Owner Scorecard


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BTSG, BrightSpring Health Services Inc.

Health Care Providers & Services diversified Distress / turnaround

We are a leading home and community-based healthcare services platform, focused on delivering complementary pharmacy and provider services to complex patients.

We have a differentiated approach to care delivery, with an integrated and scaled model that addresses critical services that the highest-need and highest-cost patients require.

With a focus on Senior and Specialty patients, which includes Behavioral populations, our platform provides pharmacy and provider services (both clinical and supportive care in nature) in lower-cost home and community settings largely to Medicare, Medicaid, and commercially-insured populations.

Latest annual: FY2025 10-K
BTSG · BrightSpring Health Services Inc.
I

The business

What it sells, where the money comes from, the kind of company it is.

Revenue · FY2025
$12.9B
+28.2% YoY · 19% 3-yr CAGR
Vital signs · TTM, with 4-yr average
Revenue $13.6B 4-yr avg $9.6B
Operating margin 2.7% 4-yr avg 1.6%
ROIC 9% 4-yr avg 4%
Owner-earnings margin 3% 4-yr avg 1%
Free cash flow margin 3% 4-yr avg 1%

The business in brief

read the 10-K →

What this business is and what moves its needle, from its own SEC filings.

What it is
Revenue is Pharmacy Solutions (89%) and Provider Services (11%).
Situation
Distress / turnaround. Thin interest coverage, or operating cash burned against real debt, across the record. The balance sheet carries this situation; the debt schedule sets the clock.
What moves the needle
Operating margin has run about 1.1% through the cycle, a thin margin, where volume, cost discipline and the price it gets all bear on the result. The operating margin has swung widely — from 0.8% to 2.4% over the years — so the through-cycle figure carries more than any single year, and the worst year more than the best. Read this kind of business on volume, payer mix and reimbursement. On its own account, the filing leans hardest on customer concentration, set against the numbers in what the filing emphasizes, below.

Every line is arithmetic on the company's filings, shown in full in the sections below.

Where the money comes from

read the 10-K →

Pharmacy Solutions is 89% of revenue, with Provider Services the other meaningful segment at 11%.

Revenue by reportable segment, FY2025
  • Pharmacy Solutions89%$11.4B
  • Provider Services11%$1.5B

From the segment footnote of the company's own 10-K. Shares are of total revenue; the profit bar shows each segment's share of segment operating profit, before unallocated corporate costs.

II

The record

Ten years of arithmetic, read across the cycle.

