Value-Based Care in ABA: Session 196 with Amanda Ralston


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If you care about the future of ABA, it's important to understand not only its strengths, but also the myriad challenges the field faces. And to that end, I can't think of a more difficult challenge the field of Applied Behavior Analysis has right now than figuring out how to adequately measure outcome quality, and how this relates to funding ABA services.

My guest for Session 196 is Amanda Ralston, and she's been thinking a lot about these issues for quite some time, and she was kind enough to spend some an hour with me to share her thoughts.

As you'll learn in this episode, Mandy has been in the ABA field for over 20 years, and has experience founding and operating a large, statewide ABA provider, consulting with large multi-state ABA organizations, and much more. Mandy most recently founded NonBinary Solutions, which she talks about briefly.

We discuss the current model of insurance reimbursement, and contrast that with what's referred to as Value-Based Pay or Value-Based Care. These payment models differ considerably from the current Fee-For-Service arrangements that most listeners are likely familiar with.

While Behavioral Observations is not a health-care policy podcast, I was encouraged to explore this topic by some friends and confidants, largely because this treatment model may be coming our way at some point. Given that Behavior Analysis is not a mature field as of 2022 - especially when it comes to funding our services - I thought it would be a good idea to explore the topic.

If you experience this conversation the same way I did, I think you'll come to the realization that there are more questions than answers when it comes to Value-Based Care (many of which are articulated in this short video), so I may return to this topic from time to time as things develop.

Here are some links to resources we discussed:

Session 196 is brought to you by the following:

  • The 2022 Stone Soup Conference! Great speakers, great cause, all for a great price. October 22nd (or later if you're busy that day). Come hear from Kirk Kirby, Drs. Camille Kolu, Nasiah Cirincione-Ulezi, Merrill Winston, Holly Gover, Tom Higbee, and Florence DiGennaro-Reed.
  • HRIC Recruiting. Barb Voss has been placing BCBAs in permanent positions throughout the US for just about a decade, and has been in the business more generally for 30 years. When you work with HRIC, you work directly with Barb, thereby accessing highly personalized service. So if you're about to graduate, you're looking for a change of pace, or you just want to know if the grass really is greener on the other side, head over to to schedule a confidential chat right away.
  • Behavior University. Their mission is to provide university quality professional development for the busy Behavior Analyst. Learn about their CEU offerings, including their brand new 8-hour Supervision Course, as well as their RBT offerings over at
  • The University of Cincinnati Online. UC Online designed a Master of Education in Behavior Analysis program that is 100% online and asynchronous, meaning you log on when it works for you. Want to learn more? Go to and click the “request info” button.

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