The dynamics of the autism services industry are quickly maturing. Applied Behavior Analysis (ABA) provider Acorn Health has appointed health care veteran Mony Iyer to lead it into the next phase as CEO.

Iyer has a diverse set of experiences in health care, from running one of the largest veterinary companies in the U.S. to serving as president of specialty health care services for Walmart.

Next, he aims to grow Acorn to meet the needs of more patients and identify the most effective ways to retain a healthy workforce.

Acorn operates in Florida, Illinois, Maryland, Michigan, Pennsylvania, Tennessee and Virginia. It is backed by the Ontario Teachers’ Pension Plan (OTPP).

Behavioral Health Business sat down with Iyer to discuss Acorn’s next chapter.

This interview has been edited for length and clarity.

Behavioral Health Business: Given your diverse experience across different healthcare sectors, what insights or approaches from those roles do you think could be transformative when applied to autism care and services?

Iyer: When you look at multi-unit health care services, a lot of what I would describe as the underlying business dynamics and pressures are similar. They’re not the same, and providers are distinctly different from each other. They have different motivations and face different pressures, both from a professional standpoint and from a regulatory and environmental standpoint. 

But some commonalities of successful companies focus on the frontline folks who are actually delivering the care.

I want to ensure that you remove administrative work and process work from the facility, and allow providers to concentrate on what they do best: taking care of clients and their families. That’s when you’re going to have the best possible outcomes. This is also true across various health care fields. And that’s what I’ve observed in every healthcare industry I’ve been a part of, and this is an industry where I think that is ever more true.

Health care is a contact sport. And you get great health care when the provider and the patient are working together in person. And when we do use technology, when we do use innovation, when we employ processes, it needs to be in a way that enables that process.

Are there any trends in the larger health care scene, value-based care, consumerization of healthcare etc… that you see as applicable to autism? Anything you’d like to see more of in the space.

Autism and ABA services and this treatment area is an area of health care that’s still somewhat in its infancy.

There’s a lot that is going on in the space. There are a lot of debates on how one ought to deliver treatment. What is the right role of technology? What is the right role of different provider levels? What ought to be the referral pathway? How do you grease the skids, remove friction from the process of getting people access to the healthcare they need?

In many other health care areas, these are fairly well-defined because they’ve been in existence for a long time. In contrast, autism and ABA treatment are still somewhat figuring out some aspects of it, and this is reflected in some of the industry’s challenges.

I think that if we can refocus on what’s important and be very clear about outcomes, that is probably the best way to identify best practices to bring into this industry and apply them in a way that makes sense in the context of autism and ABA.

I’ll give you a simple example from my past. One of the things I’ve seen work across human health care practices is the idea of team-based care. You have licensed doctors and licensed professionals working under their supervision, ensuring that everybody is practicing at the top of their license. This allows us to bring access to care to as many patients as possible who need it.

What does that look like in the ABA treatment world? What does that look like in the world of autism treatment?

This is the kind of thing that I think about in terms of expanding access to care to as many clients that need it, while also allowing our BCBAs, our techs, our RBTs, to see the patients they need to see, to see the clients they need to see, and see as many of them and their families as possible and have the impact that they need to

What’s your top priority coming into this role?

As I came in, I looked around the ABA space. I looked at the evidence-based care that Acorn provides and the outcomes that they’ve been able to show are absolutely fantastic. I see Acorn providing this kind of life-changing care to the families and clients it serves today.

I want to ensure that Acorn is able to provide this care to as many clients and their families as possible across our great country. I think that we have an opportunity to take what Acorn is doing today and find the right ways to grow, access new clients and their families responsibly. We should ensure that we provide the best possible therapies that we can offer for them and make that meaningful change in their lives.

I want to make this happen for as many families as possible across the country. So, the question on my mind is: what are the best, quick ways to drive responsible growth and ensure that, with urgency, we bring this care to as many families as possible?

How are you thinking about growth? Are you considering organic growth or inorganic growth? And then, in terms of growth, are you thinking of expanding geographically or increasing your footprint within a certain area?

I’d say today, Acorn has plenty of opportunity to grow within the geographic footprint that we already have. We have centers operating in states where we can provide great care, but I also know that those centers aren’t reaching everybody we can reach within those states.

I look at the geographic footprint that we have, and we have growth opportunities within that footprint. The big challenge in this industry is turnover, and I’ve seen that not just at Acorn. I’ve seen that across the entire industry, and I do know that within our existing centers, there is the opportunity to expand capacity.

What are some of the biggest challenges in the autism space you are looking to take on?

I see turnover as a big challenge. And you know what strikes me about the turnover? This isn’t unique to autism; it’s something we’ve seen in healthcare generally. The highest turnover is at the entry level, where people are coming in and turning over at a rate that is faster than we would like.

The real challenge is that very often, they’re not just leaving the company; they’re leaving the industry. They’re going to work in retail or in other industries. And for me, the challenge is investing in the right things that make people want to stay in our industry for the long term, to stay, to grow, to advance their education, to advance their career prospects.

This is an industry that’s still in its infancy, and we’re still figuring out what those look like.

Another challenge is the client pathway. The pathway to diagnostics is almost painfully long. It takes a long time to get that diagnosis. ASD is the kind of space where you want to diagnose as fast as possible, and you want to take that diagnosis and get folks into treatment as quickly as possible.