How to grow your ABA therapy practice

How to Run a Successful ABA Therapy Practice

Credentialing directly impacts the sustainability and growth of ABA practices — prioritize getting this right for greater patient and team satisfaction, and compliance.

Building an ABA practice is challenging. Whether it's the daily demands of operations, insurance coordination, managing providers, client intake, finances, or anything in between — finding an effective playbook that will work with your clinic is difficult (and not enough hours in the day to write every one!).

This article series will provide resources, contacts, and tips on how to navigate your ABA clinic as it grows.

How do you know your practice is operating at its best? As your ABA clinic expands and you appoint leaders to manage different functions, effectively overseeing all aspects of your clinic becomes more and more challenging. Instead of micro-managing your team and getting overwhelmed or lost in the details, monitor a few key metrics to gain a comprehensive understanding of your clinic's health at a glance.

We’ll be reviewing 2 specific sets of metrics: people-centric metrics and financial metrics and provide insights into why they matter and tips on achieving positive outcomes for each of them.

We’ve also prepared a cheat sheet in Excel here for you, so you can start tracking each of these metrics in your practice today - reach out to us below and we'll send it over! 

Get in Touch

Get the full playbook

Discover white papers, articles, and case studies tailored to your practice — from an experienced partner that has worked with multi-clinic to national ABA providers.

Key People-Centric Metrics for ABA Therapy Practices

The first category of metrics focuses on the people aspect of an ABA practice, including your clients and staff members who are at the core of your practice's success. These metrics represent how you create positive client experiences and nurture a motivated team.

Patient retention rate

Your patient retention rate measures the percentage of clients who stay with your clinic over time. A high retention rate indicates exceptional patient experiences, satisfaction, and loyalty. Striving for a high retention rate leads to long-term relationships, consistent recurring sessions, and positive word-of-mouth referrals.

We recommend tracking this metric and monitoring its performance over time by recording the total number of clients at the start and end of a month period, excluding any clients that have either aged out or have transitioned out /graduated upon clinical recommendation, calculating the percentage difference from both. This measures the rate at which client families discontinue services outside of expected discharges. To improve patient retention, gather client feedback regularly with recurring client family surveys, and train your clinical staff to provide quality services with effective family communication that enhances client satisfaction and increases the likelihood of them remaining with your practice.


Staff turnover rate

Your staff turnover rate is the percentage of employees who remain with your ABA clinic over time. A low turnover rate indicates high levels of clinician satisfaction, loyalty, and experience, while a high turnover rate can disrupt operations, strain client-family relationships, and increase recruitment and training costs. We recommend calculating this metric by recording the number of employees who leave your clinic over a 6-month period divided by the total number of employees at the beginning of the period.

Maintain a low turnover rate by fostering a positive work environment, offering competitive compensation and benefits, providing professional growth opportunities, and regularly seeking employee feedback to enhance staff satisfaction and retention. Remember that cultivating a low turnover rate begins as soon as you’ve hired a new team member, and must be an active focus even for your longest-tenured employees.


Time on waitlist

Time-on-waitlist measures the average time individuals start treatment from when they first get on the waitlist. Regularly monitor the average wait time to see if it is satisfactory and if not, try to understand the circumstances that made it so. By managing your waitlist effectively, you ensure a steady flow of clients and a balance between demand and available capacity.

While coming up with an “optimal” average time-on-waitlist can be challenging, it is advisable to keep it as short as possible. If this metric is increasing for you, assess whether it is growing longer due to an influx of new clients or delays in moving them off the waitlist. Monitor and optimize staffing levels, consider expanding capacity, and implement efficient intake and scheduling processes to minimize wait times and ensure timely access to services for your clients.


Staff training and development

Develop the skills and knowledge of your clinicians and other staff members. Ongoing training ensures high-quality services, staff competence, and improved client outcomes.

How you train your staff effectively depends on how you choose to run your clinic - regardless of strategy, make sure to dedicate sufficient time and resources to training and professional development for your BCBAs, RBTs, BTs and office staff. Offer a range of opportunities, such as online courses, workshops, and conferences, to keep staff updated with the latest research and best practices in ABA therapy. This not only enhances staff satisfaction but also raises the overall quality of your workforce.


