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. Turning to our third quarter 2025 results, we reported adjusted net income attributable to UHS of $5.69 per share, representing a 53% increase from the third quarter of 2024. Our third quarter performance reflects continued growth in our acute care operating environment, modest volume improvement in our behavioral health segment, and solid pricing across both segments. We have a long track record of expanding presence in core markets with new state-of-the-art hospitals and are excited to build on our existing presence on the East Coast of Florida.
Same-facility revenue growth was driven by a 7.9% increase in revenue per adjusted patient day as compared to the prior year. Excluding the prior period impact of the District of Columbia Supplemental Revenue, same-facility revenue per adjusted patient day increased 7.1% during the third quarter of 2025. During the first nine months of 2025, we spent $734 million on capital expenditures, close to 30% of which related to the new hospital in Florida and a replacement facility in California. Today, our Board of Directors authorized a new $1.5 billion increase to our stock repurchase program, bringing our total authorization to $1.759 billion, including amounts remaining under the previous authorization.
In the absence of compelling acquisition opportunities over the near term, we expect to continue to prioritize our excess free cash flow for share buyback and dividends. Turning to an update on Medicaid supplemental payment programs, our current projected 2025 full-year net benefit from various previously approved programs is $1.3 billion. As we discussed during our second quarter 2025 earnings call, the OB3 legislation includes several significant changes in the Medicaid program, including changes to state-directed payment programs and provider taxes. What's the kind of run rate on the exchange volume and revenue year to date?
| Metric | Period | Current guidance |
|---|---|---|
| Adjusted EPS (FY2025) | Full year 2025 | $21.80 midpoint (up 6%) |
| Medicaid supplemental payments net benefit (FY2025) | Full year 2025 | ~$1.3B (excludes programs pending CMS approval) |
| Behavioral adjusted patient day growth | Q4 2025 / intermediate term | 2%-3% range, near-term at the lower end |
| Pending Florida DPP program | Upon CMS approval | ~$47M annual (still pending, not in guidance) |
| Pending Nevada DPP increase | Upon CMS approval | ~$30M (pending, not in guidance) |
| Exchange subsidy expiration impact | Annual, if subsidies expire | Trending toward the higher end of $50M-$100M |
| OB3 aggregate net benefit reduction | 2028 onset, ramping to 2032 | ~$420M-$470M by 2032 (increased for recent approvals) |
| Metric | YoY | Note |
|---|---|---|
| Adjusted EPS (Q3) | +53% | D.C. supplemental benefit, acute growth, and share repurchase; $5.69 per share |
| Revenue (Q3) | +13.4% | Acute growth, pricing, and supplemental Medicaid benefits |
| Acute same-facility net revenues (Q3) | +12.8% | Pricing and D.C. benefit; +9.4% excluding insurance subsidiary and prior-period D.C. benefit |
| Acute revenue per adjusted admission (Q3) | +9.8% | Acuity, revenue-cycle initiatives, and D.C. benefit; +7.3% on a core basis |
| Acute same-facility EBITDA margin (Q3) | +190 bps to 15.8% | Revenue growth combined with 4.0% opex-per-admission growth (excluding D.C.) |
| Behavioral same-facility net revenues (Q3) | +9.3% | 7.9% revenue per adjusted patient day and 1.3% patient day growth; +8.5% excluding D.C. |
| Behavioral same-facility EBITDA (Q3) | +7.6% | Revenue growth with stable margins (excluding prior-period D.C. benefit) |
| Acute same-facility adjusted admissions (Q3) | +2.0% | Solid inpatient medical and outpatient growth; surgical volumes up slightly |
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| Outpatient behavioral strategy | Building step-down and step-in programs; roughly 100 access points | ~100 behavioral access points, on track to open 10 step-in programs this year under Thousand Branches Wellness; dedicated outpatient personnel reorganization | — |
| Medicaid supplemental payments (DPP) | 2025 net benefit tracking toward ~$1.2B | FY2025 net benefit ~$1.3B including D.C.; Florida (~$47M) and Nevada (~$30M) still pending CMS approval | — |
| OB3 / DPP cliff | $360M-$400M reduction by 2032 (Q2 estimate) | Increased to $420M-$470M by 2032 to reflect recent program approvals | — |
| Exchange (HIX) exposure | Exchange 6%-6.5% of acute admissions; $50M-$100M subsidy-expiry risk | Exchange volumes ticking up (concentrated in Texas and Florida); trending toward the higher end of the $50M-$100M risk range | — |
| Behavioral supply-demand and staffing | Volumes muted by labor scarcity in a quarter to a third of hospitals | Hiring improving steadily; national behavioral utilization rising, much on the outpatient side, which UHS aims to capture | — |
| Capital allocation and leverage | Prioritizing buybacks; leverage at low end of history | New $1.5B authorization; expects to devote most/all free cash flow to buybacks and dividends absent compelling M&A; open to levering up | — |