BrightSpring Health Services (BTSG)
Market Price (12/29/2025): $37.75 | Market Cap: $7.7 BilSector: Health Care | Industry: Health Care Services
BrightSpring Health Services (BTSG)
Market Price (12/29/2025): $37.75Market Cap: $7.7 BilSector: Health CareIndustry: Health Care Services
Investment Highlights Why It Matters Detailed financial logic regarding cash flow yields vs trend-riding momentum.
| Strong revenue growthRev Chg LTMRevenue Change % Last Twelve Months (LTM) is 37% | Trading close to highsDist 52W High is -0.7%, Dist 3Y High is -0.7% | Expensive valuation multiplesP/EBITPrice/EBIT or Price/(Operating Income) ratio is 23x, P/EPrice/Earnings or Price/(Net Income) is 59x |
| Low stock price volatilityVol 12M is 46% | Stock price has recently run up significantly12M Rtn12 month market price return is 122% | |
| Megatrend and thematic driversMegatrends include Aging Population & Chronic Disease, and Digital Health & Telemedicine. Themes include Geriatric Care, Remote Patient Monitoring, Show more. | Valuation getting more expensiveP/S 6M Chg %Price/Sales change over 6 months. Declining P/S indicates valuation has become less expensive. is 52% | |
| Yield minus risk free rate is negativeERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -2.5% | ||
| Key risksBTSG key risks include [1] a substantial debt burden, Show more. |
| Strong revenue growthRev Chg LTMRevenue Change % Last Twelve Months (LTM) is 37% |
| Low stock price volatilityVol 12M is 46% |
| Megatrend and thematic driversMegatrends include Aging Population & Chronic Disease, and Digital Health & Telemedicine. Themes include Geriatric Care, Remote Patient Monitoring, Show more. |
| Trading close to highsDist 52W High is -0.7%, Dist 3Y High is -0.7% |
| Expensive valuation multiplesP/EBITPrice/EBIT or Price/(Operating Income) ratio is 23x, P/EPrice/Earnings or Price/(Net Income) is 59x |
| Stock price has recently run up significantly12M Rtn12 month market price return is 122% |
| Valuation getting more expensiveP/S 6M Chg %Price/Sales change over 6 months. Declining P/S indicates valuation has become less expensive. is 52% |
| Yield minus risk free rate is negativeERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -2.5% |
| Key risksBTSG key risks include [1] a substantial debt burden, Show more. |
Why The Stock Moved
Qualitative Assessment
AI Analysis | Feedback
Here are the key points highlighting why BrightSpring Health Services (BTSG) stock moved by 59.3% based on available information up to late 2025:
1. Strong Financial Performance and Upgraded Guidance. The company reported robust year-over-year increases in net revenue and Adjusted EBITDA throughout 2024, consistently beating analyst estimates. This strong performance led to increased full-year 2024 guidance for both revenue and Adjusted EBITDA, and positive outlooks for 2025, signaling sustained growth to investors.
2. Explosive Growth in Specialty and Infusion Pharmacy. The Pharmacy Solutions segment, particularly specialty and infusion pharmacy, was a significant driver of revenue growth, with some reports calling it "explosive growth". The company's success in winning new limited distribution oncology drugs further contributed to this segment's strong performance and investor confidence.
Show more
1. Strong Financial Performance and Upgraded Guidance. The company reported robust year-over-year increases in net revenue and Adjusted EBITDA throughout 2024, consistently beating analyst estimates. This strong performance led to increased full-year 2024 guidance for both revenue and Adjusted EBITDA, and positive outlooks for 2025, signaling sustained growth to investors.
2. Explosive Growth in Specialty and Infusion Pharmacy. The Pharmacy Solutions segment, particularly specialty and infusion pharmacy, was a significant driver of revenue growth, with some reports calling it "explosive growth". The company's success in winning new limited distribution oncology drugs further contributed to this segment's strong performance and investor confidence.