The record, 2022–2025

realized figures from each filing · older years to the left
2022’222023’232024’242025’25TTMTTMMar 2026
Income statement
$7.7B$7.7B$10.1B$12.9B$13.6BRevenueRevenue
15%14%12%9%9%SG&A / revenueSG&A/rev
$188M$58M$108M$295M$366MOperating incomeOp. inc.
2.4%0.8%1.1%2.3%2.7%Operating marginOp. mgn
($54M)($155M)($18M)$191M$310MNet incomeNet inc.
15%12%Effective tax rateTax rate
Cash flow & returns
($5M)$211M$24M$490M$512MOperating cash flowOp. cash
$204M$202M$204M$164M$161MDepreciationDeprec.
($158M)$159M($232M)$65M($18M)Working capital & otherWC & other
$70M$74M$81M$95M$99MCapexCapex
0.9%1.0%0.8%0.7%0.7%Capex / revenueCapex/rev
($75M)$137M($57M)$395M$412MOwner earningsOwner earn.
−1.0%1.8%−0.6%3.1%3.0%Owner earnings marginOE mgn
($75M)$137M($57M)$395M$412MFree cash flowFCF
−1.0%1.8%−0.6%3.1%3.0%Free cash flow marginFCF mgn
$42M$63M$60M$205M$240MAcquisitionsAcquis.
$650K$650K$43MBuybacksBuybacks
2%6%9%ROICROIC
-7%-26%-1%10%16%Return on equityROE
−7%−26%−1%10%16%Retained to equityRetained/eq
Balance sheet
$13M$61M$88M$889MCash & investmentsCash+inv
$882M$903M$990M$1.1BReceivablesReceiv.
$403M$637M$815M$560MInventoryInvent.
$642M$924M$1.2B$1.1BAccounts payablePayables
$643M$615M$587M$582MOperating working capitalOper. WC
$1.5B$1.9B$2.9B$2.7BCurrent assetsCur. assets
$1.2B$1.4B$1.8B$1.5BCurrent liabilitiesCur. liab.
1.2×1.3×1.6×1.7×Current ratioCurr. ratio
$2.6B$2.3B$2.4B$2.5B$2.5BGoodwillGoodwill
$5.5B$5.9B$6.4B$6.2BTotal assetsAssets
$3.4B$2.6B$2.5B$2.5BTotal debtDebt
$3.4B$2.5B$2.4B$1.6BNet debt / (cash)Net debt
0.8×0.2×0.6×1.9×2.4×Interest coverageInt. cov.
$755M$585M$1.6B$1.9B$2.0BShareholders’ equityEquity
0.0%0.1%0.7%0.5%0.4%Stock comp / revenueSBC/rev
Per share
118M118M193M220M221MShares out (diluted)Shares
$65.52$65.25$52.19$58.74$61.66Revenue / shareRev/sh
$-0.46$-1.31$-0.09$0.87$1.40EPS (diluted)EPS
$-0.63$1.16$-0.30$1.80$1.86Owner earnings / shareOE/sh
$-0.63$1.16$-0.30$1.80$1.86Free cash flow / shareFCF/sh
$0.59$0.62$0.42$0.43$0.45Cap. spending / shareCapex/sh
$6.41$4.96$8.54$8.53$8.94Book value / shareBVPS

The diluted share count moved ×1.64 into 2024 — shares issued, not a split the totals corroborate — and the per-share figures carry the counts as filed.

Per-share growththe realized rate an owner's share compounded
3-yr5-yr
Revenue / share−3.6%/yr−3.6%/yr (3-yr)
Capital spending / share−10.0%/yr−10.0%/yr (3-yr)
Book value / share+10.0%/yr+10.0%/yr (3-yr)

The record, charted

FY2022–2025

Each measure over its full record; the current point and the worst year marked.

Share count
220Mpeak FY2025

Owner earnings vs. net income

Owner earningsNet income

The accountant's number, and the cash an owner can take; the gap is the tell.

$395Mowner earningsvs.$191Mnet incomelow FY2022

Where the cash went

ReinvestBuybacksDividendsAcquisitionsRetainedBeyond op. cash

Each year's outlays against its operating cash: the mix, and how it drifts. The hatched cap is spending beyond that year's operating cash — financed from the balance sheet or borrowing, not operations.

FY2023FY2025

Net income is the accountant's number; owner earnings is the cash an owner could take out. The walk between them, off the cash-flow statement, and whether the gap is widening or holding.

In fiscal 2025 the business turned $191M of profit into $395M of owner earnings: more cash than the profit line showed, after the non-cash charges and the capital it put back in.

Reported net income$191M
Owner earnings$395M · 3% of revenue
FY2025FY2024FY2023FY2022
Reported net income$191M($18M)($155M)($54M)
Depreciation & amortizationnon-cash charge added back+$164M+$204M+$202M+$204M
Stock-based compensationreal costnon-cash, but a real cost+$70M+$69M+$4M+$4M
Working capital & othertiming of cash in and out, other non-cash items+$65M−$232M+$159M−$158M
Cash from operations$490M$24M$211M($5M)
Capital expenditurecash put back in to keep running and to grow−$95M−$81M−$74M−$70M
Owner earnings$395M($57M)$137M($75M)
Owner-earnings marginowner earnings ÷ revenue3%-1%2%-1%

Owner earnings is the cash an owner could pull out without starving the business: operating cash less the capital it must spend to hold its position . The cash-flow statement also adds stock comp back as non-cash, but it is a real cost paid in shares; counted as the expense it is (less $70M), owner earnings is nearer $325M.

