10-Q · April 29, 2026
Acadia Healthcare reported Q1 2026 revenue of $828.8 million, a 7.6% increase from Q1 2025, and an EPS of $0.37, exceeding analyst estimates by $0.10. The company demonstrated growth in patient volumes across its…
Earnings analysis · 10-Q
ACHC earnings analysis
Filed July 28, 2026 · Our reading of the company's report
The latest report
Acadia's Q2 revenue was essentially flat year over year at $865.8 million, with admissions growth of 6.4% offset by a 0.8% decline in same-facility revenue per patient day. Earnings and margins deteriorated sharply, as…
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Acadia's Q2 revenue was essentially flat year over year at $865.8 million, with admissions growth of 6.4% offset by a 0.8% decline in same-facility revenue per patient day. Earnings and margins deteriorated sharply, as attributable net income declined to $10.9 million from $30.1 million amid a $28.6 million adverse liability-reserve adjustment, higher labor and professional-fee ratios, and impairment charges. Offsetting factors include substantially stronger first-half operating cash flow of $223.6 million, lower investigation-related costs, and continued capacity additions. Item 1A did not add or revise risk factors relative to the 2025 10-K; it incorporated those prior risks by reference.
Gross and operating margin
How much of each revenue dollar the business keeps.
One point per quarterly or annual filing. Both margins are shares of that report's revenue.
How we read each report
Our analysis across the last few reports.
Our model's reading of each filing, not the share price or the market's reaction. Annual and quarterly reports each occupy one position.
Reported figures
- Earnings per share
- $0.12
- Operating margin
- 7.0%
What stood out
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Sequential revenue recovery, but YoY decline
Q2 revenue was $865.8 million, down $3.4 million (0.4%) year over year from $869.2 million, but up from $828.8 million in Q1 2026. For the first six months, revenue increased $54.9 million (3.3%) to $1.695 billion.
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Volume growth offset by lower yield
Same-facility Q2 revenue declined 0.1%: patient days increased 0.8% and admissions increased 6.4%, but revenue per patient day fell 0.8%. The six-month same-facility revenue growth rate was 3.4%.
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Capacity expansion continues
Management added 322 beds in the first six months, including 42 beds at existing facilities and 280 beds through one wholly owned and three joint-venture facilities. Acadia operated 279 facilities and approximately 12,600 beds at June 30, 2026.
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Cash generation improved materially
Six-month operating cash flow rose to $223.6 million from $145.0 million, while capital expenditures fell to $115.1 million from $342.4 million. This implies $108.5 million of operating cash flow less capex for the first half, with capex equal to 6.8% of revenue.
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Investigation-related costs declined
Transaction, legal and other costs fell to $22.6 million in Q2 from $64.4 million a year earlier, including government-investigation costs of $7.5 million versus $53.5 million.
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Liquidity increased and revolver was repaid
Cash and cash equivalents increased to $171.3 million at June 30, 2026 from $133.2 million at December 31, 2025. Revolver availability was $669.8 million after $85.0 million of borrowings and $160.0 million of repayments during the first half.
What to watch
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Claims reserve adjustment pressured margins
Profitability weakened despite nearly flat revenue: net income attributable to Acadia fell to $10.9 million from $30.1 million, while the implied operating margin was 7.0% versus 9.8% a year earlier. A $28.6 million unfavorable adjustment to self-insured professional and general-liability claims was recorded in other operating expense.
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High Medicaid reimbursement exposure
Medicaid represented $540.2 million, or 62.4%, of Q2 revenue. Management says OBBBA-related Medicaid eligibility and state-directed-payment changes may negatively affect performance; state compliance with new eligibility requirements is required by December 31, 2026, and grandfathered payment programs begin reducing January 1, 2028.
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Leverage and floating-rate exposure
Debt and rate sensitivity remain substantial: debt consisted of $1.464 billion fixed-rate and $951.1 million variable-rate obligations at June 30, 2026. A hypothetical 1% rate increase would reduce annual pretax income by approximately $9.5 million; leverage was 4.1x versus a 5.0x covenant limit.
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Older receivables increased
Receivables aging deteriorated even as days sales outstanding stayed at 49 days: balances aged over 150 days were 23.2% at June 30, 2026 versus 19.3% at December 31, 2025.
Management's outlook
The 10-Q contains no quantitative revenue or EPS outlook. Management states that it expects to continue pursuing bed additions, de novos, joint ventures and acquisitions; no numeric guidance was embedded in MD&A.
Earlier filings 4
10-K · February 27, 2026
Acadia grew revenue to $3,312.8 million in 2025 (from $3,154.0 million in 2024) and expanded scale to 277 facilities and over 12,500 beds, adding 1,089 beds (311 bed adds to existing facilities and 778 via one…
10-Q · May 12, 2025
Acadia reported Q1 2025 revenue of $770,505,000, up modestly from $768,051,000 a year earlier, but profitability deteriorated materially: income before taxes fell to $13,468,000 (from $98,844,000) and diluted EPS…
10-K · February 27, 2025
Acadia positions itself as the leading publicly traded pure‑play behavioral healthcare provider, growing to 262 facilities and $3,154.0 million of revenue in 2024 while adding 776 beds and opening nine CTCs. Management…
This is our reading of a public filing, not the filing itself. Analysis can contain errors; check the source document for full context.