King of Prussia, Pa.-based Universal Health Services is continuing to execute its growth strategy, with a focus on outpatient and behavioral health expansion, President and CEO Marc D. Miller told Becker’s.
The system’s recent plan to acquire online behavioral health provider Talkspace is one example of that strategy in action. In March, UHS announced plans to acquire Talkspace, which has a network of about 6,000 licensed behavioral health professionals serving all 50 states, the District of Columbia and Puerto Rico. The deal is expected to close in the third quarter, pending regulatory approval.
“We are continuing to execute our strategic plan, knowing that there are uncertainties in front of us,” Mr. Miller said. “We’re confident that as long as we stay focused on what we’re trying to do, we will continue to be successful. There’s been a lot of discussion about continuing to offer patient care in our inpatient settings, while at the same time trying to focus on continued growth in outpatient, both on the acute and the behavioral side.”
UHS operates across acute care and behavioral health, with more than 540 facilities and 100,000 employees, and is one of the nation’s largest behavioral health providers. Within its acute care segment, the system projects ACA exchange volumes will decline 25% to 30% in 2026 due to the expiration of enhanced premium tax credits, creating a roughly $75 million headwind.
Mr. Miller said he continues to see opportunities despite headwinds. He discussed growth and investment priorities, the Talkspace decision and his outlook moving forward.
Editor’s note: Responses were lightly edited for clarity and flow.
Question: UHS operates across both acute care and behavioral health, which is a somewhat unique mix at scale. How are you thinking about growth and investment across those segments right now, and where are you seeing the strongest opportunities?
Marc D. Miller: We continue to see a lot of opportunities in both segments and continue to evaluate a lot of possible opportunities in both. There’s not one that jumps out. We’ve done a good job on the acute care side growing in our current markets and adding increased options for patients, both with different inpatient programs as well as a whole host of outpatient offerings, and we’ll continue to do that. We look at new markets as well on the acute care side, but at times they’re more difficult to penetrate. We’re comfortable in our current markets and continuing to build those out.
On the behavioral side, it’s a bit easier to get into new markets when those opportunities become available. We have a pretty significant outpatient platform already, certainly multiple step-down outpatient programs in many of our markets. We’re in 40 states on the behavioral side, as well as the United Kingdom. We’re looking to expand that into other areas, fill in some programs where we haven’t had them, and continue to look at partnership opportunities as well as acquisition opportunities.
Q: The acquisition of Talkspace is a significant move into virtual behavioral health, with access to millions of patients and a large clinician network. What problem were you most focused on solving with that deal, and how do you see Talkspace fitting into UHS’ broader care delivery model?
MM: We’re pretty built out in intensive outpatient as well as partial hospitalization programs, those types of step-down outpatient programs that we’ve been doing for many years. As we look to build out our outpatient portfolio, we’ve talked to a number of companies over the last few years, many in the outpatient space.
We were always intrigued with Talkspace. They’ve been around over a decade, with 6,000 licensed professionals. That was very attractive to us, and we wanted to learn more. They went into a process where they were looking to possibly sell their company, so we continued to talk with them.
As we learned more, it became more evident that this was the type of business that would complement what we’re already doing. I look at them almost as a step-in, because the type of tele-outpatient behavioral care they’re doing is quite different from what we have. We do have some telehealth and some step-in type of business, but the vast majority of their patients will never become inpatient, nor should they. They’re not appropriate for inpatient care.
By adding a company like Talkspace, we’re now going to be the industry’s first nationally scaled end-to-end modern continuum in the behavioral health space. We think that’s quite attractive for payers and for patients. We’re really excited about it. The talent we’ve seen at Talkspace is very intriguing. They have a terrific tech team. They’re doing some things we’re also doing, but in a different way. They have an EMR system, they’re doing some things with AI, and they have the first mental health large language model trained on real clinical data. We’re excited about the possibilities of bringing the two entities together
Q: UHS is projecting a 25% to 30% drop in ACA exchange volumes this year. How are you preparing — both operationally and strategically — for that headwind?
MM: While we’ve announced that, we’re preparing by continuing to run our business and adjust and adapt. While there are certainly some headwinds, we’ve been able to deal with situations like this in the past, maybe not exactly this, but we’re confident we’ll be able to pivot and handle these issues.
Q: As you look ahead over the next few years, what do you see as the biggest factors shaping growth and performance for organizations like UHS — whether that’s care delivery, payer mix, or access — and where are you positioning the company within that?
MM: The main thing we focus on is continuing to offer quality care. We know that on both sides, both segments, there is a continued need for care. We don’t think that need is going to subside. While there are changes with reimbursement, those happen from time to time. The industry takes a hit, and then a few years later the pendulum swings back. We can’t predict that.
What we know is that patients have needs, and we want to be one of the top providers providing quality care, so that we continue to be chosen by patients and by payers. That’s what we focus on. With our track record — we’ve been doing this 47 years — I feel confident that we’ll be able to compete for business as we have in the past and will continue to do well in all the markets we serve.
