Acadia Healthcare Q2 Earnings Call Highlights

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Acadia Healthcare (NASDAQ:ACHC) reported second-quarter 2026 results that management said were in line with expectations, supported by progress at recently opened facilities, disciplined spending and strong free cash flow generation.

Revenue totaled $866 million, unchanged from the prior-year quarter. The comparison was affected by supplemental payment programs: second-quarter 2025 included $48.7 million from Tennessee payments related to prior periods, while the latest quarter included $22.3 million from Florida payments related to the 2025 program year. Excluding those items, revenue would have increased 2.8% year over year, according to Interim Chief Financial Officer David Duckworth.

Adjusted EBITDA was $149.2 million. The result included a $26.1 million benefit from Florida supplemental payments, offset by a $28.6 million actuarial adjustment increasing professional and general liability reserves for prior-year cases. Together, those items reduced adjusted EBITDA by $2.5 million relative to the company’s April guidance, Duckworth said.

Same-Facility Trends and Service Lines

Same-facility revenue was flat year over year, as a 0.8% increase in patient days was offset by a 0.8% decline in revenue per patient day. After adjusting for the Florida and Tennessee supplemental payments related to prior periods, same-facility revenue growth would have been 3.2%.

Duckworth said changes to New York’s Medicaid program affected Acadia’s Pennsylvania facilities and reduced same-facility revenue growth by about 1 percentage point. The company said it has been working to expand referral sources in Pennsylvania and other states.

• Acute care: Revenue was $495 million, flat year over year but up 6% after normalizing for supplemental payments. Management cited strong volumes and admissions at existing acute facilities as well as newer joint-venture and de novo locations.
• Specialty care: Revenue was $134 million, up 4% sequentially from the first quarter. The business experienced the full-quarter impact of the New York Medicaid decision.
• Residential treatment centers: Revenue rose 12% year over year to $97 million, driven by volume growth and higher revenue per day.
• Comprehensive treatment centers: Revenue was $141 million, flat year over year. Acadia opened two CTC clinics during the quarter and said it continues to see demand for opioid-treatment services, although the segment performed slightly below its expectations.

Chief Executive Officer Debbie Osteen said Acadia’s facilities opened between 2023 and 2026 generated revenue and facility-level EBITDA ahead of management’s expectations during the quarter. The company continues to target $200 million of incremental adjusted EBITDA from that group of facilities relative to 2025.

Osteen pointed to Coachella Valley, a 2024 de novo facility, as an example of the ramp-up progress. The facility is above 90% occupancy, she said, and Acadia is evaluating additional bed capacity there.

Expansion, Staffing and Cost Controls

Acadia opened two acute facilities during the quarter: a 144-bed joint-venture facility with Orlando Health in Florida and a 96-bed joint-venture facility with Methodist Jennie Edmundson in Iowa. The company added more than 300 beds in the first half and remains on track to add 500 to 600 beds in 2026, including a planned de novo acute-facility opening near Jacksonville, Florida, in the third quarter.

Management said it has shortened timelines for licensing, accreditation and payer contracting at new facilities. Osteen also cited closer communication with joint-venture partners and greater expense discipline as factors helping new sites ramp more quickly.

Start-up facility losses were $12 million in the second quarter, better than management expected, although Duckworth said losses could rise to roughly $12 million to $14 million in the third quarter because of recent and planned openings. He said the company expects the amount to decline below $12 million in the fourth quarter as facilities mature.

Duckworth said the labor market remained stable, with wage-cost growth running around 3% overall, though results vary by role and geography. Acadia also reported that corporate overhead declined by about $3 million from the first quarter and was flat year over year.

Cash Flow, Debt Reduction and Updated Outlook

Operating cash flow was $162 million in the second quarter, while capital expenditures were $39 million, resulting in free cash flow of $124 million. Acadia repaid $113 million of debt and ended the quarter with $171 million in cash and cash equivalents. Its net leverage ratio was approximately 4.1 times adjusted EBITDA as of June 30.

The company revised its full-year capital-expenditure forecast to $235 million to $255 million, including $120 million to $140 million expected in the second half. Duckworth said the revision reflects the timing of projects and a more disciplined approach to capital deployment. Acadia expects positive free cash flow in the second half.

For 2026, Acadia updated its outlook to:

• Revenue of $3.4 billion to $3.45 billion;
• Adjusted EBITDA of $590 million to $615 million;
• Adjusted earnings per share of $1.45 to $1.60; and
• Operating cash flow of $350 million to $400 million.

The guidance does not fully include potential expansion of supplemental payment programs. Duckworth said Florida and Ohio programs under regulatory review for the 2026 program year could add more than $20 million in incremental EBITDA, while the company included a $5 million historical baseline amount for Florida in its third-quarter expectations.

On liability reserves, Duckworth said the $28.6 million second-quarter adjustment was primarily tied to prior-year cases from the 2025 policy year moving toward settlement. He said reserves for the current year remain consistent with prior expectations of $100 million to $110 million, while the inclusion of the prior-year adjustment puts the total annual amount in a range of roughly $130 million to $135 million.

About Acadia Healthcare (NASDAQ:ACHC)

Acadia Healthcare Company, Inc (NASDAQ: ACHC) is a publicly traded provider of behavioral healthcare services headquartered in Franklin, Tennessee. Founded in 2005, the company has grown through organic expansion and strategic acquisitions to establish itself as a leading specialist in mental health and addiction treatment across the United States.

Acadia operates a diversified network of inpatient psychiatric hospitals, residential treatment centers, outpatient clinics and intensive outpatient programs.

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