Private Equity Acquires Over 500 Autism Centers in a Decade

Private equity firms have acquired more than 500 autism therapy centers across the United States in the past decade. A recent study from the Brown University Center for Advancing Health Policy through Research revealed that nearly 80% of these acquisitions occurred within a four-year period, highlighting a significant trend in the healthcare landscape.

The study’s author, Yashaswini Singh, a health economist at Brown’s School of Public Health, emphasized the implications of this shift. “The big takeaway is that there is yet another segment of health care that has emerged as potentially profitable to private equity investors,” Singh stated. She noted that this trend is distinct from traditional areas of investment, suggesting a potential for serious consequences, particularly in a sector that focuses on children who are largely covered by Medicaid programs.

Study Findings and Context

The findings of this analysis, published in JAMA Pediatrics, provide one of the first comprehensive assessments of private equity’s growing involvement in autism therapies and services. Between 2011 and 2022, autism diagnoses among U.S. children have nearly tripled. This increase has garnered significant attention, particularly amid political discussions that have wrongly linked autism to childhood vaccinations.

The researchers did not evaluate how private equity ownership affects access to treatment, quality of care, or the experiences of families seeking services. Nonetheless, they discovered that investment in autism centers has been concentrated in states with higher rates of autism diagnoses and those with fewer limitations on insurance coverage.

Geographic Distribution and Acquisition Trends

The research identified a total of 574 autism therapy centers owned by private equity firms as of 2024, spanning 42 states. Most acquisitions occurred between 2018 and 2022, resulting from 142 separate deals. The largest concentrations of centers were found in states such as California (97 centers), Texas (81), Colorado (38), Illinois (36), and Florida (36). Notably, sixteen states had one or no private equity-owned clinics by the end of 2024.

The study indicated that states in the top third for childhood autism prevalence were 24% more likely to host private equity-owned clinics compared to others. This rapidly expanding trend underscores the growing interest of private equity in the autism care market.

Concerns have arisen regarding the motivations behind these acquisitions. According to Daniel Arnold, a senior research scientist at the School of Public Health, the primary worry is that financial incentives may overshadow the needs of families. “It’s all about the financial incentives,” Arnold remarked. “I worry about the same types of revenue-generating strategies seen in other private equity-backed settings. I worry about children receiving more than the clinically appropriate amount of services and worsening disparities in terms of which children have access to services.”

To assess where private equity firms are investing and their reasons, the research team employed a combination of proprietary databases, public press releases, and manual verification of archived websites to track ownership changes. The lack of disclosure requirements for private equity firms complicates data collection, making it a labor-intensive process.

Looking ahead, the team aims to study the impacts of private equity ownership on various outcomes, including changes in therapy intensity, medication use, age of diagnosis, and duration of treatment. They plan to evaluate whether these investments are genuinely addressing needs or primarily focused on profitability.

As Singh noted, “Private investors making a little bit of money while expanding access is not a bad thing, per se. But we need to understand how much of a bad thing this is and how much of a good thing this is. This is a first step in that direction.”