Private equity firms have acquired more than 500 autism therapy centers across the United States in the past decade, with nearly 80% of these acquisitions occurring within a four-year period. This significant trend is highlighted in a new study conducted by researchers at the Brown University Center for Advancing Health Policy through Research. The study’s author, Yashaswini Singh, a health economist at Brown’s School of Public Health, emphasizes the swift movement of financial firms into a crucial area of health care that has not received adequate public scrutiny.
Singh notes that the findings reveal a new segment of health care that is attracting private equity investors, which could have serious implications, particularly because the majority of children receiving autism treatment are covered by Medicaid. As private equity firms increase the intensity of care, there may be significant impacts on state Medicaid budgets in the future.
Study Findings and National Context
The analysis, published in JAMA Pediatrics, offers one of the first comprehensive assessments of the growing influence of private equity in autism therapies and services. Autism diagnoses among U.S. children have surged in recent years, nearly tripling from 2011 to 2022. This rise has coincided with heightened public discourse surrounding autism, often marked by misinformation linking the condition to childhood vaccines.
While the study does not assess the effects of private equity ownership on treatment accessibility or quality of care, it does indicate that investments have predominantly concentrated in states with higher autism diagnosis rates and fewer insurance coverage limits.
Geographic Distribution and Acquisition Trends
The researchers identified a total of 574 autism therapy centers owned by private equity firms as of 2024, distributed across 42 states. A substantial majority of these centers were acquired between 2018 and 2022, resulting from a total of 142 separate transactions. The largest concentrations of private equity-owned centers were found in California (97), Texas (81), Colorado (38), Illinois (36), and Florida (36). In contrast, sixteen states had either one or no private equity-owned clinics by the end of 2024.
The study revealed that states with the highest prevalence of childhood autism diagnoses were 24% more likely to host private equity-owned clinics compared to other states, underscoring a concerning trend regarding the concentration of resources.
The speed and scale of these acquisitions prompted researchers to investigate after receiving anecdotal reports from families and health providers about noticeable changes following private equity takeovers.
Concerns about the implications of these ownership changes are voiced by Daniel Arnold, a senior research scientist at the School of Public Health. He highlights the potential for private equity firms to prioritize financial incentives over family needs. Arnold expresses worry that children may receive more services than clinically appropriate and that disparities in access may worsen.
To track private equity investments, the research team combined proprietary databases, public press releases, and manual verification of archived websites. Unlike public companies, private equity firms are not mandated to disclose acquisitions, making data collection challenging.
Moving forward, the team aims to investigate how private equity ownership influences various outcomes, including therapy intensity, medication usage, diagnosis age, and treatment duration. They seek to determine whether these investments address genuine needs or primarily serve profit motives.
Singh concludes, “Private investors making a little bit of money while expanding access is not a bad thing, per se. But we need to understand how much of a bad thing this is and how much of a good thing this is. This is a first step in that direction.”
