TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Today’s topic concerns how technology can increase access to outcomes-based behavioral health care for underserved families, improving the progress and effectiveness of care for those children with autism. Our author, Jeff Beck, LCSW, is the co-founder and CEO of AnswersNow, which provides virtual support based on applied behavior analysis (ABA) therapy. Mr. Beck spent the first 15 years of his career working directly with children in low-income and rural communities.

Recent reporting in The New York Times is just the latest to detail allegations of fraud, abuse, and excessive billing across parts of the autism therapy industry. But this story was especially troubling because of the stories of the children and families caught in the middle. It’s a reminder that the challenges in autism therapy today are human ones with real and urgent consequences. 

At the center of these issues is healthcare’s longstanding fee-for-service reimbursement system, which incentivizes autism providers to bill for therapy hours rather than patient progress. Now, the ongoing surge in autism diagnoses and the continued scarcity of highly trained clinicians have created an even greater opportunity for those same providers to ramp up their billings and lock children into extended cycles of therapy without producing meaningful improvement.

The encouraging news is that technology is changing that calculus.

For years, healthcare leaders have talked about shifting from fee-for-service reimbursement toward outcomes-based care. In autism therapy, that means aligning families, providers, and payers around a holistic goal to help children make progress faster and more efficiently. The challenge has been how to measure outcomes, scale care, and manage costs.

Today, virtual care and artificial intelligence are making all three increasingly achievable.

Virtual Care Solves More Than Access

Telehealth is often described as a convenience. However, in autism therapy, virtual care is creating entirely new ways to deliver higher-quality care.

1. Virtual care expands access. Traditional autism therapy relies heavily on centralized clinics, forcing families to travel long distances and organize their schedules around available appointments. In many communities, waitlists stretch for months or even more than a year. Virtual therapy removes geography as a barrier and allows families to receive support directly from home.
2. Virtual care helps solve a workforce problem. The shortage of Board-Certified Behavior Analysts (BCBAs), our industry’s most highly trained therapists, is unlikely to disappear anytime soon. Virtual care allows a BCBA in one location to support families hundreds of miles away, dramatically expanding access without requiring a corresponding increase in the workforce. It also means that, rather than spending large portions of their day supervising less-trained staff, BCBAs can work more directly with children and caregivers. More one-on-one interaction can lead to more personalized care and stronger therapeutic relationships. It also has the added benefit of boosting clinician retention rates. 
3. Virtual care can improve the therapy experience itself. Children often learn best in environments where they feel comfortable and secure. Sessions conducted in the home allow therapists to work within real-world routines and challenges rather than simulated clinical settings. And for some children, interacting through a screen can even feel more natural and familiar.

AI Makes Better Care More Scalable

AI can be a force multiplier, improving both the efficiency and availability of BCBAs. But it can also be deployed to enhance the therapy experience itself and measure progress over time. 

1. AI enables more personalized therapy. Historically, creating individualized materials and activities required substantial clinician time. AI can now help therapists generate customized content aligned to a child’s interests, developmental goals, and learning style in real time. That allows clinicians to adapt more quickly and keep sessions engaging and relevant for faster progress by kids.
2. AI helps reduce administrative burden. Highly trained clinicians routinely spend hours each week documenting sessions, reviewing records, writing notes, and developing care plans. These activities are necessary, but they reduce the time available for direct patient care. AI can take on many of these tasks, returning meaningful time to clinicians. 
3. AI can improve how providers measure and manage outcomes. It can help identify patterns earlier, track progress more consistently, and support more informed treatment planning. Just as importantly, it generates the data needed to evaluate whether children are actually improving rather than simply accumulating therapy hours.

Of course, security and compliance are non-negotiable in this space, especially given the strict regulations health systems and payers face. The default industry standard should include a “compliance toggle” that allows enterprise partners and families to completely disable AI tools whenever their internal security protocols require it.

Building the Next Generation of Autism Care

Autism therapy is entering a period of necessary scrutiny, and bad actors should be held accountable. But the larger opportunity is to build something better.

• Providers should view virtual care and AI as more than operational tools. Together, they make it possible to deliver higher-quality care with greater efficiency, personalization, and transparency.
• More importantly, they create the foundation for a different model of care, one where success is measured by a child’s progress rather than the number of hours billed.

That shift will take time. But providers using technology to expand access, strengthen outcomes, and improve accountability will help define what better autism care looks like for the next generation of children and families.