This is an exclusive BHB+ article.
The start of 2026 has already seen some surprises for publicly traded behavioral health companies.
For starters, I did not have Universal Health Services (NYSE: UHS) buying virtual provider Talkspace (Nasdaq: TALK) on my bingo card at the start of the year. The two entities seemed to be operating in different spheres. But after listening to UHS’ most recent earnings call, I’m curious about how the two will not only work together to share patients up and down the continuum but also develop new products and service lines catering to each other’s strengths.
Meanwhile, Acadia (Nasdaq: ACHC) has brought back several former C-Suite leaders following a challenging year on the market amid legal battles. On the company’s first-quarter earnings call, leadership appeared focused on buttoning up operational execution.
Teladoc (NYSE: TDOC) sees a path forward for its virtual mental health care segment, BetterHelp. The company has been rolling out insurance coverage for BetterHelp, which appears to be helping current members access more visits and converting potential users into active clients.
The latest batch of earnings calls from the largest behavioral health companies in the sector shed light on where they are headed.
In this BHB+ Update, I will explore:
–Why UHS’ acquisition of Talkspace could create a new kind of provider in the future.
–How BetterHelp’s bet on in-network care is performing by the numbers.
–Where Acadia plans to cut and grow operationally in 2026.
The gang is back together
After a year of challenges, Acadia reinstated several of its veteran C-suite executives. Earlier this year, Debbie Osteen returned to her CEO role, and the company announced earlier this month that David Duckworth will resume his position as CFO. Following these changes, additional operational and executive leadership shifts are on the horizon.
“For 2026, our primary focus is operational execution and deriving more value from our facilities and recent bed additions. That starts with having the right leaders in place and supporting our operators in the field,” Osteen said. “It also requires clear decision-making and accountability at every level so we can drive stronger fundamentals and more consistent performance across all four lines of business.”
Overall, the company’s revenue totaled $828.8 million, a 7.6% increase compared with the first quarter of 2025. It also reported a 7.3% increase in same-facility revenue and a 5.6% increase in patient days.
Osteen noted that in her first three months back in the CEO role, she conducted talent and operational structure reviews that led to leadership changes at multiple levels. The reviews have also led to the reorganization of its acute service line, including reducing the number of facilities and geographies within each division to enable better oversight. Acadia has also created a new operating group for acute facilities focused on joint venture hospitals and recently opened facilities. Additionally, the company will hire a new head of joint ventures.
Referrals are another core priority for the new leadership as they enter the rest of 2026. “We are focused on execution, referrals, and leadership at all our facilities, but particularly in locations that have not ramped as quickly as expected,” she noted.
In particular, Osteen noted that the company is prioritizing sharing patient outcomes with referral sources and communicating the breadth of services they offer.
My two cents: Overall, this is a positive quarter for Acadia after a turbulent stint. I think having experienced leadership at the helm—people who truly know the landscape—could help steer the company on an upward trajectory. It appears that joint ventures will remain a top priority, and I’m curious to see how a new executive overseeing these programs could advance that goal.
Promising signs
Teladoc’s virtual behavioral health platform, BetterHelp, is beginning to see results from its initiative to offer in-network services. The provider’s insurance rollout is live in 30 states and Washington, D.C. So far, insurance-covered users are averaging 20% more sessions than cash-pay users in their first 90 days.
“And we’re beginning to see some meaningful separation in performance between markets where insurance has been active for an extended period compared to cash-only markets,” Charles Divita, CEO of Teladoc, said during the company’s Q1 earnings call. “For example, in states where insurance was live by the third quarter of 2025, we’re seeing a nearly 800 basis point improvement in revenue performance compared to cash pay-only markets, an indication that insurance access is improving activation and helping stabilize underlying trends as markets scale.”
The company expects this shift to have substantial financial implications going forward. BetterHelp’s total insurance-covered sessions have reached over 14,000 per week, representing an annualized revenue run rate of more than $75 million. The company now expects to exit 2026 with a run rate of $125 million or more.
Still, for the second quarter, the company reported that BetterHelp’s segment revenue was $218 million, down 9% year over year. Revenue for the company as a whole was $618 million, down 2% year over year. While the in-network rollout is moving along, challenges remain, such as ensuring enough therapist capacity to meet demand.
“I think one of the challenges we have in insurance is we’ve got to make sure that we’ve got the right therapist capacity to meet the demand,” Divita said. “We’ve now credentialed and enrolled over 6,000 providers, and BetterHelp has a large therapist network of over 30,000 in its consumer cash-pay business. So we’re just urgently activating that.”
My take: BetterHelp was one of the last major holdouts committed to the cash-pay model. When the company finally began pivoting to an in-network model, my first thought was “finally.” With inflation continuing to strain household budgets, expanding insurance coverage is a smart move that could shield the company from ongoing consumer headwinds.
UHS bets on Talkspace acquisition
Universal Health Services (NYSE: UHS) has ambitious plans for its pending $835 million acquisition of virtual provider Talkspace (Nasdaq: TALK). UHS is generally associated with traditional behavioral health and acute levels of care, as one of the only large inpatient providers in the country. But the acquisition of Talkspace and its new outpatient strategy is poised to change that image.
This deal will help UHS reach a new patient population, as Talkspace serves lower-acuity patients virtually. The provider is also betting on the acquisition to help develop new intermediate service lines.
“There is a significant opportunity for us to introduce Talkspace’s team of 6,000 clinicians into our environment to develop higher acuity virtual offerings, such as virtual intensive outpatient programs (IOPs),” Marc Miller, CEO of UHS, said on the company’s Q1 earnings call. “This will improve our ability to manage more patients stepping down from UHS facilities with a preferred virtual option.”
Overall, the company’s net revenue increased by 9.6% to $4.5 billion in the first quarter of 2026. UHS’s focus on outpatient care is larger than its Talkspace deal; the company launched its outpatient brand, Thousand Branches, in 2024. The provider has since been focused on growing the service line, though according to Miller, the rollout has been somewhat slower than initially anticipated.
My thoughts: Ever since UHS announced its plans to acquire Talkspace, I’ve started to reconsider what type of provider UHS will be in the future. Historically, we’ve seen brick-and-mortar providers on one side and digital health companies on the other. This deal could really shake up that narrative for the whole industry. UHS has the opportunity to become the first traditional behavioral health provider with a truly consumer-first digital platform.