Acadia Healthcare Company (ACHC) Q2 2026 earnings summary

Executive summary

• Q2 2026 revenue was $865.8 million, flat year-over-year but up 2.8% after normalizing for supplemental payment timing; net income attributable to shareholders was $10.9 million ($0.12 per diluted share), down from $30.1 million ($0.33 per share) in Q2 2025.

• Adjusted EBITDA was $149.2 million, down 26% year-over-year, impacted by higher PLGL reserves and lower supplemental payment benefits.

• Free cash flow improved to $124 million, with operating cash flow rising to $162.1 million; first positive free cash flow quarter since Q2 2024.

• Opened two new acute joint venture facilities (144 beds in Florida, 96 beds in Iowa), adding 240 licensed beds in Q2 and over 300 beds in the first half of 2026.

• Medicaid remained the largest payor, accounting for 62.4% of Q2 2026 revenue.

Financial highlights

• Q2 2026 revenue: $865.8 million, down 0.4% year-over-year; normalized revenue growth was 2.8% after adjusting for supplemental payments.

• Adjusted EBITDA was $149.2 million, including a $26.1 million benefit from Florida Supplemental Payments and a $28.6 million PLGL reserve increase.

• Adjusted EPS dropped 54% year-over-year to $0.38; net income margin was 1.3%.

• Free cash flow reached $124 million; operating cash flow for the first half was $223.6 million, up from $145 million in the prior year.

• Salaries, wages, and benefits rose to $474.1 million (54.8% of revenue), reflecting labor market pressures.

Outlook and guidance

• Full-year 2026 guidance: revenue $3.40–$3.45 billion, adjusted EBITDA $590–$615 million, adjusted EPS $1.45–$1.60, operating cash flow $350–$400 million, and capital expenditures $235–$255 million.

• Guidance assumes 1–2% same facility patient day growth and 2–3% revenue per patient day growth.

• Positive free cash flow expected in the second half; potential for >$20 million incremental EBITDA from pending supplemental payment programs.

• Management expects continued demand for behavioral healthcare services and ongoing expansion through new facilities and joint ventures.