Show more
Stock Movement Drivers
Fundamental Drivers
The 37.8% change in BTSG stock from 9/28/2025 to 12/28/2025 was primarily driven by a 86.9% change in the company's Net Income Margin (%).| 9282025 | 12282025 | Change | |
|---|---|---|---|
| Stock Price ($) | 27.39 | 37.75 | 37.82% |
| Change Contribution By | LTM | LTM | |
| Total Revenues ($ Mil) | 12568.28 | 13301.16 | 5.83% |
| Net Income Margin (%) | 0.52% | 0.97% | 86.88% |
| P/E Multiple | 84.36 | 59.28 | -29.74% |
| Shares Outstanding (Mil) | 201.81 | 203.49 | -0.83% |
| Cumulative Contribution | 37.81% |
Market Drivers
9/28/2025 to 12/28/2025| Return | Correlation | |
|---|---|---|
| BTSG | 37.8% | |
| Market (SPY) | 4.3% | 53.0% |
| Sector (XLV) | 15.2% | 28.9% |
Fundamental Drivers
The 60.4% change in BTSG stock from 6/29/2025 to 12/28/2025 was primarily driven by a 101.9% change in the company's Net Income Margin (%).| 6292025 | 12282025 | Change | |
|---|---|---|---|
| Stock Price ($) | 23.54 | 37.75 | 60.37% |
| Change Contribution By | LTM | LTM | |
| Total Revenues ($ Mil) | 11858.83 | 13301.16 | 12.16% |
| Net Income Margin (%) | 0.48% | 0.97% | 101.88% |
| P/E Multiple | 82.68 | 59.28 | -28.30% |
| Shares Outstanding (Mil) | 201.00 | 203.49 | -1.23% |
| Cumulative Contribution | 60.34% |
Market Drivers
6/29/2025 to 12/28/2025| Return | Correlation | |
|---|---|---|
| BTSG | 60.4% | |
| Market (SPY) | 12.6% | 44.2% |
| Sector (XLV) | 17.0% | 24.7% |
Fundamental Drivers
The 121.8% change in BTSG stock from 12/28/2024 to 12/28/2025 was primarily driven by a 65.8% change in the company's P/S Multiple.| 12282024 | 12282025 | Change | |
|---|---|---|---|
| Stock Price ($) | 17.02 | 37.75 | 121.80% |
| Change Contribution By | LTM | LTM | |
| Total Revenues ($ Mil) | 9699.79 | 13301.16 | 37.13% |
| P/S Multiple | 0.35 | 0.58 | 65.82% |
| Shares Outstanding (Mil) | 198.49 | 203.49 | -2.52% |
| Cumulative Contribution | 121.66% |
Market Drivers
12/28/2024 to 12/28/2025| Return | Correlation | |
|---|---|---|
| BTSG | 121.8% | |
| Market (SPY) | 17.0% | 45.5% |
| Sector (XLV) | 13.8% | 29.1% |
Fundamental Drivers
nullnull
Market Drivers
12/29/2023 to 12/28/2025| Return | Correlation | |
|---|---|---|
| BTSG | ||
| Market (SPY) | 48.4% | 38.4% |
| Sector (XLV) | 17.8% | 27.8% |
Price Returns Compared
| 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Total [1] | |
|---|---|---|---|---|---|---|---|
| Returns | |||||||
| BTSG Return | - | - | - | - | 55% | 122% | 243% |
| Peers Return | 16% | 38% | -12% | 21% | 26% | 16% | 150% |
| S&P 500 Return | 16% | 27% | -19% | 24% | 23% | 18% | 114% |
Monthly Win Rates [3] | |||||||
| BTSG Win Rate | - | - | - | - | 75% | 58% | |
| Peers Win Rate | 52% | 65% | 42% | 68% | 57% | 52% | |
| S&P 500 Win Rate | 58% | 75% | 42% | 67% | 75% | 73% | |
Max Drawdowns [4] | |||||||
| BTSG Max Drawdown | - | - | - | - | -25% | -8% | |
| Peers Max Drawdown | -34% | -5% | -26% | -7% | -9% | -23% | |
| S&P 500 Max Drawdown | -31% | -1% | -25% | -1% | -2% | -15% | |
[1] Cumulative total returns since the beginning of 2020
[2] Peers: HPQ, HPE, IBM, CSCO, AAPL.
[3] Win Rate = % of calendar months in which monthly returns were positive
[4] Max drawdown represents maximum peak-to-trough decline within a year
[5] 2025 data is for the year up to 12/26/2025 (YTD)
How Low Can It Go
BTSG has limited trading history. Below is the Health Care sector ETF (XLV) in its place.
| Event | XLV | S&P 500 |
|---|---|---|
| 2022 Inflation Shock | ||
| % Loss | -16.1% | -25.4% |
| % Gain to Breakeven | 19.1% | 34.1% |
| Time to Breakeven | 599 days | 464 days |
| 2020 Covid Pandemic | ||
| % Loss | -28.8% | -33.9% |
| % Gain to Breakeven | 40.4% | 51.3% |
| Time to Breakeven | 116 days | 148 days |
| 2018 Correction | ||
| % Loss | -15.8% | -19.8% |
| % Gain to Breakeven | 18.8% | 24.7% |
| Time to Breakeven | 326 days | 120 days |
| 2008 Global Financial Crisis | ||
| % Loss | -40.6% | -56.8% |
| % Gain to Breakeven | 68.3% | 131.3% |
| Time to Breakeven | 1,100 days | 1,480 days |
Compare to HPQ, HPE, IBM, CSCO, AAPL
In The Past
SPDR Select Sector Fund's stock fell -16.1% during the 2022 Inflation Shock from a high on 4/8/2022. A -16.1% loss requires a 19.1% gain to breakeven.
