BTSG vs AVAH vs PACS Stock Comparison

BrightSpring Health Services, Aveanna Healthcare Holdings and Pacs Prices as of Oct 23, 2026 Peers: Industry group
PACS PACS Group, Inc.
$47.65 +16.1% 1M +274.0% 1Y
Market cap
$7.72B
P/E
28.7x
Revenue (TTM)
$5.55B
Div. yield
–
Home Health and Senior Care Healthcare
3 wins

Head to Head

10 decided of 12

Aveanna Healthcare Holdings leads on 4 of the 12 questions below (Aveanna Healthcare Holdings 4, BrightSpring Health Services 3, Pacs 3). Which ones matter depends on what you are buying for; a cheap multiple and slow growth often come together.

QuestionBTSGAVAHPACSLeader
Larger companyMarket capitalisation $12.13B $2.87B $7.72B BTSG
Cheaper on earningsLower P/E, profitable companies only 33.1x 11.0x 28.7x AVAH
Cheaper on forward earningsLower price / next fiscal year consensus EPS 34.7x 15.7x 20.9x AVAH
Faster revenue growthRevenue growth, trailing twelve months +26.4% +16.8% +15.2% BTSG
More profitableNet margin, trailing twelve months 2.5% 10.2% 4.8% AVAH
Better return on capitalReturn on invested capital 8.6% 18.4% 21.8% PACS
Less leveragedLower net debt / EBITDA 2.6x 4.0x 0.2x PACS
Higher dividend yieldTrailing dividend yield 0.00% 0.00% 0.00% –
Better 1-year returnPrice return, last 12 months +79.4% +46.7% +274.0% PACS
Better 5-year returnAnnualised price return, 5 years — +13.1%/yr — –
Less volatileAnnualised volatility, 1 year 44.5% 47.7% 81.5% BTSG
Higher overall scoreMean of the five percentile scores vs peers 62/100 66/100 64/100 AVAH

Percentile Scorecard

BTSGAVAHPACS

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

AxisBTSGAVAHPACS
Valuation 65 #33 of 93 70 #29 of 93 69 #30 of 93
Growth 93 #7 of 88 84 #15 of 88 75 #23 of 88
Profitability 56 #39 of 87 91 #9 of 87 67 #29 of 87
Financial Health 41 #59 of 100 21 #79 of 100 46 #55 of 100
Shareholder Returns 56 #25 of 56 – –
Overall 62 66 64
  • BTSG ranked among 103 companies in Healthcare Providers
  • AVAH ranked among 103 companies in Healthcare Providers
  • PACS ranked among 103 companies in Healthcare Providers

Price Performance

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

Returns

PeriodBTSGAVAHPACSSPY
1 month +7.8%+4.6%+16.1% -1.0%
3 months -17.6%+41.6%+1.7% +2.9%
6 months +24.8%+104.3%+34.5% +6.4%
Year to date +60.5%+63.8%+24.1% +11.4%
1 year +79.4%+46.7%+274.0% +13.1%
3 years —+1,033.9%— +79.4%
3 years, per year —+124.8%— +21.5%
5 years —+85.3%— +67.7%
5 years, per year —+13.1%— +10.9%

Risk

MeasureBTSGAVAHPACSSPY
Volatility, 1Y 44.5%47.7%81.5% 12.7%
Downside volatility, 1Y 51.8%43.2%48.4% 12.7%
Beta vs S&P 500, 1Y 1.310.670.36 1.00
Return / volatility, 1Y 1.780.983.36 1.03
Max drawdown, 5Y -35.6%-92.3%-82.0% -25.4%
From 52-week high -17.6%-7.0%-1.7% -2.5%
52-week high $72.91$14.38$48.45 $779.14
52-week low $31.36$6.22$10.58 $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.

MultipleBTSGAVAHPACS
P/E now vs peer median 33.8xmedian 25.3x 11.2xmedian 25.3x 28.0xmedian 25.3x
P/S now vs peer median 0.8xmedian 1.6x 1.1xmedian 1.6x 1.4xmedian 1.6x
EV/EBITDA now vs peer median 21.8xmedian 14.6x 13.7xmedian 14.6x 15.9xmedian 14.6x
P/FCF now vs peer median 29.5xmedian 22.7x —median 22.7x 62.1xmedian 22.7x
P/B now vs peer median 5.8xmedian 3.3x 10.2xmedian 3.3x 6.8xmedian 3.3x
PEG now vs peer median —median 0.66 0.25median 0.66 —median 0.66

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 monthsBTSGAVAHPACS
Revenue $14.37B $2.54B $5.55B
Gross profit $1.78B $845.45M $1.30B
Operating income $447.80M $284.64M $410.32M
Net income $365.85M $260.11M $269.17M
Free cash flow $402.35M – $121.47M
EPS (diluted) $1.66 $1.16 $1.66
Cash & equivalents $550.38M $97.20M $164.45M
Total debt $9.71B $5.19B $246.09M
Shares (diluted) 220.28M 224.86M 161.99M
Enterprise value $10.46B $2.34B $6.76B

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
MetricBTSGAVAHPACS
P/E 33.8x 11.2x 28.0x
P/FCF 29.5x – 62.1x
P/Operating cash flow 23.4x – 13.2x
P/S 0.8x 1.1x 1.4x
P/B 5.8x 10.2x 6.8x
P/Tangible book 7.7x 15.6x 6.8x
EV/EBITDA 21.8x 13.7x 15.9x
EV/EBIT 30.2x 14.5x 18.6x
EV/Revenue 0.9x 1.6x 1.4x
EV/FCF 33.6x – 62.8x
EV/Operating cash flow 26.7x – 13.3x
PEG (3Y EPS CAGR) – 0.25 –