Maintenance capex is estimated as depreciation where a growing business invests above it; free cash flow is the figure the scorecard's free-cash margin reads.

III

Quality & stewardship

Returns, the balance sheet, capital allocation, and pay.

Owner’s Scorecard

FY2025 10-K · source on SEC EDGAR →

Will it survive?

  • Thin
    Operating income $295M ÷ interest expense $157M
    What this means

    Operating profit covers interest, but with little room. A bad year, a refinancing at higher rates, or a revenue wobble closes the gap fast.

  • How heavy is the debt, net of cash? $2.4B · 8.2× operating profit
    Heavy net debt
    Cash $88M − debt $2.5B
    What this means

    Netting $88M of cash and short-term investments against $2.5B of debt leaves $2.4B owed, about 8.2× a year's operating profit (8.5× on the gross debt, before the cash). Net debt is the leverage figure that matters: the cash is already set against the debt. Strategic or illiquid investments aren't counted here.

  • Not enough data
    What this means

    The filing data didn't include the inputs for this check.

Is it a good business?

  • Below average
    NOPAT $252M ÷ invested capital $4.3B (debt + equity − cash)
    Industry peers: median 9%
    What this means

    The rate the business earns on the money tied up in it, Buffett's north star, because over time a stock tracks the ROIC beneath it. Above ~15% sustained hints at a moat; a return below the cost of capital (~8%) erodes value as a business grows rather than building it — the test Buffett weighs most. Asset-light businesses (R&D expensed, little capital) read artificially high, pair this with Owner Earnings.

  • Positive this year, negative across the cycle
    latest $395M = operating cash $490M − maintenance capex $95M (positive this year), after an earlier loss stretch (4-yr median -1%)
    Industry peers: median 9%
    What this means

    What an owner could take out without starving the business: operating cash less the maintenance capital it must spend to hold its position — Buffett's owner earnings. That's 3% of revenue this year, a -1% median across 4 years. Treating stock comp as the real expense it is (less $70M of SBC) leaves $325M.

  • Cash-backed
    Cash from ops $490M ÷ net income $191M
    What this means

    How much of reported profit showed up as operating cash. Above 1× is reassuring; well below suggests earnings lean on accruals. One year is noisy, growth and working-capital swings distort it, and this is operating cash, not free cash. Watch the multi-year trend.

How is the cash used?

  • Reinvests most of it
    Dividends + buybacks $43M ÷ Owner Earnings $395M
    What this means

    Of $395M Owner Earnings, $43M (11%) went back to shareholders, $0 dividends, $43M buybacks. But the buybacks barely exceed stock issued to employees ($70M SBC), net of dilution, little was truly returned. Returning most of it is the mark of a mature business with little left to reinvest at a high return; reinvesting most could mean a long runway, or empire-building. The split doesn't say which; the return earned on it (see ROIC) does.

  • Investing or harvesting? 0.58×
    Harvesting
    Capex $95M ÷ depreciation $164M
    What this means

    Descriptive, not a grade. Above ~1× means investing faster than assets wear out (growth, or, sustained for years, today's earnings carrying less depreciation than tomorrow's will). Below means spending less than it's wearing out (efficiency, or a melting asset base). The ratio won't tell you which; the filings will.

Graham’s defensive tests · 1 of 3 met

Graham’s numerical criteria for the defensive investor (The Intelligent Investor, ch. 14), run on the filings. A floor of safety, not a buy signal; many fine modern businesses fail his strictest liquidity rules by design.

  • Adequate size Pass
    Revenue ≥ $2B · $12.9B
    What this means

    Big enough to weather a storm. Graham's 1972 floor was ~$100M of sales (≈ $700M today); we use a $2B revenue line as a conservative modern stand-in.

