Breaking Down Acadia Healthcare Company, Inc. (ACHC) Financial Health: Key Insights for Investors

You've defintely noticed the mixed signals coming out of Acadia Healthcare Company, Inc. (ACHC) lately, and it's a classic case of growth costs meeting market reality. The company's recent downward revision to its full-year 2025 outlook-now projecting Revenue between $3.28 billion and $3.30 billion and Adjusted Earnings Per Share (EPS) in the $2.35 to $2.45 range-is the kind of friction that makes seasoned investors nervous. Still, the underlying demand is robust; Q3 2025 revenue came in at $851.6 million, and same-facility admissions grew 3.3%, but the price of their aggressive expansion is clear: they anticipate absorbing up to $65 million in startup losses this fiscal year alone, which is a significant headwind to earnings. We need to cut through the noise and figure out if this short-term pressure is a buying opportunity or a warning sign, so let's map out the precise financial health and the clear actions you should take now.

Revenue Analysis

You need a clear picture of where Acadia Healthcare Company, Inc. (ACHC)'s money is coming from, especially with the shifting sands of healthcare policy. The direct takeaway is that while the company is still growing, with a projected full-year 2025 revenue of around $3.29 billion at the midpoint of their revised guidance, the growth is uneven across its service lines and is increasingly reliant on volume and strategic facility expansion.

The company's trailing twelve months (TTM) revenue as of September 30, 2025, stood at $3.27 billion, representing a solid 4.58% year-over-year increase. This follows a 2024 annual revenue of $3.15 billion. For the third quarter of 2025 alone, revenue totaled $851.6 million, a 4.4% jump from the prior year. Same-facility revenue is the key metric here, growing 3.7% in Q3 2025, driven by a 2.3% rise in revenue per patient day and a 1.3% increase in patient days. That's a good sign, but you have to look closer at the segment mix.

Here is the breakdown of Acadia Healthcare Company, Inc.'s primary revenue streams from the third quarter of 2025, showing where the growth-and the drag-is happening:

The Acute Inpatient Psychiatric Facilities and Comprehensive Treatment Centers are the clear growth engines, posting increases of 7.2% and 7.7%, respectively. Honestly, those are impressive numbers in a tight labor market. The drag comes from Specialty Treatment Facilities, which saw a 4.9% revenue decrease in Q3 2025, a direct result of certain facility closures over the last twelve months as the company optimizes its portfolio. This is a strategic cleanup, but it defintely impacts the near-term top line.

Significant changes in the revenue mix are also tied to patient payor sources. In the second quarter of 2025, Commercial and Medicare volumes were up strongly-9% and 8%, respectively-while Medicaid volumes in acute care were slightly down. Still, the company anticipates a net increase in Medicaid supplemental payments of $30 million to $40 million for the full year 2025, partly due to a new Tennessee program. This supplemental revenue is a crucial, though politically sensitive, component of their financial health. You need to keep an eye on federal and state policy shifts here. To understand who is driving this demand, you might want to consider Exploring Acadia Healthcare Company, Inc. (ACHC) Investor Profile: Who's Buying and Why?

The company is making a conscious trade-off: portfolio optimization and capital conservation in some areas, while aggressively expanding in others. They are adding between 800 and 1,000 total beds in 2025, which will drive future revenue but also creates short-term startup losses, projected to be in the range of $60 million to $65 million for the full year. Here's the quick math: you are investing heavily for future volume, but it's hitting current earnings. Your action item is to track the revenue contribution from these new beds in early 2026 to ensure the investment pays off.

Profitability Metrics

You're looking for a clear picture of Acadia Healthcare Company, Inc.'s (ACHC) ability to turn revenue into profit, and honestly, the 2025 numbers show a company prioritizing aggressive growth over near-term margin expansion. The short story is that profitability is under pressure right now, but it's a deliberate, strategic pressure.