Growth

14 metrics
MetricBTSGAVAHPACS
Revenue growth (1Y) 26.4% 16.8% 15.2%
Revenue CAGR (3Y) – 11.6% –
Gross profit growth (1Y) 29.4% 16.5% 33.3%
Gross profit CAGR (3Y) – 14.5% –
Operating income growth (1Y) 143.5% 34.5% 83.5%
Operating income CAGR (3Y) – 58.3% –
Net income growth (1Y) 472.6% 1,302% 103.5%
Net income CAGR (3Y) – 47.1% –
EPS growth (1Y) 448.6% 1,212% 107.9%
EPS CAGR (3Y) – 44.2% –
Operating cash flow growth (1Y) 88.6% – 20.3%
Operating cash flow CAGR (3Y) – – –
Free cash flow growth (1Y) 110.5% – -58.3%
Free cash flow CAGR (3Y) – – –

Profitability

14 metrics
MetricBTSGAVAHPACS
Gross margin 12.4% 33.2% 23.5%
EBITDA margin 4.3% 11.8% 8.6%
Operating margin 3.1% 11.2% 7.4%
Pretax margin 2.1% 6.0% 6.9%
Net margin 2.5% 10.2% 4.8%
FCF margin 2.8% – 2.2%
Operating cash flow margin 3.5% – 10.3%
Return on equity 18.2% 108.0% 24.9%
Return on assets 6.0% 12.6% 4.8%
Return on invested capital 8.6% 18.4% 21.8%
Return on capital employed 9.9% 17.3% 8.9%
Asset turnover 2.4x 1.2x 1.0x
Cash conversion (OCF / net income) 1.4x – 2.1x
Stock comp / revenue 0.4% – 1.3%

Financial Health

11 metrics
MetricBTSGAVAHPACS
Debt / assets 36.6% 61.6% 4.4%
Debt / equity 1.1x 4.5x 0.2x
Net debt / EBITDA 2.6x 4.0x 0.2x
Debt / FCF 5.4x – 2.0x
Liabilities / assets 65.8% 86.4% 80.3%
Equity / assets 34.2% 13.6% 19.7%
Interest coverage 2.9x 2.2x 13.9x
Current ratio 1.6x 1.2x 0.9x
Quick ratio 1.1x 1.1x 0.8x
Cash ratio 0.4x 0.2x 0.2x
Altman Z-score 4.65 1.94 2.31

Shareholder Returns

7 metrics
MetricBTSGAVAHPACS
Dividend yield – – –
Net buyback yield 0.6% – –
Shareholder yield 0.6% – –
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.

ConsensusBTSGAVAHPACS
Forward P/E 34.7xFY2026 15.7xFY2026 20.9xFY2026
EPS, next fiscal year $1.73FY2026 $0.85FY2026 $2.28FY2026
EPS growth, next FY +73.0%FY2026 +41.7%FY2026 +23.9%FY2026
EPS growth, the year after +41.6% +11.8% +25.4%
Revenue, next fiscal year $15.99BFY2026 $2.76BFY2026 $6.17BFY2026
Revenue growth, next FY +23.9%FY2026 +13.4%FY2026 +16.6%FY2026
Revenue growth, the year after +1.3% +8.7% +1.1%

Institutional Ownership

13F filings, quarter ended Jun 30, 2026
HoldersBTSGAVAHPACS
Held by institutions 100.0% 92.5% 31.3%
Institutions holding 421 215 239
Change in shares held, QoQ -0.7% +1.8% +5.8%
Institutions buying 309 151 155
Institutions selling 83 52 54
Buyers to sellers 3.72 2.90 2.87

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.

BTSGAVAHPACS
BTSG 1.00 0.28 0.13
AVAH 0.28 1.00 0.11
PACS 0.13 0.11 1.00

Add a Peer

Largest companies in the same industry

Related Comparisons

Frequently Asked Questions

Which is bigger, BTSG, AVAH and PACS?

BrightSpring Health Services (BTSG) is the largest by market capitalisation: BrightSpring Health Services (BTSG) $12.13B, Aveanna Healthcare Holdings (AVAH) $2.87B, Pacs (PACS) $7.72B.

Which stock is cheaper, BTSG, AVAH and PACS?

Aveanna Healthcare Holdings (AVAH) trades on the lowest price-to-earnings ratio (BrightSpring Health Services (BTSG) 33.1x, Aveanna Healthcare Holdings (AVAH) 11.0x, Pacs (PACS) 28.7x). On next year's consensus earnings, Aveanna Healthcare Holdings (AVAH) is cheapest (BrightSpring Health Services (BTSG) 34.7x, Aveanna Healthcare Holdings (AVAH) 15.7x, Pacs (PACS) 20.9x). 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%, Pacs (PACS) +15.2%.

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%, Pacs (PACS) 4.8%). On return on invested capital, Pacs (PACS) leads (BrightSpring Health Services (BTSG) 8.6%, Aveanna Healthcare Holdings (AVAH) 18.4%, Pacs (PACS) 21.8%).

Which stock has performed better?

Over the past year Pacs (PACS) returned the most: BrightSpring Health Services (BTSG) +79.4%, Aveanna Healthcare Holdings (AVAH) +46.7%, Pacs (PACS) +274.0%. Returns are price only, before dividends.

Which stock is riskier?

By one-year price volatility, BrightSpring Health Services (BTSG) has been the steadiest (BrightSpring Health Services (BTSG) 44.5%, Aveanna Healthcare Holdings (AVAH) 47.7%, Pacs (PACS) 81.5%). Volatility measures how widely the price swings, not the risk of the business.

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

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 4. 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.