Private equity in autism care
Across America, where treatment for autistic children once was fairly rare, there now are thousands of clinics in a multibillion-dollar industry, says The New York Times.
The growth has been the result of increasing autism diagnoses, state insurance mandates and a federal requirement that Medicaid cover the therapy.
"Private equity investors have rushed into the business, buying up chains and opening new clinics,” a Times investigation has found.
Longtime readers of this blog will be familiar with KFF’s series “Patients for profit: How private equity hijacked health care,” covering private equity’s purchases of hospitals, doctors’ practices, nursing homes, hospices and more.
The Times says there’s been little regulatory oversight of the autism facilities, and there have been allegations of children being harmed by profit-motivated practices. Dozens of current and former clinic workers told the Times how clinics frequently overprescribe hours and even recommend that some families remove children from school so they can receive more therapy.
Fourteen former employees of the chain Compleat Kidz, ranging from top executives to those working directly with patients, told the Times they left the company out of concern that its focus on profit was harming children. Their experiences echoed concerns from 15 workers at other chains across the country interviewed by the Times.
Compleat Kidz has in-house psychologists to diagnose children, creating a pipeline of new patients that some ethics experts see as a conflict of interest (North Carolina plans to outlaw the practice later this year). Bonuses for salespeople are partially based on the number of hours the children they recruit attend.
The facilities can have a double appeal for parents, the Times says: in addition to promising better behavior, they can amount to free child care because Medicaid pays all the costs.
Private equity companies have acquired at least 500 clinics over the past decade, says the Times. The profits are high. Medicaid often pays about $70 per hour for therapy that’s mainly provided by workers with high school diplomas who earn about $20 an hour.
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