Share count
220Mpeak FY2025
← All companies ← BTSG Manual BTU → ← BTSG Health Care Providers & Services CCM →
BTSGU, Brightspring Health Services, Inc.
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.
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
Revenue $3.6B +25.6% vs yr-ago qtr
Operating margin 3.4% yr-ago 1.8%
Net income $149M yr-ago $29M
Net margin 4.1% yr-ago 1.0%
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.
The record
Ten years of arithmetic, read across the cycle.
The record, 2022–2025
realized figures from each filing · older years to the left| 2022’22 | 2023’23 | 2024’24 | 2025’25 | TTMTTMMar 2026 | |
|---|---|---|---|---|---|
| Income statement | |||||
| $7.7B | $7.7B | $10.1B | $12.9B | $13.6B | RevenueRevenue |
| 15% | 14% | 12% | 9% | 9% | SG&A / revenueSG&A/rev |
| $188M | $58M | $108M | $295M | $366M | Operating incomeOp. inc. |
| 2.4% | 0.8% | 1.1% | 2.3% | 2.7% | Operating marginOp. mgn |
| ($54M) | ($155M) | ($18M) | $191M | $310M | Net incomeNet inc. |
| — | — | — | 15% | 12% | Effective tax rateTax rate |
| Cash flow & returns | |||||
| ($5M) | $211M | $24M | $490M | $512M | Operating cash flowOp. cash |
| $204M | $202M | $204M | $164M | $161M | DepreciationDeprec. |
| ($158M) | $159M | ($232M) | $65M | ($18M) | Working capital & otherWC & other |
| $70M | $74M | $81M | $95M | $99M | CapexCapex |
| 0.9% | 1.0% | 0.8% | 0.7% | 0.7% | Capex / revenueCapex/rev |
| ($75M) | $137M | ($57M) | $395M | $412M | Owner earningsOwner earn. |
| −1.0% | 1.8% | −0.6% | 3.1% | 3.0% | Owner earnings marginOE mgn |
| ($75M) | $137M | ($57M) | $395M | $412M | Free cash flowFCF |
| −1.0% | 1.8% | −0.6% | 3.1% | 3.0% | Free cash flow marginFCF mgn |
| $42M | $63M | $60M | $205M | $240M | AcquisitionsAcquis. |
| — | $650K | $650K | $43M | — | BuybacksBuybacks |
| — | — | 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 | $889M | Cash & investmentsCash+inv |
| — | $882M | $903M | $990M | $1.1B | ReceivablesReceiv. |
| — | $403M | $637M | $815M | $560M | InventoryInvent. |
| — | $642M | $924M | $1.2B | $1.1B | Accounts payablePayables |
| — | $643M | $615M | $587M | $582M | Operating working capitalOper. WC |
| — | $1.5B | $1.9B | $2.9B | $2.7B | Current assetsCur. assets |
| — | $1.2B | $1.4B | $1.8B | $1.5B | Current liabilitiesCur. liab. |
| — | 1.2× | 1.3× | 1.6× | 1.7× | Current ratioCurr. ratio |
| $2.6B | $2.3B | $2.4B | $2.5B | $2.5B | GoodwillGoodwill |
| — | $5.5B | $5.9B | $6.4B | $6.2B | Total assetsAssets |
| — | $3.4B | $2.6B | $2.5B | $2.5B | Total debtDebt |
| — | $3.4B | $2.5B | $2.4B | $1.6B | Net debt / (cash)Net debt |
| 0.8× | 0.2× | 0.6× | 1.9× | 2.4× | Interest coverageInt. cov. |
| $755M | $585M | $1.6B | $1.9B | $2.0B | Shareholders’ equityEquity |
| 0.0% | 0.1% | 0.7% | 0.5% | 0.4% | Stock comp / revenueSBC/rev |
| Per share | |||||
| 118M | 118M | 193M | 220M | 221M | Shares out (diluted)Shares |
| $65.52 | $65.25 | $52.19 | $58.74 | $61.66 | Revenue / shareRev/sh |
| $-0.46 | $-1.31 | $-0.09 | $0.87 | $1.40 | EPS (diluted)EPS |
| $-0.63 | $1.16 | $-0.30 | $1.80 | $1.86 | Owner earnings / shareOE/sh |
| $-0.63 | $1.16 | $-0.30 | $1.80 | $1.86 | Free cash flow / shareFCF/sh |
| $0.59 | $0.62 | $0.42 | $0.43 | $0.45 | Cap. spending / shareCapex/sh |
| $6.41 | $4.96 | $8.54 | $8.53 | $8.94 | Book 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-yr | 5-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
FY2022–2025Each measure over its full record; the current point and the worst year marked.
Owner earnings vs. net income
Owner earningsNet incomeThe 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. cashEach 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.
| FY2025 | FY2024 | FY2023 | FY2022 | |
|---|---|---|---|---|
| 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 ÷ revenue | 3% | -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.
Quality & stewardship
Returns, the balance sheet, capital allocation, and pay.
Owner’s Scorecard
FY2025 10-K · source on SEC EDGAR →
Will it survive?
- ThinOperating 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 profitHeavy net debtCash $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 averageNOPAT $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 cyclelatest $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-backedCash 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 itDividends + 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×HarvestingCapex $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 PassRevenue ≥ $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 NearCurrent 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 MissDebt ≤ 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 contestabilityAI 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, 2026Can 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 recordGoodwill 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.
| Company | Revenue | Gross margin | Op. margin | ROIC | Owner earn. margin |
|---|---|---|---|---|---|
| LHLabcorp | $14.0B | 30% | 11.9% | 8% | 9% |
| DVADaVita | $13.6B | — | 14.8% | 13% | 11% |
| BTSGUBrightspring Health Services, Inc. | $12.9B | — | 1.7% | 6% | 1% |
| DGXQuest Diagnostics | $11.0B | 35% | 14.6% | 10% | 12% |
| OPCHOption Care Health Inc. | $5.6B | 22% | 4.6% | 9% | 4% |
| CHEChemed | $2.5B | 33% | 14.4% | 30% | 12% |
| AVAHAveanna Healthcare Holdings Inc. | $2.4B | — | 1.6% | 3% | -2% |
| AMEDAmedisys | $2.3B | 43% | 7.0% | 4% | 6% |
| Group median | — | — | 9.4% | 8% | 8% |
The price
What a price has to assume.
What the price implies
reverse-DCFType 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.
A dated snapshot of the price you typed, the assumptions you set, and what the page showed for them. A snapshot is never edited after it is saved. Your notebook is yours alone — the commitment states what is stored and what we will never do.
Implied by the price—
Owner-earnings growth · ’22→’25+75%/yr
Owner-earnings growth · ’22→’25+75%/yr
Owner-earnings yield—
What a growth belief costs, in multiples
The growth each return requires, at your price
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 yield—
High-grade bond yield—
Margin over the 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. (BTSGU), the owner's record," https://ownerscorecard.com/c/BTSGU, data as of 2026-07-09.
Manual order: ← BTSG its page in the Manual BTU →
Industry order: ← BTSG the Health Care Providers & Services chapter CCM →