Acadia Healthcare Company (ACHC) Leerink Global Healthcare Conference 2026 summary

Leadership and organizational review

• New CEO Debbie Osteen returned in January, bringing renewed energy and industry expertise.

• Active review of organizational structure underway, with expected changes in leadership and accountability soon.

• Emphasis on reducing bureaucracy, clarifying decision-making, and supporting staff to drive growth.

• Focus on aligning the right people in key roles to improve execution and facility performance.

• Corporate overhead is expected to remain flat or decrease, with ongoing cost reviews and potential headcount reductions.

Facility performance and growth strategy

• Demand for services remains strong, with a diversified business across inpatient, residential, and outpatient segments.

• Recent years saw significant new bed additions, but some new facilities underperformed due to optimistic expectations and slow licensure processes.

• Facility closures are largely complete, with future focus on maximizing occupancy and efficiency in existing locations.

• No new de novo facilities planned for 2027; growth will focus on adding beds to existing facilities.

• 400-600 new beds expected in 2026, mainly through expansions at high-occupancy sites.

Financial outlook and capital allocation

• 2026 guidance reflects conservative assumptions, including a $25-30 million revenue headwind from New York Medicaid changes.

• Startup losses from new facilities are factored into flat to slightly down EBITDA guidance.

• CapEx will decrease significantly in 2026 and further in 2027, as major facility builds conclude.

• Free cash flow is expected to turn positive in 2026, with priority on debt reduction over share buybacks.

• Embedded earnings potential of $200 million as new facilities ramp up over a typical five-year period.