10 Tips for Bridging the Gap between Payors and Providers of Applied Behavior Analysis

By: Dana D’Ambrosio, MS, BCBA, LBA
ABA provider with student using connecting toys

Since Applied Behavior Analysis treatment became an effective autism benefit through private and public health insurance, there has been a great deal of friction between Behavior Analysts and health plans.

As more children are being diagnosed with autism, it is critical that these two entities come together, to ensure that those diagnosed with autism, and their families, receive the highest quality care and support.

How to build the payor-provider partnership:

  1. Arrange support/parent mediated intervention options while in the diagnostic process and/or while on waitlists for treatment
  2. Use a standardized method of treatment plan submission and utilization review to eliminate subjectivity
  3. Utilize an evidence-based tool to individualize care and aid in dosage recommendations
  4. Monitor and synthesize data to quantify progress
  5. Simplify processes to complete required standardized assessments to eliminate travel, co-pays, and waitlists
  6. Determine barriers to treatment and progress, working together for a solution
  7. Consider Social Determinants of Health to provide appropriate resources for the family
  8. Implement a Value-Based Care initiative to ensure high quality services
  9. Provide substantial caregiver training on ABA principles and techniques, offering remote/on-demand support
  10. Offer caregiver focused mental health support/resources to reduce anxiety, stress, and caregiver fatigue

If you have questions about improving your relationship with ABA providers, contact us and we’ll be glad to help. 

About the Author

Headshot of Dana D’Ambrosio, MS, BCBA, LBA, Clinical Development for RethinkFutures

Clinical Development

Dana D’Ambrosio leads Clinical Development for RethinkFutures. She is a New York state licensed and Board-Certified Behavior Analyst. She brings over a decade of clinical knowledge, with experience spanning from direct patient care in various treatment settings to utilization and care management within the payor realm. She specializes in the creation and enhancement of technology solutions utilized by providers and health plans, to ensure best practice, high quality, coordinated care and streamlined review processes for all parties. She received a BS from the University of Central Florida and an MS degree in Counseling, specializing in Applied Behavior Analysis, from Nova Southeastern University.

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