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Side-by-side financial comparison of Acadia Healthcare Company, Inc. (ACHC) and Custom Truck One Source, Inc. (CTOS). Click either name above to swap in a different company.

Acadia Healthcare Company, Inc. is the larger business by last-quarter revenue ($821.5M vs $461.6M, roughly 1.8× Custom Truck One Source, Inc.). Custom Truck One Source, Inc. runs the higher net margin — -0.9% vs -143.3%, a 142.5% gap on every dollar of revenue. On growth, Acadia Healthcare Company, Inc. posted the faster year-over-year revenue change (6.1% vs -12.6%). Over the past eight quarters, Custom Truck One Source, Inc.'s revenue compounded faster (20.0% CAGR vs 3.4%).

Acadia Healthcare Company, Inc. is an American provider of for-profit behavioral healthcare services. It operates a network of over 225 facilities across the United States and Puerto Rico.

Custom Truck One Source, Inc. is a leading provider of specialized heavy truck and equipment solutions in North America. It offers custom vehicle manufacturing, equipment sales and rentals, aftermarket parts, and maintenance services, serving core infrastructure, utility, construction, and energy industry segments.

ACHC vs CTOS — Head-to-Head

Bigger by revenue
ACHC
ACHC
1.8× larger
ACHC
$821.5M
$461.6M
CTOS
Growing faster (revenue YoY)
ACHC
ACHC
+18.7% gap
ACHC
6.1%
-12.6%
CTOS
Higher net margin
CTOS
CTOS
142.5% more per $
CTOS
-0.9%
-143.3%
ACHC
Faster 2-yr revenue CAGR
CTOS
CTOS
Annualised
CTOS
20.0%
3.4%
ACHC

Income Statement — Q4 FY2025 vs Q1 FY2026

Metric
ACHC
ACHC
CTOS
CTOS
Revenue
$821.5M
$461.6M
Net Profit
$-1.2B
$-4.1M
Gross Margin
22.3%
Operating Margin
-142.4%
6.8%
Net Margin
-143.3%
-0.9%
Revenue YoY
6.1%
-12.6%
Net Profit YoY
-3710.4%
76.9%
EPS (diluted)
$-12.98
$-0.02

Green = leading value per metric. Periods may differ when fiscal calendars don't align.

8-Quarter Revenue & Profit Trend

Side-by-side quarterly history. Quarters aligned by calendar period so offset fiscal years line up.

Revenue
ACHC
ACHC
CTOS
CTOS
Q1 26
$461.6M
Q4 25
$821.5M
$387.3M
Q3 25
$851.6M
$359.9M
Q2 25
$869.2M
$392.2M
Q1 25
$770.5M
$307.1M
Q4 24
$774.2M
$398.3M
Q3 24
$815.6M
$337.5M
Q2 24
$796.0M
$320.6M
Net Profit
ACHC
ACHC
CTOS
CTOS
Q1 26
$-4.1M
Q4 25
$-1.2B
$20.9M
Q3 25
$36.2M
$-5.8M
Q2 25
$30.1M
$-28.4M
Q1 25
$8.4M
$-17.8M
Q4 24
$32.6M
$27.6M
Q3 24
$68.1M
$-17.4M
Q2 24
$78.5M
$-24.5M
Gross Margin
ACHC
ACHC
CTOS
CTOS
Q1 26
22.3%
Q4 25
31.8%
Q3 25
28.0%
Q2 25
26.1%
Q1 25
27.9%
Q4 24
29.7%
Q3 24
27.2%
Q2 24
27.8%
Operating Margin
ACHC
ACHC
CTOS
CTOS
Q1 26
6.8%
Q4 25
-142.4%
13.4%
Q3 25
4.7%
9.1%
Q2 25
5.8%
7.1%
Q1 25
1.7%
4.0%
Q4 24
4.9%
16.9%
Q3 24
12.1%
6.8%
Q2 24
13.4%
5.5%
Net Margin
ACHC
ACHC
CTOS
CTOS
Q1 26
-0.9%
Q4 25
-143.3%
5.4%
Q3 25
4.3%
-1.6%
Q2 25
3.5%
-7.2%
Q1 25
1.1%
-5.8%
Q4 24
4.2%
6.9%
Q3 24
8.4%
-5.2%
Q2 24
9.9%
-7.6%
EPS (diluted)
ACHC
ACHC
CTOS
CTOS
Q1 26
$-0.02
Q4 25
$-12.98
$0.10
Q3 25
$0.40
$-0.03
Q2 25
$0.33
$-0.13
Q1 25
$0.09
$-0.08
Q4 24
$0.36
$0.11
Q3 24
$0.74
$-0.07
Q2 24
$0.85
$-0.10

Balance Sheet & Financial Strength

Snapshot of each company's liquidity, leverage and book value from the latest quarter.

