Revenue grew to $4.2B with operating margin holding in a narrow 2-4% band and net margin at 2.4% in 2026Q3, suggesting growth is not yet translating into meaningful operating leverage.
BrightSpring Health Services, Inc. Common Stock (BTSG) annual income statement — 7-year revenue, gross profit & net income history
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 |
|---|
| Sales/Revenue | 15.25B | 12.91B | 11.27B | 8.83B | 7.72B | 6.7B | 5.58B | 4.53B |
| Revenue Growth % | 22.86% | 14.59% | 27.65% | 14.32% | 15.27% | 20.03% | 23.32% | - |
| Cost of Goods Sold | 13.34B | 11.39B | 9.68B | 7.39B | 6.37B | 5.45B | 4.53B | 3.69B |
| COGS % of Revenue | - | 88.24% | 85.9% | 83.76% | 82.46% | 81.36% | 81.21% | 81.57% |
| Gross Profit | 1.91B | 1.52B | 1.59B | 1.43B | 1.35B | 1.25B | 1.05B | 833.91M |
| Gross Margin % | 12.5% | 11.76% | 14.1% | 16.24% | 17.54% | 18.64% | 18.79% | 18.43% |
| Gross Profit Growth % | - | -4.45% | 10.79% | 5.87% | 8.49% | 19.02% | 25.76% | - |
| Operating Expenses | 1.36B | 1.22B | 1.38B | 1.29B | 1.17B | 1.01B | 883.55M | 770.59M |
| OpEx % of Revenue | - | 9.47% | 12.27% | 14.58% | 15.11% | 15.14% | 15.83% | 17.03% |
| Selling, General & Admin | 1.36B | 1.22B | 1.38B | 1.29B | 1.13B | 1.01B | 883.55M | 770.59M |
| SG&A % of Revenue | - | 9.47% | 12.27% | 14.58% | 14.58% | 15.14% | 15.83% | 17.03% |
| Research & Development | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| R&D % of Revenue | - | - | - | - | - | - | - | - |
| Other Operating Expenses | 0 | 0 | 0 | 0 | 40.86M | 0 | 0 | 0 |
| Operating Income | 550.74M | 295.25M | 206.37M | 147.18M | 187.83M | 234.18M | 165.19M | 63.31M |
| Operating Margin % | 3.61% | 2.29% | 1.83% | 1.67% | 2.43% | 3.5% | 2.96% | 1.4% |
| Operating Income Growth % | - | 43.07% | 40.22% | -21.64% | -19.79% | 41.77% | 160.91% | - |
| EBITDA | 709.15M | 459.53M | 410.86M | 349.52M | 391.8M | 433.34M | 346.69M | 218.18M |
| EBITDA Margin % | 4.65% | 3.56% | 3.65% | 3.96% | 5.07% | 6.47% | 6.21% | 4.82% |
| EBITDA Growth % | 59.06% | 11.85% | 17.55% | -10.79% | -9.59% | 24.99% | 58.9% | - |
| D&A (Non-Cash Add-back) | 158.41M | 164.28M | 204.48M | 202.34M | 203.97M | 199.16M | 181.5M | 154.87M |
| EBIT | 550.74M | 295.25M | 193.65M | 147.18M | 187.83M | 234.18M | 165.19M | 63.31M |
| Net Interest Income | -145.07M | -157.31M | -228.39M | -324.59M | -233.58M | -165.32M | -138.95M | -166.89M |
| Interest Income | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Interest Expense | 145.07M | 157.31M | 228.39M | 324.59M | 233.58M | 165.32M | 138.95M | 166.89M |
| Other Income/Expense | -175.37M | -157.31M | -241.11M | -324.59M | -233.58M | -165.32M | -138.95M | -166.89M |
| Pretax Income | 375.37M | 137.94M | -34.74M | -177.41M | -45.75M | 68.86M | 26.24M | -103.58M |
| Pretax Margin % | 2.46% | 1.07% | -0.31% | -2.01% | -0.59% | 1.03% | 0.47% | -2.29% |
| Income Tax | 64.13M | 33.15M | -14.22M | -20.58M | 8.46M | 17.6M | 5.09M | -32.49M |
| Effective Tax Rate % | 17.08% | 24.03% | 40.93% | 11.6% | -18.5% | 25.56% | 19.39% | 31.37% |
| Net Income | 338.34M | 190.67M | -18.06M | -154.6M | -53.91M | 49.8M | 20.81M | -72.38M |
| Net Margin % | 2.22% | 1.48% | -0.16% | -1.75% | -0.7% | 0.74% | 0.37% | -1.6% |
| Net Income Growth % | 161.1% | 1155.62% | 88.32% | -186.8% | -208.25% | 139.3% | 128.75% | - |
| Net Income (Continuing) | 311.24M | 104.8M | -20.52M | -156.84M | -54.22M | 51.26M | 21.15M | -71.09M |
| Discontinued Operations | 497K | 84.32M | 0 | 0 | 0 | 0 | 0 | 0 |
| Minority Interest | 9.28M | 11.3M | 3.73M | 27.81M | 29.31M | 25.65M | 30.39M | 53.36M |
| EPS (Diluted) | 1.54 | 0.87 | -0.09 | -0.90 | -0.31 | 0.29 | 0.12 | -0.42 |
| EPS Growth % | 150.82% | 1029.49% | 89.6% | -190.32% | -206.9% | 141.67% | 128.57% | - |
| EPS (Basic) | - | 0.94 | -0.09 | -0.90 | -0.31 | 0.29 | 0.12 | -0.42 |
| Diluted Shares Outstanding | 220.23M | 219.77M | 193M | 171.19M | 171.19M | 171.19M | 171.19M | 171.19M |
| Basic Shares Outstanding | 207.02M | 202.56M | 193M | 171.19M | 171.19M | 171.19M | 171.19M | 171.19M |
| Dividend Payout Ratio | - | - | - | - | - | - | - | - |
Quick answers to the most common questions about buying BTSG stock.
