Acadia Healthcare vs Astrana Health
Add, change or remove companies; up to four.
The short version
- Acadia Healthcare is the larger business, with $3.3B of revenue in fiscal 2025 against $3.2B for Astrana Health.
- Astrana Health grew revenue faster (56.4%, against 5.0%).
- Astrana Health turned more of its sales into free cash flow (3.3% FCF margin, against −13.3%).
- Astrana Health earned a higher return on the capital invested in it (4.2%, against −16.0%).
| Latest fiscal year | ACHC · FY25 | ASTH · FY25 |
|---|---|---|
| Size | ||
| Market cap | $2.9B | $1.9B |
| Revenue | $3.3B | $3.2B |
| Free cash flow | −$440M | $104M |
| Net income | −$1.1B | $22.5M |
| Growth | ||
| Revenue growth | 5.0% | 56.4% |
| 5-year growth | 9.7% | 35.9% |
| Share count change | −1.5% | 2.9% |
| Profitability | ||
| Gross margin | — | — |
| Operating margin | — | 2.5% |
| Net margin | −33.3% | 0.7% |
| FCF margin | −13.3% | 3.3% |
| Return on capital | −16.0% | 4.2% |
| Return on equity | −43.9% | 3.0% |
| Balance sheet | ||
| Net debt | $2.4B | $609M |
| Net debt / EBITDA | — | 4.9x |
| Dividends and buybacks | $50.0M | $33.5M |
| Valuation & quality | ||
| P/E | — | 45.1x |
| Piotroski F-score | 4 | 4 |
Revenue
FY16
ACHC $2.8B
ASTH —
FY17
ACHC $2.8B
ASTH $356M
FY18
ACHC $1.9B
ASTH $520M
FY19
ACHC $2.0B
ASTH $561M
FY20
ACHC $2.1B
ASTH $687M
FY21
ACHC $2.3B
ASTH $774M
FY22
ACHC $2.6B
ASTH $1.1B
FY23
ACHC $2.9B
ASTH $1.4B
FY24
ACHC $3.2B
ASTH $2.0B
FY25
ACHC $3.3B
ASTH $3.2B
ACHC
ASTH
Operating margin
FY16
ACHC 21.7%
ASTH —
FY17
ACHC 21.3%
ASTH 9.9%
FY18
ACHC 31.2%
ASTH 17.0%
FY19
ACHC 29.2%
ASTH 5.8%
FY20
ACHC —
ASTH 11.7%
FY21
ACHC —
ASTH 12.7%
FY22
ACHC —
ASTH 9.1%
FY23
ACHC —
ASTH 6.1%
FY24
ACHC —
ASTH 4.4%
FY25
ACHC —
ASTH 2.5%
ACHC
ASTH
Free cash flow
FY16
ACHC $54.0M
ASTH —
FY17
ACHC $125M
ASTH $49.8M
FY18
ACHC $161M
ASTH $24.3M
FY19
ACHC $100M
ASTH $12.6M
FY20
ACHC $434M
ASTH $45.0M
FY21
ACHC $130M
ASTH $51.1M
FY22
ACHC $84.4M
ASTH $59.2M
FY23
ACHC $38.2M
ASTH $39.7M
FY24
ACHC −$561M
ASTH $44.2M
FY25
ACHC −$440M
ASTH $104M
ACHC
ASTH
Return on capital
FY16
ACHC 6.5%
ASTH —
FY17
ACHC 9.1%
ASTH —
FY18
ACHC 9.0%
ASTH —
FY19
ACHC 7.2%
ASTH 15.9%
FY20
ACHC 4.9%
ASTH 21.4%
FY21
ACHC 6.5%
ASTH 17.6%
FY22
ACHC 8.2%
ASTH 13.6%
FY23
ACHC 1.1%
ASTH 10.3%
FY24
ACHC 7.8%
ASTH 7.6%
FY25
ACHC −16.0%
ASTH 4.2%
ACHC
ASTH
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.