Dr. Suzanne Goh, co-founder and chief medical officer of Cortica, works with a young patient at one of the company’s 27 clinics.
Cortica’s interdisciplinary model pairs medical care with behavioral and developmental therapy, delivering less than half the standard volume of ABA hours.
Over the past year, major Applied Behavior Analysis (ABA) providers have pulled out of entire states, citing Medicaid rates and authorization burdens. Cortica did the opposite. It opened an 8,400-square-foot center in Plano, Texas, and went before the Concord, California, planning commission this summer to relocate into a larger downtown clinic.
Here is the strange part. Cortica sells less than half the industry’s standard volume of its core product, and health plans reimburse it at higher rates for doing so. Dr. Suzanne Goh, the pediatric neurologist who co-founded the company and serves as its chief medical officer, designed value-based autism care around outcomes roughly a decade before the federal government arrived at the same conclusion. On August 4, CMS released a toolkit for state Medicaid programs, stating that more services are not always better.
How Selling Fewer Hours Turned Into A Growth Strategy
Dr. Suzanne Goh, co-founder and chief medical officer of Cortica, designed a value-based autism care model roughly a decade before federal regulators reached the same conclusion.
Cortica’s interdisciplinary model pairs medical care with behavioral and developmental therapy, delivering less than half the standard volume of ABA hours.
Ask Goh why the economics work for Cortica and not for her competitors, and she goes straight to clinical design rather than to billing.
“The right care model is one that is not ABA alone; it’s one that is interdisciplinary, where ABA is just one part, an important part,” she told me.
The mechanism is more concrete than it sounds. Many autistic children sleep badly, and chronic sleep deprivation produces exactly the daytime attention problems, memory difficulties, and meltdowns that intensive behavioral therapy then spends hours managing. Treat the sleep disorder and those hours become unnecessary.
“A lot of that 40-hour-a-week sort of modeled ABA is trying to address those things, but those things get much, much better with the appropriate medical care,” Goh explained. Diagnose seizures, genetic and metabolic conditions, and gastrointestinal problems early, she argues, and “they need far fewer ABA hours because you’re correcting, in a sense, the source.”
Cortica now runs 27 clinics across California, Arizona, Texas, Illinois, North Carolina, Massachusetts, New Jersey, and Connecticut, and has raised more than $250 million.
What Rivals Copying The Model Still Get Wrong
Several large providers have begun pivoting toward multidisciplinary care. Goh welcomes it without pretending they have arrived.
“It’s hugely gratifying that the field is moving in this direction,” she noted, before adding the caveat that matters, “I think they’re still missing the medical care, so that is key, and the model won’t succeed without that component.”
Martha Temple, an advisor to .406 Ventures and former CEO of Optum Behavioral Health, frames the same point from the buyer’s side. Cortica’s “physician-led interdisciplinary model addresses one of the biggest challenges in autism care: fragmentation,” she said.
What It Cost To Get Paid For Outcomes Instead Of Hours
Whole-child autism care did not arrive pre-funded. Cortica grew out of Goh’s private practice in Del Mar, California, in 2014 and was formally founded in 2017. For years, it delivered an expensive interdisciplinary model under the same reimbursement terms as everyone else.
“We had to start off with the same fee-for-service reimbursement model that you know has been standard in our field, which is hard because we were delivering something of greater value and not being reimbursed for it,” Goh recalled.
What broke the impasse was measurement. Cortica built what it calls a whole-child scorecard, with “10 domains of outcomes metrics that we’re looking at across medical, developmental, behavioral, and family-and-child quality of life.” Goh describes it as “both a process and an outcomes framework, and that is what we measure rigorously, and report to our payer partners.” If it hits the agreed benchmarks, Cortica earns a bonus.
She is careful not to oversell what that adds up to. “It’s not fully value-based, but it is where we are incentivized to show outcomes,” she conceded. Most of these arrangements are commercial, though the company recently launched Medicaid partnerships with Mercy Care in Arizona and Alliance Health in North Carolina.
Where The Autism Money Is Actually Going Wrong
Medicaid and CHIP payments for ABA climbed from roughly $1.94 billion in 2021 to $10.1 billion in 2025, a 421% increase that far outpaced growth in the number of children receiving services. Federal auditors have flagged improper payments across multiple states, including at least $77.8 million in Colorado.
Goh’s diagnosis is not that the country spends too much. It is that the money lands in the wrong place. “The waste is excessive ABA hours,” she stated flatly. “The problem is right now the funds are being misdirected to ABA-only care.”
She also draws a distinction the trade press mostly skips. “I don’t think the majority of autism behavior therapy providers are committing fraud, but I do think a significant proportion are engaging in overutilization,” she observed, describing national chains “prescribing for every child that comes through their doors 30 to 40 hours of ABA per week,” then dropping to zero at an age cutoff.
Asked which providers survive the current squeeze, she did not hedge, “I do think some should not survive.”
Why She Recruited Payers And Parents Instead Of Growth Equity
Dr. Neil Hattangadi, chief executive officer of Cortica, speaks at the Behavioral Health Business VALUE conference. Hattangadi joined the company Suzanne Goh started, in 2017 to lead its national expansion.
Cortica’s interdisciplinary model pairs medical care with behavioral and developmental therapy, delivering less than half the standard volume of ABA hours.
Cortica’s cap table reads oddly for a scaling healthcare company. CVS Health Ventures, Optum, Ascension, and Morgan Health are strategic investors, alongside the Autism Impact Fund, which represents families raising autistic children.
“It was deliberate,” Goh confirmed. That syndicate, she says, “allowed us to maintain the integrity of our clinical model.” She is blunt about the tradeoff. “It’s a harder model to build and to scale, but they have been key in allowing us to do that,” she said.
Chris Male, co-founder and managing partner of the Autism Impact Fund in Winter Park, Florida, sits on both sides of that arrangement as an investor and the father of an autistic child. “What Suzanne and Neil built wasn’t another autism services company—it was a fundamentally different healthcare model,” he said.
The 10-Year Goal Is For Her Own Industry To Disappear
Goh’s ambition is not to build the largest autism company in the country. It is for the category to stop existing as a category.
“I hope that 10 years from now it is absorbed into pediatric medicine, that interdisciplinary care teams are the norm rather than a rarity,” she said. Getting there requires one structural change. “ABA needs to come out from its silo,” and “for physicians to begin to recognize that ABA is a form of health care, and it falls within their purview.”
For Holly and Bob Baltera of San Diego, whose daughter Lauren is a Cortica patient, that abstraction has a plainer shape. The company has given them “one team that truly knows our child.” They add, “They work together every day to help her be as happy and healthy as possible.”
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