BTSG vs AVAH vs ENSG Stock Comparison

BrightSpring Health Services, Aveanna Healthcare Holdings and Ensign Prices as of Oct 29, 2026 Peers: Industry group
ENSG Ensign Group, Inc
$186.32 +6.1% 1M +2.0% 1Y
Market cap
$10.51B
P/E
26.3x
Revenue (TTM)
$5.67B
Div. yield
–
Home Health and Senior Care Healthcare
3 wins

Head to Head

11 decided of 12

Aveanna Healthcare Holdings leads on 5 of the 12 questions below (Aveanna Healthcare Holdings 5, BrightSpring Health Services 3, Ensign 3). Which ones matter depends on what you are buying for; a cheap multiple and slow growth often come together.

QuestionBTSGAVAHENSGLeader
Larger companyMarket capitalisation $13.69B $2.84B $10.51B BTSG
Cheaper on earningsLower P/E, profitable companies only 37.4x 10.9x 26.3x AVAH
Cheaper on forward earningsLower price / next fiscal year consensus EPS 34.8x 15.6x 22.5x AVAH
Faster revenue growthRevenue growth, trailing twelve months +26.4% +16.8% +17.5% BTSG
More profitableNet margin, trailing twelve months 2.5% 10.2% 7.0% AVAH
Better return on capitalReturn on invested capital 8.6% 18.4% 14.3% AVAH
Less leveragedLower net debt / EBITDA 2.6x 4.0x -0.3x ENSG
Higher dividend yieldTrailing dividend yield 0.00% 0.00% 0.00% –
Better 1-year returnPrice return, last 12 months +76.9% +34.5% +2.0% BTSG
Better 5-year returnAnnualised price return, 5 years — +11.4%/yr +19.0%/yr ENSG
Less volatileAnnualised volatility, 1 year 44.6% 47.8% 29.3% ENSG
Higher overall scoreMean of the five percentile scores vs peers 65/100 68/100 65/100 AVAH

Percentile Scorecard

BTSGAVAHENSG

Each axis is the mean percentile of its metrics against the company's industry group. 100 is the best in the group, 50 the middle.

Scores by Axis

AxisBTSGAVAHENSG
Valuation 66 #32 of 92 73 #26 of 92 70 #28 of 92
Growth 93 #7 of 87 84 #15 of 87 63 #33 of 87
Profitability 57 #38 of 86 93 #7 of 86 74 #23 of 86
Financial Health 41 #58 of 97 23 #75 of 97 72 #28 of 97
Shareholder Returns 67 #19 of 55 – 44 #31 of 55
Overall 65 68 65
  • BTSG ranked among 102 companies in Healthcare Providers
  • AVAH ranked among 102 companies in Healthcare Providers
  • ENSG ranked among 102 companies in Healthcare Providers

Price Performance

Price return, split-adjusted, before dividends. Click a name to hide or show it.

Returns

PeriodBTSGAVAHENSGSPY
1 month +8.1%+3.8%+6.1% +0.7%
3 months -17.4%+36.8%+4.2% +3.7%
6 months +25.5%+102.8%-0.2% +7.1%
Year to date +60.8%+62.3%+7.0% +12.8%
1 year +76.9%+34.5%+2.0% +11.9%
3 years —+854.0%+95.5% +85.2%
3 years, per year —+112.2%+25.1% +22.8%
5 years —+71.8%+138.8% +67.6%
5 years, per year —+11.4%+19.0% +10.9%
10 years ——+993.4% +262.0%
10 years, per year ——+27.0% +13.7%

Risk

MeasureBTSGAVAHENSGSPY
Volatility, 1Y 44.6%47.8%29.3% 12.7%
Downside volatility, 1Y 51.5%43.2%24.9% 12.6%
Beta vs S&P 500, 1Y 1.300.63-0.06 1.00
Return / volatility, 1Y 1.720.720.07 0.94
Max drawdown, 5Y -35.6%-92.3%-31.8% -25.4%
From 52-week high -17.4%-7.8%-13.7% -1.2%
52-week high $72.91$14.38$215.83 $779.14
52-week low $31.36$6.22$147.13 $631.97

Valuation History

Weekly multiples on trailing twelve-month fundamentals. Negative or extreme readings (a loss year, a collapsed denominator) are left out so the chart stays readable.