Preserve Wealth
Limiting losses and compounding gains is essential to preserving wealth over time.
Asset Allocation
Actively managed asset allocation strategies protect wealth. Learn more.
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. We are an essential part of our nation’s health delivery network as a front-line provider of high-quality and cost-effective care to a large and growing number of people, who increasingly require a combination of specialized solutions to enable holistic health care management. Our presence spans all 50 states, we serve over 400,000 patients daily through our approximately 10,000 clinical providers and pharmacists, and our services make a profound impact in the lives and communities of the people we serve. Our model focuses on delivering high-touch and coordinated services to medically complex clients and patients, which is a large, growing, and underserved population in the U.S. healthcare system. These high-need and high-cost Senior and Specialty patients comprise a market of over $1.0 trillion across our business. The chronic conditions and long-term health needs of these patients not only represent an outsized share of health care spend today, according to RAND, but we believe that they are expected to also drive a disproportionate share of future expenditures. Americans with five or more chronic conditions make up over 10% of the population and account for 40% of total health care spending, on average spending 10 times more on health services than those without chronic conditions. These patients most often require both pharmacy and provider services to achieve the best outcomes, but must often navigate disjointed and separately-administered health services. This can result in uncoordinated care delivery with adverse medical consequences, as compared to receiving timely, proximal, and complete care support in the home and community that improves health and reduces cost. We have built a significant presence and capability in delivering complementary and high-touch daily healthcare services and programs to complex patients in their homes and in communities in order to address their multiple health needs and requirements more completely. In pharmacy, we leverage our national infrastructure to provide daily medication therapy management to various customer and patient types wherever they reside in the community, including home and in-clinic infusion patients, oncology and other specialty patients in their homes, residents of independent and senior living communities, people receiving hospice care, neuro and Behavioral clients’ and patients’ homes, residents of skilled nursing and rehabilitation facilities, hospital patients, and the homes of Seniors who are on a significant number of medications. Within provider services, we address the clinical and supportive care needs of Senior and Specialty populations, including neuro and Behavioral patients, primarily in their homes, as well as some clinic and community settings. Our clinical services consist of home health and hospice and rehab therapy, and our supportive care services address activities of daily living and social determinants of health as well. We also provide home-based primary care for patients in senior living communities, long-term care, and individual homes to directly manage and optimize patient outcomes and to enable value-based care. By providing these complementary and necessary services for complex patients, our care model is designed to address multiple patient needs and better integrate health services delivery to improve quality and patient experiences, while reducing overall costs. We believe that our Company addresses important needs today and is also well-positioned for the long-term, as it is underpinned by capabilities and characteristics that suggest continued differentiation and growth: • Complementary pharmacy and provider services that address multiple patient needs – We have a healthcare platform that can combine pharmacy and provider care in order to address the spectrum of interrelated and chronic needs that Senior and Specialty patients possess. Through our comprehensive care capabilities, we are able to develop longitudinal relationships and views of our patients, which enables us to more closely manage daily medication requirements and adherence, provide primary care and other skilled nursing and therapy clinical services, and address social determinants of health and daily care needs. Moreover, we believe that this integrated model and capability set will increasingly be a more effective approach for providing high-need and high-cost Senior and Specialty populations the pharmacy and care services solutions they require. • Effectively serving complex patients in the home and community setting – With over 40 years of experience caring for “must-serve” client and patient populations, we deliver care in preferred and lower-cost settings with strong quality results. Our services reduce cost by providing care for many of these individuals in non-institutional home and community settings and reducing hospitalizations. For example, across our pharmacies, we achieve 99.99% order accuracy and 98.46% order completeness, “excellent” and “world class” NPS, and a reduction in hospitalizations with CCRx, while also driving savings through medication adherence and therapeutic interchanges. We achieve 99% patient satisfaction in our outpatient rehab services, an 84% overall rating of care in hospice, and, as reported by the Agency for Healthcare Research and Quality, hospitalizations 30% lower than the national average in our home-based primary care. Our complex Behavioral clients, often with three or more comorbidities and requiring eight or more medications, are still able to spend 359 days a year at home on average. We believe that we are positioned to identify potential medical problems and avoid adverse events due to our highly proximate position to patients. • Market-leading scale with a focus on operational excellence and coordinated front-line care – We manage one of the nation’s largest independent platforms of both pharmacy and provider services offered on a daily basis in home and community settings – to address the multiple needs of medically complex Senior and Specialty patients. Our leading scale across all 50 states has