Private Equity's Quiet Takeover of Autism Therapy: 500+ Centers Acquired in Decade

Private equity firms have quietly acquired more than 500 autism therapy centers across the United States over the past decade, with nearly 80% of those deals occurring in just four years. The rapid consolidation of a sensitive healthcare sector serving vulnerable children is now drawing scrutiny from health policy researchers.

A new study from Brown University's Center for Advancing Health Policy through Research provides one of the first national assessments of private equity's expanding role in autism therapies and services. Researchers identified 574 autism therapy centers owned by private equity firms as of 2024, spanning 42 states. The acquisitions were concentrated between 2018 and 2022, resulting from 142 separate deals.

"The big takeaway is that there is yet another segment of health care 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," said Yashaswini Singh, a health economist at Brown's School of Public Health and the study's author.

The timing coincides with rising autism diagnoses among U.S. children, which nearly tripled between 2011 and 2022. The study found investment patterns align with market opportunity: states in the top third for childhood autism prevalence were 24% more likely to have private equity-owned clinics. States with fewer insurance coverage limits also attracted more investment.

The Financial Model Under Scrutiny

The primary concern centers on whether private equity's profit motive aligns with optimal care for children with autism. Unlike traditional healthcare acquisitions, private equity firms typically operate on shorter investment horizons, seeking returns within 3-7 years through operational changes, increased service intensity, or consolidation.

"It's all about the financial incentives," said Daniel Arnold, a senior research scientist at Brown's School of Public Health. "I worry about the same types of revenue-generating strategies seen in other private equity-backed settings. I worry about children receiving more than the clinically appropriate amount of services and worsening disparities in terms of which children have access to services."

The concern is particularly acute because most children receiving autism services are covered by Medicaid programs. If private equity ownership leads to increased therapy intensity or expanded service offerings, the financial burden falls on state Medicaid budgets.

"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 looking at are impacts to state Medicaid budgets down the road," Singh explained.

Geographic Concentration

The study reveals significant geographic clustering of private equity-owned centers:

• California: 97 centers
• Texas: 81 centers
• Colorado: 38 centers
• Illinois: 36 centers
• Florida: 36 centers

Sixteen states had one or no private equity-owned clinics at the end of 2024, suggesting the strategy targets markets with favorable regulatory and demographic conditions.

Data Challenges and Research Gaps

One of the study's key findings is how difficult it is to track private equity's movement into healthcare. Unlike publicly traded companies, private equity firms and private practices face no disclosure requirements for acquisitions. The Brown University team used a combination of proprietary databases, public press releases, and manual verification of archived websites to build their dataset.

"To establish a baseline of where private equity firms are investing and why, the team used a mix of proprietary databases, public press releases and manual verification of archived websites to track changes in ownership," the study notes. "Unlike public companies, private equity firms and private practices are not required to disclose acquisitions, making data collection challenging and labor-intensive."

This opacity means policymakers, families, and even researchers lack basic information about who owns these centers and how ownership changes affect care.

Next Steps: Measuring Impact

The Brown University team is now seeking federal funding to examine how private equity ownership affects actual outcomes. Their research agenda includes:

• Changes in therapy intensity
• Medication use patterns
• Age of diagnosis
• Duration of treatment
• Access disparities

The goal is to determine whether these investments primarily meet genuine healthcare needs or represent a profit extraction strategy.

"Private investors making a little bit of money while expanding access is not a bad thing, per se," Singh said. "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."

Broader Context

The autism therapy market consolidation reflects a larger pattern of private equity's expansion into healthcare sectors serving vulnerable populations. The study, published in JAMA Pediatrics, highlights how financial firms are moving into sensitive areas of healthcare with little public scrutiny or data on where this is happening or why.

The research was funded by the National Institute on Aging and the National Institute on Mental Health, indicating recognition among federal agencies that understanding private equity's healthcare role requires systematic investigation.

As autism diagnoses continue rising and political debate around the condition intensifies, the question of who controls the infrastructure of care—and whose interests they serve—has become increasingly urgent. The Brown study provides the first national map, but the territory it reveals suggests a healthcare market segment operating largely outside public view, serving a vulnerable population with limited oversight, and driven by financial incentives that may not align with clinical best practices.

For families seeking autism services, the consolidation means fewer independent providers and potentially less transparency about ownership and care models. For state Medicaid programs, it represents an unquantified financial risk. And for policymakers, it highlights a regulatory blind spot in healthcare markets that directly affect children's wellbeing.