New Data Quantifies COVID-19’s Impact on Autism Treatment Providers

New data from the electronic health record (EHR) provider CentralReach is painting a picture of how autism treatment providers have held up amid the pandemic — and, more importantly, how the coronavirus will shape their business models into the future.

First and foremost, remote care will continue to play a role in providers’ delivery of services, according to Chris Sullens, CEO of CentralReach.

“Telehealth is here to stay as part of the solution that providers need to have in their mix,” Sullens told Behavioral Health Business. “They’re still trying to figure out exactly what role telehealth ultimately plays, but there’s a general consensus that it’s going to play a role.”

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Headquartered in Fort Lauderdale, Florida, CentralReach builds applied behavior analysis (ABA) practice management and clinical data collection software for providers that treat autism and related disorders. With its focus on research and practice, CentralReach offers fully integrated solutions to help organizations with everything from intake to scheduling to data collection and more. 

The company currently has about 1,400 provider clients of all shapes and sizes. Within those organizations, CentralReach has about 100,000 employee users, who serve a total of about 200,000 learners.

When the country closed and went into lockdown, CentralReach unsprisingly saw its provider clients pivot to remote treatment options. Pre-COVID, the most billable entries CentralReach ever saw submitted to telehealth payers in a single month was around 3,000, according to Sullens. But after COVID-19 hit, that number jumped to almost 400,000 at its height, he said.

Now, months later, telehealth usage remains at about 80% of what it was during that peak, Sullens said. These days, organizations are leveraging hybrid models of care, strategically providing clients with a mix of both in-person and telehealth services when appropriate, according to CentralReach Marketing SVP Karen Parisi.

“A lot of these organizations have really evolved their processes so that they’ve been able to navigate through the waves [of COVID-19] that we’ve seen,” Parisi told BHB. “I expect we’re going to see that continue into this quarter and even into the spring.” 

More so than other providers in the behavioral health space, autism treatment organizations are typically heavily reliant on face-to-face service delivery. The nature of ABA is a big reason for that. ABA therapy focuses on helping children with autism improve specific behaviors such as communication, social skills and more.

ABA can be delivered in a variety of settings — from homes to schools to centers — but historically it’s almost always delivered in person.

However, the coronavirus could bring telehealth more effectively into the mix. While ABA services are best delivered to children in-person, some things can be appropriately handled remotely.

For example, Kadiant, a private equity-backed ABA provider composed of nine legacy autism services companies, sees the benefit in using the technology to help behavioral analysts remotely supervise ABA technicians.

“Programs are typically designed and supervised by a behavior analyst, and a lot of that work can be very effectively delivered via telehealth,” Kadiant CEO Lani Fritts previously told BHB. “It has morphed the model into a hybrid service delivery model in a lot of ways, and enhanced the ability for behavior analysts to be in many places virtually at the same time, when historically they might be driving from location to location.”

Provider impact

Overall, ABA organizations who use CentralReach saw billable charges decrease between 48% and 52% when the coronavirus hit in March. Meanwhile, medium-sized providers typically saw the largest decline.

When segmented by setting, CentralReach’s center-based autism treatment providers were hit hardest. While in-home providers saw their number of overall billable sessions decrease by 36% on average after the coronavirus hit, center-based providers saw business drop by almost 68%, according to Sullens.

Another notable COVID-19 trend relates to hiring: Even in some of the hardest hit states, hiring is increasing. For example, California has seen an 8.3% growth in hiring since April.

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