At a glance
BrightSpring Health Services, Inc. is worth $11.83B, about 68 times its fiscal 2025 earnings. Revenue grew 28.2% to $12.91B in fiscal 2025, with 1.5% kept as profit. It pays no dividend; it spent $44.5M buying back its shares over FY2022–FY2025. The stock returned +74.9% over the past year with dividends reinvested, against +11.5% for the S&P 500.
The business in plain English
BrightSpring Health Services provides pharmacy and health care services to people with complex, long-term medical needs. It works mostly in homes and community settings, where care costs less than in institutions. Its patients are mainly seniors and people with specialized needs, such as behavioral or neurological conditions. Its annual 10-K report for fiscal 2025 says it served over 465,000 patients daily across all 50 states, with about 10,500 clinical providers and pharmacists.
Pharmacy Solutions is by far the larger segment. It brought in 88.7% of fiscal 2025 revenue of $12.9 billion. More than 175 pharmacies, infusion centers and cancer-drug locations filled over 43 million prescriptions in 2025. They served nursing facilities, senior living communities, hospice patients and people at home. Infusion means drugs given through a vein. Infusion and specialty prescriptions grew more than 27% from December 2024 to December 2025. Supplying drugs brings in large revenue but keeps little of each dollar: gross margin was 11.8%.
Provider Services, the other 11.3%, covers home health, hospice (comfort care near the end of life), rehab therapy, help with daily activities and home-based primary care. Government programs pay most of the bills. Medicare Part D, the drug benefit, supplied 31.7% of revenue, Medicare Advantage (Part C) 18.7% and Medicaid 11.6%. Commercial insurers added 25.6%. About 53% of revenue came from 10 states.
Price history
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BTSG +74.9% over the year to Oct 28, 2026, total return with dividends reinvested.
How it makes money
By product or service
| Medicare D | $4.10B | 31.7% |
| Commercial Insurance | $3.30B | 25.6% |
| Medicare C | $2.41B | 18.7% |
| Medicaid | $1.50B | 11.6% |
| Medicare A | $1.09B | 8.5% |
| Private And Other | $424.1M | 3.3% |
| Medicare B | $82.8M | 0.6% |
By business segment
| Pharmacy Solutions | $11.45B | 88.7% |
| Provider Services | $1.46B | 11.3% |
Latest results
- In Q3 FY2026 (ended Sep 30, 2026), revenue was $4.21B, up 26.4% from a year earlier, and net income was $100.1M (+79.3%).
- For fiscal 2025, revenue was $12.91B (+28.2% year over year) with a 1.5% net margin.
Financial health check
| Operating margin | 2.3% weak |
|---|---|
| Free cash flow margin | 3.1% watch |
| Return on equity (FY2025) | 10.2% watch |
| Return on assets (FY2025) | 3% watch |
| Net cash (cash minus debt) | $-1.46B weak |
| Fiscal year | Revenue | Net income | Free cash flow |
|---|---|---|---|
| FY2022 | $7.72B | $-53.9M | $-74.8M |
| FY2023 | $7.69B | $-154.6M | $137.3M |
| FY2024 | $10.07B | $-18.1M | $-57.1M |
| FY2025 | $12.91B | $190.7M | $394.7M |
Valuation snapshot
| Market value | $11.83B |
|---|---|
| P/E ratio | 68.3 |
| Dividend yield | None |
Rank among 1514 US companies
Market value at each year end
BrightSpring Health Services’s market value went from $2.97B at the end of 2024 to $11.83B on Oct 28, 2026, about 4.0 times as much; since the end of 2025 it is up 75%.
Show as a table
| Year end | Market value | Change |
|---|---|---|
| Oct 28, 2026 | $11.83B | +75.2% |
| 2025 | $6.75B | +127.8% |
| 2024 | $2.97B |
Price behavior
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | |
|---|---|---|---|---|---|
| BTSG price data to Oct 28, 2026 | +58.8% | +74.9% | — | — | — |
Show as a table
| Year | Price data |
|---|---|
| 2026 (to date) | +58.8% |
| 2025 | +119.9% |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Before this security existed |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Before this security existed |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Before this security existed |
Insider activity
Form 4 filings from 2025-10-31 to 2026-10-31 (25 read): 0 open-market purchases and 12 sales ($3.36B), 1 of them under pre-arranged 10b5-1 trading plans.
| Date | Insider | Type | Value |
|---|---|---|---|
| Jun 5, 2026 | KKR Group Partnership L.P. 10% owner | sell | $857.5M |
| Jun 5, 2026 | Phoenix Aggregator L.P. KKR 10% owner | sell | $857.5M |
| Mar 4, 2026 | KKR Group Partnership L.P. 10% owner | sell | $807.5M |
| Mar 4, 2026 | Phoenix Aggregator L.P. KKR 10% owner | sell | $807.5M |
| Mar 4, 2026 | Jon B Rousseau See Remarks, Director | sell | $9.1M |
Who owns it
Large shareholders (13G filings)
| BlackRock, Inc. | 12% | Jun 30, 2026 |
| FMR LLC | 7% | Jun 30, 2026 |
| T. Rowe Price Associates, Inc. | 5.7% | Sep 30, 2025 |
| Invesco Ltd. | 5.3% | Jun 30, 2025 |
| Vanguard Portfolio Management | 4.57% | Sep 30, 2026 |
| Norges Bank | 2.5% | Dec 31, 2024 |
ETFs with the most weight in BTSG
| XHS SPDR S&P Health Care Services ETF | 1.92% |
| FNY First Trust Mid Cap Growth AlphaDEX Fund | 0.77% |
| FFSM Fidelity Fundamental Small-Mid Cap ETF | 0.48% |
| ROSC Hartford Multifactor Small Cap ETF | 0.48% |
| BUYO KraneShares Man Buyout Beta Index ETF | 0.43% |
| FNX First Trust Mid Cap Core AlphaDEX Fund | 0.39% |
| USVM VictoryShares US Small Mid Cap Value Momentum ETF | 0.29% |
| FAD First Trust Multi Cap Growth AlphaDEX Fund | 0.23% |
What could go wrong
- Drug pricing changes could squeeze pharmacy profits. Pharmacy brought in 88.7% of fiscal 2025 revenue on slim margins. Changes in drug prices, Medicare Part D payments, supplier terms or contracts with pharmacy benefit managers, which run drug plans for insurers, could cut profits.
