Financial Data and Key Metrics Changes - First quarter revenue was $770.5 million, slightly above the midpoint of the guidance range of $765 million to $775 million [6] - Adjusted EBITDA for the first quarter was $134.2 million, near the high end of the guidance range of $130 million to $135 million [6] - Same facility patient days grew by 2.2% in the first quarter, impacted by an unfavorable leap year effect of approximately 110 basis points [6][15] - Adjusted EBITDA margin was 17.4% for the first quarter [16] Business Line Data and Key Metrics Changes - Same facility revenue grew by 2.1% year-over-year, driven by patient day growth of 2.2% [15] - Same facility adjusted EBITDA was $191.6 million, with an adjusted EBITDA margin of 25.2% [17] - Start-up losses related to new facilities were higher year-over-year and sequentially, reflecting an increase in newly constructed facilities [16] Market Data and Key Metrics Changes - Acadia added 378 new beds in the first quarter, including 90 beds to existing facilities and 288 beds from two new facilities [7] - The company expects to add between 800 to 1,000 total beds for the full year 2025 [18] Company Strategy and Development Direction - Acadia's strategy focuses on high-quality care and clinical health outcomes, with a commitment to quality and safety as foundational elements [10] - The company aims to bridge the gap between physical and behavioral health care, enhancing relationships with referral sources and joint venture partners [7] - Acadia plans to continue expanding its market reach, with expectations to add between 600 to 800 beds annually from 2026 to 2028 [8][21] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the demand for behavioral health services, particularly for higher acuity patients [39] - The company remains engaged in policy discussions to strengthen the behavioral health care system and expects continued support for essential care [12] - Management acknowledged the challenges posed by underperforming facilities but indicated that improvements are expected over time [17][19] Other Important Information - As of March 31, 2025, Acadia had $91.2 million in cash and cash equivalents and approximately $900 million available under its revolving credit facility [18] - The company repurchased approximately 1.6 million shares during the first quarter for a total of $47.3 million [18] Q&A Session Summary Question: Can you provide perspective on the progression of EBITDA and seasonality of the business this year? - Management highlighted several moving parts affecting EBITDA, including the timing of supplemental payments and the impact of start-up costs from new beds [25][28] Question: What are you seeing in Medicaid rate updates? - Management noted stable underlying rate growth and a cautious approach to assumptions due to policy uncertainties [32][34] Question: How is the broader demand environment for behavioral health? - Management indicated consistent demand for services, particularly for higher acuity patients, and ongoing efforts to meet that demand through new facilities and bed additions [39][41] Question: What is the expected return target for new facilities? - Management emphasized a disciplined approach to capital deployment, ensuring returns exceed the cost of capital [65][66] Question: How should we think about legal expenses moving forward? - Management is actively cooperating with ongoing investigations, and while it's difficult to predict future legal costs, significant preliminary work is being undertaken [73][74] Question: Can you provide guidance on Q2's percentage of annual guidance? - Management refrained from providing specific Q2 guidance but noted that supplemental payments, particularly from the Tennessee program, would be a significant swing factor [79][80] Question: What is happening with specialty revenue? - Management acknowledged a year-over-year decline in specialty revenue and indicated ongoing efforts to address this issue [104]

Financial Data and Key Metrics Changes - First quarter revenue for 2025 was $770.5 million, slightly above the midpoint of the guidance range of $765 million to $775 million [5][14] - Adjusted EBITDA for the first quarter was $134.2 million, near the high end of the guidance range of $130 million to $135 million, reflecting an adjusted EBITDA margin of 17.4% [5][15] - Same facility patient days grew by 2.2% in the first quarter, with same facility revenue growth of 2.1% compared to the first quarter of 2024 [5][14] Business Line Data and Key Metrics Changes - The company added 378 new beds in the first quarter, including 90 beds to existing facilities and 288 beds from two new facilities [6] - Same facility adjusted EBITDA was $191.6 million, with an adjusted EBITDA margin of 25.2% [16] - Start-up losses related to new facilities were higher year-over-year and sequentially, reflecting an increase in newly constructed facilities [15] Market Data and Key Metrics Changes - The company expects to add between 800 to 1,000 total beds for the full year 2025, with a solid pipeline of potential opportunities in attractive markets [7][18] - The company anticipates Medicaid supplemental payments to be flat to up $15 million in 2025 on a net basis [19] Company Strategy and Development Direction - Acadia's strategy focuses on high-quality care and clinical health outcomes, with a commitment to quality and safety as foundational elements [10][12] - The company aims to bridge the gap between physical and behavioral health care, maintaining strong relationships with referral sources and joint venture partners [6] - The company is engaged in policy advocacy to strengthen the behavioral health care system, emphasizing the importance of government support