  • Strong liquidity Near
    Current ratio ≥ 2× · 1.57×
    What this means

    Current assets at least twice current liabilities, near-term bills covered without touching the business. Strict by design: many cash-rich modern firms run leaner and miss it, holding their cushion in longer-dated securities.

  • Conservative debt Miss
    Debt ≤ working capital · $2.5B vs $1.0B WC
    What this means

    Graham's rule that borrowings not exceed net current assets. Capital-heavy and buyback-heavy firms routinely fail it, read it next to interest coverage, not alone.

  • Moderate price
    P/E ≤ 15 and P/E × P/B ≤ 22.5 · decided by the price
    What this means

    Graham's valuation gate, the wall he kept between a sound business and a sound investment. Three-year average earnings are $0.03/share (latest year $0.98), the averaged base the calculator's gate runs on, and book value is $9.67/share. Enter a price in “What the price implies” just below for the P/E, P/B, and whether it clears. But this is the rule Buffett outgrew: there's no hard P/E law, and a wonderful business can deserve a far richer multiple if the thesis holds, treat it as the bargain-hunter's floor, not a verdict on the price.

Durability & moat, 2022–2025

Whether the record’s returns held, and what the capital reinvested earned.

  • Profitable years 1 of 4
    What this means

    Lost money in 3 year(s), look at what happened there before trusting the average.

  • Return on capital ≥ 15% 0 of 3 yrs
    What this means

    A moat shows up as a high return on invested capital that holds year after year, not one good vintage.

  • Operating margin 2% → 2% (2-yr avg ends)

    In the filing’s words The filing attributes gains to higher prices, but the margin in the record has not followed — the claim outruns the result here.

    What this means

    Through the cycle the operating margin held roughly steady — about 2% early, 2% lately, median 1%.

  • Reinvestment, incremental ROIC returns capital
    What this means

    The capital base barely grew: this business returns cash through dividends and buybacks rather than reinvesting. Judge it on the cash returned, not on compounding.

  • Owner earnings growth +75%/yr
    What this means

    Owner earnings grew about 75% a year over the record.

  • Worst year 2023 · 0.8% op. margin
    What this means

    Stayed profitable even in its hardest year, the resilience that survives recessions.

Does AI threaten the moat?

Moderate contestability

AI is likely to reshape costs and some products here without clearly contesting or sparing the core moat; how the company itself frames it is the tell.

In its own filing Framed as a capability

The filing positions AI as something the company uses, not something it fears.

“We continue to focus on the hiring, onboarding, and training process to make it as streamlined and meaningful as possible, while also evaluating and implementing the most up-to-date technology assisted solutions, including those driven by AI.”

The question is whether a moat the record shows as durable outlasts a technology that lowers the cost of part of what the firm sells. The durability is read in the record above, the filing's own framing of AI beside it; the industry label decides nothing on its own.

Read from the filing's own risk factors, paired with the industry's structure under its SIC code; the durability is read above, the price below.

All figures as filed; the source filing is linked above.

Current Position

as of the latest quarter, Mar 31, 2026

Can the business pay what it owes this year, off the freshest balance sheet: the quality of the assets, the debt actually coming due, and what a low ratio means here.

Current assets$2.7B
  • Cash & short-term investments$889M
  • Receivables$1.1B
  • Inventory$560M
  • Other current assets$127M
Current liabilities$1.5B
  • Debt due within a year$53M
  • Accounts payable$1.1B
  • Other current liabilities$404M
Current ratio1.74×all current assets ÷ what's due · Graham looked for 2×
Quick ratio1.38×stricter: inventory excluded
Cash ratio0.57×strictest: cash alone against what's due
Working capital$1.1Bthe cushion left after near-term bills
Debt due this year vs. cash$53M due · $889M cash covered by cash on hand, no refinancing forced · both figures from the Mar 31, 2026 balance sheet
Revenue, latest quarter vs. a year ago+25.6%the freshest read on whether the business is still growing
Current ratio, recent quarters1.3× → 1.7×
Deeper floors
Tangible book value($1.1B)equity stripped of goodwill & intangibles
Net current asset value($1.5B)Graham's net-net: current assets less all liabilities
Debt incl. operating leases$2.7B$182M of it operating leases
Deferred revenue$9Mcustomer cash collected before delivery; operating float

From the company's latest filing.

