New Analysis Documents Extreme Inconsistency in Autism Care, Calling for Enhanced Accountability from Health Plans

Next generation RethinkFutures™ platform and AI engine provides greater visibility into autism treatment outcomes and supports precise, individualized patient care

NEW YORK, Aug. 29, 2023 /PRNewswire/ -- RethinkFutures, a solution from RethinkFirst, a global behavioral health technology company offering industry leading software and solutions, today announced groundbreaking analysis conducted on its proprietary – and the industry's largest – published dataset of autism and applied behavior analysis (ABA) clinical outcomes. The analysis, performed on RethinkFutures' newly launched next generation platform, reveals a disconcerting level of inconsistency in ABA treatment hours across patients who share the same clinical and situational profile. On average, the analysis revealed that over 40% of patients were receiving inadequate treatment hours, with overtreatment leading to an average excess of $68,978 in annual costs per patient and undertreatment reducing patient progress by as high as 72%.

These findings represent significant and wide-reaching implications for autism providers and patients.

• Overtreatment consumes provider hours with little to no additional patient progress and exacerbates the provider access challenge faced by the autism community.
• For patients with autism, overtreatment takes time away from other social involvement, family relationship-building and more targeted skill development.
• Undertreatment holds patients back, and keeps them in treatment longer.

"For more than 15 years, we've been entrenched in autism services through our work with schools, parents, and ABA providers. However, even with a front seat on the observation deck, we didn't know the true extent of the problem," said Daniel Etra, RethinkFirst CEO. "When we launched the new version of our payor platform leveraging twice more clinical data points than the previous version, we were able to quantify, for the first time, the extreme inconsistency in care."

There's a reason why the lack of precision is so pervasive in the category. There are no agreed upon standardized guidelines for determining appropriate hours of ABA, so it's left up to the health plan to work with the provider to determine how many hours of ABA a patient needs. But determining recommended hours based on the treatment plan is not so straightforward: Humans can only account for a limited number of variables when evaluating a situation, while Rethink's data shows that accurately determining an autism patient's individual needs is driven by over 70 variables, including individual medical necessity, social determinants of health (SDOH), comorbid conditions and personal barriers to progress. Making sense of this complexity can be extremely challenging, even when using sophisticated analytic techniques. Further, no known published literature provides health plans with an objective way to turn those 70+ variables into an hours recommendation.

Instead, the power of AI can help providers and health plans quickly and accurately determine the right care for each patient's individual needs. RethinkFutures has released the next version of its ABA clinical platform with over 530 million clinical data points representing over 70 million hours of ABA sessions. "Payors can now compare patients' actual progress to predicted progress across all providers in their network to manage potential inconsistencies across their autism patient and provider populations," said Dr. David Cox, Vice President, Data Science, RethinkFirst.

Despite the explosion of data-driven decision-making across the payor landscape, the autism category has lagged woefully behind. This analysis gives payors the data they need to take immediate action and redouble their commitment to optimizing autism care management.

For payors interested in evaluating the current state of autism management across their membership, RethinkFutures is offering a complimentary Situational Analysis. Schedule your Situational Analysis by emailing [email protected] or through our website at https://www.rethinkfutures.com/contact/.

About RethinkFutures

RethinkFutures is the only data-driven solution for ABA treatment management in the payor market. The company's offering encompasses a unique AI-powered clinical decision support platform that's proven to significantly outperform previous models in predicting response to ABA treatment, and a reporting solution that provides health plans with the data needed for network management and to lay the foundation for pay for performance. The platform is built upon the company's proprietary–and the industry's largest–published dataset of autism outcomes, and incorporates over 70 different member variables including social determinants of health and health equity data to support holistic decision making and analysis. RethinkFutures is a part of RethinkFirst.

About RethinkFirst

RethinkFirst is a global health technology company providing cloud-based treatment tools, training, and clinical support to employers, educators, payors, and behavioral health professionals. Rethink's award-winning solutions serve thousands of clients globally, including nearly one-third of the Fortune 100 and many of the country's largest public-school systems and health plans. Each of Rethink's award-winning solutions incorporates evidenced-based protocols, workflow automation, and advanced data analytics to drive meaningful clinical outcomes and improved performance for customers and the communities that they serve.

For more information please visit our RethinkFirst website or for media inquiries email [email protected].

Media contact for RethinkFirst
Erin Bocherer
678-294-2258
[email protected]

SOURCE RethinkFutures