Why CentralReach’s Rapid Growth Reflects the Emerging Challenges of the Autism Services Market

Autism and disability services software provider CentralReach has seen rapid growth of the past year, largely due to the changing needs of its provider partners and macro-level trends.

The success of the Fort Lauderdale, Florida-based company additionally demonstrates the potential of billing and administrative tools to help behavioral health operators address the market challenges, especially following a run of recent autism service layoffs.

Demand for autism services has inflated in the last several years, and the supply of services, specifically Applied Behavioral Analysis (ABA), has struggled to keep pace.


The latest autism rate estimates in the U.S. suggest that between 1 in 32 and 1 in 29 children have the life-long condition. That’s about 5 times higher than estimated rates from 2005. This imbalance inspired a flood of capital into ABA therapy and the rise of several fast-growing platform companies.

Despite the growing demand for services and new investment, the last few months have been marked by layoffs in the ABA treatment space as major providers readjusted their priorities. Layoffs at just two organizations, for instance, wiped out more than 650 jobs.

CentralReach is seeing increased demand as the industry attempts to overcome emerging difficulties.


“We only grow when our customers’ bases grow, and I think our technology is a key component to allowing customers to navigate the waters,” CentralReach CEO Chris Sullens told Behavioral Health Business.

The enterprise behavioral health electronic health (EHR) record and technology services provider has 2,800 enterprise clients and 130,000 users. In 2022 so far, the organizations using CentralReach increased hiring by 8.4%. For the same period, the company’s largest 10 customers saw a 16% increase in hiring.

Those figures suggest there’s a growing role for EHRs in behavioral health care moving forward, with an estimated 6% of operators currently using such technology.

CentralReach’s tech services focus on the ABA therapy space, K-12 special education and school-to-work transitions for students with disabilities.

Sullens attributes the growth of CentralReach’s clients to making data-based decisions that account for the challenges of the market.

“Everyone’s dealing with the same kind of dynamics and certainly trying to be prudent about their expenses and managing their growth,” Sullens said. “Our top 10 providers, which are equivalent to some of the [large, private equity-backed autism providers], their growth rate has been double that of our other customers. So, some providers are trying to manage things a little bit differently in the more recent term.”

Previous reporting has shown that stagnant ABA reimbursement rates and uneven reimbursement parity creates a vicious cycle of ballooning staff salaries, leading also to high staff turnover rates. These trends speak to the need for successful billing and collections tech platforms.

“If you’re not collecting nearly 100% of the services that you’re providing, the cost and the investment that you’re putting in to provide the services certainly has an impact,” Sullens said.

Many ABA providers with strong investor backing also try to use homegrown tech stacks. Or, they try to cobble together disparate point solutions into a cohesive system. This was a near-fatal problem for Foresight Mental Health.

On top of pulling capital away from investing in providers and services, Sullens says issues with billing-related tech can cause operators cash flow issues. In a cash flow crunch, the largest expense for autism care is staff salaries and benefits, making it the most likely source of potential cost-cutting in the face of shortfalls.

“It’s just tough to spend the capital that way,” Sullens said of placing major investments into building tech systems internally.

Sullens described CentralReach as the Epic Systems Corp. of the autism treatment space. Epic, a Madison, Wisconsin-based healthcare IT and EHR provider, holds a 32.9% share of the hospital market, the largest according to a report by KLAS Research.