Cortica CEO: ‘You Don’t Need ABA to Solve All of a Child’s Problems’

Cortica Inc. aims to emulate academic medical centers’ focus on comprehensive care offerings and science-backed autism interventions in its care model.

That model calls for just a fraction of the Applied Behavioral Analysis (ABA) services that children receive in other care settings. Rather, the San Diego-based operator says it can deliver improved outcomes by offering some ABA services alongside neurology, physical therapy and developmental pediatrics — to name just a few.

In turn, it eventually hopes to win over payers by showing them that Cortica can improve care and lower costs in a value-based care arrangement, Cortica co-founder and CEO Neil Hattangadi said in an interview.

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Dr. Suzanne Goh started a private practice autism clinic in 2014 that eventually became Cortica. Goh, who is married to Hattangadi, is now Cortica’s chief medical officer.

Goh pulled inspiration for Cortica’s model from the academic medical centers where she and Hattangadi trained as physicians. Goh, a pediatric neurologist and board-certified behavioral analyst, sought to address the biological and behavioral aspects of autism all in the same place.

“From the standpoint of a parent, you’re bouncing between — if you’re in San Diego — UCSD, then a general pediatrician, then a specialist in genetics and epilepsy, ABA providers, a speech provider,” Hattangadi said. “So to bring all that together and help them streamline a defragmented model — that’s been critical.”

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The model also seeks to keep the vital aspects of academic medical centers, like a keen focus on science and outcomes, while solving some of their problems such as care coordination and time to care.

The Cortica model includes an average of 9.2 hours of ABA services a week. The U.S. National Research Council suggests that children with autism get 25 hours of ABA over a five-day week for a year. For some children, the Behavior Analyst Certification Board, recommends up to 40 hours of ABA a week.

The company’s pre-print research, accepted by this year’s Child Neurology Society and International Child Neurology Congress, shows that its model delivered better outcomes on standardized assessments compared to the reference cohort maintained within the National Database of Autism Research (NDAR). 

“The reason for it is that you don’t need ABA to solve all of a child’s problems,” Hattangandi said.

Early on Cortica built a model that integrated several types of care specialties that focused on the latest science. This includes services based on neurophysiology, genetics, gastroenterology and nutrition.

These services include medical diagnostics, neurology, developmental pediatrics, occupational and speech therapy, physical therapy, ABA services and family counseling and care navigation.

Better care outcomes position the company to engage with payers on a value-based care basis. To this point, Cortica has operated under fee-for-service arrangements.

“It’s very hard. You have to coexist in two worlds where, in the fee-for-service world, you’re incentivized to do indiscriminate, high-volume ABA,” Hattangadi said. “It just isn’t what we do and, therefore, we are starting from a place where we’d be inherently less profitable than the company that’s doing it the other way.”

Coordinating services are not paid for, Hattangadi said. He credits Cortica’s investors for seeing the potential of the model and the direction of how care is paid for and bearing with the company as it grows.

Equity investments have also helped the company develop its own comprehensive electronic health record and data tracking system. Cortica was a preview customer of health data service Amazon HealthLake.

Cortica landed a $60 million Series C round in June 2021 led by Longitude Capital. That funding round was one of the largest tracked by BHB in 2021.

In April 2022, the San Francisco-based venture capital Autism Impact Fund placed an investment of an undisclosed sum with Cortica. While Hattangadi remained tight-lipped about the amount, he did say it was “certainly not at the scale of $60 million.”

“It was much less about the capital they put into the company,” Hattangadi said. “We wanted to be close to some very thoughtful investors who were exclusively dedicated to the space.”

Following the investment, Cortica provides a testing ground for new technologies from other Autism Impact Fund portfolio companies. Some of these include biotech companies focused on the gut biome, new molecular biomarker diagnostics and virtual reality services.

“We are an engine or point of care solution where all these other technologies can come to be studied and that data is used for FDA approval,” Hattangadi said. “Then once they’re approved, we’re the same network that can then make this available to 8,000 families a year based on the clients that we serve around the country.”

Presently, the company operates 15 centers in five states.

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