Astrana Health vs Ensign Group
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KIRA’s take AI analyst
I put Astrana Health and Ensign Group side by side, using each one’s latest annual report. Here is what stands out:
- 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 44.9x against 27.7x for Ensign Group.
Who comes out ahead
Of the 9 measures where higher (or lower) is clearly better, how many each company leads.
Astrana Health
ASTH
2/9
Revenue growth5-year growth
Ensign Group
ENSG
7/9
Operating marginNet marginReturn on capitalReturn on equityPiotroski F-scoreNet debt / EBITDAShare count change
Side by side
Best in the row
| Latest fiscal year | ASTH FY25 | ENSG FY25 |
|---|---|---|
| Size | ||
| Market cap | $1.9B | $10.5B |
| 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 | 44.9x | 27.7x |
| Piotroski F-score | 4 | 6 |
Ten years
Revenue
Operating margin
Free cash flow
Return on capital
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.