How the cash was used, 2022–2025

Over the record, the business generated $720M of operating cash; how management split it reads as a balanced allocator, splitting cash between the business, owners, and the balance sheet.

  • Reinvested$320M · 44%
  • Buybacks$44M · 6%
  • Retained (debt / cash)$356M · 49%
  • Returned to owners$44M

    11% of the owner earnings the business produced over the span, $0 as dividends and $44M as buybacks.

  • Average price paid for buybacks

    Buybacks ran $44M over the span, but the filings don't tag the share count needed to deduce the average price paid.

  • Net change in share count87.8%

    The diluted count rose from 118M to 221M: issuance (stock pay, deals) outran any buybacks, so owners were diluted on net.

  • Dividend record

    No dividend line was reported in the filing data over the span; the record here neither confirms nor rules out a payout.

Buybacks are gross of stock issued to staff; the share-count line above is the net of that, the figure that decides whether owners gained. The average price paid blends a year of purchases (and any accelerated repurchase), so it is close, not exact. The record of where the cash went and on what terms.

Acquisitions & goodwill

from the balance sheet & the 4-year cash-flow record

Goodwill grows only when a company acquires and falls only when it concedes it overpaid. The size of that bet, the cash put into buying rather than building, and how much has already been written off.

Goodwill & intangibles$3.1B48% of all assets; the premium carried on the balance sheet for businesses acquired
Against book equityexceeds itgoodwill alone is larger than the company’s entire book equity; stripped of the acquisition premium, there is no net book worth
Cash spent acquiring$370Mover 4 years buying other businesses, against $320M of capital spent building

$41M written down across 1 year (2022): goodwill the company has already conceded it overpaid for, charged against earnings. A write-down costs no cash (the cash went out when the deal was signed), but it is management marking its own past judgment to market.

Goodwill, acquired intangibles and equity from the latest balance sheet; acquisition spend and write-downs summed across the 4-year record, from the company's own filings.

Management, ownership & pay

read the proxy →

From the proxy: how much of the business the people running it own, and how they are paid.

  • Insider ownership2.8%

    The stake all directors and executive officers hold together, per the 2026 proxy: skin in the game, the first thing Munger reads.

  • CEO pay ratio382:1

    What the chief earns for every dollar the median employee makes, per the 2026 proxy. A high ratio alone settles nothing; some businesses are genuinely top-heavy in scarce skill. A runaway figure is where Buffett starts asking whether the board is doing its job.

  • Stock-based compensation$70M

    The slice of the business handed to employees in shares this year, 1% of revenue, equal to 24% of operating profit. Buffett's oldest accounting fight: this is compensation, compensation is an expense, real whether or not the headline earnings admit it. One trap: the cash-flow statement adds SBC back, so the operating cash, and the owner earnings drawn from it, are flattered by exactly this amount; counted as the cost it is, what an owner keeps is lower.

Inverting the record

Invert: instead of why BrightSpring Health Services Inc. is a good business, the question is what would make owning it a mistake, and whether those marks are in the record. Disconfirming tests across 2022–2025.

2 of the 3 tests turned up something to look into; the other 1 came back clean.

  • Look hereDid the share count rise anyway?87.8%

    Diluted shares grew 87.8% over 2022–2025, even as the company spent $44M on buybacks. The repurchases were outrun by issuance — to staff, in a raise, or in a deal — and the filing says which; owners' slice still shrank. Read the buyback line beside this one, not on its own.

  • Look hereAre "one-time" charges a yearly habit?4 of 4 years

    Management took an impairment or write-down in 4 of the last 4 years, $85M in all. A charge taken almost every year is not one-time; it is the business — past deals coming due, and an admission the assets were worth less than what was paid. Munger's rule: when the "one-time" keeps happening, it is the business. Read it beside the goodwill the company still carries.

