BTSG vs ENSG vs HR Stock Comparison

BrightSpring Health Services, Ensign and Healthcare Realty Trust 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
7 wins

Head to Head

11 decided of 12

Ensign leads on 7 of the 12 questions below (Ensign 7, BrightSpring Health Services 3, Healthcare Realty Trust 1). Which ones matter depends on what you are buying for; a cheap multiple and slow growth often come together.

QuestionBTSGENSGHRLeader
Larger companyMarket capitalisation $13.69B $10.51B $6.30B BTSG
Cheaper on earningsLower P/E, profitable companies only 37.4x 26.3x -140.1x ENSG
Cheaper on forward earningsLower price / next fiscal year consensus EPS 34.8x 22.5x — ENSG
Faster revenue growthRevenue growth, trailing twelve months +26.4% +17.5% -5.8% BTSG
More profitableNet margin, trailing twelve months 2.5% 7.0% -4.0% ENSG
Better return on capitalReturn on invested capital 8.6% 14.3% — ENSG
Less leveragedLower net debt / EBITDA 2.6x -0.3x — ENSG
Higher dividend yieldTrailing dividend yield 0.00% 0.00% 0.05% –
Better 1-year returnPrice return, last 12 months +76.9% +2.0% +2.4% BTSG
Better 5-year returnAnnualised price return, 5 years — +19.0%/yr -11.3%/yr ENSG
Less volatileAnnualised volatility, 1 year 44.6% 29.3% 19.9% HR
Higher overall scoreMean of the five percentile scores vs peers 65/100 65/100 40/100 ENSG

Percentile Scorecard

BTSGENSGHR

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

AxisBTSGENSGHR
Valuation 66 #32 of 92 70 #28 of 92 38 #91 of 145
Growth 93 #7 of 87 63 #33 of 87 51 #70 of 143
Profitability 57 #38 of 86 74 #23 of 86 35 #89 of 136
Financial Health 41 #58 of 97 72 #28 of 97 39 #84 of 138
Shareholder Returns 67 #19 of 55 44 #31 of 55 39 #81 of 131
Overall 65 65 40
  • BTSG ranked among 102 companies in Healthcare Providers
  • ENSG ranked among 102 companies in Healthcare Providers
  • HR ranked among 149 companies in Property REITs

Price Performance

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

Returns

PeriodBTSGENSGHRSPY
1 month +8.1%+6.1%+1.3% +0.7%
3 months -17.4%+4.2%-15.6% +3.7%
6 months +25.5%-0.2%-2.8% +7.1%
Year to date +60.8%+7.0%+7.2% +12.8%
1 year +76.9%+2.0%+2.4% +11.9%
3 years —+95.5%+27.6% +85.2%
3 years, per year —+25.1%+8.5% +22.8%
5 years —+138.8%-45.0% +67.6%
5 years, per year —+19.0%-11.3% +10.9%
10 years —+993.4%-42.0% +262.0%
10 years, per year —+27.0%-5.3% +13.7%

Risk

MeasureBTSGENSGHRSPY
Volatility, 1Y 44.6%29.3%19.9% 12.7%
Downside volatility, 1Y 51.5%24.9%19.3% 12.6%
Beta vs S&P 500, 1Y 1.30-0.060.10 1.00
Return / volatility, 1Y 1.720.070.12 0.94
Max drawdown, 5Y -35.6%-31.8%-61.1% -25.4%
From 52-week high -17.4%-13.7%-17.0% -1.2%
52-week high $72.91$215.83$21.89 $779.14
52-week low $31.36$147.13$16.34 $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.

