Why Acadia Healthcare Is Expanding Eating Disorder Treatment as Competitors Scale Back

Amid a slew of closures and layoffs in the eating disorder market, behavioral health provider Acadia Healthcare (Nasdaq: ACHC) is expanding its eating disorder programming.

Acadia is furthering its reach into trauma-focused treatment and wrap-around care, leadership told Behavioral Health Business. The provider also recently launched an eating disorder awareness campaign and plans to add more eating disorder capacity.

Dr. Nasser Khan, newly appointed chief operating officer, acknowledged the recent challenges in the eating disorder industry and said that the expansion is “first and foremost” driven by clinical need.

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“Our clinical strategy and our business strategy are very intermeshed and in some ways are one and the same,” Khan said. “This is a large and growing problem … this is an essential service. … From a business standpoint, it’s [on] us to build the service, the product, the care model, the programming that fits those needs.”

The focus on eating disorders also aligns with Acadia’s prioritization of high-acuity patients, Khan said.

“If you look at the data from eating disorders and those with opioid use disorder, those are the things that have the highest mortality in our space,” Dr. Stephanie Eken, chief medical officer at Acadia, told BHB. “They are a population that not everyone can or will serve because of the medical complexities that go with those disorders.”

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One type of eating disorder, anorexia nervosa, has an extremely high mortality rate compared with other mental health disorders, according to the National Institute of Mental Health.

Acadia’s “additional focus” on eating disorders

Eating disorder patients often have trauma in their backgrounds, Eken said.

To address this co-occurring condition, Acadia is expanding its eye movement desensitization and reprocessing (EMDR) treatment modality.

The provider has extensively utilized EMDR at Timberline Knolls, a residential and outpatient facility for women and girls in Illinois. The provider is now ramping up training in EMDR to expand to other facilities.

Acadia also created a treatment plan for eating disorder patients with specialized needs, such as athletes and people who use GLP-1 drugs including Ozempic and Wegovy. 

The program, called structure health, offers wrap-around care including evaluations of fitness needs and diet.

“It’s really a lifestyle intervention,” Eken said.

The new offerings are not available at all of Acadia’s eating disorder facilities but the provider ensures that certain core components of the treatment modalities are available at all of its eating disorder facilities, Eken said.

The additional focus on eating disorder treatment pathways may also be accompanied by more eating disorder facilities.

Acadia has previously committed to meaningfully expanding its geographic footprint. In 2024, the provider plans to add 1,200 new hospital beds and open 14 comprehensive treatment centers (CTCs) de novo facilities.

The aggressive growth plans will “certainly” include added capacity for eating disorder patients, Khan said.

A less-than-friendly eating disorder market

Acadia’s expanded programming contrasts with other hybrid and brick-and-mortar behavioral health providers that have scaled back or eliminated their eating disorder programs.

Optum subsidiary Refresh Mental Health completely shuttered its eating disorder service line in January due to “local market conditions.” The move resulted in the closures of at least 16 locations.

Discovery Behavioral Health consolidated or closed 14 to 16 locations as of January, opting for a “more efficient” business model.

The closures and consolidations represented around 10% of Discovery’s national footprint, approximately 150 before the change in strategy. The new business model emphasizes outpatient services, telehealth, outcomes tracking and larger facilities.

“There is an imbalance between the cost-drivers — labor, cost of doing business with the national inflation rates — and reimbursement from payers,” Peloquin previously told Behavioral Health Business. “That requires [Discovery Behavioral Health] to become more efficient.”

Hybrid eating disorder provider Monte Nido found that several of its markets were underperforming, a source told BHB, and laid off almost 130 members of its staff in May.

Before the layoffs, Monte Nido had experienced notably quick growth, expanding its footprint by 23% since the beginning of 2023.

Odyssey Behavioral Health closed its eating disorder facility, Shoreline Center for Eating Disorder Treatment, at the end of 2023. Shoreline operated two locations in California.

Odyssey’s chief operating officer, Justin Adams, cited an “increasingly challenging operating environment for eating disorder services in this particular market” as the reason for the closures.

Despite these closures and restructurings, two virtual disorder treatment providers have landed funding in the last year.

In February, virtual eating disorder provider Arise raised roughly $6.5 million.

Digital eating disorder provider Equip landed $20 million in September 2023. Simultaneously, Equip announced that it would expand its patient population to include adults.

While virtual eating disorder care may be attractive to investors, it may not be in the best interests of all patients, Khan said.

“Care of those patients and those populations can only be done at a best-in-class level if there’s a physical component,” Khan said. “Which isn’t to say you can’t complement it with virtual therapy; it’s just to say that the core of it requires the in-person provider-patient interaction in my opinion.”

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