ENSG vs OPCH vs AVAH Stock Comparison

Ensign, Option Care Health and Aveanna Healthcare Holdings 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
5 wins
OPCH Option Care Health, Inc.
$31.85 +39.6% 1M +11.1% 1Y
Market cap
$4.87B
P/E
23.2x
Revenue (TTM)
$5.69B
Div. yield
–
Home Health and Senior Care Healthcare

Head to Head

11 decided of 12

Aveanna Healthcare Holdings leads on 6 of the 12 questions below (Aveanna Healthcare Holdings 6, Ensign 5). Which ones matter depends on what you are buying for; a cheap multiple and slow growth often come together.

QuestionENSGOPCHAVAHLeader
Larger companyMarket capitalisation $10.51B $4.87B $2.84B ENSG
Cheaper on earningsLower P/E, profitable companies only 26.3x 23.2x 10.9x AVAH
Cheaper on forward earningsLower price / next fiscal year consensus EPS 22.5x 16.4x 15.6x AVAH
Faster revenue growthRevenue growth, trailing twelve months +17.5% +5.9% +16.8% ENSG
More profitableNet margin, trailing twelve months 7.0% 3.7% 10.2% AVAH
Better return on capitalReturn on invested capital 14.3% 9.9% 18.4% AVAH
Less leveragedLower net debt / EBITDA -0.3x 2.4x 4.0x ENSG
Higher dividend yieldTrailing dividend yield 0.00% 0.00% 0.00% –
Better 1-year returnPrice return, last 12 months +2.0% +11.1% +34.5% AVAH
Better 5-year returnAnnualised price return, 5 years +19.0%/yr +3.1%/yr +11.4%/yr ENSG
Less volatileAnnualised volatility, 1 year 29.3% 52.0% 47.8% ENSG
Higher overall scoreMean of the five percentile scores vs peers 65/100 54/100 68/100 AVAH

Percentile Scorecard

ENSGOPCHAVAH

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

AxisENSGOPCHAVAH
Valuation 70 #28 of 92 80 #19 of 92 73 #26 of 92
Growth 63 #33 of 87 27 #64 of 87 84 #15 of 87
Profitability 74 #23 of 86 68 #28 of 86 93 #7 of 86
Financial Health 72 #28 of 97 43 #56 of 97 23 #75 of 97
Shareholder Returns 44 #31 of 55 – –
Overall 65 54 68
  • ENSG ranked among 102 companies in Healthcare Providers
  • OPCH ranked among 102 companies in Healthcare Providers
  • AVAH ranked among 102 companies in Healthcare Providers

Price Performance

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

Returns

PeriodENSGOPCHAVAHSPY
1 month +6.1%+39.6%+3.8% +0.7%
3 months +4.2%+41.8%+36.8% +3.7%
6 months -0.2%+56.7%+102.8% +7.1%
Year to date +7.0%0.0%+62.3% +12.8%
1 year +2.0%+11.1%+34.5% +11.9%
3 years +95.5%+18.7%+854.0% +85.2%
3 years, per year +25.1%+5.9%+112.2% +22.8%
5 years +138.8%+16.5%+71.8% +67.6%
5 years, per year +19.0%+3.1%+11.4% +10.9%
10 years +993.4%—— +262.0%
10 years, per year +27.0%—— +13.7%

Risk

MeasureENSGOPCHAVAHSPY
Volatility, 1Y 29.3%52.0%47.8% 12.7%
Downside volatility, 1Y 24.9%50.4%43.2% 12.6%
Beta vs S&P 500, 1Y -0.060.040.63 1.00
Return / volatility, 1Y 0.070.210.72 0.94
Max drawdown, 5Y -31.8%-46.7%-92.3% -25.4%
From 52-week high -13.7%-13.0%-7.8% -1.2%
52-week high $215.83$36.59$14.38 $779.14
52-week low $147.13$19.52$6.22 $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.