And these came back clean
  • Is it less profitable than it was?

Each test is read from the filings and is noisy alone; a flag can mark a cyclical trough or a year of heavy investment as easily as a problem. The filing says which.

What an owner would ask, FY2025

read the 10-K →
  • Which reported numbers are a judgment call?
    Management names Revenue recognition, Credit & receivables, Insurance reserves as critical estimates

    each rests partly on management's judgment; the filing's note sets out the assumptionsverify →

The questions the record and the charts do not answer on their own; each carries the figure and the place to look.

Peers, Health Care Providers & Services

The same industry, side by side on owner economics. Each figure is a through-cycle median, so a peak or trough year can’t distort it; the group median at the foot is the line to read each against.

CompanyRevenueGross marginOp. marginROICOwner earn. margin
LHLabcorp$14.0B30%11.9%8%9%
DVADaVita$13.6B14.8%13%11%
BTSGBrightSpring Health Services Inc.$12.9B1.7%6%1%
DGXQuest Diagnostics$11.0B35%14.6%10%12%
OPCHOption Care Health Inc.$5.6B22%4.6%9%4%
CHEChemed$2.5B33%14.4%30%12%
AVAHAveanna Healthcare Holdings Inc.$2.4B1.6%3%-2%
AMEDAmedisys$2.3B43%7.0%4%6%
Group median9.4%8%8%
IV

The price

What a price has to assume.

What the price implies

reverse-DCF

Type today's close and see the owner-earnings growth you'd have to believe to justify it, beside what BrightSpring Health Services Inc. has delivered.

BrightSpring Health Services Inc.’s latest year runs above its own through-cycle margin — the reported figure may flatter a peak. So the tool opens on the through-cycle base, Graham’s averaging cutting both ways; clear the toggle below to read the latest year exactly as reported.

$

Through the cycle, BrightSpring Health Services Inc. earns about $79M on its 0.6% median owner-earnings margin. This year’s 3.1% margin runs above that; the reported figure may flatter a peak you'd be paying on. Normalize, below, values the price on that through-cycle figure rather than the latest year. It comes pre-checked here for that reason, the same rule that already normalizes a trough; clear it to price the year as filed.

Base

The assumptions

9.0% = the 4.55% 10-year Treasury (Jul 15, 2026) + 4.45 points of equity premium. The rate you require is yours to set.

Enter a price above to run it.

Implied by the price
Owner-earnings growth · ’22→’25+75%/yr
Owner-earnings yield
P/E (3-yr earnings ’23–’25)
P/B
Graham’s price gate

Graham capped the multiple at 15×; Buffett and Munger let that rule go: a wonderful business can deserve 50× if the thesis holds. The gate marks the bargain-hunter's floor.

Against a high-grade bond: Graham’s yardstick bond yield%

Prefilled with the 10-year Treasury (4.55%, as of Jul 15, 2026). Edit it for today’s exact figure, or a AAA corporate yield.

Graham measured a stock against the bond you could own instead, the heart of his margin of safety. Enter a price above to weigh the owner-earnings yield against this bond.

Owner earnings $412M on 194M shares outstanding, per the 10-Q cover, as of 2026-04-28; net debt $1.6B. The if-converted diluted count is 221M, 14% above the shares outstanding: the dilution overhang (convertibles, options) a buyer inherits. The base opens on the through-cycle figure (the latest year sits above the record’s own median, and Graham’s averaging cuts both ways); clear Normalize to use the year as filed. Net of stock comp treats option pay as the expense it is. The dials set the multiple a growth belief justifies; the price, and every dollar on this page, is yours.

Cite: Owner Scorecard, "BrightSpring Health Services Inc. (BTSG), the owner's record," https://ownerscorecard.com/c/BTSG, data as of 2026-07-09.

Manual order: ← BTBT its page in the Manual BTSGU →

Industry order: ← BKD the Health Care Providers & Services chapter BTSGU →