Private Equity’s Impact on Autism Clinic’s Quality of Care

In 2017, Misty Richard found hope for her autistic son, J.J., at a clinic run by the Center for Autism and Related Disorders (CARD) in Baton Rouge, Louisiana. CARD, known for its Applied Behavior Analysis program, was a part of a national company with a strong reputation. However, after the Blackstone Group, a notable private equity firm, acquired CARD in 2018, Richard noticed alarming changes, particularly in staffing.

Her concerns escalated in June 2022 when J.J. returned home distressed due to a therapy session involving simulated lightning, which deeply upset him. Richard’s subsequent complaint to the Louisiana Behavior Analyst Board led to disciplinary action against the involved staff member.

A Blackstone spokesman stated that the firm did not influence treatment decisions but expected high care standards. This incident underscores a larger trend in the U.S., where the rising demand for autism services has attracted numerous businesses, many backed by private equity. These firms, seeking profitable investments, have increasingly influenced the autism services industry, which is valued at $7 billion annually.

The prevalence of private equity in this sector raises questions about the quality of patient care. Studies indicate that healthcare services owned by private-equity firms often experience a decline in patient care quality. For instance, a study found increased infections and falls at hospitals under private-equity ownership.

Rosemary Batt, a Cornell University professor, co-authored a study highlighting the extensive private-equity investment in autism services. The top 12 private-equity-backed companies in this sector employed 30,000 people and managed around 1,300 locations.

While Blackstone’s ownership did not ostensibly reduce the quality of care at CARD, financial challenges led to CARD’s bankruptcy in 2023, and over 100 facilities were closed. Critics argue that private equity’s focus on profit can overshadow patient care.

In 2023, CARD’s founder, Doreen Granpeesheh, reacquired most of the company’s operations, aiming to prioritize clinical quality. This move was seen as a positive step towards restoring the company’s focus on patient care rather than financial gains.

The case of CARD highlights the complex dynamics between healthcare services and private-equity ownership, illustrating the potential impact on patient care quality and the operational challenges in balancing profit with effective treatment.