Dealmaking in autism and intellectual and developmental disabilities (IDD) services looks different in 2026, shaped by an uptick in demand and heightened federal scrutiny. Buyers, both on the provider side and from investment firms, are adjusting their playbooks accordingly.
IDD services recently set a record for the highest transaction volume the sector had seen since 2021, with 31 deals in 2025, with autism deals following closely behind, according to a recent report from M&A advisory firm The Braff Group. Despite headwinds from inflation, tariffs, changes in Medicaid eligibility, and the expiration of ACA subsidies, that trend in dealmaking is likely to continue throughout 2026.
Indeed, from last week’s sale of Little Leaves Behavioral Services to LEARN Behavioral, the launch of a new health care PE firm Momentum Health Partners, which purchased Advanced Autism Center for Treatment (AACT), to the Center for Social Dynamics’ acquisition of the Behavior Change Institute, the sector is ripe with activity.
Amid the action, buyers are honing in on three Ts in their playbooks: talent, technique and technology.
“We want someone who’s got their arms around data in a way to describe why their operation is a quality operation,” Kelly Bozarth, CEO of the Center for Social Dynamics, said at Behavioral Health Business’ Autism Investor Summit West. “So talent, technique, what makes them special, what’s unique about their operation, and if they’re leading in technology, that’s a big one for us.”
The Center for Social Dynamics provides comprehensive therapy services for individuals with autism and other IDD conditions.
Recent events – including the closure of Piece by Piece Autism Centers, other Medicaid billing fraud investigations, rising industry spending, federal audits and Office of Inspector General reports showing documentation issues in applied behavior analysis – have made quality a top priority for buyers, Bozarth added.
“Quality is at a whole new level,” she said. “The bar, I think, is much higher now, which is probably no surprise given the press and the media.”
Still, a renewed focus on quality is not that simple.
It’s also about quality that matches outcomes and is delivering services in a way that makes sense for payers, patients and employees, Daniel Pianko, managing partner at Achieve Partners, explained at AIS West.
“Quality is the single most important thing, and it is not just are you delivering a good experience for kiddos in other environments,” Pianko said. “Are you delivering the number of hours that makes sense for payers? Are you delivering on the promise to your employees? Are you building in an appropriate way? So all these things are absolutely critical – not just the generic behavior of quality.”
Achieve Partners is an investment firm that backs mental health and autism service organizations such as Westside Children’s Therapy.
While the headlines around all the changes across the autism services sector signal there are issues, they also signal new opportunities for those who can do things differently, according to Ed Staren, a partner at the recently launched PE firm Momentum Health Partners.
In turn, due diligence has also taken on a more important role for buyers than it has in the past.
“Due diligence is not just a financial review,” Staren said. It’s really a character test. … Cash in on earning trust with your people as soon as possible. If you screw that up, there’s no perfect operational playbook that’s going to fix that. And then … growing too fast, that’s a mistake I’ve seen several times. You’ve got to focus on the capabilities of the organization and really getting strong.”
Of course, there are opportunities that no matter how strong the growth story is, buyers will not take the bait.
Bozarth, Pianko and Staren agreed that organizations with poor quality, compliance issues and reputationally risk cause them to look the other way in dealmaking.
Glassdoor reviews, Reddit forums, Google reviews and other signals from staff and families that point to any of these problem areas are all data points buyers use to factor into their ultimate decision on whether an acquisition will be a fit.
Over-indexing on ABA hours, a growth-at-all-costs mindset, high turnover and staff issues, over-reliance on Medicaid as a payer, and documentation issues are also common red flags.
“If you look at what happened to the industry in that first kind of [consolidation] wave, those were the seeds of the destruction of that wave of companies,” Pianko said. “It’s really sad, because at the end of day, if you look at the numbers, there’s effectively unlimited demand for the services of what people in this room offer, but there’s unlimited demand only for high-quality offerings. … Think about this new generation of really great mission-aligned companies doing really well for kids as sort of the true north star of what will create value long term.”
As the autism services sector grapples with a crackdown on waste, fraud and abuse, additional scrutiny from federal oversight and significant changes to its mainstay ABA therapy, what is working well — and what buyers in the space want to see right now – is methodical growth, leaning into technology and leveraging talent.
Those aspects are also likely to fuel consolidation in the sector, Bozarth predicts.
“Find people who are super passionate about what they’re doing and are out to change the game,” she said. “Find the people you want to go on a road trip with and do incredible ABA with, and those quality providers who are leaning into technology. That talent creates an ecosystem that just fuels itself. … I think we’ll see a big flight to quality. I think we’ll see a lot of people out of the space a year from now and consolidation of those who are doing good and innovative work together.”