important benefits. Our scale provides complementary diversification and risk mitigation in payor sources, end markets, and geographies, while also creating exposure and access to a broader set of market growth opportunities. Further, we leverage economies of scale and best practices across the company, including in purchasing and all supplier contracting, quality, technology, human resources, and advocacy and payor relations. Scale from our pharmacy and provider businesses allow us to effectively deliver and coordinate integrated solutions to and across patient types and care settings, which we believe will be more important in the ongoing development of value-based care solutions. Ultimately, our track record of building market density, expanding core services to additional customer and patient types, and replicating this model across new geographies underpins both our historical results as well as our growth strategies. We are one of the largest independent providers of home and community-based health services in the United States, offering skilled, complementary, integrated, and impactful health care solutions. Almost all of the clients and patients that we serve have chronic conditions and the vast majority of them receive their services on a recurring basis over long periods of time. In our pharmacy business, patients have an average of nine prescriptions at a given time and are supported by our local pharmacy model that delivers daily services, often within an hour or two, from over 180 pharmacies, infusion centers, and specialty oncology locations across all 50 states. We have specifically focused on and built a fast, local, and “white-glove” delivery model that is supported by expert clinical teams in the field, which fulfilled over 34 million prescriptions in 2022 across customer and patient settings and types. Patients who receive our provider services average six chronic conditions per patient, and we delivered approximately 20 million hours of quality and compassionate care in 2022 to home health, hospice, rehab, and home care patients and clients. Combined, our daily pharmacy and provider services are delivered from and to approximately 9,500 office, clinic, and customer locations across the country, with over 400,000 patients serviced at any one time, including over 250,000 patients served in their homes at any one time. --- We believe the historical results of the Company are due to both our scale and diversified yet complementary services, which have underpinned historical financial stability while also enabling us to grow and pursue opportunities in attractive markets principally in home and community settings. We target customer and patient markets that exhibit strong demand, where we can leverage our scale and infrastructure, and where our services have a clear and tangible value proposition, for example improving quality and reducing healthcare system costs. We also seek to expand our services through targeted de novo locations, accretive acquisitions, and integrated care opportunities, i.e., providing care management and multiple needed services to a patient. The Pharmacy Solutions segment revenue totaled $5,264.4 million in 2022, accounting for 68.3% of total revenue, with Segment EBITDA of $344.5 million, accounting for 52.7% of total Segment EBITDA. The Provider Services segment revenue totaled $2,181.5 million in 2022, accounting for 28.2% of total revenue, with Segment EBITDA of $288.8 million, accounting for 44.2% of total Segment EBITDA. We believe that underlying market growth combined with our scale, integrated services platform, operating capabilities, and acquisition opportunity set have allowed us to grow and increase market share. From 2020 to 2022, we have grown revenue from $5,580.4 million to $7,720.6 million, primarily from organic growth along with strategic acquisitions. From 2020 to 2022, net income (loss) decreased from $21.2 million to $(54.2) million and Adjusted EBITDA increased from $407.8 million to $522.5 million. Longer term, our compound annual growth rate, or CAGR, from 2018 (including the legacy business of BrightSpring Health Holdings Corp. and its subsidiaries prior to the BHS Acquisition in March 2019 for comparability) to 2022 in Revenue and Adjusted EBITDA was 15% and 15%, respectively. For the nine months ended September 30, 2023, total revenue was $6,451.6 million, representing a 12.2% increase from $5,749.9 million in the nine months ended September 30, 2022. For the nine months ended September 30, 2023 and 2022, our net (loss) income was $(148.1) million and $2.3 million, respectively. For the nine months ended September 30, 2023, Adjusted EBITDA was $395.2 million, representing a 3.1% increase from $383.5 million in the nine months ended September 30, 2022. Impacting comparability, our results for the nine months ended September 30, 2022 included $247.4 million of revenue and $18.1 million of Segment EBITDA relating to our Other segment comprised of Workforce Solutions, which we divested in November 2022. Through our predecessors, we commenced operations in 1974 and have grown organically and through acquisitions. We were incorporated in Delaware on July 19, 2017, as Phoenix Parent Holdings Inc., in connection with KKR Stockholder’s and Walgreen Stockholder’s acquisition of PharMerica Corporation, which was completed in December 2017. In March 2019, we acquired BrightSpring Health Holdings Corp. and its subsidiaries. We changed our name to BrightSpring Health Services, Inc. in May 2021. Our principal offices are located at 805 N. Whittington Parkway, Louisville, Kentucky.
AI Analysis | Feedback
Here are 1-2 brief analogies for BrightSpring Health Services (BTSG):1. Like the home care and specialized pharmacy divisions of a major health insurer like Humana or Optum, but as an independent company. 2. The home healthcare version of Optum.
AI Analysis | Feedback
- Home and Community-Based Services: Provides comprehensive non-clinical and clinical support services for individuals with intellectual and developmental disabilities, seniors, and those requiring post-acute care in their homes or communities.
- Pharmacy Services: Offers specialized pharmacy solutions, including institutional and home infusion pharmacy services, focusing on medication management for complex patient populations.