- Heavy reliance on Medicare and Medicaid. Government programs supplied most fiscal 2025 revenue, Medicare Part D alone 31.7%. Payment rate cuts, budget decisions or moves of patients into managed care plans could reduce revenue. The company cannot set those rates.
- KKR's stake and large share sales. The 10-K says KKR owns a significant stake and its interests may conflict with other holders'. KKR entities sold large blocks of shares in March and June 2026. More sales could weigh on the price.
- Large debt load, partly at variable rates. As of June 30, 2026, total debt was $2.19 billion against $550 million in cash and investments. Some borrowing has variable rates, so higher interest rates could raise payments. Loan terms also limit flexibility.
- Government audits and investigations. The company says it is subject to reviews, audits and investigations by government agencies and other payers. Adverse findings could lead to repayments, fines or forced changes to operations, and could hurt its reputation.
- Staffing shortages and rising labor costs. Care depends on hiring and keeping nurses, pharmacists, therapists and caregivers. Shortages, wage laws or labor disputes could raise costs. The company cannot easily recover those costs because it has limited control over what it is paid.
Recent events
- Quarterly results released
- Quarterly results released
- Executive or board change; Investor presentation or announcement
- Major agreement signed
- Shareholder vote results
- Quarterly results released
- Acquisition or sale of assets completed; Executive or board change; Investor presentation or announcement
- Major agreement signed
- Quarterly results released
For income and retirement investors
BrightSpring pays no dividend. Its 10-K, filed February 27, 2026, says it has no plans to pay cash dividends. For an income investor, that means no regular income from the shares. Any return depends on the price rising. Buybacks, where a company repurchases its own stock, have been small: about $43 million in fiscal 2025 and $650,000 in each of the two prior years. The share count still rose 15.5% between May 1, 2024, and July 28, 2026, which spreads ownership more thinly.
The stock's price history spans only about 2.8 years. It does not show how the shares behaved in the 2008 financial crisis, the 2020 COVID crash or the 2022 bear market. Swings have been large. As of October 28, 2026, the stock was up 74.9% over one year, yet its deepest fall from a peak in that history was 35.6%. A single stock like BrightSpring carries more risk than a diversified fund.
Questions investors ask
How does BrightSpring Health Services make money?
Mostly by supplying prescription drugs. Its Pharmacy Solutions segment produced 88.7% of fiscal 2025 revenue of $12.9 billion. It delivers medicines, infusions and specialty drugs to nursing facilities, senior living communities, hospice patients and people at home. The other 11.3% came from Provider Services: home health, hospice, rehab therapy, help with daily activities and home-based primary care. Medicare, Medicaid and commercial insurers pay for most of these services.
Does BrightSpring (BTSG) pay a dividend?
No. BrightSpring paid no dividends from fiscal 2022 through fiscal 2025. Its 10-K, filed February 27, 2026, says it has no plans to pay cash dividends, so a shareholder's return depends on the share price rising. The company repurchased about $43 million of its own stock in fiscal 2025. Even so, the number of shares outstanding grew 15.5% between May 1, 2024, and July 28, 2026.
Is BrightSpring profitable?
Yes, based on its latest annual results. In fiscal 2025 it earned $190.7 million, or $0.87 per diluted share, after net losses in fiscal 2022, 2023 and 2024. Margins are thin: net income was 1.5% of revenue. Free cash flow, the cash left after operating costs and capital spending, was $394.7 million. As of October 28, 2026, its price-to-earnings ratio, which compares the share price with profit per share, was about 68 based on fiscal 2025 earnings.
How much of BrightSpring's revenue comes from Medicare and Medicaid?
Most of it. In fiscal 2025, Medicare Part D, the prescription drug benefit, supplied 31.7% of revenue. Medicare Advantage (Part C) supplied 18.7%, Medicare Part A 8.5% and Part B 0.6%. Medicaid added 11.6%. Commercial insurance made up 25.6% and private and other payers 3.3%. Because it relies so heavily on these programs, changes to government payment rates, budgets or rules can have a large effect on results. The company has limited control over those rates.
How much debt does BrightSpring have?
About $2.19 billion as of June 30, 2026, against roughly $550 million in cash and investments. That leaves net debt of about $1.64 billion. Shareholders' equity was about $2.05 billion. The 10-K lists the debt as a risk. Some of it carries variable interest rates, so rising rates could increase interest costs, and loan terms can restrict what the company does. Heavy debt can also leave less room to absorb a downturn.