ARC Health (ARC), a portfolio company of Thurston Group, has secured a $182m credit facility to refinance existing indebtedness and fund growth initiatives in the US. Founded in 2021 and based in Cleveland, Ohio, ARC is an outpatient behavioural health provider. Serving patients across 91 locations in 20 US states with more than 1,300 clinicians, ARC offers full-service behavioural health offerings and is claimed to focus on a data-driven, patient-centred model for strong clinical and operational results ...

Financial Data and Key Metrics Changes - The company reported revenue of $851.6 million for Q3 2025, a 4.4% increase compared to the same quarter last year [5][20] - Adjusted EBITDA was $173 million, down from $194.3 million in the prior year period, reflecting lower volumes and increased expenses [5][20] - Same facility volume growth was 1.3%, which was approximately 100 basis points below internal expectations [5][6] - Adjusted EBITDA guidance for 2025 was reduced to $650-$660 million from a previous range of $675 million-$700 million [6][24] Business Line Data and Key Metrics Changes - Same facility revenue grew 3.7% year over year, driven by a 2.3% increase in revenue per patient day and a 1.3% growth in patient days [20] - The company faced increased pressure on volumes, particularly in the Medicaid segment, impacting overall performance [6][30] Market Data and Key Metrics Changes - The company added 83 beds to existing facilities in Q3, bringing the year-to-date total to 274 beds added through expansions [22] - The company expects to add 500-700 beds in 2026, following the addition of over 1,700 beds in 2024 and 2025 [8][23] Company Strategy and Development Direction - The company is focusing on optimizing growth investments and its existing portfolio to improve financial performance amid increasing headwinds [7][12] - A comprehensive portfolio and capital allocation review led to a pause on several development projects that no longer projected acceptable returns [11][39] - The company aims to ensure a portfolio that meets patient demand while maximizing returns on investments [12][46] Management's Comments on Operating Environment and Future Outlook - Management acknowledged increasing headwinds in the operating environment, particularly regarding pressures on managed care companies and Medicaid funding uncertainty [6][7] - The company remains confident in its strategy to deliver strong clinical outcomes and expects to see benefits from recent investments in quality and technology [26][52] Other Important Information - The company expects full-year 2025 startup losses to be in the range of $60 million-$65 million, with a modest decrease anticipated in 2026 [21][24] - Legal expenses related to government investigations were $39 million in Q3, down 28% from the previous quarter, with expectations for continued moderation [22][43] Q&A Session Summary Question: Can you provide more color on the challenges with payers, particularly in Medicaid? - Management noted that payer friction is more pronounced in Medicaid-heavy markets, with increased scrutiny on discharge criteria and more frequent utilization reviews [30][31] Question: How should we think about the durability of bad debts and denials as we move into 2026? - Management indicated that Q4 is seasonally slow, and while some pressures may persist, they expect a reduction in startup losses and other costs in 2026 [33][34] Question: Can you clarify the CapEx reduction and its implications for future bed openings? - The company plans to reduce CapEx by at least $300 million in 2026 while still opening multiple large facilities, as much of the capital for these projects has already been spent [39][41] Question: What is the expected impact of the five facility closures on EBITDA? - Management anticipates a mid-single-digit tailwind in 2026 from the closures, with a focus on ensuring returns on capital [45][46] Question: Can you provide insight into the $22 million in Medicaid supplemental benefits? - The company highlighted that Florida is a key state for these benefits, which could provide a significant run rate going forward [49]

Financial Performance - Revenue for Q3 2025 is reported at $64 million, with Payor contributing 54% and DTE contributing 34%[6] - The company achieved a +111% YoY growth in Adjusted EBITDA in Q3 2025 and a LTM Adjusted EBITDA of approximately $119 million, compared to approximately $40 million a year ago[17] - Approximately $9 million of shares were repurchased in Q3 under the company's buyback plan[17] Business Growth & Innovation - Unique Active Payor Members increased by +29% YoY, and Payor sessions increased by +37% YoY[16] - Initial psychiatry sessions experienced a +46% sequential growth[16] - Payor Revenue increased by +42% YoY, and Total Revenue increased by +25% YoY[17] - The company broadened its comprehensive care platform with the acquisition of Wisdo Health[16] - Product platform enhancements led to a +50% increase in clients attending the 3rd session in 30 days[16] Partnerships & Brand Awareness - Brand awareness increased, with over 35% of people now recognizing the company[17] Financial Guidance - The company narrowed its 2025 Revenue guidance to $226 million to $230 million, representing a +20% to +23% YoY increase[23] - The company narrowed its 2025 Adjusted EBITDA guidance to $14 million to $16 million, representing a +101% to +130% YoY increase[23]

