Carlsmed, Inc. (CARL) vs HealthStream, Inc. (HSTM)

Carlsmed, Inc. and HealthStream, Inc. are both Health Information Services companies. HealthStream, Inc. is the larger, with a market value of $905.6M against $418.3M — 2.2× the size. Carlsmed, Inc. has negative trailing earnings, so its P/E is not meaningful; HealthStream, Inc. trades at 42.0×. Carlsmed, Inc. grew revenue faster over the last twelve months: 81.1% against 9.83%. HealthStream, Inc. has the higher net margin (6.25% vs −57.4%) and the higher return on invested capital (5.41% vs −234.5%). Across the 17 metrics below, HealthStream, Inc. leads on 13 and Carlsmed, Inc. on 4.

Valuation

Metric CARL HSTM Health Information Services median
P/E n/m 42.03 42.03
P/S 6.55 2.65 1.80
P/B 4.92 2.17 1.87
Price to free cash flow n/m 12.61 16.74
EV/EBITDA n/m 9.35 13.40
EV/Sales 5.38 2.39 2.63
Earnings yield (9.38%) 2.38% (2.73%)
Free cash flow yield (8.61%) 7.93% 0.00%

Profitability

Metric CARL HSTM Health Information Services median
Gross margin 76.63% 64.74% 59.61%
Operating margin (61.09%) 7.57% (10.54%)
Net margin (57.42%) 6.25% (16.14%)
Free cash flow margin (56.36%) 21.04% 0.00%
Return on equity (6,196.93%) 5.45% (3.15%)
Return on assets (42.39%) 3.84% (5.62%)
Return on invested capital (234.53%) 5.41% 0.00%

Growth

Metric CARL HSTM Health Information Services median
Revenue growth (TTM) 81.14% 9.83% 6.48%
EPS growth (last fiscal year) 65.30% (7.58%) 63.46%
Revenue growth, 5-year CAGR — 4.43% 10.98%
Net income growth, 5-year CAGR — 5.41% 0.00%

Health

Metric CARL HSTM Health Information Services median
Debt to equity 0.18 0.00 0.00
Current ratio 8.84 1.48 2.15
Net debt to EBITDA 3.12 (0.75) 0.71

Dividend

Metric CARL HSTM Health Information Services median
Dividend yield — 0.46% —
Payout ratio — 0.19 —

Size

Metric CARL HSTM Health Information Services median
Market cap 418.28m 905.63m 309.94m

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