MissionViewpoint Monthly Update — August 2026
Almost everyone wants to switch. Almost no one does.
That gap became this month's subject. Over three articles I worked through what it actually costs an ABA provider to change the operating system of its business — and why the deciding variable was never price, and never really features. It was adaptability.
“The greatest competitive advantage a provider can build isn't choosing the right platform today. It's remaining free to choose again tomorrow.”
The rest of the month pointed the same direction. Six new adaptive behavior CPT codes arrived in the proposed 2027 fee schedule, and the interesting part wasn't reimbursement — it was that the codes ask platforms to represent work they were never designed to hold. And the SCUBA data kept telling a more resilient story than the industry's conversation about it.
The Economics of Switching Practice Management Platforms
- 1Almost Everyone Wants to Switch. Almost No One Does.
- 2What a Platform Has to Prove Before an ABA Provider Will Switch.
- 3Your New Practice Management Platform Is Also Your Next 'Legacy' Platform.
Almost Everyone Wants to Switch. Almost No One Does.
After several hundred conversations with operators, the same pattern keeps surfacing: dissatisfaction runs the full length of the maturity curve — from the handful still on paper to the providers on the newest, best-funded platforms.
Yet almost no one moves. Not because the software is bad or providers resist change, but because switching isn't a software purchase. It's an organizational transformation, and most operators price that risk well.
The real question was never whether another platform is better. It's whether it's better enough to justify replacing the operating foundation of the business.
Read →What a Platform Has to Prove Before an ABA Provider Will Switch.
If switching is that hard, what does a platform have to prove? Not that it's better — providers concede that constantly, then renew anyway. It has to be better by a margin wide enough to cover the cost of getting there.
Three things decide it: who the platform is actually built for, whether it takes responsibility for the departure, and whether it lets the provider keep building afterward.
The dividing line in every migration is the authorization — the smallest unit of operational obligation a provider carries. Work becomes obligation. Evidence becomes reference.
Read →Your New Practice Management Platform Is Also Your Next 'Legacy' Platform.
For the smaller group that has decided to move. The premise is uncomfortable: the platform you adopt today is also the one you'll someday leave. Every entry decision is an exit decision.
A migration is worth its considerable cost only if it leaves the organization more adaptable than the one that started.
That means understanding your operation well enough to move it, choosing for the organization you intend to become, negotiating both contracts on the day you hold the most leverage, and owning the capabilities that differentiate you outside the platform.
Read →Also This Month
The Six New 2027 Adaptive Behavior CPT Codes & Impact on Your Tech Stack
On July 14, CMS released the proposed 2027 Medicare Physician Fee Schedule with the six new adaptive behavior codes.
The descriptors landed more focused than expected. Rather than new categories of care, they recognize work providers have long performed — multi-technician harmful behavior services, non-face-to-face professional work, and direct physician/QHP treatment.
The technology story is the one worth watching. One code — 97X3X, non-face-to-face professional services — asks platforms to represent clinical review, protocol versioning, and traceability between assessments, decisions, and services.
Those aren't billing capabilities. They're workflow and data architecture.
Proposed rule, subject to a 60-day comment period; codes remain unofficial until the AMA publishes the 2027 CPT® Professional Edition. The ABA Coding Coalition advises against reconfiguring systems until then. I agree.
Read →Provider SCUBA — July
The data still isn't cooperating with the industry's caution.
Nineteen of the Top 20 providers maintained or increased LinkedIn headcount in July. Only one posted a decline, and the rankings barely moved — a single position change on the month. Providers may be operating under greater financial pressure; they are not yet staffing like organizations preparing for contraction.
The Q2 2026 MVP Cohort — Action Behavior Centers, ABA Centers of America, Behavioral Framework, Golden Steps ABA, and Brighter Strides ABA — carried its momentum into the first month of Q3, again outpacing the Top 20 by roughly 2×. Reported layoffs and restructuring at ABA Centers of America are not yet visible in its overall LinkedIn trend.
Elsewhere: seven providers launched Project ALIGN around EarliPoint Health's assessment technology, and Merakey announced an affiliation with I Am Boundless, creating a combined organization expected to exceed $1B in annual revenue.
Platform SCUBA — July
Execution becomes the differentiator.
Rather than headline product launches, several platforms invested in the capabilities required to execute at a higher level — intake operations, CRM connectivity, ecosystem leadership, and organizational scale. As the market matures, advantage increasingly depends less on adding another feature and more on helping providers operate, implement, and grow.
Hiring held steady despite continued margin pressure. Camber added headcount for a fourth consecutive month, with modest growth at Motivity, Boost, Finni, and Alpaca Health.
- Artemis announced a native integration with HighLevel, extending connectivity into CRM and marketing workflows.
- AlohaABA introduced Intake Manager, reinforcing intake as a strategic operational workflow.
- EarliPoint Health launched Project ALIGN, positioning itself as a platform helping shape industry standards — not only a technology vendor.
- AnswersNow expanded its leadership team across sales, operations, HR, and other functions, signaling continued investment in organizational scale.
Read the full Platform SCUBA update →
These are fundamentally different businesses — some deliver virtual autism care, some support franchise networks, some build the operational infrastructure independent providers run on. Growth rates read as momentum rather than scale: some centralize headcount under one corporate brand while others keep separate provider identities, and faster percentage moves often reflect a smaller starting base.
LinkedIn headcount growth by provider cohort & provider-platforms. Source: LinkedIn Company Pages · MissionViewpoint SCUBA · Data as of July 29, 2026.
Three articles, one subject.
They looked like a series about replacing software. They were really about adaptability — the same thread that ran through the operating layer and the data spine before this series ever turned to switching.
Clinical care will keep changing. Reimbursement will keep evolving. AI will keep reshaping operational work. Platforms will consolidate and eventually be replaced. The providers who build lasting advantage won't be the ones who happened to pick the best software at a particular moment, because software advantages depreciate. They'll be the ones who kept the capabilities that matter above the platform — and stayed free to choose again.
P.S. The CMS comment period on the proposed 2027 rule runs 60 days, and nothing is final until the November final rule. But it's the first real look at where the adaptive behavior code set is heading — and it points away from documentation and toward decision support.
AI doesn't create organizational intelligence. It amplifies it.
AI is becoming a feature of every software platform. But competitive advantage won't come from using more AI features—it will come from building organizational capability that AI can amplify.
Next month we'll explore three questions: What is the difference between using AI and building it? How can providers point AI at their own operations instead of just their software? And as AI learns from every interaction, whose data does the intelligence ultimately compound on?
