BTSG · Health care(services-home health care services) · 5 years of annual accounts filed with the SEC · latest fiscal year ended 2025-12-31
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BrightSpring Health Services, Inc. reported revenue of $12.9 billion in fiscal 2025. Of the $720.1 million its operations generated over 5 years, 51.4% went to acquisitions and 44.4% back into the business. On the accounting screens, it passes 7 of 8 Piotroski tests, its Altman Z'' of 1.78 is in the grey zone and its Beneish M-score is below the -1.78 line; 2 of the six cross-checks between its statements fire.
Revenue, fiscal 202512.9B
Operating margin2.3%gross margin —
Return on invested capital5.1%3.3% on average over 3 years
Free cash flow after stock pay324.6M2.5% of revenue
Net debt ÷ EBITDA5.3×net debt 2.4B
Piotroski F-score7/8tests of improvement passed
Is it growing?
Revenue and the operating income it turns into. Growth that does not reach operating income is growth bought with margin.
RevenueOperating income
05.0B10.0B15.0B
2021
2022Revenue 7.7BOperating income 187.8M
2023Revenue 7.7BOperating income 58.1M
2024Revenue 10.1BOperating income 108.0M
2025Revenue 12.9BOperating income 295.3M
20212022202320242025
Compound growth a year
3 yrs
4 yrs
Revenue
+18.7%
—
Operating income
+16.3%
—
Shares
+23.1%
—
Falling shares are buybacks: each remaining share owns more of the company.
Does it earn more than its capital costs?
Margins say how much of each sale is kept; return on invested capital says how much the business earns on the money it needs to operate. Growth only creates value when that return is above the cost of the capital.
GrossOperatingNetFree cash flow
-4.0%-2.0%0.0%2.0%4.0%
2021
2022Operating 2.4%Net -0.7%Free cash flow -1.0%
2023Operating 0.8%Net -2.0%Free cash flow 1.8%
2024Operating 1.1%Net -0.2%Free cash flow -0.6%
2025Operating 2.3%Net 1.5%Free cash flow 3.1%
20212022202320242025
Return on invested capital
Return on invested capitalCost of capital today · 7.1%
0.0%2.0%4.0%6.0%8.0%
2021
2022
2023Return on invested capital 1.7%
2024Return on invested capital 3.2%
2025Return on invested capital 5.1%
20212022202320242025
Economic profit
Economic profit
-300.0M-200.0M-100.0M0
2021
2022
2023Economic profit -212.8M
2024Economic profit -163.6M
2025Economic profit -85.9M
20212022202320242025
(return on capital − cost of capital) × capital invested: the profit left after paying for the money used. Today's cost of capital is applied to every year, since a past one cannot be rebuilt honestly.
Return on equity
10.2%
Return on assets
3.0%
Asset turnover
2.01×
Overheads (SG&A)
9.5% of revenue
Is the profit cash, and where does the cash go?
Net income is an accounting opinion; free cash flow is what was left in the bank after investing. Stock-based pay does not leave the bank — shareholders pay it through dilution — so it is shown taken off as well.
Net incomeFree cash flowAfter stock-based pay
-200.0M0200.0M400.0M
2021
2022Net income -53.9MFree cash flow -74.8MAfter stock-based pay -78.3M
2023Net income -154.6MFree cash flow 137.3MAfter stock-based pay 133.3M
2024Net income -18.1MFree cash flow -57.1MAfter stock-based pay -126.3M
2025Net income 190.7MFree cash flow 394.7MAfter stock-based pay 324.6M
20212022202320242025
Where 5 years of operating cash went, 2021–2025
720.1M generated by the business. Each band is its share of that total.
Reinvested in the business 44%320.0M
Acquisitions 51%369.9M
Dividends 0%0
Share buybacks 6%44.5M
More than it generated: funded with cash or new debt -2%-14.3M
Over the same years it paid 146.7M in stock. The buybacks did not even cover what was handed out in stock.
Per share
Earnings per shareFree cash flow per shareDividend per share
$-2.00$-1.00$0.00$1.00$2.00
2021
2022Earnings per share $-0.46Free cash flow per share $-0.63
2023Earnings per share $-1.31Free cash flow per share $1.16
2024Earnings per share $-0.09Free cash flow per share $-0.30
2025Earnings per share $0.87Free cash flow per share $1.80
20212022202320242025
Shares outstanding
Diluted shares
100.0M150.0M200.0M250.0M
2021
2022Diluted shares 117.8M
2023Diluted shares 117.9M
2024Diluted shares 193.0M
2025Diluted shares 219.8M
20212022202320242025
How strong is the balance sheet?
