In addition, we may reference during today's call measures such as EBITDA, adjusted EBITDA, adjusted EBITDA net of NCI, and adjusted net income attributable to UHS, which are non-GAAP financial measures. Adjusted EBITDA net of NCI increased 8.4%, and adjusted EPS increased 16.1% as compared to the first quarter of 2025. Talkspace successful payer-driven business model aligns well with our strategy to increase access to a full spectrum of outpatient services and diversify our behavioral payer mix. We plan to share more details about the impact of the transaction after closing, but I'd like to highlight two primary benefits for the acquisition.
First, from a strategic perspective, Talkspace represents a multi-year value creation opportunity underpinned by access to new sources of outpatient revenue growth. Second, from a financial perspective, we expect the deal to be accretive to earnings during the first 12 months post-closing, and we expect it to be increasingly accretive thereafter. By Year 3 post-closing, we expect the effective EBITDA multiple for the Talkspace transaction to be in the single-digit range. From a growth perspective, we met our internal same-facility revenue growth and earnings objectives in the first quarter, despite a more dynamic operating backdrop.
In the operational domain to impact quality and patient experience, and in the administrative domain to increase efficiency. We deployed and scaled a total of eight different use cases of AI solutions into our revenue cycle operations that are now yielding significant benefit on a go-forward basis. After adjusting for the impact of the items reflected on the supplemental schedule as included with the press release, our adjusted EPS was $5.62 for the first quarter. We estimate acute care volumes during the first quarter of 2026 were impacted by approximately 200 basis points due to weaker flu and respiratory activity and winter weather in certain markets.
| Metric | Period | Current guidance |
|---|---|---|
| Revenue (FY2026) | Full year 2026 | $18.4B-$18.8B (reiterated) |
| Adjusted EBITDA net of NCI (FY2026) | Full year 2026 | $2.64B-$2.79B (reiterated) |
| Adjusted EPS (FY2026) | Full year 2026 | $22.64-$24.52 (reiterated) |
| Same-facility volume growth, both segments | Full year 2026 | 2%-3% (reiterated; Q1 below range on seasonal factors) |
| Health insurance exchange pre-tax impact | Full year 2026 | ~$75M adverse (reiterated) |
| Talkspace deal accretion | First 12 months post-closing | Accretive to earnings, increasingly accretive thereafter; single-digit effective EBITDA multiple by year 3 |
| Share repurchase | Full year 2026 | Expect to remain active throughout 2026 including around Talkspace closing |
| Metric | YoY | Note |
|---|---|---|
| Revenue (Q1) | +9.6% | Growth across both segments driven by pricing and health plan growth |
| Adjusted EBITDA net of NCI (Q1) | +8.4% | Efficiency initiatives and expense discipline offsetting soft seasonal volumes |
| Adjusted EPS (Q1) | +16.1% | EBITDA growth plus share repurchase; reported adjusted EPS $5.62 |
| Acute same-facility net revenues (Q1) | +8.2% | Pricing/acuity gains and health plan growth; +6.2% excluding health plan |
| Acute same-facility segment EBITDA (Q1) | +11.7% | Strong expense management plus prior-period Nevada supplemental benefit |
| Acute revenue per adjusted admission (Q1) | +6.3% | Higher acuity mix (lower flu), Nevada supplemental; +4.9% excluding ~$30M supplemental |
| Behavioral same-facility net revenues (Q1) | +7.3% | 5.8% revenue per adjusted patient day and 1.6% patient day growth |
| Behavioral same-facility segment EBITDA (Q1) | +8.4% | Pricing and moderating wage growth; +4.3% excluding prior-period supplemental payments |
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| Outpatient behavioral strategy | Building out Thousand Branches freestanding clinics and step-down/step-in programs organically | Accelerated dramatically via the announced Talkspace acquisition to create an end-to-end behavioral continuum from virtual outpatient to inpatient | — |
| AI and technology adoption | In 2025 deployed and scaled eight AI use cases in revenue cycle operations | For 2026 shifting focus to clinical operations with new use cases built with Hippocratic AI; expected incremental to margins over time | — |
| Medicaid supplemental payments (DPP) | Large prior-year programs (Tennessee, D.C.) recognized after Q1 2025 | $46 million of out-of-period Nevada/Ohio DPP recorded in Q1 2026, all within guidance; Florida ~$50M program still pending, California uncertain | — |
| Health insurance exchange headwind | Assumed 25%-30% exchange volume decline for the full year | 5% reported Q1 decline booked at a higher effective rate; still expects steepening as the year progresses toward 25%-30% | — |
| Behavioral labor and wages | 2025 behavioral salary/wage expense up ~8% including heavy headcount investment | Moderated to ~6% in Q1 2026 with less aggressive hiring and improving turnover; expects further moderation | — |
| Capital allocation | Low leverage (just under 2x) prioritizing buybacks and CapEx | Expanded credit facilities by $900M; Talkspace lifts leverage only to just over 2x, leaving room for buybacks, CapEx, and other M&A | — |