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Side-by-side financial comparison of ALERUS FINANCIAL CORP (ALRS) and HEALTHSTREAM INC (HSTM). Click either name above to swap in a different company.

HEALTHSTREAM INC is the larger business by last-quarter revenue ($79.7M vs $45.2M, roughly 1.8× ALERUS FINANCIAL CORP). On growth, ALERUS FINANCIAL CORP posted the faster year-over-year revenue change (18.0% vs 7.4%). ALERUS FINANCIAL CORP produced more free cash flow last quarter ($58.8M vs $13.0M). Over the past eight quarters, HEALTHSTREAM INC's revenue compounded faster (4.7% CAGR vs -2.5%).

Alerus Financial Corporation, marketed as simply Alerus, is a chain of financial institutions headquartered in Grand Forks, North Dakota, with locations in North Dakota, Minnesota, Wisconsin, and Arizona. Alerus offers banking, mortgage, wealth management, and retirement services.

HealthStream Inc is a leading U.S.-based provider of workforce development, compliance, and training solutions tailored for the healthcare industry. It offers cloud-based platforms covering clinical skill training, talent management, patient safety education, and regulatory adherence tools, serving over 4,000 healthcare organizations including hospitals, clinics, and long-term care facilities nationwide.

ALRS vs HSTM — Head-to-Head

Bigger by revenue
HSTM
HSTM
1.8× larger
HSTM
$79.7M
$45.2M
ALRS
Growing faster (revenue YoY)
ALRS
ALRS
+10.6% gap
ALRS
18.0%
7.4%
HSTM
More free cash flow
ALRS
ALRS
$45.8M more FCF
ALRS
$58.8M
$13.0M
HSTM
Faster 2-yr revenue CAGR
HSTM
HSTM
Annualised
HSTM
4.7%
-2.5%
ALRS

Income Statement — Q4 FY2025 vs Q4 FY2025

Metric
ALRS
ALRS
HSTM
HSTM
Revenue
$45.2M
$79.7M
Net Profit
$-33.1M
Gross Margin
Operating Margin
-96.0%
3.0%
Net Margin
-73.2%
Revenue YoY
18.0%
7.4%
Net Profit YoY
-49232.8%
EPS (diluted)
$-1.27
$0.09

Green = leading value per metric. Periods may differ when fiscal calendars don't align.

8-Quarter Revenue & Profit Trend

Side-by-side quarterly history. Quarters aligned by calendar period so offset fiscal years line up.

Revenue
ALRS
ALRS
HSTM
HSTM
Q4 25
$45.2M
$79.7M
Q3 25
$72.6M
$76.5M
Q2 25
$74.8M
$74.4M
Q1 25
$68.8M
$73.5M
Q4 24
$72.2M
$74.2M
Q3 24
$50.9M
$73.1M
Q2 24
$51.4M
$71.6M
Q1 24
$47.5M
$72.8M
Net Profit
ALRS
ALRS
HSTM
HSTM
Q4 25
$-33.1M
Q3 25
$16.9M
$6.1M
Q2 25
$20.3M
$5.4M
Q1 25
$13.3M
$4.3M
Q4 24
$-67.0K
Q3 24
$5.2M
$5.7M
Q2 24
$6.2M
$4.2M
Q1 24
$6.4M
$5.2M
Operating Margin
ALRS
ALRS
HSTM
HSTM
Q4 25
-96.0%
3.0%
Q3 25
30.4%
9.9%
Q2 25
35.2%
7.9%
Q1 25
25.5%
6.0%
Q4 24
-0.8%
6.3%
Q3 24
13.4%
8.9%
Q2 24
15.8%
6.2%
Q1 24
17.9%
7.8%
Net Margin
ALRS
ALRS
HSTM
HSTM
Q4 25
-73.2%
Q3 25
23.3%
8.0%
Q2 25
27.1%
7.2%
Q1 25
19.4%
5.9%
Q4 24
-0.2%
Q3 24
10.2%
7.8%
Q2 24
12.1%
5.8%
Q1 24
13.5%
7.2%
EPS (diluted)
ALRS
ALRS
HSTM
HSTM
Q4 25
$-1.27
$0.09
Q3 25
$0.65
$0.20
Q2 25
$0.78
$0.18
Q1 25
$0.52
$0.14
Q4 24
$-0.06
$0.16
Q3 24
$0.26
$0.19
Q2 24
$0.31
$0.14
Q1 24
$0.32
$0.17

Balance Sheet & Financial Strength

Snapshot of each company's liquidity, leverage and book value from the latest quarter.

Metric
ALRS
ALRS
HSTM
HSTM
Cash + ST InvestmentsLiquidity on hand
$67.2M
$36.2M
Total DebtLower is stronger
$59.2M
Stockholders' EquityBook value
$564.9M
$354.0M
Total Assets
$5.2B
$520.4M
Debt / EquityLower = less leverage
0.10×

8-quarter trend — quarters aligned by calendar period.