Acadia Healthcare Company Conference Call Summary Company Overview - Acadia Healthcare Company is one of the largest operators of behavioral health facilities in the U.S. [1] Core Industry Insights - The demand for behavioral health services remains structurally strong, particularly for patients with rising acuity and comorbidities [17] - There is a supply-demand imbalance in behavioral health, especially in underserved areas [17] - The company is focused on delivering high-quality, evidence-based behavioral health services [2] Financial Performance and Guidance - 2025 has been a challenging year for Acadia, with volumes coming in below expectations due to weaker Medicaid volumes [2][3] - The company has paused several projects, reducing 2026 CapEx by at least $300 million compared to 2025 levels [4][12] - Acadia added nearly 1,800 beds between 2024 and 2025 and expects to add an additional 500 to 700 beds in 2026 [4][7] - The company anticipates significant improvement in EBITDA growth and free cash flow generation in 2026 and 2027 [7][8] Operational Strategy - Acadia is taking a more measured approach to capital deployment, focusing on markets with favorable reimbursement environments [13][18] - The company has closed five underperforming facilities to concentrate resources on core business areas [23] - A comprehensive review of facilities is ongoing, with five additional facilities being monitored for potential closure [26] Medicaid Dynamics - Challenges in the acute line of business include payer behavior, leading to denials and reduced lengths of stay for patients [9][10] - The company is experiencing tighter scrutiny from managed Medicaid plans [10] Capital Expenditure and Investment - The decision to cut CapEx was driven by a thorough review of growth opportunities and market demand [11][12] - Acadia is focusing on optimizing capital deployment and enhancing shareholder value through strategic facility closures [22][28] Quality and Technology Investments - Acadia has made significant investments in technology and quality infrastructure, which are expected to improve clinical outcomes and operational consistency [20][47] - The company tracks over 50 key performance indicators (KPIs) to ensure quality and operational efficiency [47] Market Position and Competitive Landscape - Acadia differentiates itself through technology and quality, addressing the historical underinvestment in behavioral health [20] - The company is well-positioned to leverage its joint venture partnerships for reimbursement advantages [41] Future Outlook - Acadia expects to unlock free cash flow potential and achieve strong top and bottom line growth in the coming years [48] - The company is closely monitoring the evolving reimbursement environment, particularly with upcoming changes in state-directed payments [44][46] Key Takeaways - The depth of Acadia's quality infrastructure and operational discipline is often underappreciated by investors [47] - The company is committed to sustainable growth and long-term expansion despite current challenges [48]

Group 1 - Bank of America (BofA) downgraded Acadia Healthcare Inc from Buy to Neutral and lowered the price forecast from $27 to $25 due to anticipated headwinds from Medicaid state-directed payment program cuts in 2028 and beyond [1] - Acadia's same-store volumes have decelerated to low single digits, impacted by legal issues at some locations and reduced inpatient admissions due to payor pressure [3] - Acadia Healthcare reported second-quarter adjusted earnings of 83 cents per share, exceeding the consensus estimate of 68 cents, with sales increasing 9.2% year over year to $869.23 million, also surpassing the consensus of $840.02 million [4] Group 2 - Analyst Joanna Gajuk expects volume growth to improve as new bed capacity increases, with Acadia expanding beds by 12% in 2024 and an additional 8% planned for 2025 [4] - Acadia Healthcare has revised its fiscal 2025 adjusted earnings per share guidance down from $2.50-$2.80 to $2.45-$2.65, compared to the consensus of $2.67 [5] - The company narrowed its sales guidance for fiscal 2025 from $3.3 billion-$3.4 billion to $3.3 billion-$3.35 billion, against a consensus of $3.334 billion [5]

