To the families, providers, and leaders who care about Nebraska’s children:
Over the years, I’ve sat across from hundreds of families navigating an autism diagnosis. Some were hopeful. Some overwhelmed. Many unsure where to begin. But almost all believed the system would guide them—to care that was ethical, personal, and truly helpful.
That trust has been betrayed.
ABA therapy in Nebraska isn’t just changing—it’s being exploited. Not for progress. Not for innovation. But for profit.
Let me be clear: the way some companies operate today doesn’t prioritize helping kids—it prioritizes billing.
Companies didn’t expand into Nebraska because of unmet need—they came because it was financially attractive.
What’s emerged is a system that looks good on paper—but is designed for volume billing over meaningful outcomes. In my experience, here’s what that model often looks like:
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“Immediate availability” that skips informed choice.
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30–40 hour prescriptions for nearly every child—like clockwork.
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Reliance on remote supervision to prop up the model.
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Supervision stretched thin across massive caseloads.
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Copy-paste treatment plans slapped with the word “individualized.”
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Families pushed through like numbers in a queue.
It’s not just happening. It’s strategic. It’s a playbook.
And the result? From 2020 to 2024, Medicaid spending on ABA in Nebraska exploded—from $4.6 million to over $85 million. That’s not a typo. That’s what happens when volume is rewarded more than value—and no one’s watching closely.
In July 2025, the state finally acted. DHHS slashed rates. Predictably, the strongest opposition has come from those whose business models benefited most from the old system.
Let’s be honest:
Access isn’t what’s at risk. Accountability is.
When therapy becomes a business strategy, families don’t get better care. They get more hours, more staff turnover, more chaos. Eventually, they start wondering if the “help” is actually helping at all.
What I’ve seen is deeply concerning:
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Kids scheduled for 30–40 hours a week in what’s labeled therapy—but often functions more like daycare with data sheets.
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Families with no idea how progress is tracked—or if it’s happening.
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Staff quitting. Kids shuffled. Relationships broken.
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Parents with gut instincts screaming “something’s wrong”—but unsure who to ask or how to fight back.
Not every provider is guilty. But if this sounds familiar in your clinic—or in your home—it’s time to ask why.
Because guess what? People are paying attention now.
Families. Clinicians. Even policymakers. They’re watching.
This isn’t a warning. It’s a reckoning.
At Radical Minds, we chose a different path. We’re Nebraska-owned. Clinician-led. Built on values—not volume. We don’t chase hours. We don’t rubber-stamp referrals. We don’t follow the script.
We’ve grown carefully, not recklessly—because for us, trust matters more than scale.
To the families reading this:
You didn’t get it wrong. You weren’t naive. You just weren’t told the truth.
You have the right to ask questions. To pause. To expect more.
And if your provider doesn’t welcome that—there’s your answer.
To the good providers still out there:
This work matters. Don’t let your clinic become a sales funnel. If your team is uncomfortable, listen.
To our state leaders:
If you want a future for autism care that actually serves children, stop confusing billing power with clinical value.
We can do better. And we must.
Nebraska families deserve nothing less.
Sincerely,
Corey Cohrs
Founder & CEO, Radical Minds
📞 Want clarity or a second opinion—no pressure?
Visit radicalmindsomaha.com or call (402) 230-5861.
