From Acadia to Altocare: How Reeve Waud Perfected the Healthcare Buy-and-Build Strategy

When Reeve Waud founded Acadia Healthcare in 2005, he established a template for healthcare consolidation that has generated billions in value creation. Twenty years later, the formation of Altocare and acquisition of MedTec Healthcare demonstrates how Waud has refined this buy-and-build approach.

Both platforms share common elements: fragmented markets, essential services, and experienced management teams capable of executing aggressive growth approaches. However, Altocare reflects the sophistication gained from two decades of healthcare investment experience, incorporating lessons learned from multiple successful exits and market cycles.

The Acadia Healthcare Model: Blueprint for Consolidation

Acadia Healthcare began as Waud’s answer to behavioral health’s fragmented structure, where hundreds of independent psychiatric facilities operated without the scale advantages of national networks. Starting with growth capital and guidance, Waud transformed Acadia from a startup platform into one of the nation’s largest behavioral health hospital systems.

The Acadia model emphasized expansion through acquisitions while maintaining quality standards across diverse facilities. Within six years, the company had achieved sufficient scale to complete a successful IPO in 2011, demonstrating the viability of Waud’s consolidation thesis. Acadia’s growth trajectory from inception to public company status established credibility for subsequent healthcare investments.

Reeve Waud’s continued role as Chairman of Acadia’s board reflects his commitment to long-term value creation rather than quick exits. This approach has enabled Acadia to maintain its market position while continuing expansion, currently operating over 260 facilities across 40 states and Puerto Rico.

Lessons Applied: GI Alliance and Platform Scaling

The success of Acadia Healthcare provided Waud Capital Partners with both capital and credibility to pursue larger consolidation opportunities. GI Alliance exemplified the firm’s ability to replicate the Acadia model across different healthcare specialties, transforming fragmented gastroenterology practices into a national platform.

GI Alliance’s 2022 sale to Apollo Global Management at approximately $2.2 billion validated Waud’s buy-and-build methodology across multiple healthcare sectors. The transaction occurred just four years after the platform’s formation, demonstrating accelerated execution compared to Acadia’s longer development timeline.

These experiences taught Waud Capital Partners to identify management teams earlier in the process, streamline integration procedures, and leverage technology more effectively across portfolio companies. Each platform investment reinforced the firm’s operational playbook while revealing sector-specific nuances.

Altocare’s Evolution: Multi-Service Platform Strategy

Altocare represents a more sophisticated approach than Waud’s earlier single-service platforms. The combination of Senior Helpers’ franchise model with MedTec Healthcare’s direct-service operations creates complementary revenue streams and multiple growth pathways within a single platform.

Senior Helpers’ network of over 380 locations provides immediate national scale, while MedTec’s specialized focus on culturally tailored services and adult day centers expands the care continuum. This diversified structure reduces risk while maximizing market opportunity across different demographics and payer sources.

The platform’s balanced approach to serving both private-pay and Medicaid-supported clients reflects lessons learned from Acadia Healthcare’s diversified payer mix, which provided stability during regulatory changes and economic downturns.

Execution Advantages: Three Decades of Healthcare Experience

Waud’s 30-year track record provides institutional advantages unavailable to newer healthcare investors. The firm’s deep relationships with healthcare executives, regulatory expertise, and operational knowledge enable faster due diligence and more effective post-acquisition integration.

Altocare benefits from this accumulated experience through sophisticated technology implementation, streamlined compliance processes, and proven management recruitment approaches that have generated consistent returns across multiple healthcare platforms and market cycles.