Driven by demand, growth in autism, IDD care at all-time high, CentralReach report finds

Growth in autism and intellectual & developmental disability (IDD) services is at an all-time high, according to a new report.

The report was put together by CentralReach, a provider of software and services for therapists and others who work with people with IDDs. Its aim with the report was to allow stakeholders to monitor and track industry trends over time and have benchmark data on the subject. 

The report is based on a curated subset of CentralReach’s dataset, CanaryBI, which encompasses more than 3 billion anonymized clinical and financial data points. The report offered aggregated data from 1,000 therapy providers offering applied behavior analysis, speech therapy, occupational therapy and related services. The data includes insurance payments, claims, service hours, providers, clients or those diagnosed with an IDD.

The overall growth in services has been driven by a simultaneous increase in prevalence rates and demand for services. Autism services grew 49% year-over-year between Q1 and Q3 2023, compared to the same period in 2022. Demand is likely on an upward trajectory, the report said.

Generally, over the past three years, therapy providers have been moving away from in-home services towards clinic-based services annually. This trend has been the case across 49 states, with the exception of California, per the report. This could be in part because of payer dynamics in the state, which require providers to offer services at home even if they could be provided in person, CentralReach CEO Chris Sullens told Fierce Healthcare. The state has also always been a leader in home-based care.

Though tech offerings are growing, in-person settings remain ideal for some. “When you think about the efficiency of trying to deliver care, it makes it hard to do that in-home when an RBT or a therapist needs to go to the home to provide ABA services,” Sullens said in an interview.

Multi-disciplinary services have grown 56% since 2021, per CentralReach data, a trend projected to continue into 2024. Historically, applied behavior analysis providers operated separately from others, like speech therapists and occupational therapists, that has shifted in the last three years, CentralReach data revealed. 

This has coincided with many patients currently receiving more than one type of therapy at once. One recent study cited in the report found that among kids and teens with autism, for instance, 80% received speech therapy or occupational therapy, while more than half received both. Siloed care risks inefficiencies and a lack of coordination, the report said. 

Recognizing the need for convenience and better customer experience for families, providers serving those with IDDs have been expanding services across multiple disciplines under the same provider umbrella. 

“The organizations that are doing more of multidisciplinary services also tend to be doing more services in-clinic,” Sullens said. 

Caregiver training services have skyrocketed this year and are expected to expand in 2024. From Q2 to Q4 2023, there was a 428% increase in demand for tools to enable caregiver training, CentralReach data showed. Payers offer providers authorized, billable hours to spend on this training. In 2023, providers averaged about 20% utilization of these hours, the report found, suggesting about 450,000 hours unused for training per month.

CentralReach data suggested that top utilizers of caregiver training were more likely to retain clients compared with providers that were not delivering these hours. In some cases, providers saw a 34% decrease in client churn, resulting in more services provided. 

“Parent, caregiver, or family training has long been recognized as critical in the delivery of ABA care as it can equip caregivers who are eager to assist and guide their children,” the report said.