📬ABA Mission Viewpoint Monthly Update – December 2025

The Mission of ABA Mission

👉To drive more—and better—access to ABA care through the smarter use of technology and data.

Welcome to the December 2025 Monthly Update

Theme: Infrastructure Readiness — the systems that shape access, coordination, and cost in autism care.

Much of ABA delivery is governed by an administrative layer that families rarely see: behavioral health management organizations (BH-MOs). These entities manage credentialing, authorizations, documentation cadence, and network operations—and they quietly determine how quickly care begins and how reliably it continues.

This layer is becoming even more relevant as many states explore whether delegated behavioral-health management still aligns with goals around cost containment, oversight, and access. Some are reconsidering what should remain delegated to BHMOs versus brought closer to integrated care models.

At the same time, the ecosystem is preparing for the 2027 autism-related CPT code updates. While final AMA descriptors will be published through official channels, leaders across payors, platforms, and provider organizations are increasingly aligned around several operational themes: clearer evaluation pathways, more structured coordination, and stronger linkage between assessments, plans, and reviews.

The broader message:
Infrastructure—not scale—will define the next phase of ABA delivery.

🧭 The Role of BHMOs: The Infrastructure Layer Being Quietly Reconsidered

Behavioral health management organizations sit between payors and providers, shaping:

• network participation
• intake routing
• treatment-plan review
• re-authorization cadence
• documentation expectations
• data and compliance reporting

They translate benefit design into day-to-day operational rules.

As more states evaluate cost structures and administrative efficiency, delegated behavioral-health models are being reconsidered. Regardless of where these discussions land, BHMOs remain a defining part of ABA infrastructure today.

Takeaway:
Providers that treat BHMO requirements as structured workflows—not reactive tasks—gain speed, predictability, and leverage.

🤖 AI in ABA: Early Tools, Clearer Outcomes, Stronger Careers

AI in ABA is still early, with most current tools aimed at reducing friction in documentation, claims, and intake. But its most important long-term contribution may be in clarifying outcomes.

ABA produces vast amounts of therapeutic data, yet very little is analyzed consistently across organizations. AI can help identify meaningful patterns—what interventions drive progress, how supervision quality impacts outcomes, and when treatment plans begin to drift.

When outcomes become clearer, careers strengthen:

• clinicians can specialize in interventions shown to be effective
• supervisors can focus skill building around measurable progress
• operations teams can evolve into outcome-enablement roles
• career ladders become more defined as competencies become clearer

AI doesn’t replace staff—it gives structure to the data ABA already produces, helping the field align around what “effective care” means.

Takeaway:
AI’s biggest long-term impact may be enabling ABA to define common, measurable outcomes—and with that, more specialized and sustainable career pathways.

📝 2027 CPT Codes: Emerging Operational Themes

The AMA will release official descriptors for new autism-related CPT codes in 2027.
Without anticipating that language, several operational themes are emerging across the organizations preparing for the transition:

• structured evaluation workflows
• clearer care-coordination steps
• distinct operational pathways for caregiver-facing work
• stronger linkage between assessment, plan, and re-evaluation
• readiness for digital and tech-assisted assessment inputs

These themes reflect preparation, not prediction.

Takeaway:
This is the right moment to tighten evaluation, re-evaluation, and coordination workflows to reduce friction ahead of the 2027 transition.

📍 Market Insight: Indiana and the Power of Data-Informed Expansion

This month’s analysis used Clinivise’s workforce and hiring datasets to illustrate how operators can use publicly available data to make better expansion decisions. Indiana was a useful test case because it shows how easily growth strategies can falter without structured insight.

A few observations stood out:

• RBT supply is strong, but BCBA supervisory capacity is tightening in ways that impact sustainability.
• County-level momentum reveals where workforce growth or competition is shifting.
• Hiring pressure is significant, with more than 500 ABA openings in 90 days.
• Border markets such as Chicago, Louisville, and Dayton influence wages and recruitment dynamics.
• ZIP-level saturation data clarifies which areas show meaningful opportunity versus overcrowding.

The broader lesson is not about Indiana specifically. It is that operators finally have the ability to ground expansion decisions in evidence rather than intuition. Workforce and hiring analytics provide a clearer picture of staffing feasibility, competitive conditions, and saturation risk.

At the same time, critical data is still missing—particularly around reimbursement, denial patterns, rate adequacy, and drive-time access. Workforce and hiring data offer a strong starting point, but they do not fully answer whether a market can sustain long-term operations.

Takeaway:
Indiana demonstrates how data—when structured and accessible—can help operators grow responsibly, reduce avoidable mistakes, and expand access in ways that are sustainable for both staff and families.

🚌 Operator Spotlight: Akoya

Akoya continues to demonstrate what it looks like to build an operational platform around staff experience as intentionally as client experience.

Their approach emphasizes:

• simplified evaluation and documentation workflows
• predictable cross-team coordination loops
• transparent outcomes measurement
• reduced administrative friction for clinicians and supervisors
• tools aligned with the real daily rhythms of care delivery

This philosophy reflects a growing truth across the field:
infrastructure that supports clinicians ultimately strengthens care.

As expectations around workflow quality, documentation consistency, and data reliability rise, Akoya’s staff-centered design and Viventium platform becomes a strategic advantage—not an optional one.

Takeaway:
Designing systems that clinicians want to use is becoming a durable source of operational strength in a more structured and data-visible ecosystem.

✅ Platform Highlights

• EarliPoint Health added Cortica as its newest Top-35 provider logo.
• Rethink launched a bi-directional integration with Raintree. Rethink also expanded content distribution through Netsmart.
• Artemis announced AI-powered session notes.

📊 Provider Trends

• Mid-sized operators again outpaced national groups. This cohort includes SOAR Autism Center, Achievements ABA, Yellow Bus ABA, Golden Steps ABA, and Brighter Strides ABA.
  • SOAR Autism Center secured $17M in new capital, in my opinion - a green shoot, not a trend.
  • Behavioral Framework posted one of the strongest month-over-month growth rates of any provider this year, up roughly 12%.
• Aetna’s new neurodiversity navigation program pairs digital coaching and care navigation with Cortica.
  

💬 Closing Thoughts

As 2025 ends, ABA is entering a phase where infrastructure—not footprint—defines competitiveness.

Despite heightened Medicaid scrutiny and cost-containment efforts, the field is not shrinking. Capital is still in the space — but it’s moving slowly and selectively.

BHMOs, CPT structures, AI-enabled insight, workflow quality, documentation integrity, and workforce design all point toward a more predictable, accountable, outcomes-driven era. It won't come easy, but it will come.......

On a personal note:
A year ago, I had no website, no content, and no readers.
Today, thousands of leaders across the ABA ecosystem engage with this work each month. Thank you for the time, attention, and dialogue that make this newsletter possible.

Until next time,
— Scott

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