2021 Autism Outlook: Stakeholders Predict Consolidation, Service Expansions in Year Ahead

Autism treatment providers have been hit especially hard by the COVID-19 pandemic, as many of their services are dependent upon in-person connections. But in 2021, stakeholders predict the industry will bounce back; however, it won’t look the same way it did pre-pandemic.

Executives and insiders in the space anticipate more children will need higher levels of care due to the coronavirus. Plus, they say telehealth is here to stay, consolidation is primed to pick up and comprehensive services offerings are set to become the norm.

You can read industry stakeholders’ 2021 predictions for the autism treatment space below.

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With the federal commitment to build on the Affordable Care Act and strengthen Medicaid, we anticipate that our families will have more predictable and increased access to funding for autism treatment across funding sources like commercial insurance and Medicaid.

Even with the autism provider sector’s growth, many patients continue not to have access to behavioral health services, and we anticipate continued expansion as provider capacity increases. For those patients who struggled to access services during the COVID-19 pandemic, we anticipate higher needs to address the loss of skills. The growing awareness that it is critical to treat mental health conditions to benefit society at large will continue to impact access to care positively.

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The broad adoption of telehealth triggered by the COVID-19 pandemic has increased accessibility to applied behavior analysis services and demonstrated the important role telehealth plays in delivering effective autism treatment. With the continuation of telehealth, patients in rural and densely populated areas will have increased access to care.

The growing recognition and enforcement of mental health parity laws at the state and federal level will provide more certainty for patients and insurers alike. A focus on integrating and coordinating care as a contributing variable to optimal patient outcomes will likely be reflected in best practices and how insurers fund the benefit.

— Statement from the executive leadership team at the Center for Autism & Related Disorders (CARD)

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The biggest factors continuing to shape autism services are the quality and training of clinicians, specifically Board Certified Behavior Analysts (BCBA). Annually 5,000 new BCBAs enter the job market without undergoing a residency-type of program. It is incumbent on service providers to offer a level of training and supervision that helps ensure a high-level quality of services.

Another change we anticipate [in 2021] is the blurring of education and healthcare. The location of where services are provided is becoming more important to ensure appropriate skill acquisition and generalization. Soon, service location – whether in a school or a clinic – will no longer be a barrier to accessing care. Using outcome-based assessment to measure quality of services is gaining momentum and a trend that will continue well into 2021.

— Marina Major, president of Little Leaves Behavioral Services

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I see there being two major factors to shape the autism space in 2021.  One will be finding new ways to support our children and their families via distance learning.  The second is reversing the regression we see from months of children being in their homes with limited services. 

At Gersh Autism, I have started implementing new creative ways to address these challenges, and I believe that we will see that across the board to ensure our kids are not left behind.

– Kevin Gersh, founder and CEO of Gersh Autism

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In 2021, add-on acquisitions by private equity-backed platforms will accelerate, as decreasing COVID-19 risk allows them to focus on growth. Platforms are largely looking at beachhead acquisitions to access some combination of clinicians, payor contracts and referral networks in a new market and subsequently leverage the attractive unit economics in the sector to build from there.

The sector should continue the move toward a more integrated offering and ABA therapy-focused providers will consider expansion into complementary therapy services. Providers will also look to offer compliant diagnostic services, particularly in regions where it is the bottleneck to starting services.

Finally, it will be interesting to see if center-based providers become more flexible on their care settings, given the experience and expertise gained from the pivot to in-home services during COVID.

— Rajat Bangar, managing director at Edgemont Partners

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I think that the end of the pandemic is going to be a major key for autism services.

Like all health care providers, these providers have been hit hard by the shutdowns, requirements for social distancing, etc. With vaccines on the way, there is great hope for the health care industry, including autism providers.

— Roger Strode, partner and health care business lawyer at Foley & Lardner LLP

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