MultipleENSGOPCHAVAH
P/E now vs peer median 27.0xmedian 26.0x 23.2xmedian 26.0x 11.1xmedian 26.0x
P/S now vs peer median 1.9xmedian 1.6x 0.8xmedian 1.6x 1.1xmedian 1.6x
EV/EBITDA now vs peer median 16.9xmedian 15.4x 14.0xmedian 15.4x 13.7xmedian 15.4x
P/FCF now vs peer median 21.3xmedian 21.5x 15.7xmedian 21.5x —median 21.5x
P/B now vs peer median 4.2xmedian 3.2x 3.8xmedian 3.2x 10.1xmedian 3.2x
PEG now vs peer median 1.70median 0.87 22.50median 0.87 0.25median 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 monthsENSGOPCHAVAH
Revenue $5.67B $5.69B $2.54B
Gross profit $1.20B $1.09B $845.45M
Operating income $509.16M $333.69M $284.64M
Net income $399.32M $209.58M $260.11M
Free cash flow $509.91M $303.85M –
EPS (diluted) $6.73 $1.37 $1.16
Cash & equivalents $337.59M $193.77M $97.20M
Total debt $198.72M $1.16B $1.30B
Shares (diluted) 59.30M 153.49M 224.86M
Enterprise value $8.63B $3.96B $2.31B

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
MetricENSGOPCHAVAH
P/E 27.0x 23.2x 11.1x
P/FCF 21.3x 15.7x –
P/Operating cash flow 15.6x 13.8x –
P/S 1.9x 0.8x 1.1x
P/B 4.2x 3.8x 10.1x
P/Tangible book 4.3x 4.9x 15.4x
EV/EBITDA 16.9x 14.0x 13.7x
EV/EBIT 21.0x 17.2x 14.4x
EV/Revenue 1.9x 1.0x 1.6x
EV/FCF 20.9x 18.9x –
EV/Operating cash flow 15.4x 16.5x –
PEG (3Y EPS CAGR) 1.70 22.50 0.25

Growth

14 metrics
MetricENSGOPCHAVAH
Revenue growth (1Y) 17.5% 5.9% 16.8%
Revenue CAGR (3Y) 16.8% 11.3% 11.6%
Gross profit growth (1Y) 21.7% 2.6% 16.5%
Gross profit CAGR (3Y) 16.3% 5.3% 14.5%
Operating income growth (1Y) 26.6% -0.1% 34.5%
Operating income CAGR (3Y) 18.3% 6.3% 58.3%
Net income growth (1Y) 21.6% -0.8% 1,302%
Net income CAGR (3Y) 17.2% -4.4% 47.1%
EPS growth (1Y) 20.9% 6.1% 1,212%
EPS CAGR (3Y) 15.9% 1.0% 44.2%
Operating cash flow growth (1Y) 44.5% 24.0% –
Operating cash flow CAGR (3Y) 26.8% -3.8% –
Free cash flow growth (1Y) 76.1% 26.0% –
Free cash flow CAGR (3Y) 29.2% -4.7% –

Profitability

14 metrics
MetricENSGOPCHAVAH
Gross margin 21.2% 19.1% 33.2%
EBITDA margin 11.1% 7.2% 11.8%
Operating margin 9.0% 5.9% 11.2%
Pretax margin 9.4% 5.0% 6.0%
Net margin 7.0% 3.7% 10.2%
FCF margin 9.0% 5.3% –
Operating cash flow margin 12.3% 6.1% –
Return on equity 16.0% 16.0% 108.0%
Return on assets 6.8% 6.2% 12.6%
Return on invested capital 14.3% 9.9% 18.4%
Return on capital employed 10.4% 13.0% 17.3%
Asset turnover 1.0x 1.7x 1.2x
Cash conversion (OCF / net income) 1.7x 1.7x –
Stock comp / revenue 1.1% 0.7% –

Financial Health

11 metrics
MetricENSGOPCHAVAH
Debt / assets 3.3% 34.3% 61.6%
Debt / equity 0.1x 0.9x 4.5x
Net debt / EBITDA -0.3x 2.4x 4.0x
Debt / FCF 0.4x 3.8x –
Liabilities / assets 57.3% 62.7% 86.4%
Equity / assets 42.7% 37.3% 13.6%
Interest coverage 62.8x 6.2x 2.2x
Current ratio 1.2x 1.5x 1.2x
Quick ratio 1.1x 1.0x 1.1x
Cash ratio 0.4x 0.2x 0.2x
Altman Z-score 3.64 3.90 1.93

Shareholder Returns

7 metrics
MetricENSGOPCHAVAH
Dividend yield 0.1% – –
Net buyback yield 0.2% – –
Shareholder yield 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.