For fiscal year 2025, BrightSpring Health Services, Inc. Common Stock (BTSG) reported total revenue of $12.91B. This represents a 185.3% increase compared to $4.53B in 2019.
BrightSpring Health Services, Inc. Common Stock (BTSG) is profitable, generating $190.7M in net income for the fiscal year ending 2025 with a net profit margin of 1.5%.
BrightSpring Health Services, Inc. Common Stock (BTSG) reported an operating income of $295.3M, resulting in an operating profit margin of 2.3%. This margin reflects the operational efficiency of the business before interest and taxes.
BrightSpring Health Services, Inc. Common Stock (BTSG) generated $1.52B in gross profit for the year, representing a gross profit margin of 11.8%. This demonstrates the company's core pricing power and production efficiency.
Key Metrics
Top Statement Risk
Thin margins versus leverage
Metrics are mathematically derived from official filings.
Revenue Growth Holds Near Mid-Teens
According to the reported figures, BTSG's revenue grew 14.59% year over year to roughly $12.9 billion, a pace that suggests sustained volume gains alongside acquisition-driven expansion within both pharmacy and provider segments.
The growth rate appears consistent with combined organic patient volume increases and integration of smaller acquisitions, though the data does not separate these drivers. Durability depends on whether reimbursement rates keep pace with volume, which warrants further investigation. Investors should monitor whether growth continues without requiring further debt-funded deals.
Thin Gross Margin Limits Cushion
Based on reported figures, BTSG's gross margin of 11.76% and operating margin of 3.16% suggest a business with little room to absorb clinical wage inflation or drug pricing pressure before profitability is materially affected.
The structurally low gross margin reflects the high-volume nature of drug distribution combined with labor-intensive provider services. This profile suggests pricing power is limited relative to specialty peers such as Addus HomeCare, which reports materially higher gross margins. Margin cyclicality may track labor market conditions more than demand conditions.
Operating Income Scaling Modestly
As reported in financial statements, BTSG's operating income rose across recent quarters to $160.5 million in the latest period, but operating margin stayed in a narrow 2-4% band, indicating limited operating leverage so far.
SG&A has grown roughly in line with gross profit, which suggests overhead efficiency gains are not yet visible in the margin structure. The data does not clearly show operating income outpacing gross profit on a sustained basis. Investors should watch whether SG&A as a share of revenue begins to decline.
Net Income Volatile Versus Operations
Based on the quarterly data, BTSG's net income swung from a loss of $8.2 million to $100.1 million across ten quarters, a volatility that may reflect non-operating items, amortization, or tax effects rather than operating performance alone.
The gap between operating income and net income in several quarters suggests meaningful interest expense and other non-operating charges. Stock-based compensation is modest relative to revenue, so it does not appear to be the primary driver of the volatility. Earnings quality would benefit from clearer disclosure of amortization related to acquisitions.
Growth Could Mask Margin Dilution
The bear case centers on whether BTSG's 14.6% revenue growth is being purchased with lower-margin service mix, since gross margin has not expanded meaningfully despite rapid top-line gains.
If growth is driven by lower-margin pharmacy volume or pricing concessions, it may dilute profitability rather than enhance it. Elevated leverage combined with thin net margins leaves limited buffer against reimbursement changes. Short-sellers would likely focus on whether the reported earnings recovery is durable or reflects favorable timing.