Core Insights - Magellan Health's collaborative care model (CoCM) enhances pediatric behavioral health by integrating support directly into primary care settings, leading to improved access and provider satisfaction [1][3] Company Overview - Magellan Health, Inc. is a leader in behavioral health services, focusing on innovative healthcare access through technology while maintaining essential personal relationships [4] Collaborative Care Model (CoCM) - CoCM is an evidence-based approach proven effective in over 90 randomized controlled trials, ensuring timely access to behavioral health support and personalized care [2] - The model empowers pediatric clinics to provide team-based behavioral health support, addressing the need for transformation in pediatric behavioral healthcare [3] Program Outcomes - In a pediatric clinic serving over 7,900 patients, 84% of referred children enrolled in the CoCM program, with 56% remaining engaged or graduating from it [6] - The program demonstrated a 40% reduction in PHQ-A scores among graduates, indicating significant improvement in mental health outcomes [6]

Financial Data and Key Metrics Changes - The company reported total revenue of $869.2 million for Q2 2025, representing a 9.2% increase year-over-year [5][19] - Adjusted EBITDA for the quarter was $201.8 million, reflecting a 7.5% increase compared to the same period last year, with an adjusted EBITDA margin of 23.2% [5][19] - Same facility revenue grew by 9.5% year-over-year, including a 7.5% increase in revenue per patient day and a 1.8% growth in patient days [19][20] Business Line Data and Key Metrics Changes - The company added 101 beds to existing facilities in Q2, totaling 191 beds added for 2025, and 479 beds added to date in 2025 [8][10] - Same facility patient days increased by 1.8%, with strong performance in specialty and comprehensive treatment centers (CTCs) [11][12] - The company experienced a slight decline in Medicaid volumes year-over-year in its acute care hospitals, while commercial and Medicare volumes increased by 98% respectively [12] Market Data and Key Metrics Changes - The company anticipates approximately $230 million in gross revenue from existing state Medicaid supplemental programs for the full year 2025, with potential reductions starting in fiscal 2028 [6][20] - The approval of the Tennessee supplemental payment program resulted in a favorable pre-tax benefit of $51.8 million for the quarter [20] Company Strategy and Development Direction - The company remains committed to delivering essential care to underserved populations and prioritizes partnerships with payers and state agencies [7] - The company is focusing on quality initiatives and technology investments to enhance patient safety and care coordination [12][15] - The company plans to pause some capital spending to unlock more free cash flow and reduce startup costs [35][36] Management's Comments on Operating Environment and Future Outlook - Management noted that the primary driver of lower-than-expected volumes was weaker Medicaid volumes in the acute care business, reflecting evolving utilization patterns among managed Medicaid plans [26][27] - The company expects adjusted EBITDA for the full year to be in the range of $675 million to $700 million, with startup losses projected to be approximately $60 million to $65 million [21][22] - Management expressed confidence in the long-term growth potential despite current challenges, emphasizing the importance of quality care and operational efficiency [15][34] Other Important Information - Heather Dixon, the Chief Financial Officer, will be stepping down, and Tim Sides will assume the role of Interim CFO [17][18] - The company is experiencing more favorable labor trends in 2025, supported by initiatives focused on recruitment and retention [16] Q&A Session Summary Question: Can you elaborate on the Medicaid volume issues? - Management indicated that weaker Medicaid volumes were primarily due to evolving utilization patterns among managed Medicaid plans, impacting admissions trends [26][27] Question: What is driving the increase in startup costs? - The increase in startup costs is due to an accelerated opening pace of new facilities, resulting in earlier-than-expected costs [28][29] Question: How does the company view free cash flow opportunities in 2026? - Management believes there is an opportunity to accelerate the path to becoming free cash flow positive by pausing some capital spending [34][35] Question: What is the impact of underperforming facilities on patient volumes? - Underperforming facilities had a negative impact of about 80 basis points on same facility patient volume growth in Q2, with management monitoring the situation closely [42][43] Question: How is the company addressing referral sources for underperforming facilities? - The company is actively engaging with referral sources to highlight the quality of care and investments made in technology and patient outcomes [95][96]

