Acadia Healthcare's Q2 2025: Key Contradictions on Medicaid Pressures, Facility Performance, and CapEx Strategy

Medicaid volume pressures, underperforming facilities and drag on performance, capital expenditure strategy are the key contradictions discussed in Acadia Healthcare's latest 2025Q2 earnings call.



Revenue and Patient Volume Growth:
- Acadia Healthcare reported total revenue of $869.2 million for Q2 2025, up 9.2% over the same period last year.
- While same-facility patient days increased by 1.8%, this was slightly below expectations due to underperforming facilities and weaker Medicaid volumes in the acute care business.
- The growth was driven by strong performance in specialty and CTC lines of business.

Quality and Patient Safety Initiatives:
- Acadia emphasized the importance of quality patient care, highlighting investments in technology and safety measures.
- The company implemented remote patient monitoring devices and wearable safety devices for staff, enhancing patient safety and care consistency.
- These efforts are part of an ongoing strategy to improve clinical outcomes and meet payers' focus on value-based care.

Financial Performance and Outlook:
- Adjusted EBITDA for Q2 was $201.8 million, reflecting a 7.5% increase over the same period last year.
- Acadia updated its full-year 2025 adjusted EBITDA guidance to $675 million to $700 million due to lower expected volume growth and higher start-up costs.
- These adjustments were partially offset by higher anticipated supplemental payments, including a $40 million to $45 million recurring benefit from the Tennessee program.

Regulatory and Legislative Impact:
- Acadia discussed the potential impact of the One Big Beautiful Bill Act, noting that reduced supplemental payments from existing state Medicaid programs may commence in fiscal 2028.
- The company does not expect significant impacts from Medicaid work requirements as exemptions apply to many of their patient populations.
- Acadia remains committed to expanding access to behavioral health services and integrating mental health into broader healthcare systems.