ConsensusENSGOPCHAVAH
Forward P/E 22.5xFY2026 16.4xFY2026 15.6xFY2026
EPS, next fiscal year $8.29FY2026 $1.94FY2026 $0.85FY2026
EPS growth, next FY +26.2%FY2026 +12.8%FY2026 +41.7%FY2026
EPS growth, the year after -1.8% +12.9% +11.8%
Revenue, next fiscal year $5.76BFY2026 $5.93BFY2026 $2.76BFY2026
Revenue growth, next FY +13.9%FY2026 +5.0%FY2026 +13.4%FY2026
Revenue growth, the year after +16.9% -2.1% +8.7%

Institutional Ownership

13F filings, quarter ended Jun 30, 2026
HoldersENSGOPCHAVAH
Held by institutions 89.8% 100.0% 92.5%
Institutions holding 548 373 215
Change in shares held, QoQ -1.2% -4.6% +1.8%
Institutions buying 250 213 151
Institutions selling 214 121 52
Buyers to sellers 1.17 1.76 2.90

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.

ENSGOPCHAVAH
ENSG 1.00 0.16 0.29
OPCH 0.16 1.00 0.11
AVAH 0.29 0.11 1.00

Add a Peer

Largest companies in the same industry

Related Comparisons

Frequently Asked Questions

Which is bigger, ENSG, OPCH and AVAH?

Ensign (ENSG) is the largest by market capitalisation: Ensign (ENSG) $10.51B, Option Care Health (OPCH) $4.87B, Aveanna Healthcare Holdings (AVAH) $2.84B.

Which stock is cheaper, ENSG, OPCH and AVAH?

Aveanna Healthcare Holdings (AVAH) trades on the lowest price-to-earnings ratio (Ensign (ENSG) 26.3x, Option Care Health (OPCH) 23.2x, Aveanna Healthcare Holdings (AVAH) 10.9x). On next year's consensus earnings, Aveanna Healthcare Holdings (AVAH) is cheapest (Ensign (ENSG) 22.5x, Option Care Health (OPCH) 16.4x, Aveanna Healthcare Holdings (AVAH) 15.6x). A lower multiple can reflect slower expected growth, so read it next to the growth figures.

Which company is growing faster?

Ensign (ENSG) grew revenue fastest over the trailing twelve months: Ensign (ENSG) +17.5%, Option Care Health (OPCH) +5.9%, Aveanna Healthcare Holdings (AVAH) +16.8%.

Which company is more profitable?

Aveanna Healthcare Holdings (AVAH) has the highest net margin (Ensign (ENSG) 7.0%, Option Care Health (OPCH) 3.7%, Aveanna Healthcare Holdings (AVAH) 10.2%). On return on invested capital, Aveanna Healthcare Holdings (AVAH) leads (Ensign (ENSG) 14.3%, Option Care Health (OPCH) 9.9%, Aveanna Healthcare Holdings (AVAH) 18.4%).

Which stock has performed better?

Over the past year Aveanna Healthcare Holdings (AVAH) returned the most: Ensign (ENSG) +2.0%, Option Care Health (OPCH) +11.1%, Aveanna Healthcare Holdings (AVAH) +34.5%. Over five years, Ensign (ENSG) compounded fastest (Ensign (ENSG) +19.0%/yr, Option Care Health (OPCH) +3.1%/yr, Aveanna Healthcare Holdings (AVAH) +11.4%/yr). Returns are price only, before dividends.

Which stock is riskier?

By one-year price volatility, Ensign (ENSG) has been the steadiest (Ensign (ENSG) 29.3%, Option Care Health (OPCH) 52.0%, Aveanna Healthcare Holdings (AVAH) 47.8%). Volatility measures how widely the price swings, not the risk of the business.

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

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 6. 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.