Autism diagnoses have jumped dramatically in recent years. The number of children in the U.S. diagnosed as on the autism spectrum nearly tripled between 2011 and 2022.

The condition has been in the national spotlight amid political debate falsely linking autism to childhood vaccines.

“I worry about the same types of revenue generating strategies seen in other private equity-backed settings…and worsening disparities in terms of which children have access to services.”

At the same time, private equity firms have acquired more than 500 autism therapy centers across the U.S. over the past decade, with nearly 80 percent of those acquisitions occurring over a four-year span, according to a new study from researchers at the Brown University Center for Advancing Health Policy through Research.

“The big takeaway is that there is yet another segment of health care that has emerged as potentially profitable to private equity investors and it is very distinct from where we have traditionally known investors to go, so the potential for harm can be a lot more serious,” study author, Yashaswini Singh, a health economist at Brown's School of Public Health, said. “We're also dealing with children who are largely insured by Medicaid programs, so if private equity increases the intensity of care, what we're really looking at are impacts to state Medicaid budgets down the road.”

The researchers identified a total of 574 autism therapy centers owned by private equity firms in 42 states as of 2024. Most of those centers were acquired between 2018 and 2022, the result of 142 separate deals.

Private equity–owned clinics were most common in states in the top third for childhood autism prevalence, the study found. States with the highest concentrations of centers were California (97), Texas (81), Colorado (38), Illinois (36) and Florida (36). Sixteen states had one or no private equity-owned clinics at the end of 2024.

Private equity firms have acquired more than 500 autism therapy centers across the U.S. over the past decade, with nearly 80 percent of those acquisitions occurring over four years.

“Private investors making a little bit of money while expanding access is not a bad thing, per se,” Singh said. But we need to understand how much of a bad thing this is and how much of a good thing this is. This is a first step in that direction.”

The primary concern is that private equity firms will put making money over providing support for families, Daniel Arnold, a senior research scientist at the School of Public Health, said.

“It's all about the financial incentives. I worry about the same types of revenue generating strategies seen in other private equity-backed settings. I worry about children receiving more than the clinically appropriate amount of services and worsening disparities in terms of which children have access to services.”

Unlike public companies, private equity firms and private practices are not required to disclose acquisitions, making data collection challenging and labor-intensive. The team used a mix of proprietary databases, public press releases and manual verification of archived websites to track changes in ownership and establish a baseline of where private equity firms are investing and why.

The team is now seeking federal funding to study how private equity ownership affects autism treatment, children's outcomes, and whether these investments are helping meet real needs or are primarily a way to make money.

The study is published in JAMA Pediatrics.