Acadia Healthcare vs Ensign Group
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The short version
- Ensign Group is the larger business, with $5.1B of revenue in fiscal 2025 against $3.3B for Acadia Healthcare, about 1.5 times as much.
- Ensign Group grew revenue faster (18.7%, against 5.0%).
- Ensign Group earned a higher return on the capital invested in it (19.7%, against −16.0%).
| Latest fiscal year | ACHC · FY25 | ENSG · FY25 |
|---|---|---|
| Size | ||
| Market cap | $2.9B | $10.4B |
| Revenue | $3.3B | $5.1B |
| Free cash flow | −$440M | — |
| Net income | −$1.1B | $344M |
| Growth | ||
| Revenue growth | 5.0% | 18.7% |
| 5-year growth | 9.7% | 16.1% |
| Share count change | −1.5% | 1.1% |
| Profitability | ||
| Gross margin | — | 20.5% |
| Operating margin | — | 8.4% |
| Net margin | −33.3% | 6.8% |
| FCF margin | −13.3% | — |
| Return on capital | −16.0% | 19.7% |
| Return on equity | −43.9% | 16.9% |
| Balance sheet | ||
| Net debt | $2.4B | −$428M |
| Net debt / EBITDA | — | −0.8x |
| Dividends and buybacks | $50.0M | $34.4M |
| Valuation & quality | ||
| P/E | — | 27.5x |
| Piotroski F-score | 4 | 6 |
Revenue
FY16
ACHC $2.8B
ENSG $1.7B
FY17
ACHC $2.8B
ENSG $1.6B
FY18
ACHC $1.9B
ENSG $1.8B
FY19
ACHC $2.0B
ENSG $2.0B
FY20
ACHC $2.1B
ENSG $2.4B
FY21
ACHC $2.3B
ENSG $2.6B
FY22
ACHC $2.6B
ENSG $3.0B
FY23
ACHC $2.9B
ENSG $3.7B
FY24
ACHC $3.2B
ENSG $4.3B
FY25
ACHC $3.3B
ENSG $5.1B
ACHC
ENSG
Operating margin
FY16
ACHC 21.7%
ENSG 5.6%
FY17
ACHC 21.3%
ENSG 2.7%
FY18
ACHC 31.2%
ENSG 4.8%
FY19
ACHC 29.2%
ENSG 6.3%
FY20
ACHC —
ENSG 9.3%
FY21
ACHC —
ENSG 9.9%
FY22
ACHC —
ENSG 9.8%
FY23
ACHC —
ENSG 6.9%
FY24
ACHC —
ENSG 8.4%
FY25
ACHC —
ENSG 8.4%
ACHC
ENSG
Free cash flow
FY16
ACHC $54.0M
ENSG $8.2M
FY17
ACHC $125M
ENSG $25.5M
FY18
ACHC $161M
ENSG $159M
FY19
ACHC $100M
ENSG $121M
FY20
ACHC $434M
ENSG —
FY21
ACHC $130M
ENSG —
FY22
ACHC $84.4M
ENSG —
FY23
ACHC $38.2M
ENSG —
FY24
ACHC −$561M
ENSG —
FY25
ACHC −$440M
ENSG —
ACHC
ENSG
Return on capital
FY16
ACHC 6.5%
ENSG 9.8%
FY17
ACHC 9.1%
ENSG 3.3%
FY18
ACHC 9.0%
ENSG 8.9%
FY19
ACHC 7.2%
ENSG 11.9%
FY20
ACHC 4.9%
ENSG 22.0%
FY21
ACHC 6.5%
ENSG 25.1%
FY22
ACHC 8.2%
ENSG 23.3%
FY23
ACHC 1.1%
ENSG 17.9%
FY24
ACHC 7.8%
ENSG 21.4%
FY25
ACHC −16.0%
ENSG 19.7%
ACHC
ENSG
Each company's latest fiscal year; fiscal years end in different months. The best value in each row is highlighted where higher (or lower) is clearly better. Not investment advice.