The autism and intellectual and developmental disabilities (IDD) care sector is undergoing one of the most transformational periods in its history, according to the Autism and IDD Care Market Report: 2025 Recap & 2026 Outlook from CentralReach. Driven by rising demand, expanding service models, and accelerating adoption of artificial intelligence, the industry is scaling faster than ever—and the pace is expected to intensify into 2026.
CentralReach’s CanaryBI dataset—one of the most comprehensive in the field with more than 5 billion anonymized data points—reveals significant year-over-year growth across nearly every operational indicator. From insurance payments and claims volume to provider counts and learning opportunities, the numbers show an ecosystem that is expanding rapidly to meet increasing needs.
AI Adoption Crosses Into Mainstream Practice
One of the most notable shifts highlighted in the report is the solidification of artificial intelligence as a core operational pillar rather than an experimental add-on. Seventy-five percent of organizations purchased AI-enabled tools early in the year, and the momentum has remained strong. What began as early innovation has now moved into the critical infrastructure category, with providers leveraging AI for tasks ranging from note and claim auditing to scheduling optimization and compliance monitoring.
AI’s role is particularly pronounced in addressing workforce and administrative challenges. Providers are increasingly using automation to reduce friction in back-office workflows, surface quality insights, and improve overall care continuity. As CEO Chris Sullens notes in the report’s foreword, AI is now part of how “the most effective organizations already operate.”
Demand for Services Continues to Surge
The sector’s growth is being propelled by rising prevalence rates and increasing public demand for services. Autism and IDD-related appointments are projected to grow by 24 percent by the end of 2025, with long-term upward trends anticipated to continue through 2026. Since 2022, the market has experienced a steep climb, with total appointments and revenue following parallel expansion curves.
Across the 2025 cohort, key year-over-year indicators show strong performance:
- Insurance payments: up 22.49%
- Claims volume: up 21.79%
- Service hours: up 19.65%
- Provider count: up 25.11%
- Client count: up 17.93%
- Learning opportunities: up 31.23%
Combined, these metrics point to a market not just rebounding from past volatility, but expanding into a more data-driven and tech-enabled future.
Employee Turnover Remains a Persistent Challenge—But Leaders Are Breaking the Pattern
High turnover continues to be one of the most pressing challenges in autism and IDD care. Industry-wide, organizations report significant churn among Registered Behavior Technicians (RBTs) and therapists, which in turn affects scheduling stability and service delivery.
However, the report surfaces an important distinction: top-performing organizations—particularly those under $5 million in annual revenue—achieved a 70.4 percent reduction in turnover compared to their peers.
These top performers share several common strategies:
- Strong staff training and comprehensive onboarding
- Clear professional development pathways
- Robust supervision and mentorship
- Competitive compensation
- High fulfillment of requested hours, which helps stabilize staff schedules
The data suggests that while turnover is endemic to the sector, it is not immutable—and that targeted investment in workforce management can dramatically shift outcomes.
Clinic-Based Care Becomes the Dominant Model
A major transformation is underway in service delivery settings. In 2025, for the first time on record, California is projected to exceed 50 percent clinic-based service delivery, mirroring a broader national trend. Across the U.S., providers are continuing to shift away from in-home therapy toward clinic-based care.
Drivers of this migration include:
- Operational efficiency
- Growing family preference for structured environments
- Improved ability to coordinate multidisciplinary services
- Staffing optimization
Across organizations of all sizes, projections through 2026 show steady year-over-year gain in clinic-based treatment, signaling a long-term systemic change in care delivery models.
Multidisciplinary Care Becomes a Defining Industry Standard
Another major shift is the rapid expansion of multidisciplinary service models. Since 2020, multidisciplinary care—which integrates ABA with speech, occupational therapy, physical therapy, and mental health services—has maintained a 30 percent compound annual growth rate, with no signs of slowing.
The trend is driven by two converging forces:
- ABA providers adding allied therapies
- Allied therapy organizations expanding into ABA
Several states have experienced explosive year-over-year growth in multidisciplinary services. For example, Virginia, Alabama, and New Mexico posted growth rates ranging from 163 percent to 368 percent year over year.
As the report emphasizes, multidisciplinary models are no longer an emerging trend but a defining feature of the future industry landscape—creating more seamless care and higher client retention.
Authorized Hours Remain Underserved—Especially for Caregiver Training
Despite strong overall growth, a major untapped opportunity remains: fully utilizing authorized hours.
Overall utilization rates continue to hover between 35 and 44 percent, depending on provider size, with large practices seeing a slight decline and smaller providers showing incremental improvement.
Where the challenge is most stark is caregiver training:
- Authorized caregiver hours were utilized at only 20 percent in the first half of 2025
- This is down from 26 percent in 2024
- Approximately 608,000 caregiver hours per month are going unused across the sector
Yet the impact of caregiver engagement is clear. Organizations that are top utilizers of caregiver training saw up to a 35 percent reduction in client churn, demonstrating the significant clinical and financial upside of strengthening family involvement.
A Market Moving Toward Higher Complexity—and Higher Opportunity
Taken together, the 2025 data paints a picture of an industry that is expanding rapidly while undergoing substantial structural change. AI is now an essential operational tool. Multidisciplinary care is becoming the default model. Clinic settings are overtaking in-home services. And organizations that invest in workforce stability and caregiver engagement are outperforming their peers.
As the industry moves into 2026, the report suggests that the strongest organizations will be those that embrace these shifts early—leveraging data, technology, and integrated care models to meet rising demand while improving outcomes for individuals with autism and IDD.