Key Financial Metrics for ABA Practices

The second category of metrics revolves around the financial aspects of your ABA practice, crucial for monitoring your financial health, stability, and growth. Paying close attention to these metrics is crucial for making informed decisions, identify areas for improvement, and ensure the long-term success and financial viability of your practice.


Collections rate

One essential financial metric is your collections rate, which measures the percentage of billed services that have been filed 3 to 6 months out, that are successfully collected from payers- with the time frame usually excluding the most recent 3 months to account for processing times. A high collections rate indicates an effective collection process with insurance payers, ensuring a steady cash flow and financial stability.

Your target collections rate will vary depending on the insurance payers and funding types involved. Aim for an overall collections rate of 85-95% of your total agreed charges (which are based on negotiated in-network rates), aiming for 90-95% collection rates with each insurance payer. An ideal collections rate will be largely determined by your payer mix and number of payers — and an experienced billing partner can help you determine the right set of target benchmarks for each of your insurance payers.

Improve collections rate by regularly reviewing and streamlining your billing processes, understanding payer requirements, and promptly addressing any billing-related concerns to increase collections and minimize payer adjudication rejections. Partnering with an experienced, ABA-specific revenue cycle company or having highly specialized billers in-house is critical for discovering insights and driving actions towards collections rate impact.



Measure time-to-pay by tracking the average number of days to collect payment from payers after date of service. A low time-to-pay, also referred to as Days Sales Outstanding (DSO), indicates efficient financial and insurance billing operations and reduces the risk of cash flow issues.

For simplicity, you can track the average time-to-pay by measuring the different steps in the claim life cycle pre-submission and post-submission. The front-end, pre-submission work includes the steps immediately after the treatment session (i.e., time to convert, validate, and bill that session), and the back-end, post-submission work includes the steps afterwards (i.e., time to receive payer adjudication, work denials, correct claims, and work accounts receivable).

·      From our experience working with both local clinics and national clinic systems, we often recommend some of the following benchmarks: Time to convert should ideally be less than 3 days after the date of service (DOS).

·      Time to bill should be less than 7 days after the DOS. Automated claim submission can accelerate this further to daily billing.

·      Time to correct/appeal should be less than 3 days from adjudication.

In addition to following up on denials, regularly check the claim status to ensure claims are progressing smoothly, following upon any claims without statuses at least every 30 days. This may involve contacting the payer for updates via phone call or email, or viewing the insurance payer portal for details

To decrease time-to-pay, train staff to sign and convert sessions effectively, implement effective billing and collection processes, establish clear payment policies, proactively follow up on overdue invoices, and consider offering convenient payment options to ensure timely payments and maintain a healthy cash flow.


Cash flow

Finally, closely monitor your cash flow, calculated by taking cash received from your ABA services and subtracting operating expenses that were paid in cash for a given period. Maintaining a consistent, positive cash flow is crucial for operational stability, growth, and covering expenses and investments.

Be sure to use an effective accounting software or process on at least a monthly basis to track revenue and expenses. If you use accrual accounting practices, be sure to actively monitor cash transactions and accounts receivable.

To ensure a healthy cash flow, regularly monitor transactions, manage expenses efficiently, maintain appropriate cash reserves, and implement strategies above on increasing collections rate and decreasing time to pay to reduce payment delays and improve cash inflows.



Tracking these people-centric and financial metrics will give you valuable insights into the overall health and success of your ABA practice, empowering you to strengthen your practice’s organizational and operational health.  Consider each of these metrics above as a quick litmus test to assess your practice at a glance. Then, consider making investments into your people and functions to best set yourself up for long term success.


To get started, reach out to receive our Excel sheet for comprehensive tracking of these metrics.


Key Takeaways

  1. Practice owners need to keep track of 2 sets of key metrics: people-centric and financial metrics, in order to get an overview of their clinic’s health and have a successful ABA practice.
  2. A trusted billing partner with ABA-specific knowledge and experience can help improve your financial metrics and set your clinic up for financial success.
Get in Touch

Get the full playbook

Discover white papers, articles, and case studies tailored to your practice — from an experienced partner that has worked with multi-clinic to national ABA providers.