05 (2016) to $0.81 (2025) — a -3% CAGR.
Chart 6Free Cash Flow — 5 Years
Healthcare Services Group, Inc. generated $139M FCF in 2025 (+343% vs 2021). American Shared Hospital Services generated $-8M FCF in 2024 (-269% vs 2021).
HCSG vs AMS: Frequently Asked Questions
8 questions · data-driven answers · updated daily
01Is HCSG or AMS a better buy right now?
American Shared Hospital Services (AMS) offers the better valuation at 6.4x trailing P/E, making it the more compelling value choice. Analysts rate Healthcare Services Group, Inc. (HCSG) a "Buy" — based on 14 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 — HCSG or AMS?
On trailing P/E, American Shared Hospital Services (AMS) is the cheapest at 6.4x versus Healthcare Services Group, Inc. at 26.9x.
03Which is the better long-term investment — HCSG or AMS?
Over the past 5 years, American Shared Hospital Services (AMS) delivered a total return of -18.8%, compared to -22.3% for Healthcare Services Group, Inc. (HCSG). A $10,000 investment in AMS five years ago would be worth approximately $8K today (assuming dividends reinvested). Over 10 years, the gap is even starker: AMS returned +15.3% versus HCSG's -23.5%. 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 — HCSG or AMS?
By beta (market sensitivity over 5 years), American Shared Hospital Services (AMS) is the lower-risk stock at -0.01β versus Healthcare Services Group, Inc.'s 0.74β — meaning HCSG is approximately -6889% more volatile than AMS relative to the S&P 500. On balance sheet safety, Healthcare Services Group, Inc. (HCSG) carries a lower debt/equity ratio of 3% versus 77% for American Shared Hospital Services — giving it more financial flexibility in a downturn.
05Which has better profit margins — HCSG or AMS?
American Shared Hospital Services (AMS) is the more profitable company, earning 7.7% net margin versus 3.2% for Healthcare Services Group, Inc. — meaning it keeps 7.7% of every revenue dollar as bottom-line profit. Operating margin tells a similar story: HCSG leads at 2.6% versus -9.9% for AMS. At the gross margin level — before operating expenses — AMS leads at 32.4%, 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.
06Which pays a better dividend — HCSG or AMS?
None of the stocks in this comparison currently pay a material dividend. All are effectively zero-yield and should be held for capital appreciation rather than income.
07Is HCSG or AMS better for a retirement portfolio?
For long-horizon retirement investors, American Shared Hospital Services (AMS) is the stronger choice — it scores higher on the combination of lower volatility, dividend reliability, and long-term compounding (low volatility (β -0.01)). Both have compounded well over 10 years (AMS: +15.3%, HCSG: -23.5%), 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.
08What are the main differences between HCSG and AMS?
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: HCSG is a small-cap quality compounder stock; AMS is a small-cap deep-value 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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