for underserved populations [12] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the demand for behavioral health services, particularly for higher acuity patients, and noted consistent demand across various lines of business [38] - The company acknowledged challenges from underperforming facilities but expects to see improvements as they comp over headwinds in the fourth quarter of 2025 [19] - Management remains cautious about rate growth due to uncertainties in the policy environment but noted stable underlying rate growth [35] Other Important Information - As of March 31, 2025, the company had $91.2 million in cash and cash equivalents and approximately $900 million available under its revolving credit facility [18] - The company repurchased approximately 1.6 million shares during the first quarter for a total of $47.3 million [18] Q&A Session Summary Question: Can you provide perspective on the progression of EBITDA and seasonality this year? - Management highlighted several moving parts affecting Q1, including the timing of supplemental payments and the highest level of start-up costs, leading to a steeper ramp in EBITDA as the year progresses [25][28] Question: What are you seeing in Medicaid rate updates? - Management noted ongoing positive discussions with payer partners and maintained a conservative outlook on rate growth due to policy uncertainties, but underlying rate growth has been stable [33][35] Question: How is the broader demand environment for behavioral health? - Management indicated consistent demand for higher acuity patients across various business lines, with ongoing efforts to meet that demand through new facilities and bed additions [38] Question: What is the expected return target for new facilities? - The company applies a disciplined approach to capital deployment, ensuring that all projects meet required return thresholds, with sensitivity analyses incorporated for future projects [63][66] Question: How should we think about legal expenses moving forward? - Management is actively cooperating with ongoing investigations and anticipates that legal costs may normalize as preliminary work is completed [70][72] Question: What is happening with specialty revenue? - Management acknowledged that closures of specialty facilities have contributed to a decline in specialty revenue, but they are working to stabilize and grow this line moving forward [97][98]

Financial Data and Key Metrics Changes - Total revenue for Q4 2024 increased by 4.2% year-over-year to $774 million, with full-year revenue exceeding $3.1 billion, marking a 7.7% increase over 2023 [8][21] - Same facility patient days grew by 3.2% in Q4, remaining stable between 3% and 4% throughout the quarter [8][21] - Adjusted EBITDA for Q4 2024 was $153.1 million, with an adjusted EBITDA margin of 19.8%, down from 22.8% in the same quarter last year [22][23] - Adjusted income attributable to Acadia stockholders per diluted share was $0.64 for Q4 2024, compared to $0.85 for the prior year period [25] Business Line Data and Key Metrics Changes - Same facility revenue grew by 4.7% compared to Q4 2023, driven by patient day growth and a 1.4% increase in revenue per patient day [21] - Startup losses related to new facilities were $11.2 million in Q4 2024, a $6 million increase year-over-year [23] Market Data and Key Metrics Changes - The company reported a more stable labor environment in 2024, which supported recruitment and retention initiatives [9] - The company anticipates adding between 800 and 1,000 total beds in 2025, reflecting ongoing demand for behavioral health services [18] Company Strategy and Development Direction - The company is focused on transforming the lives of patients and communities by providing specialized behavioral health care [10] - Acadia is committed to expanding access to care, with a strong pipeline of potential partnerships with leading health systems [19] - The company plans to moderate the pace of bed additions to 600 to 800 beds per year starting in 2026, balancing growth and free cash flow generation [42] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's strategy and goals, emphasizing the need to address the mental health and addiction crisis in the U.S. [19] - The company expects to return to free cash flow positive by the end of 2026, driven by new bed contributions and reduced startup costs [50][51] Other Important Information - The Board of Directors authorized a new $300 million share repurchase program, subject to market conditions [44] - The company recorded a $4 million increase in reserves for self-insured professional and general liability claims, reflecting unfavorable industry trends [23][34] Q&A Session Summary Question: Follow-up on capital commitments and cash flow - Management confirmed refinancing existing bank facilities and upsizing to about a billion dollars, with expectations of cash flow returning to positive by the end of 2026 [47][48] Question: Clarification on first-quarter guidance - Management indicated that the first quarter is expected to contribute less to the full year than typical, with startup losses anticipated to be high [55][56] Question: Update on referral activity - Management noted that referral issues are less of a challenge now, focusing on a small number of underperforming facilities [99][102] Question: Long-term growth outlook and margin assumptions - Management reiterated a balanced approach to growth, expecting revenue growth of 7% to 9% and EBITDA growth of 8% to 10% in the coming years [62][66] Question: Update on underperforming facilities - Management is conducting comprehensive reviews of underperforming facilities, focusing on business development, leadership, and technology adoption [118][122]