Astrana Health 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 $3.2B for Astrana Health, about 1.6 times as much.
- Astrana Health grew revenue faster (56.4%, against 18.7%).
- Ensign Group kept more of each dollar of sales as operating profit (8.4% operating margin, against 2.5%).
- Ensign Group earned a higher return on the capital invested in it (19.7%, against 4.2%).
- Investors pay more for each dollar of Astrana Health’s earnings: a P/E of 45.1x against 27.5x for Ensign Group.
| Latest fiscal year | ASTH · FY25 | ENSG · FY25 |
|---|---|---|
| Size | ||
| Market cap | $1.9B | $10.4B |
| Revenue | $3.2B | $5.1B |
| Free cash flow | $104M | — |
| Net income | $22.5M | $344M |
| Growth | ||
| Revenue growth | 56.4% | 18.7% |
| 5-year growth | 35.9% | 16.1% |
| Share count change | 2.9% | 1.1% |
| Profitability | ||
| Gross margin | — | 20.5% |
| Operating margin | 2.5% | 8.4% |
| Net margin | 0.7% | 6.8% |
| FCF margin | 3.3% | — |
| Return on capital | 4.2% | 19.7% |
| Return on equity | 3.0% | 16.9% |
| Balance sheet | ||
| Net debt | $609M | −$428M |
| Net debt / EBITDA | 4.9x | −0.8x |
| Dividends and buybacks | $33.5M | $34.4M |
| Valuation & quality | ||
| P/E | 45.1x | 27.5x |
| Piotroski F-score | 4 | 6 |
FY16
ASTH —
ENSG $1.7B
FY17
ASTH $356M
ENSG $1.6B
FY18
ASTH $520M
ENSG $1.8B
FY19
ASTH $561M
ENSG $2.0B
FY20
ASTH $687M
ENSG $2.4B
FY21
ASTH $774M
ENSG $2.6B
FY22
ASTH $1.1B
ENSG $3.0B
FY23
ASTH $1.4B
ENSG $3.7B
FY24
ASTH $2.0B
ENSG $4.3B
FY25
ASTH $3.2B
ENSG $5.1B
ASTH
ENSG
FY16
ASTH —
ENSG 5.6%
FY17
ASTH 9.9%
ENSG 2.7%
FY18
ASTH 17.0%
ENSG 4.8%
FY19
ASTH 5.8%
ENSG 6.3%
FY20
ASTH 11.7%
ENSG 9.3%
FY21
ASTH 12.7%
ENSG 9.9%
FY22
ASTH 9.1%
ENSG 9.8%
FY23
ASTH 6.1%
ENSG 6.9%
FY24
ASTH 4.4%
ENSG 8.4%
FY25
ASTH 2.5%
ENSG 8.4%
ASTH
ENSG
FY16
ASTH —
ENSG $8.2M
FY17
ASTH $49.8M
ENSG $25.5M
FY18
ASTH $24.3M
ENSG $159M
FY19
ASTH $12.6M
ENSG $121M
FY20
ASTH $45.0M
ENSG —
FY21
ASTH $51.1M
ENSG —
FY22
ASTH $59.2M
ENSG —
FY23
ASTH $39.7M
ENSG —
FY24
ASTH $44.2M
ENSG —
FY25
ASTH $104M
ENSG —
ASTH
ENSG
FY16
ASTH —
ENSG 9.8%
FY17
ASTH —
ENSG 3.3%
FY18
ASTH —
ENSG 8.9%
FY19
ASTH 15.9%
ENSG 11.9%
FY20
ASTH 21.4%
ENSG 22.0%
FY21
ASTH 17.6%
ENSG 25.1%
FY22
ASTH 13.6%
ENSG 23.3%
FY23
ASTH 10.3%
ENSG 17.9%
FY24
ASTH 7.6%
ENSG 21.4%
FY25
ASTH 4.2%
ENSG 19.7%
ASTH
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.