Alignment Healthcare vs Quest Diagnostics
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KIRAβs take AI analyst
I put Alignment Healthcare and Quest Diagnostics side by side, using each oneβs latest annual report. Here is what stands out:
- Quest Diagnostics is the larger business, with $11.0B of revenue in fiscal 2025 against $3.9B for Alignment Healthcare, about 2.8 times as much.
- Alignment Healthcare grew revenue faster (46.1%, against 11.8%).
- Quest Diagnostics kept more of each dollar of sales as operating profit (14.1% operating margin, against 0.4%).
- Quest Diagnostics turned more of its sales into free cash flow (12.3% FCF margin, against 2.9%).
- Investors pay more for each dollar of Alignment Healthcareβs earnings: a P/E of 41.5x against 24.2x for Quest Diagnostics.
Who comes out ahead
Of the 9 measures where higher (or lower) is clearly better, how many each company leads.
Alignment Healthcare
ALHC
3/9
Revenue growth5-year growthNet debt / EBITDA
Quest Diagnostics
DGX
6/9
Operating marginNet marginFCF marginReturn on equityPiotroski F-scoreShare count change
Side by side
Best in the row
| Latest fiscal year | ALHC FY25 | DGX FY25 |
|---|---|---|
| Size | ||
| Market cap | $1.7B | $27.2B |
| Revenue | $3.9B | $11.0B |
| Free cash flow | $113M | $1.4B |
| Net income | β$0.7M | $992M |
| Growth | ||
| Revenue growth | 46.1% | 11.8% |
| 5-year growth | 32.7% | 3.2% |
| Share count change | 3.8% | 0.0% |
| Profitability | ||
| Gross margin | β | 33.2% |
| Operating margin | 0.4% | 14.1% |
| Net margin | β0.0% | 9.0% |
| FCF margin | 2.9% | 12.3% |
| Return on capital | β | 9.5% |
| Return on equity | β0.5% | 14.2% |
| Balance sheet | ||
| Net debt | β$281M | $5.3B |
| Net debt / EBITDA | β6.2x | 2.5x |
| Dividends and buybacks | $0.0M | $803M |
| Valuation & quality | ||
| P/E | 41.5x | 24.2x |
| Piotroski F-score | 5 | 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.