Core Points - Magellan Health, Inc. has appointed Dr. Caroline Carney as the new Chief Executive Officer, succeeding Derrick Duke [1][2] - Dr. Carney has been with Magellan since 2016, serving in various clinical leadership roles, including Chief Medical Officer and President of the Behavioral Health Business [2][3] - As CEO, Dr. Carney will oversee the strategic direction and operational execution of the company's business strategy [2] Company Background - Magellan Health focuses on delivering innovative and integrated behavioral health solutions, emphasizing a person-centered approach and a clinical-first philosophy [3] - The company serves a diverse customer base, including health plans, managed care organizations, employers, labor unions, military and governmental agencies, and third-party administrators [5]

Company Overview - T&R Recovery Holdings, LLC is a leading provider of mental health and addiction treatment services, operating three accredited facilities in Arizona and Texas [3] - The company offers a comprehensive continuum of care, including residential treatment, partial hospitalization, intensive outpatient, detoxification, and other specialized services [3] Investment Details - Truxton Capital Advisors acted as the exclusive financial advisor to T&R Recovery in securing a strategic growth investment from GP Capital Partners and Cyprium SBIC I LP [1][2] - The transaction involved a combination of debt and minority equity, along with a delayed draw facility to support future expansion initiatives [2] - The capital infusion aims to accelerate T&R Recovery's strategic growth through acquisitions and market expansion within the behavioral health sector [2] Strategic Importance - The transaction highlights Truxton Capital Advisors' expertise in the healthcare services sector, particularly in behavioral health, and its capability to deliver favorable outcomes for founder-led and mission-driven businesses [4] - The investment is expected to enhance T&R Recovery's operational strength and clinical excellence, positioning the company for continued growth [3]

Acadia Healthcare Company (ACHC) 2025 Conference Summary Industry Overview - Acadia Healthcare is one of the largest behavioral health providers in the US, operating a network of 270 facilities with approximately 12,000 beds across 39 states and Puerto Rico, serving over 80,000 patients daily [6][7][8]. Key Financial Performance - The company reported that revenue, EBITDA, volume, revenue per day, and margins were all in line with guidance, with EBITDA at the high end of the range [2][3]. - Acadia added 378 newly licensed beds in Q1 and reaffirmed its full-year financial guidance for both revenue and adjusted EBITDA [3][4]. Demand and Growth Outlook - Consistent demand is observed across all four lines of business, with a significant opportunity in the behavioral health sector due to an estimated 75,000 additional beds needed in the US to meet demand [6][7]. - The company is in a period of record growth, expecting to add 800 to 1,000 beds in 2025, with nearly half already achieved in Q1 [10][11]. - The Comprehensive Treatment Centers (CTCs) segment is expected to grow mid-single digits over the next few years, with a strong demand for opioid use disorder treatment [9][15]. Operational Insights - The average cost per new facility bed is estimated at $500,000 to $550,000, with a target breakeven period of 12 to 13 months and expected maturity occupancy of 80% to 85% within three to five years [12][13]. - The company is focused on tuck-in M&A to acquire existing CTCs, which is a fragmented part of healthcare, enhancing growth and efficiency [18]. Policy and Regulatory Environment - Acadia is monitoring the implications of the opioid settlement funds, with $50 billion available but only a small percentage reaching states and counties [19][20]. - The company is optimistic about the potential impact of the reconciliation bill on access to high acuity mental health care, which could mitigate costs in other healthcare areas [24][25]. Pricing and Revenue Guidance - The company anticipates low single-digit pricing growth, with supplemental payments being a significant factor in revenue projections [46][47]. - For 2025, Acadia expects revenue growth of 6%, but EBITDA is projected to decline year-over-year due to various headwinds, including supplemental payment reductions and underperforming facilities [52][53]. Challenges and Risks - The company faces challenges from underperforming facilities, which are expected to impact EBITDA by approximately $20 million for the year [34][38]. - There is ongoing concern regarding potential policy changes and their impact on Medicaid access and reimbursement rates [26][30]. Conclusion - Acadia Healthcare is positioned for growth in the behavioral health sector, with strong demand and strategic plans for bed additions and acquisitions. However, it must navigate regulatory challenges and operational headwinds to achieve its financial targets [41][44].