From Fee-for-Service to Value-Based Care: What ABA Providers Should Know

Across the broader healthcare industry, value-based care (VBC) is accelerating. More than 60% of healthcare organizations now report participating in value-based models, reflecting a sustained shift toward accountability, quality, and measurable outcomes (Advisory Board, 2025).

Within ABA, however, VBC adoption has been slower to take shape, with many providers just beginning to explore what it could look like in practice. At the same time, the field is facing increasing regulatory scrutiny, including heightened attention to fraud, waste, and abuse. A 2026 Office of Inspector General (OIG) report, for example, found nearly $80 million in improper fee-for-service Medicaid payments to ABA providers, underscoring growing expectations around oversight and transparency (Office of Inspector General, 2026).

Historically, ABA has operated within a fee-for-service model, where reimbursement is tied to billable hours, rather than demonstrated outcomes. While this structure has supported the expansion of services and improved access to medically necessary care, it also reinforces a system in which service volume can be prioritized over measurable impact (as noted in the OIG reports).

The result is a widening gap between how care is delivered and how it's evaluated and reimbursed. As value-based models continue to gain traction across healthcare, ABA providers are increasingly faced with a critical question: how can value-based care move from concept to operational reality?