- Rehabilitation Services: Delivers physical, occupational, and speech therapy services across various care settings, helping patients recover and improve functional abilities.
AI Analysis | Feedback
BrightSpring Health Services (symbol: BTSG) primarily sells its services to other companies and entities, which act as payors or direct institutional customers for the care and pharmacy services it provides. While individuals are the ultimate recipients of care, the direct contractual relationships and payment streams are largely with these organizations. BrightSpring's major customers fall into the following categories: *Managed Care Organizations (MCOs)
BrightSpring contracts with numerous Managed Care Organizations to provide home and community-based health services to their members, particularly those enrolled in Medicaid and Medicare Advantage plans. These organizations act as significant payors for BrightSpring's services. While BrightSpring's regulatory filings do not disclose specific revenue concentration from any single MCO, it is understood to contract with many of the leading players in the industry. Examples of major public MCOs include:- UnitedHealth Group (UNH)
- Centene Corporation (CNC)
- Elevance Health (ELV)
Institutional Healthcare Providers
For its Pharmacy Services segment, BrightSpring directly serves various healthcare facilities. These institutions are direct customers that contract with BrightSpring for pharmacy services. This category includes:- Long-term care facilities (e.g., nursing homes, assisted living facilities)
- Correctional facilities (jails, prisons)
- Behavioral health facilities
- Hospice providers
AI Analysis | Feedback
null
AI Analysis | Feedback
Jon Rousseau, President and Chief Executive Officer
Jon Rousseau is a seasoned executive with extensive experience leading multi-billion dollar healthcare organizations, particularly in pharmacy solutions and home health services. He has a strong background in accounting and financial management, successfully navigating complex corporate strategies and executing numerous acquisitions throughout his career. Before joining BrightSpring in 2016, he was an Executive Vice President at Kindred Healthcare, Inc., serving as President of Kindred Rehabilitation Services and President of the Care Management and Kindred at Home Divisions. Earlier, he held senior leadership positions at Mylan, Inc. and Medtronic PLC. Rousseau also worked with the private equity firm Friedman Fleischer & Lowe LLC from 1998 to 2005 and in Mergers and Acquisitions and Investment Banking at Morgan Stanley from 1996 to 1998. Under his leadership, BrightSpring was acquired by global investment firm KKR and an affiliate of Walgreens Boots Alliance Inc. in March 2019, merging with PharMerica. He holds an MBA from Harvard Business School and an A.B. degree from Princeton University.
Jennifer Phipps, Executive Vice President and Chief Financial Officer
Jennifer Phipps was promoted to Chief Financial Officer on March 4, 2025, succeeding Jim Mattingly. With eight years at BrightSpring Health Services, she previously served as Chief Accounting Officer and CFO of BrightSpring's Home Health and Hospice segment. Her contributions include significant improvements in financial processes, technology implementation, and her involvement in the company's initial public offering. Prior to BrightSpring, Ms. Phipps accumulated over 20 years of experience in the healthcare sector, including senior accounting positions at Cardinal Health and six years at Ernst & Young, where she focused on auditing financial statements. She is a CPA and holds Bachelor's and Master's degrees in Accounting from The Ohio State University.
Rachael Kurzer Givens, Chief Compliance Officer
Rachael Kurzer Givens has been a key member of BrightSpring's quality and regulatory compliance team for over 20 years, holding various leadership roles. As Chief Compliance Officer, she is responsible for overseeing all compliance practices, establishing internal policies and procedures to ensure adherence to local, state, federal, and third-party regulations, and managing audits and investigations. Before joining BrightSpring, she served as a quality enhancement coordinator for a multi-state intellectual and developmental disabilities provider. Ms. Givens earned a Master of Science degree in rehabilitation counseling from Virginia Commonwealth University and a bachelor's degree from North Carolina State University. She is also certified in health care compliance.
Lisa Nalley, Chief of Staff and Senior Vice President, Human Resources
Lisa Nalley has served as Chief of Staff since February 2017 and Senior Vice President of Human Resources since August 2020, also leading the Executive Project Management Office. Her operational experience allows her to work closely with the CEO, CFO, presidents, and operating leaders. Before her tenure at BrightSpring, Ms. Nalley was a business consultant at Barrel Consulting, LLC. From 2003 to 2016, she held various business improvement roles at Kindred Healthcare, Inc., including Sr. Director of Strategic Initiatives for Kindred Rehabilitation Services and Kindred at Home. She holds an A.A.S. in Applied Science in paralegal science from Marshall University. Ms. Nalley has also engaged in insider stock sales.