MultipleBTSGENSGHR
P/E now vs peer median 33.9xmedian 26.0x 27.0xmedian 26.0x -137.7xmedian 25.7x
P/S now vs peer median 0.8xmedian 1.6x 1.9xmedian 1.6x 5.4xmedian 4.1x
EV/EBITDA now vs peer median 21.8xmedian 15.4x 16.9xmedian 15.4x —median 14.3x
P/FCF now vs peer median 29.6xmedian 21.5x 21.3xmedian 21.5x 38.2xmedian 23.5x
P/B now vs peer median 5.8xmedian 3.2x 4.2xmedian 3.2x 1.5xmedian 1.3x
PEG now vs peer median —median 0.87 1.70median 0.87 -3.18median 1.86

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 monthsBTSGENSGHR
Revenue $14.37B $5.67B $1.13B
Gross profit $1.78B $1.20B –
Operating income $447.80M $509.16M –
Net income $365.85M $399.32M -$45.27M
Free cash flow $402.35M $509.91M $161.54M
EPS (diluted) $1.66 $6.73 $-0.13
Cash & equivalents $550.38M $337.59M $17.50M
Total debt $2.19B $198.72M $4.25B
Shares (diluted) 220.28M 59.30M 340.62M
Enterprise value $12.03B $8.63B $6.21B

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
MetricBTSGENSGHR
P/E 33.9x 27.0x -137.7x
P/FCF 29.6x 21.3x 38.2x
P/Operating cash flow 23.5x 15.6x 13.7x
P/S 0.8x 1.9x 5.4x
P/B 5.8x 4.2x 1.5x
P/Tangible book 7.8x 4.3x 1.5x
EV/EBITDA 21.8x 16.9x –
EV/EBIT 30.2x 21.0x –
EV/Revenue 0.9x 1.9x 9.2x
EV/FCF 33.6x 20.9x 64.4x
EV/Operating cash flow 26.7x 15.4x 23.1x
PEG (3Y EPS CAGR) – 1.70 -3.18

Growth

14 metrics
MetricBTSGENSGHR
Revenue growth (1Y) 26.4% 17.5% -5.8%
Revenue CAGR (3Y) – 16.8% -5.7%
Gross profit growth (1Y) 29.4% 21.7% –
Gross profit CAGR (3Y) – 16.3% –
Operating income growth (1Y) 143.5% 26.6% –
Operating income CAGR (3Y) – 18.3% –
Net income growth (1Y) 472.6% 21.6% 87.8%
Net income CAGR (3Y) – 17.2% 45.3%
EPS growth (1Y) 448.6% 20.9% 87.4%
EPS CAGR (3Y) – 15.9% 43.2%
Operating cash flow growth (1Y) 88.6% 44.5% -2.8%
Operating cash flow CAGR (3Y) – 26.8% -4.6%
Free cash flow growth (1Y) 110.5% 76.1% 28.9%
Free cash flow CAGR (3Y) – 29.2% -1.8%

Profitability

14 metrics
MetricBTSGENSGHR
Gross margin 12.4% 21.2% –
EBITDA margin 4.3% 11.1% –
Operating margin 3.1% 9.0% –
Pretax margin 2.1% 9.4% –
Net margin 2.5% 7.0% -4.0%
FCF margin 2.8% 9.0% 14.2%
Operating cash flow margin 3.5% 12.3% 39.7%
Return on equity 18.2% 16.0% -1.1%
Return on assets 6.0% 6.8% -0.5%
Return on invested capital 8.6% 14.3% –
Return on capital employed 9.9% 10.4% –
Asset turnover 2.4x 1.0x 0.1x
Cash conversion (OCF / net income) 1.4x 1.7x -9.9x
Stock comp / revenue 0.4% 1.1% 1.6%

Financial Health

11 metrics
MetricBTSGENSGHR
Debt / assets 36.6% 3.3% 47.4%
Debt / equity 1.1x 0.1x 1.0x
Net debt / EBITDA 2.6x -0.3x –
Debt / FCF 5.4x 0.4x 26.3x
Liabilities / assets 65.8% 57.3% 53.9%
Equity / assets 34.2% 42.7% 46.1%
Interest coverage 2.9x 62.8x –
Current ratio 1.6x 1.2x –
Quick ratio 1.1x 1.1x –
Cash ratio 0.4x 0.4x –
Altman Z-score 4.65 3.64 –

Shareholder Returns

7 metrics
MetricBTSGENSGHR
Dividend yield – 0.1% 5.3%
Net buyback yield 0.6% 0.2% 3.7%
Shareholder yield 0.6% 0.3% 9.0%
Payout ratio (earnings) – – -735.1%
Payout ratio (FCF) – – 206.0%
Dividend growth (1Y) – – -19.3%
Dividend CAGR (3Y) – – -11.0%

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.

