Medicaid Payers & ABA Operators - Outcomes-Based Payment Adoption

She sells half as much therapy and gets paid more for it. Most Applied Behavior Analysis providers spent the past year exiting entire states over Medicaid rates. Dr. Suzanne Goh's company opened clinics instead. Cortica delivers less than half the standard ABA volume. Health plans reimburse it at higher rates anyway. Here's why that works 👇 🧠 Treat the medical drivers first. Sleep problems, seizures, gastrointestinal, and metabolic conditions produce the exact behaviors that 40-hour-a-week programs then spend hours managing. 📊 Measure everything. A whole-child scorecard tracks 10 domains across medical, developmental, behavioral, and quality-of-life outcomes, reported straight to payer partners. 💰 Pick investors who protect the model: CVS Health Ventures, Optum, Ascension, Morgan Health, and the Autism Impact Fund, which represents families raising autistic children. 📈 The timing is remarkable. Medicaid and CHIP spending on ABA rose 421% between 2021 and 2025. In August, CMS told states that more services are not always better. Goh built this roughly a decade before the federal government reached the same conclusion. And she is willing to say what the industry won't. Asked which providers survive the current squeeze, she didn't hedge, "I do think some should not survive." Her 10-year goal isn't to build the biggest autism company in America. It's for the category to disappear entirely into pediatric medicine. 👉 Read the full story in Forbes: https://lnkd.in/g8NS-bgf What would it take for outcomes-based payment to become the norm in pediatric behavioral health? I'd like to hear from the operators and payers in my network. Suzanne Goh, Neil Hattangadi, MD, MSc, Christopher Male, Martha R. Temple, #WomensHealth #ValueBasedCare #Autism #HealthcareInnovation #WomenFounders