Debt is not bad in itself; debt the business cannot service in a bad year is. Net debt is debt minus cash, and below zero the company holds more cash than it owes.
Net debt
01.0B2.0B3.0B4.0B
2021
2022
2023Net debt 3.4B
2024Net debt 2.5B
2025Net debt 2.4B
20212022202320242025
Net debt ÷ EBITDA
5.3×
Interest coverage
2× operating income ÷ interest
Current ratio
1.57 current assets ÷ current liabilities
Cash conversion cycle
— collects in 28d
Three classic screens of the accounts
Each asks a different question of the same statements — is it improving, does it look like a company heading for distress, do the accounts resemble ones that were manipulated. None is a verdict; each shows what moves it.
Piotroski F-score
Is the business improving? Nine yes-or-no tests, this year against last.
7of 8 tests passed
✓ProfitableReturn on assets above zeropassed
✓Cash from operationsOperating cash flow above zeropassed
✓Profitability improvedReturn on assets higher than a year beforepassed
✓Profit backed by cashOperating cash flow above net income (low accruals)passed
✓Less long-term debtLong-term debt as a share of assets fellpassed
✓More liquidCurrent ratio higher than a year beforepassed
✕No new sharesShare count did not growfailed
–Better gross marginGross margin higher than a year before — not reportedno data
✓Sells more per assetAsset turnover higher than a year beforepassed
Where it misleads: it measures change, not level. An excellent business that stood still for a year scores low; a poor one recovering from a disaster scores high.
Altman Z''-score
Does the balance sheet look like those of companies that went bankrupt?
1.78grey zone
1.12.6
Working capital ÷ assets 0.16 × 6.56+1.07
Retained earnings ÷ assets -0.01 × 3.26-0.04
Operating income ÷ assets 0.05 × 6.72+0.31
Equity ÷ liabilities 0.41 × 1.05+0.43
Where it misleads: buybacks. A company that returns so much cash that its equity turns small or negative sinks the last two ratios without being anywhere near bankruptcy. Banks and insurers do not fit the model at all.
Beneish M-score
Do the accounts resemble those of companies that manipulated their earnings?
-2.61below the -1.78 line
-1.78
Receivables vs sales 0.86+0.79
Gross margin slipping 1.00 (not reported, set to 1)+0.53
Soft assets 0.80+0.32
Sales growth 1.28+1.14
Slower depreciation 1.19+0.14
Overheads vs sales 0.82-0.14
Profit not in cash -0.05-0.22
Leverage rising 1.00-0.33
Where it misleads: fast growth and acquisitions. Sales growth carries a heavy weight, so a company growing 50% a year scores like a suspect without having done anything. It is a screen from a 1999 study, not an accusation.
Where the statements disagree
Cross-checks between the income statement, the balance sheet and the cash flow for the latest year, each with the benign reading and the worrying one.
Capital spending (95M) is well below depreciation (164M).
Benign
Mature assets, or a business that has become less capital-intensive.
Worrying
Under-investing: today's profit is being held up by consuming tomorrow's capacity.
Net debt is 5.3 times EBITDA.
Benign
A stable sector with predictable cash flows and comfortable maturities.
Worrying
Little room if earnings fall; the maturity schedule is what to check.
What is it worth, under which assumptions?
A company is worth the cash it will generate, brought back to today. This model projects revenue with growth that fades over the years, applies a free cash flow margin, and discounts the result at the cost of capital. Every assumption says where it came from, and all of them can be changed.
Value per share, with these assumptions$44.69discounted at 7.1% a year · 69% of it from after year 10
Type a share price on the left to ask the reverse questions: what growth, what margin or what discount rate that price implies.
What the value implies, in the usual multiples
At this model's value
Price ÷ earnings
51.5×
Enterprise value ÷ EBITDA
26.6×
Enterprise value ÷ revenue
0.9×
Free cash flow yield
3.3%
From cash flows to a value per share
10 years of cash flow, today3.8B
Everything after, today8.5B
The whole business12.2B
Minus net debt-2.4B
What belongs to shareholders9.8B
Divided among 219.8M shares: <strong>$44.69</strong> each.
