Large Autism Provider CARD Shuts Down Operations in 10 States

The Centers for Autism and Related Disorders (CARD) is shutting down – or has already halted – operations in 10 states.

Backed by private equity firm Blackstone, CARD is one of the largest autism providers in the U.S. At the end of 2021, CARD was operating in 24 states across the country and had 221 locations. Following these closures, it will operate in 14 states.

“CARD regularly reviews and evolves our operating footprint to ensure our centers have adequate capacity, staff, and reimbursement rates to provide outstanding care to patients,” Jeffrey Cho, vice president of field operations at CARD, said in a statement to Behavioral Health Business. “We are proud to continue to play a leading role in the overall well-being of our patients, their families, and the entire autism community as we continue to deliver high-quality care and services to our patients nationwide.”


CARD was founded in 1990 and offers applied behavior analysis (ABA) therapy, a type of one-on-one therapy focused on improving targeted behaviors. It also offers center-based services, specialized out-patient services, remote clinical services and training programs.

The company was acquired by Blackstone, whose investments also include virtual behavioral health provider Ginger and consumer genomics giant Ancestry.

The decision to pull back in certain markets comes after key CARD leadership changes. In February, Jennifer Webster came on board as CEO to replace Tony Kilgore, who resigned for undisclosed reasons.


CARD is just one of the many autism providers downsizing.

Looking at the autism space overall, investors and ABA providers grew national platforms as quickly as possible to try to gain market share and leverage in payer rate negotiations. Throughout 2022, some of these companies were forced to cut back operations to match economic realities in local employment markets and limited reimbursement increases.

Yet there is still a large demand for autism services. Rates of autism have increased significantly over the last decade. Roughly 1 in 44 children are diagnosed with autism spectrum disorder, according to the CDC. That is an increase from 1 in 69 children in 2012.

It appears CARD has been gradually closing its operations in those 10 states. Over the summer, news broke that CARD was closing 10 of its Oregon Centers, resulting in 156 layoffs, according to state documents.

In addition to Oregon, the provider will no longer operate in Georgia, Maryland, Massachusetts, Michigan, Missouri, New Mexico, New Hampshire, Rhode Island and Wisconsin. 

Over the summer, 360 Behavioral Health also laid off 503 employees in California, according to the state’s Worker Adjustment and Retraining Notification (WARN) report.

Despite the closures, autism-focused private equity deals are still going strong. In the first half of 2022, there were 46 deals, a 15% increase year over year, according to data from The Braff Group.

Chris Larson contributed to this story

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