Bob Barnes, President, ResCare Community Living
Bob Barnes has been President of ResCare Community Living, a BrightSpring Health Services brand, since July 2018, bringing over 20 years of experience in the health services field. In his role, he focuses on core operational processes and growth strategies, utilizing technology-led initiatives to enhance quality and outcome-based care. Prior to joining BrightSpring, Mr. Barnes was the Senior Vice President of Operations at Trilogy Health Services, LLC from 2016 to 2018, where he managed national healthcare operations. His previous experience also includes serving as Chief Operating Officer at Affinity Health Services, Inc. and holding operational leadership positions at Guardian Elder Care Holdings, Inc. Mr. Barnes holds a Bachelor of Science degree in nursing from Mount Aloysius College and a Nursing Home Administration certification from Slippery Rock University.
AI Analysis | Feedback
BrightSpring Health Services (BTSG) faces several key risks to its business, primarily stemming from its financial structure, the highly regulated healthcare environment, and operational challenges.
- High Debt and Thin Margins: BrightSpring Health Services carries a substantial debt load and operates with narrow profit margins, which poses a significant risk to its financial health. The company's net debt was approximately $3.48 billion as of the third quarter of 2023, and around $2.61 billion in June 2024. Furthermore, its earnings before interest and taxes (EBIT) decreased by 64% over the last year, which could complicate its ability to manage this debt. The company has also reported negative free cash flow, specifically -$368 million and -$301 million in different periods, raising concerns about its financial flexibility and capacity to service its obligations. The IPO itself was described as "underwhelming" due to these concerns about high debt and slim margins.
- Regulatory Changes and Reimbursement Pressures: Operating within a highly regulated industry, BrightSpring is vulnerable to changes in healthcare policies and reimbursement rates. The Centers for Medicare & Medicaid Services (CMS) has proposed changes that could impact reimbursement rates, directly affecting the company's revenue and financial stability. The broader effort to reduce healthcare costs in the U.S. also increases the risk of reduced reimbursement from programs like Medicaid and Medicare.
- Workforce Management and Intense Competition: The company faces challenges in recruiting and retaining qualified healthcare professionals, with the healthcare industry experiencing high annual turnover rates, potentially reaching 20%. This can lead to increased costs for recruitment and training. Additionally, the healthcare sector is intensely competitive, with BrightSpring contending with both large integrated healthcare systems and smaller regional providers, which could impact its market share and pricing power.
AI Analysis | Feedback
BrightSpring Health Services (BTSG) faces a clear emerging threat from the aggressive vertical integration and direct care delivery expansion by large payers and healthcare conglomerates. Major entities such as Optum (UnitedHealth Group), CVS Health (through acquisitions like Signify Health and Oak Street Health), and Humana (via its CenterWell brand) are rapidly building comprehensive, integrated care networks that encompass home-based care, pharmacy services, and behavioral health. This strategic shift aims to control more of the care continuum, manage costs, and improve outcomes within their own ecosystems, potentially reducing reliance on independent third-party providers like BrightSpring. As these powerful players internalize services that BrightSpring traditionally provides, they exert significant competitive pressure on contract terms, market share, and the overall demand for external specialized healthcare services.
AI Analysis | Feedback
nullAI Analysis | Feedback
BrightSpring Health Services (BTSG) is expected to drive future revenue growth over the next 2-3 years through several key strategies:
- Expansion in Specialty and Infusion Pharmacy: The company anticipates continued strong growth in its Pharmacy Solutions segment, particularly within specialty and infusion pharmacy services. This growth is fueled by strategic initiatives such as expanding its portfolio of limited distribution drugs (LDDs) and launching new LDDs. Management expects 16 to 18 additional LDD launches over the next 12 to 18 months, which is projected to drive significant script growth in these high-value areas.
- Strategic Acquisitions and Organic Growth in Provider Services: BrightSpring is focused on both strategic acquisitions and organic growth initiatives within its Provider Services segment, specifically in home healthcare and rehabilitation care. The company anticipates closing recent acquisitions of Amedisys and LHC Home Health branches, which are expected to contribute to market penetration and revenue growth in this segment.
- Investments in Operational Efficiency and Technology: The company is making significant investments in operational efficiency, including the adoption of AI technology and lean methodologies across its service lines. While not a direct revenue driver, these improvements are expected to support overall financial performance by enhancing service delivery, optimizing operations, and potentially allowing for increased capacity to serve more customers.
- Leveraging Favorable Demographic Trends and Integrated Care Models: BrightSpring is well-positioned to capitalize on demographic trends, such as an aging population and increasing demand for home- and community-based healthcare services. The company's diversified and integrated home- and community-based pharmacy and health solutions are designed to meet the needs of complex populations, driving market share gains and supporting sustainable long-term top-line growth.
AI Analysis | Feedback
BrightSpring Health Services (BTSG) has made the following significant capital allocation decisions over the last 3-5 years:Share Repurchases
- BrightSpring authorized a concurrent repurchase of 1,500,000 shares, or up to $50 million, from an underwriter as part of a secondary offering by existing stockholders that closed on October 22, 2025.
