Still, same-facility net revenues in our acute care hospital segment increased by 5.7% during the second quarter of 2025 as compared to last year's second quarter after excluding the impact of our insurance subsidiary. For the second quarter of 2025, our solid acute care revenues combined with effective expense controls resulted in a 10% increase in same-facility EBITDA. The new hospitals in Las Vegas and the District of Columbia contributed $35 million to the receivable increase. During the first half of 2025, we also acquired 1.9 million of our own shares at a total cost of approximately $332 million.
Our current projected 2025 full-year net benefit from previously approved state Medicaid supplemental programs is approximately $1.2 billion. Based primarily on the increased DPP reimbursement, we are increasing our midpoint of our 2025 EPS guidance by 7% to $20.50 per diluted share, up from $19.20 per diluted share previously. Medicaid supplemental programs in Washington, D.C., and other potential programs that are not yet fully approved are not included in our revised guidance. We remain pleased with the performance of West Henderson Hospital, which produced a positive EBITDA in the second quarter.
Timing of hospital certification and other startup issues proved a bit more challenging than we anticipated, but demand, especially for emergency services, has been very encouraging. In the table towards the back of the press release, we disclosed year-over-year growth in ADC. A number of the insurance companies, as they've been talking about their increase in Medical Loss Ratios, have pointed to the increase in spending on behavioral care. While they do not provide this level of detail, we believe that a significant chunk of that increase is in outpatient.
| Metric | Period | Current guidance |
|---|---|---|
| Adjusted EPS (FY2025) | Full year 2025 | $20.50 midpoint (up 7%) |
| Medicaid supplemental payments net benefit (FY2025) | Full year 2025 | ~$1.2B (includes ~$185M of new DPP revenues; excludes pending D.C. program) |
| Acute care revenue growth | FY2025 / intermediate term | 5%-7% (~6% midpoint); running in line |
| Behavioral pricing growth | Intermediate term | 4%-5% sustainable (Q2 at 4.2%) |
| Behavioral adjusted patient day growth target | Intermediate/long term | 2.5%-3% long-term target (remaining elusive; Q2 at 1.2%) |
| Cedar Hill EBITDA drag | Q2 + back half 2025 | $25M in Q2 plus another $25M in the back half |
| OB3 aggregate net benefit reduction | 2028 onset, ramping to 2032 | ~$360M-$400M by 2032 (~60% behavioral / 40% acute) |
| Share repurchase | Full year 2025 | Elevated above original range as free cash flow increases |
| Metric | YoY | Note |
|---|---|---|
| Adjusted EPS (Q2) | — | $5.35 per diluted share; reported net income $5.43 per share |
| Acute same-facility net revenues (Q2) | +5.7% | In line with guidance; pricing skewed by favorable payer mix (less Medicaid, more commercial/exchange) |
| Acute same-facility EBITDA (Q2) | +10% | Solid revenues plus effective expense control (other opex up 3.1%) |
| Acute same-facility adjusted admissions (Q2) | +2.0% | Volume growth partly offset by West Henderson cannibalization; surgical volumes down slightly |
| Behavioral same-facility net revenues (Q2, ex-Tennessee) | +5.4% | 4.2% revenue per adjusted day and 1.2% adjusted patient day growth |
| Behavioral revenue per adjusted day (Q2, ex-Tennessee) | +4.2% | Within the 4%-5% sustainable pricing range |
| Behavioral adjusted patient days (Q2) | +1.2% | Improved from Q1 but below target; outpatient growing faster than inpatient |
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| Outpatient behavioral strategy | Q1 discussion of outpatient focus; inpatient-centric history | Step-in freestanding model plus step-down; plans to open 10-15 low-capital outpatient facilities per year; Q2 outpatient outgrew inpatient | — |
| OB3 / DPP cliff | Legislation newly enacted | Worst-case ~$360M-$400M reduction by 2032 (60% behavioral / 40% acute); management expects mitigation and possible legislative tweaks | — |
| AI and technology | Early revenue-cycle experiments | Using AI for denial management/appeals countermeasures, ER coding, and AI-generated post-discharge follow-up calls; plus patient-rounding wearable tech | — |
| Behavioral volume struggle | Q1 volumes soft on staffing | Improved to 1.2% in Q2 but still below 2.5%-3% target; back-half projections trimmed; staffing and outpatient capture remain the levers | — |
| Cedar Hill ramp | — | Certification delay caused $25M Q2 drag and another $25M for the back half; ER demand encouraging; expected to ramp to divisional profitability by 2026 | — |
| Capital allocation | Original $600M-$700M buyback plan | Elevated buybacks as free cash flow rises; leverage continuing to decline; sub-2x leverage preserving flexibility | — |