MultipleBTSGAVAHENSG
P/E now vs peer median 33.9xmedian 26.0x 11.1xmedian 26.0x 27.0xmedian 26.0x
P/S now vs peer median 0.8xmedian 1.6x 1.1xmedian 1.6x 1.9xmedian 1.6x
EV/EBITDA now vs peer median 21.8xmedian 15.4x 13.7xmedian 15.4x 16.9xmedian 15.4x
P/FCF now vs peer median 29.6xmedian 21.5x —median 21.5x 21.3xmedian 21.5x
P/B now vs peer median 5.8xmedian 3.2x 10.1xmedian 3.2x 4.2xmedian 3.2x
PEG now vs peer median —median 0.87 0.25median 0.87 1.70median 0.87

Financial History

Reported figures by fiscal period, placed on the calendar year (or quarter) each period ended in, so companies with different fiscal years line up.

Trailing twelve monthsBTSGAVAHENSG
Revenue $14.37B $2.54B $5.67B
Gross profit $1.78B $845.45M $1.20B
Operating income $447.80M $284.64M $509.16M
Net income $365.85M $260.11M $399.32M
Free cash flow $402.35M – $509.91M
EPS (diluted) $1.66 $1.16 $6.73
Cash & equivalents $550.38M $97.20M $337.59M
Total debt $2.19B $1.30B $198.72M
Shares (diluted) 220.28M 224.86M 59.30M
Enterprise value $12.03B $2.31B $8.63B

All Metrics

58 metrics · best in bold

Bold marks the best reading: the lowest positive value for multiples, leverage and payout, the highest for everything else. The bar under each value is its percentile against that company's own peers. Hover a value for its rank and the peer median.

Valuation

12 metrics
MetricBTSGAVAHENSG
P/E 33.9x 11.1x 27.0x
P/FCF 29.6x – 21.3x
P/Operating cash flow 23.5x – 15.6x
P/S 0.8x 1.1x 1.9x
P/B 5.8x 10.1x 4.2x
P/Tangible book 7.8x 15.4x 4.3x
EV/EBITDA 21.8x 13.7x 16.9x
EV/EBIT 30.2x 14.4x 21.0x
EV/Revenue 0.9x 1.6x 1.9x
EV/FCF 33.6x – 20.9x
EV/Operating cash flow 26.7x – 15.4x
PEG (3Y EPS CAGR) – 0.25 1.70

Growth

14 metrics
MetricBTSGAVAHENSG
Revenue growth (1Y) 26.4% 16.8% 17.5%
Revenue CAGR (3Y) – 11.6% 16.8%
Gross profit growth (1Y) 29.4% 16.5% 21.7%
Gross profit CAGR (3Y) – 14.5% 16.3%
Operating income growth (1Y) 143.5% 34.5% 26.6%
Operating income CAGR (3Y) – 58.3% 18.3%
Net income growth (1Y) 472.6% 1,302% 21.6%
Net income CAGR (3Y) – 47.1% 17.2%
EPS growth (1Y) 448.6% 1,212% 20.9%
EPS CAGR (3Y) – 44.2% 15.9%
Operating cash flow growth (1Y) 88.6% – 44.5%
Operating cash flow CAGR (3Y) – – 26.8%
Free cash flow growth (1Y) 110.5% – 76.1%
Free cash flow CAGR (3Y) – – 29.2%

Profitability

14 metrics
MetricBTSGAVAHENSG
Gross margin 12.4% 33.2% 21.2%
EBITDA margin 4.3% 11.8% 11.1%
Operating margin 3.1% 11.2% 9.0%
Pretax margin 2.1% 6.0% 9.4%
Net margin 2.5% 10.2% 7.0%
FCF margin 2.8% – 9.0%
Operating cash flow margin 3.5% – 12.3%
Return on equity 18.2% 108.0% 16.0%
Return on assets 6.0% 12.6% 6.8%
Return on invested capital 8.6% 18.4% 14.3%
Return on capital employed 9.9% 17.3% 10.4%
Asset turnover 2.4x 1.2x 1.0x
Cash conversion (OCF / net income) 1.4x – 1.7x
Stock comp / revenue 0.4% – 1.1%

Financial Health

11 metrics
MetricBTSGAVAHENSG
Debt / assets 36.6% 61.6% 3.3%
Debt / equity 1.1x 4.5x 0.1x
Net debt / EBITDA 2.6x 4.0x -0.3x
Debt / FCF 5.4x – 0.4x
Liabilities / assets 65.8% 86.4% 57.3%
Equity / assets 34.2% 13.6% 42.7%
Interest coverage 2.9x 2.2x 62.8x
Current ratio 1.6x 1.2x 1.2x
Quick ratio 1.1x 1.1x 1.1x
Cash ratio 0.4x 0.2x 0.4x
Altman Z-score 4.65 1.93 3.64

Shareholder Returns

7 metrics
MetricBTSGAVAHENSG
Dividend yield – – 0.1%
Net buyback yield 0.6% – 0.2%
Shareholder yield 0.6% – 0.3%
Payout ratio (earnings) – – –
Payout ratio (FCF) – – –
Dividend growth (1Y) – – –
Dividend CAGR (3Y) – – –

Analyst Estimates

Solid lines are reported fiscal-year results; dashed lines are the consensus for the years ahead. Hover a year for the analysts' high and low, and how each result compared with its estimate.