Metric
ACHC
ACHC
CTOS
CTOS
Cash + ST InvestmentsLiquidity on hand
$133.2M
$9.6M
Total DebtLower is stronger
$2.5B
$5.1M
Stockholders' EquityBook value
$1.9B
$805.2M
Total Assets
$5.5B
$3.5B
Debt / EquityLower = less leverage
1.28×
0.01×

8-quarter trend — quarters aligned by calendar period.

Cash + ST Investments
ACHC
ACHC
CTOS
CTOS
Q1 26
$9.6M
Q4 25
$133.2M
$6.3M
Q3 25
$118.7M
$13.1M
Q2 25
$131.4M
$5.3M
Q1 25
$91.2M
$5.4M
Q4 24
$76.3M
$3.8M
Q3 24
$82.1M
$8.4M
Q2 24
$77.2M
$8.1M
Total Debt
ACHC
ACHC
CTOS
CTOS
Q1 26
$5.1M
Q4 25
$2.5B
$1.6B
Q3 25
$2.3B
$1.6B
Q2 25
$2.3B
$1.6B
Q1 25
$2.2B
$1.6B
Q4 24
$2.0B
$1.5B
Q3 24
$1.9B
$1.6B
Q2 24
$1.8B
$1.5B
Stockholders' Equity
ACHC
ACHC
CTOS
CTOS
Q1 26
$805.2M
Q4 25
$1.9B
$809.1M
Q3 25
$3.1B
$784.7M
Q2 25
$3.1B
$790.1M
Q1 25
$3.0B
$813.4M
Q4 24
$3.1B
$861.3M
Q3 24
$3.0B
$837.5M
Q2 24
$3.0B
$856.7M
Total Assets
ACHC
ACHC
CTOS
CTOS
Q1 26
$3.5B
Q4 25
$5.5B
$3.4B
Q3 25
$6.4B
$3.5B
Q2 25
$6.3B
$3.6B
Q1 25
$6.1B
$3.5B
Q4 24
$6.0B
$3.5B
Q3 24
$5.9B
$3.6B
Q2 24
$5.7B
$3.5B
Debt / Equity
ACHC
ACHC
CTOS
CTOS
Q1 26
0.01×
Q4 25
1.28×
2.03×
Q3 25
0.74×
2.10×
Q2 25
0.74×
2.04×
Q1 25
0.72×
1.97×
Q4 24
0.64×
1.77×
Q3 24
0.62×
1.87×
Q2 24
0.62×
1.79×

Cash Flow & Capital Efficiency

How much cash each business actually produces after reinvestment. Cash flow is harder to manipulate than net income.

Metric
ACHC
ACHC
CTOS
CTOS
Operating Cash FlowLast quarter
$-86.3M
Free Cash FlowOCF − Capex
$-179.5M
FCF MarginFCF / Revenue
-21.8%
Capex IntensityCapex / Revenue
11.3%
Cash ConversionOCF / Net Profit
TTM Free Cash FlowTrailing 4 quarters
$-439.9M

8-quarter trend — quarters aligned by calendar period.

Operating Cash Flow
ACHC
ACHC
CTOS
CTOS
Q1 26
Q4 25
$-86.3M
$47.3M
Q3 25
$73.2M
$81.5M
Q2 25
$133.5M
$125.7M
Q1 25
$11.5M
$55.6M
Q4 24
$116.7M
$82.1M
Q3 24
$163.1M
$16.5M
Q2 24
$171.1M
$37.8M
Free Cash Flow
ACHC
ACHC
CTOS
CTOS
Q1 26
Q4 25
$-179.5M
Q3 25
$-63.0M
Q2 25
$-34.2M
Q1 25
$-163.2M
Q4 24
$-86.8M
Q3 24
$-27.1M
Q2 24
$16.9M
FCF Margin
ACHC
ACHC
CTOS
CTOS
Q1 26
Q4 25
-21.8%
Q3 25
-7.4%
Q2 25
-3.9%
Q1 25
-21.2%
Q4 24
-11.2%
Q3 24
-3.3%
Q2 24
2.1%
Capex Intensity
ACHC
ACHC
CTOS
CTOS
Q1 26
Q4 25
11.3%
Q3 25
16.0%
Q2 25
19.3%
Q1 25
22.7%
Q4 24
26.3%
Q3 24
23.3%
Q2 24
19.4%
Cash Conversion
ACHC
ACHC
CTOS
CTOS
Q1 26
Q4 25
2.27×
Q3 25
2.02×
Q2 25
4.43×
Q1 25
1.37×
Q4 24
3.58×
2.98×
Q3 24
2.39×
Q2 24
2.18×

Financial Flow Comparison

Revenue → gross profit → operating profit → net profit for each company.

Revenue Breakdown by Segment

ACHC
ACHC

Acute Inpatient Psychiatric Facilities$451.2M55%
Comprehensive Treatment Centers$144.2M18%
Medicare$113.7M14%
Residential Treatment Centers$89.7M11%
Self Payor$16.1M2%
Other Payor$10.7M1%

CTOS
CTOS

Equipment sales$292.6M63%
Rental revenue$137.2M30%
Parts sales and services$31.8M7%

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