Share Issuance
- BrightSpring completed its Initial Public Offering (IPO) in January 2024, pricing 53,333,334 shares of common stock at $13.00 per share.
- Concurrently with the IPO, the company offered 8,000,000 of its 6.75% tangible equity units at $50.00 per unit.
- The net proceeds from these IPO offerings amounted to $656.5 million for common stock and $389.0 million for the tangible equity units, after deducting offering-related expenses. These proceeds were used to repay debt and for general corporate purposes.
Outbound Investments
- BrightSpring has pursued a strategy of "tuck-in acquisitions" to enhance market penetration and density, including a Maryland home health operation (January 2024), a Michigan behavioral therapy company (March 2024), and a Montana long-term care pharmacy (March 2024).
- The company finalized the acquisition of Haven Hospice assets in North Central Florida for $60 million, marking its entry into the Florida market for comprehensive hospice care.
- BrightSpring anticipates the acquisition of Amedisys and LHC Home Health Branch assets to close in the fourth quarter of 2025.
- In January 2025, BrightSpring announced a definitive agreement to divest its Community Living business (ResCare Community Living) to Sevita for $835 million in cash, with the transaction expected to close in the first quarter of 2026. The after-tax cash proceeds of approximately $715 million are primarily intended for debt reduction.
Capital Expenditures
- The Community Living business, which BrightSpring is divesting, was expected to incur approximately $23 million in capital expenditures and capital leases in 2024.
Latest Trefis Analyses
| Title | |
|---|---|
| ARTICLES |
Trade Ideas
Select ideas related to BTSG. For more, see Trefis Trade Ideas.
| Date | Ticker | Company | Category | Trade Strategy | 6M Fwd Rtn | 12M Fwd Rtn | 12M Max DD |
|---|---|---|---|---|---|---|---|
| 11142025 | CRL | Charles River Laboratories International | Dip Buy | DB | FCFY OPMDip Buy with High FCF Yield and High MarginBuying dips for companies with high FCF yield and meaningfully high operating margin | 21.4% | 21.4% | -3.7% |
| 11142025 | GDRX | GoodRx | Dip Buy | DB | CFO/Rev | Low D/EDip Buy with High Cash Flow MarginsBuying dips for companies with significant cash flows from operations and reasonable debt / market cap | -7.4% | -7.4% | -11.8% |
| 11142025 | ASTH | Astrana Health | Dip Buy | DB | FCF Yield | Low D/EDip Buy with High Free Cash Flow YieldBuying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap | 18.0% | 18.0% | -5.5% |
| 11142025 | SGRY | Surgery Partners | Dip Buy | DB | FCF Yield | Low D/EDip Buy with High Free Cash Flow YieldBuying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap | 3.9% | 3.9% | -1.4% |
| 11072025 | TFX | Teleflex | Dip Buy | DB | FCFY OPMDip Buy with High FCF Yield and High MarginBuying dips for companies with high FCF yield and meaningfully high operating margin | 12.2% | 12.2% | -5.1% |
Research & Analysis
Invest in Strategies
Wealth Management
Peer Comparisons for BrightSpring Health Services
| Peers to compare with: |
Financials
| Median | |
|---|---|
| Name | |
| Mkt Price | 57.95 |
| Mkt Cap | 158.8 |
| Rev LTM | 56,496 |
| Op Inc LTM | 7,584 |
| FCF LTM | 7,327 |
| FCF 3Y Avg | 7,366 |
| CFO LTM | 8,590 |
| CFO 3Y Avg | 8,697 |
Growth & Margins
| Median | |
|---|---|
| Name | |
| Rev Chg LTM | 7.4% |
| Rev Chg 3Y Avg | 3.2% |
| Rev Chg Q | 9.4% |
| QoQ Delta Rev Chg LTM | 2.1% |
| Op Mgn LTM | 12.1% |
| Op Mgn 3Y Avg | 11.9% |
| QoQ Delta Op Mgn LTM | 0.2% |
| CFO/Rev LTM | 14.6% |
| CFO/Rev 3Y Avg | 17.1% |