ConsensusBTSGAVAHENSG
Forward P/E 34.8xFY2026 15.6xFY2026 22.5xFY2026
EPS, next fiscal year $1.73FY2026 $0.85FY2026 $8.29FY2026
EPS growth, next FY +73.0%FY2026 +41.7%FY2026 +26.2%FY2026
EPS growth, the year after +42.2% +11.8% -1.8%
Revenue, next fiscal year $16.01BFY2026 $2.76BFY2026 $5.76BFY2026
Revenue growth, next FY +24.0%FY2026 +13.4%FY2026 +13.9%FY2026
Revenue growth, the year after +1.4% +8.7% +16.9%

Institutional Ownership

13F filings, quarter ended Jun 30, 2026
HoldersBTSGAVAHENSG
Held by institutions 100.0% 92.5% 89.8%
Institutions holding 422 215 548
Change in shares held, QoQ -0.7% +1.8% -1.2%
Institutions buying 309 151 250
Institutions selling 83 52 214
Buyers to sellers 3.72 2.90 1.17

Return Correlation

Daily returns, last 12 months

1.00 means two stocks move in lockstep, 0 that they move independently. Pairs below about 0.5 diversify each other.

BTSGAVAHENSG
BTSG 1.00 0.28 0.16
AVAH 0.28 1.00 0.28
ENSG 0.16 0.28 1.00

Add a Peer

Largest companies in the same industry

Related Comparisons

Frequently Asked Questions

Which is bigger, BTSG, AVAH and ENSG?

BrightSpring Health Services (BTSG) is the largest by market capitalisation: BrightSpring Health Services (BTSG) $13.69B, Aveanna Healthcare Holdings (AVAH) $2.84B, Ensign (ENSG) $10.51B.

Which stock is cheaper, BTSG, AVAH and ENSG?

Aveanna Healthcare Holdings (AVAH) trades on the lowest price-to-earnings ratio (BrightSpring Health Services (BTSG) 37.4x, Aveanna Healthcare Holdings (AVAH) 10.9x, Ensign (ENSG) 26.3x). On next year's consensus earnings, Aveanna Healthcare Holdings (AVAH) is cheapest (BrightSpring Health Services (BTSG) 34.8x, Aveanna Healthcare Holdings (AVAH) 15.6x, Ensign (ENSG) 22.5x). A lower multiple can reflect slower expected growth, so read it next to the growth figures.

Which company is growing faster?

BrightSpring Health Services (BTSG) grew revenue fastest over the trailing twelve months: BrightSpring Health Services (BTSG) +26.4%, Aveanna Healthcare Holdings (AVAH) +16.8%, Ensign (ENSG) +17.5%.

Which company is more profitable?

Aveanna Healthcare Holdings (AVAH) has the highest net margin (BrightSpring Health Services (BTSG) 2.5%, Aveanna Healthcare Holdings (AVAH) 10.2%, Ensign (ENSG) 7.0%). On return on invested capital, Aveanna Healthcare Holdings (AVAH) leads (BrightSpring Health Services (BTSG) 8.6%, Aveanna Healthcare Holdings (AVAH) 18.4%, Ensign (ENSG) 14.3%).

Which stock has performed better?

Over the past year BrightSpring Health Services (BTSG) returned the most: BrightSpring Health Services (BTSG) +76.9%, Aveanna Healthcare Holdings (AVAH) +34.5%, Ensign (ENSG) +2.0%. Over five years, Ensign (ENSG) compounded fastest (Aveanna Healthcare Holdings (AVAH) +11.4%/yr, Ensign (ENSG) +19.0%/yr). Returns are price only, before dividends.

Which stock is riskier?

By one-year price volatility, Ensign (ENSG) has been the steadiest (BrightSpring Health Services (BTSG) 44.6%, Aveanna Healthcare Holdings (AVAH) 47.8%, Ensign (ENSG) 29.3%). Volatility measures how widely the price swings, not the risk of the business.

Which is the better stock, BTSG, AVAH and ENSG?

There is no single answer; it depends on what you are buying for. On the 12 head-to-head measures on this page, Aveanna Healthcare Holdings (AVAH) leads on 5. Business Quant does not give investment advice; use the comparison as a starting point for your own research.

Data from SEC filings, exchange prices and consensus estimates, via Business Quant. Percentile scores compare each company with its own peer group, so two companies' scores are each relative to different peers unless you rank against the whole market. Price returns exclude dividends. Nothing on this page is investment advice.