In recent years, the demand for behavioral health services has surged dramatically. Communities across the United States are grappling with rising rates of mental health disorders and substance use, leaving many providers overwhelmed and short on capacity. As a result, hospitals and healthcare systems are now looking beyond traditional growth models to meet this growing demand—and many are finding success through Behavioral Health Joint Ventures.
Behavioral Health Joint Ventures are collaborative partnerships between healthcare systems and behavioral health companies that allow both parties to share resources, risk, and expertise. Rather than building from the ground up independently, these partnerships create a mutually beneficial path to expanding services in new regions, particularly in underserved areas where behavioral health access has historically been limited.
At the 2024 Behavioral Health Business INVEST conference, leaders from top organizations such as Acadia Healthcare and US HealthVest emphasized how vital Behavioral Health Joint Ventures have become in driving expansion. For Acadia Healthcare (Nasdaq: ACHC)—the largest standalone behavioral health provider in the country—JVs are now a cornerstone of its growth strategy. With 253 facilities in 39 states and Puerto Rico, Acadia has formed 20 such partnerships to expand acute inpatient behavioral health services.
“We build wholly owned de novo hospitals,” said Isa Diaz, Senior Vice President of Strategic Affairs at Acadia. “But we also thought the JV strategy was critical as we were trying to expand our footprint, especially in markets that are not easy to penetrate.”
The Value of Behavioral Health Joint Ventures
Behavioral Health Joint Ventures offer a strategic advantage, especially in areas that have regulatory hurdles such as certificate of need (CON) requirements. Partnering with a well-known health system not only gives behavioral health companies a “brand halo effect,” as Diaz describes it, but also enables faster regulatory approval, improved local trust, and easier recruitment of staff.
US HealthVest follows a similar approach, combining ground-up development with carefully selected JVs. The New York-based company currently operates 1,300 beds across the country and is actively constructing another 100. According to Dr. Richard Kresch, CEO and founder of US HealthVest, many community-based, nonprofit hospitals are eager to expand into behavioral health but lack the specialized knowledge to do so effectively. This makes Behavioral Health Joint Ventures especially appealing.
“Many not-for-profit hospitals have a mission to serve their communities broadly, but behavioral health is often where they struggle,” said Kresch. “It’s becoming more a part of their general business strategy to look for outside assistance.”
The Joint Venture Process
Despite their potential, Behavioral Health Joint Ventures are not quick or easy to execute. Both Acadia and US HealthVest emphasize that the process requires persistence, trust-building, and a shared vision. Health systems often begin by hiring investment banks to evaluate opportunities. They visit potential partner facilities, conduct extensive due diligence, and weigh what each party brings to the table—be it capital, land, operational expertise, or regulatory experience.
Location selection is one of the first critical decisions. If the hospital system owns land, that may become the proposed site. If not, partners must work together to identify a location that meets both market demand and zoning or CON guidelines. After that, it may still take years for the project to materialize.
“The pace at which the process proceeds is often very slow,” Kresch noted. “A project that we may be starting discussions about tomorrow may not see the light of day and building coming out of the ground for a couple of years.”
Challenges and Timeline of Behavioral Health Joint Ventures
In CON states, the approval process adds even more time and complexity—but both companies agree it’s worth it. These states often have the greatest unmet need, making the investment both socially and financially worthwhile. Even after initial discussions and site selection, the legal, regulatory, and financing paperwork can take a year or more to finalize.
Despite the lengthy timeline, the results of Behavioral Health Joint Ventures speak for themselves. None of Acadia’s or US HealthVest’s JV projects have failed, thanks to the extensive effort put into aligning values, setting clear expectations, and fostering mutual trust. The Acadia-Bronson Healthcare partnership in Battle Creek, Michigan, is a prime example. That JV took three and a half years to complete and produced a 96-bed hospital—an essential resource for patients and families in the region.
“For Acadia, it’s been a tremendous benefit to partner with a local entity that’s already trusted by the community,” said Diaz. “That kind of relationship gives us a running start.”
Looking Ahead to More Behavioral Health Joint Ventures
Ultimately, Behavioral Health Joint Ventures provide a powerful mechanism for expanding behavioral health services nationwide. As more health systems recognize the value of partnering with behavioral health experts, these collaborations are becoming a vital strategy in the broader effort to close access gaps and meet community needs. By sharing expertise and resources, joint ventures allow healthcare systems to provide high-quality, specialized care while reducing risk and improving scalability.
In an era where mental health and substance use concerns are more pressing than ever, Behavioral Health Joint Ventures are not just a trend—they’re a lifeline. And as the industry continues to evolve, it’s likely that we’ll see even more providers turning to these partnerships as a smart and sustainable growth model.