For the most recent reporting periods, Acadia Healthcare Company, Inc.'s margins reflect the high cost of its major expansion strategy. For the second quarter (Q2) of 2025, the Gross Profit Margin was approximately 22.12%. However, the real story is further down the income statement: the Q3 2025 Operating Margin dropped sharply to just 4.7%, down from 15.8% in the same quarter last year. This is a massive shift. The trailing twelve months (TTM) Net Profit Margin, which gives you the final takeaway after all expenses, sits at about 4.31%. [cite: 11 in step 1]

Margin Trends and Operational Efficiency

The trend in profitability is one of planned compression. Acadia Healthcare Company, Inc. is in the middle of its largest bed expansion year in history, and that costs serious money up front. Management forecasts full-year 2025 startup losses in the range of $60 million to $65 million, which is a direct hit to operating income. Here's the quick math on why the Operating Margin is so low: you have to pay for staff, utilities, and marketing for a new facility long before it reaches full patient capacity. That's a significant, non-recurring operational drag.

The focus on operational efficiency right now is less about cutting costs in existing facilities and more about managing the cost of growth. The company is betting that these new beds-like the 378 newly licensed beds added in Q1 2025-will drive future earnings, but you have to accept the margin hit today for that future payoff. If you're an investor, you need to watch how quickly those new facilities ramp up to full utilization, because that's the path to margin recovery. To see how Acadia Healthcare Company, Inc. plans to achieve this long-term, you can review its Mission Statement, Vision, & Core Values of Acadia Healthcare Company, Inc. (ACHC).

Peer Comparison: ACHC vs. Competitors

When you compare Acadia Healthcare Company, Inc.'s profitability ratios against its closest peers, the impact of its aggressive growth strategy becomes clear. Universal Health Services (UHS), a major competitor that also operates behavioral health facilities, provides a useful benchmark.

Look at the difference in gross margins-the money left after paying for direct care costs (Cost of Goods Sold). Universal Health Services' latest twelve months Gross Profit Margin is significantly higher at approximately 42.9%. [cite: 11 in step 2] Acadia Healthcare Company, Inc.'s Q2 2025 Gross Profit Margin of 22.12% suggests that its direct costs of providing care are much higher relative to its revenue base, which is defintely a factor of its operating model and current stage of expansion.

The net result of this is a lower bottom line. Universal Health Services' latest twelve months Net Profit Margin is a robust 8.1%, nearly double Acadia Healthcare Company, Inc.'s TTM Net Profit Margin of 4.31%. This gap shows the current cost of Acadia Healthcare Company, Inc.'s expansion, but also the potential for margin upside if the new facilities successfully scale and the startup costs roll off in 2026, as management predicts. It's a risk-reward trade-off.

• Gross Profit Margin: ACHC at 22.12% (Q2 2025) vs. UHS at 42.9% (LTM).
• Net Profit Margin: ACHC at 4.31% (TTM) vs. UHS at 8.1% (LTM).

Debt vs. Equity Structure

You're looking at Acadia Healthcare Company, Inc. (ACHC)'s balance sheet to see how they fund their aggressive growth, and that's defintely the right place to start. The quick takeaway is that Acadia Healthcare Company, Inc. (ACHC) uses a moderate amount of debt to fuel its expansion, but it's a manageable level that shows a clear strategy to shift short-term obligations to the long term.

As of the quarter ending June 2025, Acadia Healthcare Company, Inc. (ACHC)'s total debt stood at approximately $2.386 billion, backed by total stockholders' equity of about $3.078 billion. This is a solid foundation, but the key is the mix. The company's liabilities are heavily weighted toward long-term obligations, which is a strategic move to secure capital for their multi-year bed expansion projects.

• Long-Term Debt: Approximately $2.342 billion.
• Short-Term Debt: Approximately $44 million.

That's a very small percentage of debt coming due in the near term. That's good treasury management.

Debt-to-Equity Ratio and Industry Context

The company's debt-to-equity (D/E) ratio-which compares total debt to total shareholder equity-was approximately 0.78 (or 78%) as of June 2025. This ratio tells you that for every dollar of equity capital, the company is using 78 cents of debt capital. A D/E ratio below 1.0 is generally considered conservative, showing that assets are funded more by equity than by borrowing.

To be fair, this is slightly higher than a major competitor like Universal Health Services, which operates with a D/E ratio of about 0.55 as of November 2025. However, Acadia Healthcare Company, Inc. (ACHC)'s ratio has actually been coming down over the past five years, showing a deleveraging trend. The current 0.78 ratio is a sign of financial leverage (the use of borrowed money to increase potential returns) that is still well within a healthy range for a growth-focused healthcare provider.