Cash + ST Investments
ALRS
ALRS
HSTM
HSTM
Q4 25
$67.2M
$36.2M
Q3 25
$92.0M
$53.5M
Q2 25
$80.9M
$52.1M
Q1 25
$83.0M
$77.3M
Q4 24
$61.2M
$59.5M
Q3 24
$66.0M
$57.5M
Q2 24
$438.1M
$46.1M
Q1 24
$545.8M
$52.4M
Total Debt
ALRS
ALRS
HSTM
HSTM
Q4 25
$59.2M
Q3 25
$59.2M
Q2 25
$59.1M
Q1 25
$59.1M
Q4 24
$59.1M
Q3 24
$59.0M
Q2 24
$59.0M
Q1 24
$59.0M
Stockholders' Equity
ALRS
ALRS
HSTM
HSTM
Q4 25
$564.9M
$354.0M
Q3 25
$550.7M
$349.2M
Q2 25
$533.2M
$350.6M
Q1 25
$514.2M
$362.8M
Q4 24
$495.4M
$359.4M
Q3 24
$386.5M
$355.5M
Q2 24
$373.2M
$349.2M
Q1 24
$371.6M
$344.9M
Total Assets
ALRS
ALRS
HSTM
HSTM
Q4 25
$5.2B
$520.4M
Q3 25
$5.3B
$499.9M
Q2 25
$5.3B
$500.1M
Q1 25
$5.3B
$524.0M
Q4 24
$5.3B
$510.8M
Q3 24
$4.4B
$502.8M
Q2 24
$4.4B
$499.6M
Q1 24
$4.3B
$511.6M
Debt / Equity
ALRS
ALRS
HSTM
HSTM
Q4 25
0.10×
Q3 25
0.11×
Q2 25
0.11×
Q1 25
0.11×
Q4 24
0.12×
Q3 24
0.15×
Q2 24
0.16×
Q1 24
0.16×

Cash Flow & Capital Efficiency

How much cash each business actually produces after reinvestment. Cash flow is harder to manipulate than net income.

Metric
ALRS
ALRS
HSTM
HSTM
Operating Cash FlowLast quarter
$67.5M
$13.2M
Free Cash FlowOCF − Capex
$58.8M
$13.0M
FCF MarginFCF / Revenue
130.2%
16.3%
Capex IntensityCapex / Revenue
19.3%
0.3%
Cash ConversionOCF / Net Profit
TTM Free Cash FlowTrailing 4 quarters
$102.4M
$59.6M

8-quarter trend — quarters aligned by calendar period.

Operating Cash Flow
ALRS
ALRS
HSTM
HSTM
Q4 25
$67.5M
$13.2M
Q3 25
$32.8M
$18.0M
Q2 25
$10.7M
$5.0M
Q1 25
$7.7M
$27.1M
Q4 24
$21.7M
$11.2M
Q3 24
$20.2M
$19.1M
Q2 24
$-12.5M
$6.5M
Q1 24
$11.7M
$20.9M
Free Cash Flow
ALRS
ALRS
HSTM
HSTM
Q4 25
$58.8M
$13.0M
Q3 25
$30.3M
$17.9M
Q2 25
$7.6M
$2.7M
Q1 25
$5.7M
$26.0M
Q4 24
$9.4M
$11.0M
Q3 24
$17.4M
$18.8M
Q2 24
$-16.1M
$6.3M
Q1 24
$10.8M
$20.2M
FCF Margin
ALRS
ALRS
HSTM
HSTM
Q4 25
130.2%
16.3%
Q3 25
41.8%
23.4%
Q2 25
10.1%
3.6%
Q1 25
8.2%
35.4%
Q4 24
13.0%
14.8%
Q3 24
34.2%
25.8%
Q2 24
-31.4%
8.8%
Q1 24
22.8%
27.8%
Capex Intensity
ALRS
ALRS
HSTM
HSTM
Q4 25
19.3%
0.3%
Q3 25
3.4%
0.1%
Q2 25
4.2%
3.1%
Q1 25
3.0%
1.4%
Q4 24
17.1%
0.3%
Q3 24
5.4%
0.4%
Q2 24
7.2%
0.2%
Q1 24
1.9%
1.0%
Cash Conversion
ALRS
ALRS
HSTM
HSTM
Q4 25
Q3 25
1.94×
2.96×
Q2 25
0.53×
0.93×
Q1 25
0.58×
6.25×
Q4 24
Q3 24
3.88×
3.34×
Q2 24
-2.01×
1.55×
Q1 24
1.82×
4.01×

Financial Flow Comparison

Revenue → gross profit → operating profit → net profit for each company.

Revenue Breakdown by Segment

ALRS
ALRS

Other$17.3M38%
Retirement And Benefit Services$17.3M38%
Wealth Management$7.4M16%
Mortgage Banking$3.2M7%

HSTM
HSTM

Subscription Services$77.0M97%
Professional Services$2.7M3%

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