Authored by Sara Gershfeld Litvak, MA, BCBA, Behavioral Health Center of Excellence founder and CEO.
Currently there aren’t enough clinicians to treat people with autism who need services. The numbers are daunting. Only one of the 50 U.S. states has enough certified providers to serve patients, according to a study by Emory University’s Rollins School of Public Health. Meanwhile, the Centers for Disease Control shows that the number of children and adults living with autism and related developmental disabilities has grown from one in 150 persons in the year 2000 to one in 54 today.
As a result, the applied behavior analysis (ABA) field is stretching and growing rapidly. Forecasts predict that the industry will be valued at $2.23 billion by 2022. ABA has eclipsed other forms of communication, behavior, and drug therapies as the treatment of first choice for autism. It makes up more than half of the services being provided and is expected to continue its rise at a rate of nearly four percent each year.
The ABA community needs growth so more patients who seek services can receive them. ABA also urgently needs measures that clearly illuminate the value of services for families, payors, and providers, and that meet the demands of a healthcare system that is moving towards value-based payment.
ABA is a unique person-centered therapy. Providers’ ability to adapt services to individual patients is the beauty of this approach and its effectiveness, which has led to its position as the gold standard of autism care. But without measures to demonstrate ABA’s value, families and providers are left vulnerable. Risks already being recognized include reduced funding for treatment, impacting access, and indeterminate decision-making by third parties about the delivery of ABA services.
In recognition of its fifth anniversary as the accrediting body for the ABA field, Behavioral Health Center of Excellence (BHCOE) has much to celebrate in its efforts to increase access to quality care for people with autism, and in the ABA community’s movement to adopt Standards of Excellence for person-centered behavioral health.
The number of ABA organizations seeking evaluations for accreditation of ABA services has risen steadily and more than doubled in many of the five years since BHCOE was established in 2015. Accreditation has spread across the U.S. and is gaining ground globally. There are now BHCOE accredited ABA providers in 44 US states, eight countries, and one British Overseas Territory.
BHCOE broke new ground by introducing the industry’s first American National Standard for the Documentation of Clinical Records for ABA services and is paving the way to take clinical outcome measurement to its next logical step by developing predictive data and benchmarks for patient reported outcomes among patients of all diverse socioeconomic groups. This is the central prerequisite to reduce care variability for patients and to accelerate the delivery of true value-driven care in the ABA field.
With the number of patients increasing and the advent of value-based payment, our aim is clear. BHCOE will continue to take the lead on advancing measurement science and establishing predictive performance standards for person-centered behavioral health. The hard-working ABA community deserve no less to demonstrate their value and to preserve providers’ leading role in helping people with autism and related developmental disabilities live their best lives.