Private Equity Has Now Acquired 574 Autism Therapy Centers

Researchers at Brown University’s School of Public Health counted 574 autism therapy centers owned by private equity firms across 42 states as of December 31, 2024. That figure, published in JAMA Pediatrics in January 2026, represents one of the first national audits of private equity’s presence in autism care — and it arrives at a moment when families are already waiting an average of six months to get their children into ABA therapy at all.

Quick answer: Private equity has acquired roughly 574 autism therapy (ABA) centers in the United States, mostly during a 2018–2022 buying surge. The research on what this means for kids is early but not encouraging — costs go up, certain services get cut, and the financial logic of these deals points away from the things that families actually need.

How we got here

The autism therapy market has two features that make it attractive to investors: it is intensively reimbursed and it is fragmented. Applied behavior analysis — the primary evidence-based intervention for autism spectrum disorder — is now mandated under most commercial insurance plans, and demand has grown as diagnosis rates have risen. Until recently, most providers were small independent practices, which is exactly the kind of industry structure that invites consolidation.

According to the Brown study, authored by health economist Yashaswini Singh and senior research scientist Daniel Arnold, private equity executed 142 separate acquisition deals over the past decade, with the acquisition pace peaking between 2018 and 2022. California had 97 PE-owned centers, Texas 81, Colorado 38, Illinois 36, and Florida 36. The researchers note that investment concentrated in states with higher rates of autism diagnosis and fewer restrictions on insurance coverage — a pattern that tracks the money, not the need.

Singh put it plainly in the study: “There is yet another segment of health care that has emerged as potentially profitable to private equity investors and it is very distinct from where we have traditionally known investors to go, so the potential for harm can be a lot more serious.”

That last clause is the part worth sitting with. These are children. Many are nonverbal or have significant support needs. The relationship between a child and a skilled behavior analyst, built over months or years, is not easily replaced when a PE firm decides a clinic isn’t hitting its margin targets.

What private equity does to behavioral health — the record so far

There is a growing body of research on what PE ownership does to behavioral health facilities more broadly, and none of it lands in the “better outcomes” column.

A study by researchers at Oregon Health & Science University, the University of Pennsylvania, and Yale — published in JAMA Psychiatry — found that residential behavioral health facilities owned by private equity charge more than 15% more than comparable non-PE facilities. The same study found PE-owned facilities were less likely to offer detox services. More expensive, fewer services. That is the pattern.

The frequency of behavioral health acquisitions across all facility types rose from 32 in 2010 to 1,330 in 2021, with private equity-backed acquisitions accounting for roughly 60% of all that activity, according to a 2024 study in Health Affairs Scholar. We are not talking about a few deals at the margin. We are talking about a wholesale restructuring of who owns the places where people get care.

In January 2025, a year-long bipartisan investigation by the U.S. Senate Budget Committee — led by Senators Whitehouse and Grassley — concluded that private equity’s primary focus in health care has been financial goals rather than quality of care, leading to health and safety violations, chronic understaffing, and in some cases hospital closures. At Prospect Medical Holdings, owned by Leonard Green & Partners, the committee documented $645 million in dividends paid to investors while eight hospitals closed during or after the ownership period. The title of the report was “Profits Over Patients.”

That is the hospital record. The autism therapy record is newer, and the Brown researchers are clear that we don’t yet have outcome data specifically for PE-owned ABA centers. But there is no structural reason to think children’s therapy would be exempt from the same pressures that produced those hospital results.

A January 2026 deal shows you exactly what the math looks like

Sometimes a single transaction tells the whole story.

In January 2026, ACES ABA — backed by private equity firm General Atlantic since 2020 — announced the acquisition of Ally Pediatric Therapy, a Phoenix-based provider of ABA, speech-language pathology, occupational therapy, and feeding therapy. Ally had nine locations. ACES brought it in and announced it would wind down all of Ally’s in-house speech, occupational therapy, and feeding programs. Families who depended on those services would be referred out to community providers.

ACES reached 92 locations across seven states after the deal. The multidisciplinary model that Ally had built — the one that kept a child’s ABA therapist, speech therapist, and occupational therapist in the same building, coordinating in real time — was gone. Not because the services weren’t needed. Because ACES runs ABA-only locations, and the financial model doesn’t accommodate the rest.

This is not a critique of any individual clinician at ACES. The clinicians are working in a structure they didn’t design. The structure is the thing that was redesigned.

What this means for families sitting on a waitlist right now

Here is the access picture before you layer PE consolidation on top of it.

Roughly 75% of caregivers of children with autism report spending time on a waitlist for ABA services. The average wait is close to six months. In parts of the country, families drive hours to reach the nearest clinic. Demand for board-certified behavior analysts increased 58% between 2023 and 2024, according to workforce data cited by the AACAP in its 2025 policy statement on autism care access, while the supply of providers has lagged.

That is the baseline. A family already waiting six months for a spot finally gets their child in. If the clinic was just acquired, they have no way to know whether the staffing model, the service mix, or the ownership priorities have changed since the intake was scheduled. Private equity ownership structures are not disclosed on the clinic’s waiting room sign.