2025 Refinancing and Capital Strategy

Acadia Healthcare Company, Inc. (ACHC) is actively managing its debt profile to capitalize on market conditions. In March 2025, the company issued $550 million in 7.375% senior notes due 2033. The main goal of this issuance was to prepay outstanding borrowings on its existing senior secured revolving credit facility, effectively pushing out the maturity wall and reducing reliance on short-term debt.

Here's the quick math on their recent debt moves:

This refinancing activity earned the company an issuer credit rating of 'BB-' from S&P Global Ratings, reflecting a moderate leverage profile that S&P projects will stay below their 4x downside trigger. The company balances this debt funding with equity actions, too. In February 2025, the Board authorized a $300 million share repurchase program, and they executed on this, repurchasing 1,706,625 shares for $50.4 million through the first half of 2025. This mix of using debt for growth and equity for shareholder return is a classic financial balancing act.

For a deeper look into the strategic drivers behind these financial decisions, you should review their Mission Statement, Vision, & Core Values of Acadia Healthcare Company, Inc. (ACHC).

Next step: Check the cash flow statement to see if operating cash flow (OCF) is strong enough to cover the interest payments on this $2.386 billion debt load.

Liquidity and Solvency

You need to know if Acadia Healthcare Company, Inc. (ACHC) can cover its near-term bills and sustain its growth investments. The short answer is yes, the company's liquidity position is defintely solid, but its aggressive capital spending means its free cash flow is currently negative, which is the key risk to map.

As of September 30, 2025, Acadia Healthcare Company, Inc. reported total current assets of $747.96 million against total current liabilities of $517.92 million. This leaves the company with a healthy working capital of approximately $230.03 million, showing a clear buffer to manage day-to-day operations.

Current and Quick Ratios

The company's liquidity ratios confirm its ability to meet its short-term obligations without stress. The current ratio and quick ratio are both well above the 1.0 benchmark, which is the standard sign of immediate financial health.

• Current Ratio: The ratio is 1.44 ($747.96M / $517.92M). This means Acadia Healthcare Company, Inc. has $1.44 in current assets for every dollar of current liabilities.
• Quick Ratio: A more conservative view, excluding less-liquid assets like certain prepaid expenses, puts the quick ratio at approximately 1.06. This is still a strong position, indicating that even without selling off any non-cash current assets, the company can cover its immediate debts.

Working capital trends show a consistent positive balance, which is what you want to see from a service-based business with predictable revenue streams like behavioral healthcare. You can see the long-term strategic focus in their Mission Statement, Vision, & Core Values of Acadia Healthcare Company, Inc. (ACHC).

Cash Flow Statement Overview

When you look at the cash flow statement, a clear trend emerges: strong operational performance is being offset by a heavy investment cycle. Here's the quick math on the trends:

• Operating Cash Flow (OCF): This is robust, with a trailing twelve months (TTM) OCF of approximately $424.81 million as of mid-2025, which is the engine of the business.
• Investing Cash Flow (ICF): This is a major outflow, driven by aggressive capital expenditures (CapEx) for new facilities and expansion. TTM CapEx was around -$736.11 million as of mid-2025, which is why Free Cash Flow (OCF - CapEx) is currently negative.
• Financing Cash Flow (FCF): The company is managing its debt, but its long-term debt remains substantial at $2.28 billion as of September 30, 2025. However, the current portion of long-term debt is relatively small, at only $24.38 million.

The company is addressing this CapEx burn, announcing a plan to reduce 2026 capital expenditures by at least $300 million compared to 2025 levels to accelerate a return to positive free cash flow for the full year 2026.

Near-Term Liquidity Strengths and Risks

The immediate strength is the sheer access to capital. As of Q3 2025, Acadia Healthcare Company, Inc. held cash and cash equivalents of $118.7 million and had $786.7 million available under its $1.0 billion revolving credit facility. That's a huge cushion.

