Private Equity in ABA: Rethinking the Future of Ownership

Private Equity in ABA: Rethinking the Future of Ownership

Patrick Thorbourne never dreamed of owning an ABA company simply for the sake of entrepreneurship. After years working in Applied Behavior Analysis (ABA), he was focused on helping children and supporting families. Eventually, he began considering what it would take to build a practice of his own—one where he could shape the clinical philosophy and culture from the ground up. As he explored that possibility, he noticed a pattern. More providers were expanding rapidly, investment firms were entering the industry, and independent practices seemed increasingly rare. It raised an important question: Was partnering with outside investors the only realistic way for a Board-Certified Behavior Analyst (BCBA) to build a successful practice?

An Industry in Transition

Over the past decade, private equity has played a significant role in expanding access to ABA services. Investment firms have provided organizations with the capital to open new clinics, expand into underserved communities, hire additional staff, and invest in technology and infrastructure. As a result, many more families have gained access to autism services than would have otherwise been possible (Advisory Board, 2023; Morris et al., 2024).

At the same time, the rapid growth of the ABA industry has prompted important conversations about how organizations can continue to deliver individualized care as they expand. Because private equity firms typically invest with the goal of growing a company before eventually selling it, some researchers have questioned whether financial priorities could sometimes influence staffing, productivity expectations, or other operational decisions that shape clinical care (Morris et al., 2024; Morris, 2025). Specifically, researchers have noted that these pressures may contribute to larger caseloads, reduced supervision, and less flexibility for clinicians to individualize treatment when they are not carefully managed.

For families, those changes can have significant consequences. Larger caseloads and reduced supervision may make it more difficult for therapists to tailor interventions to each child’s needs, maintain consistency across providers, and build the strong therapeutic relationships that help children succeed. Those concerns have also been echoed by some clinicians working in the field. Some have described feeling pressure to recommend more therapy hours or manage larger caseloads than they believed best supported individualized care (Bannow, 2022). Together, these experiences have encouraged many within the profession to think carefully about how growth and high-quality, individualized care can continue to go hand in hand.

Looking Beyond Private Equity

Like many clinicians, Patrick didn’t want to spend his time negotiating with insurance companies or learning the complexities of payroll systems. He wanted to build an organization where clinical decisions remained in the hands of clinicians while creating a practice that was financially stable and capable of serving more families. The question was no longer whether private equity was the only option. It became whether there was another way to access the business infrastructure needed to build a successful practice without giving up ownership or clinical autonomy.

As the ABA profession continues to evolve, that question extends beyond Patrick’s own journey. Private equity has played an important role in expanding access to care and helping organizations grow, and Patrick’s vision is not to dismiss that contribution. Instead, he wants clinicians to recognize that it does not have to be the only path. He sees a future in which BCBAs can access the infrastructure and business support needed to build financially stable organizations while retaining ownership and keeping clinical decisions in the hands of clinicians. For Patrick, rethinking the future of ABA ownership means expanding what clinicians believe is possible: sustainable growth without sacrificing the autonomy, relationships, and commitment to individualized care that drew them to the profession in the first place.

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References

Advisory Board. (2022, August 16). Private equity in autism care: The advantages and tradeoffs. Daily Briefing. https://www.advisory.com/daily-briefing/2022/08/16/autism-private-equity

Bannow, T. (2022, August 15). Private equity is shortchanging kids with autism, parents, clinicians say. STAT. https://www.statnews.com/2022/08/15/private-equity-autism-aba-therapy/

Morris, C. (2025). Private equity in behavior analysis: A reckoning. Perspectives on Behavior Science, 48(3), 613–619. https://doi.org/10.1007/s40614-025-00446-4

Morris, C., Grauerholz-Fisher, E., Ellsworth, M. E., & Crocker, C. E. (2024). A primer on private equity ownership in ABA. Behavior Analysis in Practice, 17(4), 967–976. https://doi.org/10.1007/s40617-024-00941-1