There are now 574 centers where that is the situation. Spanning 42 states.

The fix requires looking at who owns the building

I want to be precise about what I am and am not saying here.

I am not saying every PE-owned ABA clinic delivers poor care. Individual clinicians inside these organizations are often excellent, and some PE operators run clean programs. What the research shows is a structural incentive problem: when an investment fund’s return depends on revenue growth and cost reduction inside a three-to-five-year hold period, the pressure on clinical staffing ratios, service mix, and the willingness to serve complex or lower-reimbursement cases runs in a predictable direction. That direction is not toward the kids who need the most.

The Senate investigation was bipartisan. The JAMA research is peer-reviewed. The Ally Pediatric acquisition is documented. These are not ideological claims. They are a pattern with a paper trail.

What would actually help families is a combination of things: mandatory ownership transparency at the facility level, reimbursement structures that don’t create a race to the most billable services, and a workforce investment that expands the supply of BCBAs so families aren’t trapped with whatever provider is available. None of those are quick. All of them require treating children’s mental health as a public good rather than an acquisition target.

In the meantime, if you are an employer whose health plan covers ABA therapy, it is worth knowing whether the clinics in your network are PE-backed and what the research says about what that may mean for the families on your plan who need them most.

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FAQ

How many autism therapy centers has private equity acquired in the United States? As of December 31, 2024, researchers at Brown University’s School of Public Health identified 574 autism therapy centers owned by private equity firms across 42 states. The study, published in JAMA Pediatrics in January 2026, found nearly 80% of those acquisitions occurred between 2018 and 2022 through 142 separate deals.

Does private equity ownership affect the cost or quality of behavioral health care? Research suggests it does. A study by researchers at Oregon Health & Science University, the University of Pennsylvania, and Yale, published in JAMA Psychiatry, found that residential behavioral health facilities owned by private equity charge more than 15% more than comparable non-PE facilities, and are less likely to offer detox services.

Why are ABA therapy centers attractive to private equity firms? ABA therapy is one of the most intensively reimbursed behavioral services for children, often mandated by state insurance law. Demand is growing as autism diagnosis rates rise, and the field remains fragmented — the conditions that historically made primary care and hospital systems attractive to roll-up investors.

What happens to services when a private equity firm acquires an ABA provider? The evidence is early but consistent. When ACES ABA (backed by General Atlantic since 2020) acquired Phoenix-based Ally Pediatric Therapy in January 2026, it immediately wound down Ally’s in-house speech, occupational, and feeding therapy programs and replaced them with external referral coordination. ABA-only was more profitable. The kids still needed the other services.

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Sources

1. Singh Y, Arnold D, et al. “Private Equity Acquisition of Autism Therapy Centers in the United States.” JAMA Pediatrics, published January 5–7, 2026. Brown University press release, January 7, 2026 — 574 centers, 42 states, 142 deals, 2018–2022 peak, Singh quote.

2. Zhu J, et al. “Geographic Penetration of Private Equity Ownership in Outpatient and Residential Behavioral Health.” JAMA Psychiatry, 2024. OHSU press release, May 1, 2024 — 15% higher charges at PE-owned residential BH facilities; less likely to offer detox services; PE accounts for up to 25% of BH practices in some states.

3. Acquisitions of Behavioral Health Treatment Facilities from 2010 to 2021. Health Affairs Scholar, published 2024. — 32 acquisitions in 2010 to 1,330 in 2021; PE-backed acquisitions accounting for ~60% of all activity.

4. U.S. Senate Budget Committee, “Profits Over Patients: The Harmful Effects of Private Equity on the U.S. Health Care System.” Press release, January 7, 2025 — bipartisan investigation, $645M in dividends, eight hospital closures, patient care deterioration.

5. “ACES Acquires Ally Pediatric Therapy, Transitions to ABA-Only Model.” Behavioral Health Business, January 16, 2026 — ACES backed by General Atlantic since 2020; Ally Pediatric’s nine Phoenix locations; wind-down of speech, OT, and feeding programs; 92-location footprint post-acquisition.

6. AACAP, “Policy Statement on Expanding Access to Care for the Autism Community,” 2025. — 58% increase in BCBA demand between 2023 and 2024; average wait times approaching six months; 75% of caregivers reporting waitlist experience.

7. US News & World Report / HealthDay, January 6, 2026 — independent coverage confirming Brown study findings, state distribution of PE-owned centers.

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Disclaimer

This article is for educational and informational purposes only. It does not constitute medical, clinical, legal, or therapeutic advice, and reading it does not create a therapist-client relationship with Matthew Sexton, LCSW or Mental Wealth Solutions, Inc. Although the author is a licensed clinical social worker, the content in this article is not clinical assessment, diagnosis, or treatment.

Private equity ownership structures, therapy access, and quality data in behavioral health vary by provider, geography, and over time. The research cited here reflects the best available peer-reviewed and government evidence as of the date of publication, but conditions change. Nothing in this article is investment advice or legal advice. For guidance on a specific provider, coverage situation, or legal matter, consult an appropriate professional.

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