Private equity firms have rapidly expanded their footprint in autism care, acquiring more than 500 therapy centers across the U.S. in the past decade. Nearly 80% of those transactions occurred between 2018 and 2022, according to a study published in JAMA Pediatrics by the Providence, R.I.-based Brown University Center for Advancing Health Policy through Research.
Researchers identified 574 private equity-owned autism therapy centers in 42 states as of 2024, stemming from 142 separate transactions. The highest concentrations were 97 in California, 81 in Texas, 38 in Colorado and 36 each in Illinois and Florida, compared to 16 states with one or zero private equity-owned clinics.
The study found that “states in the top third for childhood autism prevalence were 24% more likely to have a private equity-owned clinic than others.” These investments were also more common in states with fewer limits on insurance coverage.
Yashaswini Singh, PhD, health economist at Brown’s School of Public Health, said the findings raise concerns about financial firms quickly entering a sensitive area of healthcare with limited public scrutiny or data on ownership information.
“The big takeaway is that there is yet another segment of healthcare that has emerged as potentially profitable to private equity investors and it is very distinct from where we have traditionally known investors to go, so the potential for harm can be a lot more serious,” Dr. Singh said. “We’re also dealing with children who are largely insured by Medicaid programs, so if private equity increases the intensity of care, what we’re really looking at are impacts to state Medicaid budgets down the road.”
Researchers did not evaluate how private equity ownership affects care access, patient experience or quality of care but plan to study outcomes such as therapy intensity, medication use and time in treatment.