The most concrete near-term risk is a $179 million legal settlement the company agreed to resolve, which will be recorded as an expense in the fourth quarter of 2025. Management plans to fund this using anticipated insurance proceeds of approximately $30 million, plus existing cash and credit lines, so the net cash outflow is manageable given their available liquidity. Still, it's a significant one-time hit to cash on hand. The liquidity profile is strong, but the high CapEx is a strategic choice that keeps the free cash flow tight.

Valuation Analysis

You're looking at Acadia Healthcare Company, Inc. (ACHC) and asking the core question: is the stock a bargain or a trap? Based on key 2025 fiscal year valuation multiples, the stock appears undervalued relative to its historical performance and industry peers, but you must factor in the recent operational headwinds.

The market is defintely pricing in a lot of risk right now. The latest closing stock price as of November 3, 2025, was $21.31, which is a massive drop from the 52-week high of $47.08 hit on January 13, 2025. That's a significant price decline, reflecting the 60.71% drop in the stock price during 2025. This volatility is what creates the opportunity, but also the danger.

Here's the quick math on the core valuation metrics:

• Price-to-Earnings (P/E) Ratio: The trailing P/E is 13.58, but the forward P/E is only 7.26. This forward multiple suggests analysts expect a strong bounce-back in earnings, making the stock look very cheap on a future earnings basis.
• Price-to-Book (P/B) Ratio: At just 0.46, the company is trading for less than half its book value (assets minus liabilities). This is a classic sign of undervaluation, or, to be fair, a market deeply skeptical of asset quality or future profitability.
• Enterprise Value-to-EBITDA (EV/EBITDA): This multiple, which accounts for debt, sits at 6.08. For a healthcare provider, a multiple this low signals a deep discount, especially when you consider the company's total debt is substantial at $2.45 billion.

Stock Price Trend and Analyst Consensus

The stock's journey over the last 12 months has been brutal, moving from that high of $47.08 to the recent low of $17.12 in August 2025. This sharp decline is the reason the valuation multiples look so low; the price has fallen faster than the earnings. Still, the analyst community sees a clear path to recovery.

The consensus rating on Acadia Healthcare Company, Inc. (ACHC) is a Moderate Buy. Out of 14 Wall Street analysts, 8 have a Buy rating, 5 have a Hold, and only 1 has a Sell rating. The average 12-month price target is $32.82, which represents a significant upside from the current price. However, keep in mind that analysts recently reduced their average target to $28.36 in November 2025, reflecting cautious sentiment due to disappointing quarterly results and operational pressures.

Here is the breakdown of the recent analyst sentiment:

One key detail to note: Acadia Healthcare Company, Inc. (ACHC) is a growth-focused company and does not currently pay a dividend. The dividend yield is 0.00%, and the payout ratio is 0.00%. This is not an income stock; it's a capital appreciation play betting on a turnaround. You can dive deeper into who is buying and why by Exploring Acadia Healthcare Company, Inc. (ACHC) Investor Profile: Who's Buying and Why?

What this estimate hides is the execution risk. The low valuation is a function of fear, so your action is to determine if the company can execute its strategic adjustments to justify that forward P/E of 7.26.

Risk Factors

You're looking at Acadia Healthcare Company, Inc. (ACHC) right now and the core takeaway is clear: while demand for behavioral health remains strong, the company is navigating a period of significant operational and financial pressure that forced a major guidance cut in late 2025. It's a classic growth-vs-execution story, and execution is struggling.

The most immediate internal risk is the drag from new facility growth, coupled with rising costs. For the full fiscal year 2025, Acadia Healthcare expects startup losses from newly opened facilities to hit a range of $60 million to $65 million, a significant headwind. This is a direct result of the extended ramp-up period for getting new beds filled and profitable. Plus, persistent labor market tightness and wage inflation continue to impact the cost structure, squeezing operating margins.

• Staffing costs are defintely a core operational challenge.
• Slower patient volumes, especially weaker Medicaid volumes, are a factor.
• Increased bad debt and denials are pressuring revenue realization.

On the financial side, the company's significant debt burden and recent performance volatility demand attention. Acadia Healthcare operates with a substantial debt load of approximately $2.4 billion. This is manageable, but the Altman Z-Score-a measure of financial distress-was recently noted at 1.17, placing the company in the distress zone. The stock's 52-week range of $15.68 to $47.08, as of November 2025, underscores the market's uncertainty and the stock's inherent volatility.