| FCF/Rev LTM | 11.6% |
| FCF/Rev 3Y Avg | 12.1% |
Segment Financials
Revenue by Segment| $ Mil | 2024 | 2023 | 2022 | 2021 | 2020 |
|---|---|---|---|---|---|
| Pharmacy Solutions | 6,522 | 5,264 | 4,389 | 3,636 | 3,022 |
| Provider Services | 2,304 | 2,181 | 1,963 | 1,684 | 1,287 |
| Other | 275 | 346 | 261 | 216 | |
| Total | 8,826 | 7,721 | 6,698 | 5,580 | 4,525 |
| $ Mil | 2024 | 2023 | 2022 | 2021 | 2020 |
|---|---|---|---|---|---|
| Pharmacy Solutions | 371 | 344 | 321 | 275 | 250 |
| Provider Services | 307 | 289 | 262 | 230 | 154 |
| Goodwill impairment loss | 0 | -41 | 0 | 0 | |
| Depreciation and amortization | -22 | -22 | -199 | -182 | -155 |
| Segment depreciation and amortization | -180 | -182 | |||
| Selling, general, and administrative expenses | -328 | -220 | -181 | -180 | -204 |
| Other | 20 | 32 | 22 | 18 | |
| Total | 147 | 188 | 234 | 165 | 63 |
Price Behavior
Price Behavior
| Market Price | $37.75 | |
| Market Cap ($ Bil) | 7.7 | |
| First Trading Date | 01/26/2024 | |
| Distance from 52W High | -0.7% | |
| 50 Days | 200 Days | |
| DMA Price | $34.26 | $25.22 |
| DMA Trend | up | up |
| Distance from DMA | 10.2% | 49.7% |
| 3M | 1YR | |
| Volatility | 36.6% | 46.4% |
| Downside Capture | 94.85 | 80.84 |
| Upside Capture | 230.68 | 147.74 |
| Correlation (SPY) | 53.4% | 45.7% |
BTSG Betas & Captures as of 11/30/2025
[1] Upside and downside betas calculated using positive and negative benchmark daily returns respectively
| 1M | 2M | 3M | 6M | 1Y | 3Y | |
|---|---|---|---|---|---|---|
| Beta | 1.78 | 1.59 | 1.61 | 1.52 | 1.11 | 0.17 |
| Up Beta | 1.13 | 1.71 | 0.73 | 1.48 | 1.01 | 0.07 |
| Down Beta | 2.38 | 1.68 | 1.19 | 1.45 | 1.21 | -0.03 |
| Up Capture | 298% | 250% | 375% | 224% | 183% | 50% |
| Bmk +ve Days | 12 | 25 | 38 | 73 | 141 | 426 |
| Stock +ve Days | 14 | 29 | 44 | 69 | 133 | 244 |
| Down Capture | 130% | 100% | 123% | 121% | 94% | 69% |
| Bmk -ve Days | 7 | 16 | 24 | 52 | 107 | 323 |
| Stock -ve Days | 5 | 12 | 18 | 52 | 110 | 207 |
[1] Upside and downside betas calculated using positive and negative benchmark daily returns respectively
Based On 1-Year Data
nullBased On 5-Year Data
nullBased On 10-Year Data
nullReturns Analyses
Earnings Returns History
Expand for More| Forward Returns | |||
|---|---|---|---|
| Earnings Date | 1D Returns | 5D Returns | 21D Returns |
| 10/20/2025 | 5.8% | 11.0% | 3.5% |
| 8/1/2025 | -4.9% | -0.9% | 14.7% |
| 3/6/2025 | -6.3% | -3.4% | -3.3% |
| 11/1/2024 | 15.2% | 26.4% | 27.5% |
| 8/2/2024 | -8.7% | -5.8% | 2.6% |
| 2/29/2024 | -7.6% | -6.6% | 11.7% |
| SUMMARY STATS | |||
| # Positive | 2 | 2 | 5 |
| # Negative | 4 | 4 | 1 |
| Median Positive | 10.5% | 18.7% | 11.7% |
| Median Negative | -7.0% | -4.6% | -3.3% |
| Max Positive | 15.2% | 26.4% | 27.5% |
| Max Negative | -8.7% | -6.6% | -3.3% |
SEC Filings
Expand for More| Report Date | Filing Date | Filing |
|---|---|---|
| 9302025 | 10282025 | 10-Q 9/30/2025 |
| 6302025 | 8012025 | 10-Q 6/30/2025 |
| 3312025 | 5022025 | 10-Q 3/31/2025 |
| 12312024 | 3062025 | 10-K 12/31/2024 |
| 9302024 | 11012024 | 10-Q 9/30/2024 |
| 6302024 | 8022024 | 10-Q 6/30/2024 |
| 3312024 | 5022024 | 10-Q 3/31/2024 |
| 12312023 | 3062024 | 10-K 12/31/2023 |
| 6302023 | 11092023 | DRS/A 6/30/2023 |
| 12312022 | 1262024 | 424B4 12/31/2022 |
| 6302021 | 10182021 | S-1 6/30/2021 |
| 12312020 | 1042022 | S-1/A 12/31/2020 |
External Quote Links
| Y Finance | Barrons |
| TradingView | Morningstar |
| SeekingAlpha | ValueLine |
| Motley Fool | Robinhood |
| CNBC | Etrade |
| MarketWatch | Unusual Whales |
| YCharts | Perplexity Finance |
| FinViz |
Prefer one of these to Trefis? Tell us why.