The market for ABA practices in North Carolina presents a significant opportunity for owners considering a sale. High demand for services, driven by increasing autism prevalence and strong insurance support, has attracted a wave of interested buyers. However, turning this market interest into a successful sale at a premium valuation requires a clear strategy. This guide provides an overview of the key factors you need to understand to navigate the process and achieve your personal and financial goals.
Market Overview
North Carolina is an especially strong market for ABA services. The state has one of the nation’s highest autism prevalence rates, with some reports showing 1 in 39 children diagnosed with ASD, well above the national average. This creates a deep and consistent demand for quality care. The national market reflects this growth, projected to expand steadily from its $4 billion valuation in 2023.
This demand is supported by robust payer frameworks. ABA therapy is a covered service under North Carolina’s Medicaid program, which ensures a broad and stable patient base. For practice owners, this combination of high need and reliable reimbursement creates a very attractive environment for potential buyers looking to enter or expand in the region.
Key Considerations for Sellers
When preparing to sell, buyers will look beyond your high-level financials. They want to understand the health and sustainability of your operations. For a school and community-based ABA practice, they will pay close attention to a few specific areas.
- Your Clinical Team’s Strength. The experience and credentials of your staff, particularly your BCBAs and RBTs, are a core asset. A stable, qualified team reduces the perceived risk for a buyer.
- Your Referral Network. Buyers are looking for predictable revenue. Highlight your established relationships with schools, pediatricians, and other community partners that provide a steady stream of new clients.
- Your Operational Systems. Clean financial records are a must. You also need well-defined processes for scheduling, billing, and compliance that demonstrate your practice is efficient and scalable.
- Your Payer Mix. In North Carolina, strong participation with Medicaid is a significant advantage. A diverse mix of commercial insurance contracts further strengthens your position.
Market Activity
The ABA sector is currently a hotbed of M&A activity, and North Carolina is no exception. The market is seeing a clear trend of consolidation, where smaller, independent practices are being acquired by larger strategic buyers and private equity firms. These groups are actively seeking to build regional and national platforms.
We saw this happen locally with the recent acquisition of Hope Services in Raleigh by US Pediatric Partners, a move that added three locations to their network. Investors are very positive about school and community-based models because of their real-world effectiveness and strong demand. For practice owners, this influx of sophisticated buyers means more opportunities for an exit, but it also raises the stakes for running a professional sale process.
The Sale Process
Understanding the path from decision to closing can help you prepare. While every sale is unique, the process generally follows a structured timeline. Selling a practice is not a quick transaction. It often takes many months of careful planning and execution.
| Stage | What It Means for You |
|---|---|
| 1. Preparation & Valuation | We work with you to organize your financials, understand your practice’s true market value, and prepare a compelling story for buyers. |
| 2. Buyer Identification | We confidentially market your practice to a curated list of qualified strategic and financial buyers who are the best fit for your goals. |
| 3. Negotiation & Due Diligence | This is where buyers verify all financial and operational details. Proper preparation here is critical to prevent surprises that could derail the deal. |
| 4. Closing & Transition | The final legal documents are signed, funds are transferred, and we help ensure a smooth transition for you, your staff, and your clients. |
Your Practice’s Valuation
How much is your practice worth? The answer is more complex than a simple revenue multiple. Sophisticated buyers value your practice based on its true profitability, or Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). This figure is calculated by taking your net income and adding back owner-specific expenses like excess salary, personal vehicle costs, or one-time expenditures. This gives a clear picture of the cash flow a new owner could expect.
That Adjusted EBITDA is then multiplied by a certain number (the “multiple”) to determine the enterprise value. This multiple isn’t fixed. It changes based on your practice’s size, the strength of your clinical team, your growth potential, and your payer mix. Telling the right story around these factors is just as important as the numbers themselves.
Post-Sale Considerations
A successful sale is about more than just the final price. It is also about setting up a successful future for yourself, your team, and the community you serve. Planning for what comes after the transaction is a critical part of the process.
- Your Personal Transition. What do you want to do next? Whether you plan to retire, stay on in a clinical role, or pursue a new venture, your goals will shape the deal structure.
- Protecting Your Legacy and Staff. The right buyer will be one who respects the culture you have built. We help you find partners who are committed to a smooth transition and continued opportunities for your team.
- Understanding Your Proceeds. The headline price is not what you put in the bank. The deal structure, including any portion paid over time (earnout) or rolled over as equity in the new company, has major tax and financial implications that require careful planning.
Frequently Asked Questions
What makes North Carolina an attractive market for selling a School & Community-Based ABA practice?
North Carolina has one of the highest autism prevalence rates in the nation, with 1 in 39 children diagnosed with ASD, creating strong and consistent demand for ABA services. The state’s Medicaid program covers ABA therapy, ensuring a broad and stable patient base, supported by increasing insurance participation and a growing market projected to expand beyond $4 billion.
What key factors do buyers consider when purchasing a School & Community-Based ABA practice in North Carolina?
Buyers evaluate the strength and qualifications of your clinical team, particularly BCBAs and RBTs, the stability and breadth of your referral network including schools and community partners, the operational systems such as scheduling, billing, and compliance processes, and the diversity and reliability of your payer mix, with strong Medicaid participation being highly advantageous.
How is the valuation of a School & Community-Based ABA practice determined in North Carolina?
Valuation is based on the practice’s Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization), which reflects true profitability by excluding owner-specific expenses. This figure is then multiplied by a variable multiple influenced by factors such as practice size, clinical team strength, growth potential, and payer mix, rather than relying on a simple revenue multiple.
What does the sale process for an ABA practice typically involve?
The sale process involves four main stages: 1) Preparation and Valuation, where financials are organized and market value assessed; 2) Buyer Identification, involving confidential marketing to qualified strategic and financial buyers; 3) Negotiation and Due Diligence, where financial and operational information is verified; and 4) Closing and Transition, where legal documents are signed, funds transferred, and transition plans for staff and clients are implemented.
What should practice owners consider after selling their School & Community-Based ABA practice?
Owners should plan their personal transition, whether retiring, staying involved, or pursuing other ventures. Protecting their legacy and ensuring the new buyer respects the established culture and supports staff continuity is crucial. Understanding the financial implications of the deal structure, including payments over time and tax consequences, is also important for maximizing the benefits of the sale.