Autism diagnoses among children and adults in the United States have increased by 175% in the last decade, creating an urgent and growing demand for support services. Unfortunately, the cost of applied behavioral analysis (ABA) services can be significant — in some cases, totaling between $40,000 to $60,000 per child per year.
As ABA therapy costs continue to climb, employers are in a unique position to bridge this gap by enhancing benefit plans and creating an inclusive workplace that understands the needs of neurodivergent workers and/or children who may be covered through their parents’ insurance offerings.
Understanding ABA Therapy Costs
ABA therapy is an evidence-based treatment focused on encouraging positive behaviors instead of punishing undesirable behaviors. By changing the focus from punishment to reward, board-certified behavior analysts reinforce behaviors that help people with autism develop social, communication, and learning skills that improve their quality of life.
However, ABA therapy also presents a financial hurdle that can cost families hundreds of dollars per week.
Insurance is essential to lowering these costs, but plans vary widely. Some plans offer limited coverage, while others offer comprehensive support. Employees and their families often face high out-of-pocket expenses, session caps, prior authorization, and a requirement to obtain a formal diagnosis from a qualified healthcare professional.
Navigating these challenges and high costs can be difficult for many employees, who are often left to look for other options, such as financial assistance programs, state-funded programs, and nonprofit resources. This makes it crucial for employers to review and enhance their benefit offerings to ensure employees receive the support they need.
How Employers Can Help Reduce ABA Therapy Costs
Reducing the cost of ABA therapy doesn’t have to mean cutting corners. By taking strategic, intentional steps to improve access, coverage, and support, employers can ease the financial burden on families while strengthening their overall benefits offering.
Enhance health benefits.
Make it easier for employees to access and afford ABA therapy by building meaningful support into your benefits plan.
For example, offering health plans that cover ABA therapy can significantly reduce costs and ensure employees and/or their children receive the treatment they need at a cost they can afford. You can also partner with in-network providers to reduce out-of-pocket expenses. Lastly, consider providing flexible spending accounts and health savings accounts to help alleviate additional expenses.
Covering your employees isn’t enough when a child needs care. For many families, it can be financially out of reach to add dependents to a plan, especially when ongoing therapy is involved. Structuring your benefits to keep family coverage affordable is an important step in supporting working parents.
Improve care navigation.
Navigating insurance, finding in-network providers, and understanding coverage can quickly become overwhelming, especially for families seeking ABA therapy. This is why care navigation tools are especially helpful.
With solutions such as NaVcare from Vālenz Health®, employees don’t need to figure it all out on their own. NaVcare offers one-on-one guidance to help members:
- Understand their benefits and out-of-pocket costs
- Navigate prior authorizations and billing questions
- Identify in-network, high-value ABA providers
- Make informed decisions based on quality and cost
These services can be enhanced with Bluebook’s cost and quality solution, which enables members to search for a procedure, physician, or facility to quickly find high-value care. This easy-to-use solution clearly displays provider costs in a green-yellow-red format, with green providers in the top third of cost and quality ratings. With this cost and quality solution, members have the tools they need to reduce their out-of-pocket costs.
Implement flexible work options.
Flexible work arrangements are a crucial support system for employees managing healthcare challenges such as autism or caring for children with autism. Offering flexible hours or remote work options enables employees to schedule ABA therapy appointments without losing income or falling behind at work.
Even small changes, such as allowing for adjusted schedules or providing paid time off for healthcare visits, can make a significant difference. Flexible work gives employees space to focus on what matters most without the added stress of lost wages. In turn, it builds trust, improves morale, supports long-term retention, and ensures the company is still supported.
Simplify Access to Care
Healthcare shouldn’t be harder — or more expensive — than it needs to be.
With a single platform and a dedicated team of experts, Valenz simplifies the process while uncovering new ways to save. Through robust specialty claims solutions such as full claim review — including for ABA therapy — Valenz helps employers ensure every claim is accurate, necessary, and aligned with contract terms. The result? Greater transparency, less waste, and meaningful cost savings for everyone.
Connect with Valenz to learn more about how to reduce costs and steer employees toward high-value care.