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.
Anna Wilde Mathews, Christopher Weaver, and Tom McGinty at WSJ:
Many autism-therapy providers and an industry group cite studies of young children showing high-hour therapy can help those with severe challenges. Government officials and insurers have scrutinized long hours, at times pointing to other research, disputed by some providers, that raised questions about the correlation between long therapy hours and improved outcomes. New federal guidelines for Medicaid say there is no correlation.
Private-equity firms have poured hundreds of millions of dollars into building national chains of clinics to serve children diagnosed with autism. The Journal’s autism-treatment analysis looked at Centria, majority-owned by THL Partners; Action Behavior Centers, backed by Charlesbank Capital Partners; Hopebridge, acquired by Arsenal Capital Partners; Cerberus Capital Management-backed Lighthouse Autism Center; and Learn Behavioral, majority-owned by Gryphon Investors, which billed fewer hours a week, on average, than its competitors.
All five companies said they individualize treatment, including weekly hours, based on patient needs, not financial considerations.
The four companies with higher-than-average hours said the Journal’s analysis of Medicaid claims didn’t account for differences in the severity of patients’ autism, and that their nap policies aim to accommodate children’s sleep needs. Centria, Action and Lighthouse said their patients had more severe autism than average, justifying more therapy.
Centria said waking a 3-year-old as described by Hosking wouldn’t have complied with its policies, and such an incident wasn’t documented at the time. Action disputed the assertion in the Medicaid guidelines that treatment intensity doesn’t correlate with outcomes.
Former employees of the four higher-hour companies said in interviews they felt pressure to recommend long therapy schedules for children, and that centers sometimes turned away children who needed low weekly hours.