The projection next to its history
Reported free cash flow after stock pay, then the model's. A projection that looks nothing like the past needs a reason.
ReportedProjected
-250.0M0250.0M500.0M750.0M
2021
2022Reported -78.3M
2023Reported 133.3M
2024Reported -126.3M
2025Reported 324.6M
2026Projected 330.5M
2027Projected 385.8M
2028Projected 443.4M
2029Projected 501.8M
2030Projected 559.0M
2031Projected 612.7M
2032Projected 660.7M
2033Projected 700.7M
2034Projected 730.7M
2035Projected 748.9M
20212023202520272029203120332035
Year by year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
Revenue
15.3B
17.9B
20.5B
23.2B
25.9B
28.4B
30.6B
32.4B
33.8B
34.7B
Growth
18.5%
16.7%
14.9%
13.2%
11.4%
9.6%
7.8%
6.1%
4.3%
2.5%
Cash margin
2.2%
2.2%
2.2%
2.2%
2.2%
2.2%
2.2%
2.2%
2.2%
2.2%
Free cash flow
330.5M
385.8M
443.4M
501.8M
559.0M
612.7M
660.7M
700.7M
730.7M
748.9M
Worth today
308.7M
336.5M
361.2M
381.7M
397.1M
406.5M
409.3M
405.4M
394.8M
378.0M
If the least-known inputs move
Value per share as two inputs change at a time. Neighbouring cells that differ a lot are the conclusion: the value depends on numbers nobody knows to a point.
The discount rate and growth forever
discount ↓ · forever →
1.5%
2.0%
2.5%
3.0%
3.5%
6.1%
47
53
61
72
87
6.6%
41
46
52
60
70
7.1%
36
40
45
51
59
7.6%
32
35
39
44
50
8.1%
28
31
34
38
43
Year-one growth and the final margin
margin ↓ · growth →
14.5%
16.5%
18.5%
20.5%
22.5%
1.7%
28
32
35
39
43
1.9%
32
36
40
44
49
2.2%
36
40
45
49
54
2.4%
40
45
50
55
60
2.6%
44
49
54
60
66
All the inputs moving at once
4,995 valuations, each with growth, final margin, discount rate and growth forever drawn at random around the values on the left (spreads of 3.0%, 2.0%, 1.0% and 0.5%). Not a probability — the spreads are assumptions too — but an honest picture of how wide the answer is.
10th percentile$-11.33
Median$44.82
90th percentile$117.10
$0.00$100.00$200.00
Half of the simulations land between <b>$14.76</b> and <b>$78.07</b>; one in ten below $-11.33, one in ten above $117.10.
Does the long run make sense?
13.6×The terminal value prices the business in year 10 at 13.6 times that year's EBITDA.
Free growthIn year 10 free cash flow is at or above after-tax operating profit, yet the model grows 2.5% forever. Growth needs reinvestment; this assumes it comes for free, which flatters the terminal value.
69%of the value comes from after year 10. The more of it, the more the answer depends on the part nobody can see.
Every Form 4 filed in the last twelve months, read line by line: 6 filings by 15 people. Open-market purchases and sales are counted apart from awards, option exercises and shares withheld for taxes.
Bought on the open market—none in the period
Sold on the open market$1.7B3 sale(s) by 3 insider(s)
Under pre-arranged plans33%of the sales followed a 10b5-1 plan set months earlier
Kkr Phoenix Aggregator L.p.Holder of more than 10%
Gave as a gift · indirect
23,263
—
—
0
A Form 4 says what happened, when, how many shares and at what price. It does not say why: a sale can be diversification, a tax bill or a plan fixed months earlier, and an award is pay, not a purchase. Nothing here is a reason to buy or sell anything.
Which large funds report holding it
From the Form 13F of the 28 institutions followed on this site, as of the end of their last reported quarter. A 13F is filed up to 45 days later and shows only long positions in US-listed shares.
Accounts from the company's own SEC filings; lines some companies do not report are shown as a dash rather than estimated. The risk-free rate is the 10-year US Treasury yield. A DCF is a way of making assumptions explicit, not a forecast: it states what the company would be worth if the assumptions held. The scores are screens that point where to look, not verdicts. Nothing here is a recommendation to buy or sell.