ConsensusBTSGENSGHR
Forward P/E 34.8xFY2026 22.5xFY2026 –
EPS, next fiscal year $1.73FY2026 $8.29FY2026 $-0.11FY2026
EPS growth, next FY +73.0%FY2026 +26.2%FY2026 –
EPS growth, the year after +42.2% -1.8% –
Revenue, next fiscal year $16.01BFY2026 $5.76BFY2026 $1.17BFY2026
Revenue growth, next FY +24.0%FY2026 +13.9%FY2026 -0.7%FY2026
Revenue growth, the year after +1.4% +16.9% -8.9%

Institutional Ownership

13F filings, quarter ended Jun 30, 2026
HoldersBTSGENSGHR
Held by institutions 100.0% 89.8% 100.0%
Institutions holding 422 548 459
Change in shares held, QoQ -0.7% -1.2% +0.8%
Institutions buying 309 250 226
Institutions selling 83 214 145
Buyers to sellers 3.72 1.17 1.56

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.

BTSGENSGHR
BTSG 1.00 0.16 0.15
ENSG 0.16 1.00 0.21
HR 0.15 0.21 1.00

Add a Peer

Largest companies in the same industry

Related Comparisons

Frequently Asked Questions

Which is bigger, BTSG, ENSG and HR?

BrightSpring Health Services (BTSG) is the largest by market capitalisation: BrightSpring Health Services (BTSG) $13.69B, Ensign (ENSG) $10.51B, Healthcare Realty Trust (HR) $6.30B.

Which stock is cheaper, BTSG, ENSG and HR?

Ensign (ENSG) trades on the lowest price-to-earnings ratio (BrightSpring Health Services (BTSG) 37.4x, Ensign (ENSG) 26.3x, Healthcare Realty Trust (HR) -140.1x). On next year's consensus earnings, Ensign (ENSG) is cheapest (BrightSpring Health Services (BTSG) 34.8x, 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%, Ensign (ENSG) +17.5%, Healthcare Realty Trust (HR) -5.8%.

Which company is more profitable?

Ensign (ENSG) has the highest net margin (BrightSpring Health Services (BTSG) 2.5%, Ensign (ENSG) 7.0%, Healthcare Realty Trust (HR) -4.0%). On return on invested capital, Ensign (ENSG) leads (BrightSpring Health Services (BTSG) 8.6%, 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%, Ensign (ENSG) +2.0%, Healthcare Realty Trust (HR) +2.4%. Over five years, Ensign (ENSG) compounded fastest (Ensign (ENSG) +19.0%/yr, Healthcare Realty Trust (HR) -11.3%/yr). Returns are price only, before dividends.

Which pays a higher dividend?

Only one of these companies pays a dividend: BrightSpring Health Services (BTSG) 0.00%, Ensign (ENSG) 0.00%, Healthcare Realty Trust (HR) 0.05%. BrightSpring Health Services (BTSG) and Ensign (ENSG) pays no regular dividend.

Which stock is riskier?

By one-year price volatility, Healthcare Realty Trust (HR) has been the steadiest (BrightSpring Health Services (BTSG) 44.6%, Ensign (ENSG) 29.3%, Healthcare Realty Trust (HR) 19.9%). Volatility measures how widely the price swings, not the risk of the business.

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

There is no single answer; it depends on what you are buying for. On the 12 head-to-head measures on this page, Ensign (ENSG) leads on 7. 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.