External and regulatory risks are also compounding the situation. Acadia Healthcare is facing heightened regulatory scrutiny, including ongoing securities fraud investigations and legal proceedings related to patient care and billing practices. Changes in government regulations, particularly around reimbursement rates from government and third-party payors, can materially affect future revenue. Any negative finding from these investigations could severely impact their reputation and financial health.

The third-quarter 2025 results forced management to reset expectations, which is a clear signal of near-term challenges. Here's the quick math on the revised full-year 2025 guidance, which reflects the impact of lower volumes, increased startup losses, and higher professional and general liability (PLGL) expenses.

In response to these headwinds, management is taking decisive action to optimize the portfolio and increase free cash flow generation. The most material mitigation strategy is the announced plan to reduce 2026 capital expenditures (capex) by at least $300 million compared to 2025 levels. This strategic pivot includes pausing several growth projects and closing five underperforming facilities to focus resources on the highest-return opportunities. While this addresses the financial strain, it does signal a temporary slowdown in the aggressive expansion model. You can get a sense of their long-term focus here: Mission Statement, Vision, & Core Values of Acadia Healthcare Company, Inc. (ACHC).

The good news is that same-facility admissions still grew by 3.3% in Q3 2025, suggesting the underlying demand is still there. The next step is to monitor Q4 results closely to see if the portfolio optimization and capex reduction truly translate into a stronger margin profile in 2026.

Growth Opportunities

You're looking for a clear map of where Acadia Healthcare Company, Inc. (ACHC) is headed, especially after their recent strategic recalibration. The direct takeaway is that while the company has tempered its aggressive expansion to focus on cash flow, its core growth engine-driven by bed additions and strategic partnerships-remains strong, just with a more realistic near-term earnings outlook.

The behavioral health market itself is a powerful tailwind, projected to reach $96.9 billion in 2025, fueled by rising mental health needs and destigmatization. Acadia is positioned to capture that demand, but you need to watch the execution on their pivot.

Here's the quick math on the near-term financial picture, based on the latest guidance, which was lowered in November 2025:

This revised outlook reflects a more cautious stance, including an anticipated $60 million to $65 million in startup losses for new facilities this year, plus the decision to close five underperforming facilities. It's a pragmatic move to prioritize free cash flow generation over volume growth at any cost, which is defintely a sign of a seasoned management team.

The primary growth drivers for Acadia Healthcare Company, Inc. are centered on three core initiatives:

• Capacity Expansion: The company is executing its largest bed expansion in history, aiming to add between 800-1,000 total beds in 2025. This includes adding 378 newly licensed beds in the first quarter alone.
• Strategic Joint Ventures (JVs): JVs with major health systems like Ascension Seton and Henry Ford Health are a capital-efficient way to enter new markets and secure referrals. As of Q2 2025, Acadia had 21 joint venture partnerships for 22 hospitals.
• Targeted Acquisitions: Acadia continues to expand its footprint in specialized areas, such as its Comprehensive Treatment Centers (CTCs)-the largest methadone-clinic chain-now operating 170 CTCs across 33 states.

Acadia's competitive advantage lies in its scale and specialization. They are the largest pure-play behavioral healthcare provider in the U.S., operating 278 facilities with approximately 12,500 beds as of November 2025. This extensive network gives them operational efficiencies and a diversified continuum of care, from inpatient psychiatric care to addiction recovery. They can offer a full range of services, which smaller competitors can't match. To dive deeper into the full financial picture, check out Breaking Down Acadia Healthcare Company, Inc. (ACHC) Financial Health: Key Insights for Investors.

The company also announced a strategic pivot in late 2025 to reduce capital expenditures by at least $300 million in 2026, which is a clear action to improve cash flow and manage the debt burden of $2.4 billion. This shift is a direct response to activist investor pressure and slower patient volumes in Q3 2025, showing management is willing to adjust quickly. Your next step should be to monitor their Q4 2025 report for confirmation that these cost-saving measures are translating into improved cash flow.