The Politics of Autism includes an extensive discussion of autism service providers. Private equity firms now own many of them. Insurance mandates and Medicaid spending have contributed to the growth trend.
States may want to consider policies that help address some of the specific concerns surrounding private equity ownership of ABA providers. A May 2026 article in Health Affairs both describes those specific issues and proposes regulations that could help improve oversight of ABA services and private equity’s role.
Yashaswini Singh, Corrie Mook, Jared Perkins, Nathan Hostert, and Daniel R. Arnold, the authors of the Health Affairs article,noted that, in general, private equity investment “alters workforce composition and clinician turnover,” and that the rapid growth of private equity-owned ABA services can lead to higher costs and limit access to care. The authors found that in Colorado, “PE-backed centers accounted for half of the increase in billable hours in 2024, prompting concerns over unnecessarily intense treatments that lack clinical benefit.”
To allow for greater oversight of private equity-backed ABA providers, the authors recommend:The authors also suggest that policymakers engage with patient advocacy groups and community organizations to provide insight into how to refine reforms more quickly to avoid unintended consequences.
- Generating higher quality Medicaid data with more details, including state identifiers;
- Requiring ownership transparency for provider organizations; and
- Enforcing existing anti-kickback statutes, including to investor-backed management companies.
