This comparison draws in part from “Bixpli Presents: Using the R.AI.S.E. Platform to Target Your Next Clinic Location in Under a Week” by Lani Fritts (BehaviorLive), and extends it with peer-reviewed research from our library of 27,900+ ABA research articles. The decision framework, BACB ethics code references, and cross-links below are synthesized by Behaviorist Book Club.
View the original presentation →When an ABA organization decides to enter a new geographic market, two primary strategies are available: building a new clinic from the ground up (de novo development) or acquiring an existing ABA practice in the target market. Each strategy has distinct implications for timeline, capital requirements, clinical culture, staffing, and risk profile.
The R.AI.S.E. methodology is primarily designed for the de novo context, but understanding how de novo development compares to acquisition helps ABA leaders make the right strategic choice for their specific situation. In some markets and at some organizational stages, acquisition offers faster entry, established client relationships, and existing payor contracts that accelerate revenue. In others, de novo development provides more control over clinical quality, culture, and physical environment at a potentially lower acquisition price.
This comparison provides a structured framework for evaluating both strategies against the dimensions most relevant to ABA clinic expansion decisions.
| Factor | Evidence-Based Approach | Traditional Approach |
|---|---|---|
| Time to first client | De Novo: Longer lead time — typically 6-12 months from site selection to first client, including leasing, buildout, licensing, staffing, and credentialing | Acquisition: Faster entry — existing clients, staff, and payor contracts in place, often allowing revenue on Day 1 post-close |
| Capital requirements | De Novo: Higher startup capital for leasehold improvements, equipment, and cash reserves to fund operations during ramp-up to break-even | Acquisition: Capital goes primarily to purchase price plus integration costs; ongoing capital needs may be lower if acquired practice is already operational |
| Clinical culture control | De Novo: Full control over clinical culture, hiring standards, program design, and staff training from day one | Acquisition: Inherits existing clinical culture, which may require significant remediation if the acquired practice has quality concerns or staff with entrenched habits |
| Staffing risk | De Novo: High staffing risk — must recruit and credential an entirely new team in the target market before accepting clients | Acquisition: Inherits existing staff, but key staff may leave post-acquisition, creating immediate clinical continuity risk for existing clients |
| Revenue trajectory | De Novo: Slower revenue ramp as intake grows from zero; requires adequate capital reserves or credit to fund operations during the build period | Acquisition: Faster revenue from existing client base; however, due diligence must verify revenue quality and sustainability post-transition |
| Strategic fit with R.AI.S.E. | De Novo: Directly aligned with R.AI.S.E. methodology — market analysis, site selection, operational readiness, and launch planning are all relevant | Acquisition: R.AI.S.E. market analysis informs target market identification, but acquisition due diligence adds additional layers including financial, legal, and operational review of the target practice |
The ABA Clubhouse has 60+ on-demand CEUs including ethics, supervision, and clinical topics like this one. Plus a new live CEU every Wednesday.
Use this framework when approaching bixpli presents: using the r.ai.s.e. platform to target your next clinic location in under a week in your practice:
Does the data support a need for intervention? Is there a meaningful impact on the individual's quality of life, safety, or access to reinforcement?
YES → Proceed to assessment NO → Document reasoning, monitor
A functional assessment should guide intervention selection. Avoid defaulting to standard protocols without individual analysis. Consider environmental variables, setting events, and private events.
YES → Select evidence-based approach matched to function NO → Complete assessment first
Goals should be co-developed. Assent and informed consent are ethical requirements. The individual's preferences and values matter in selecting both goals and methods.
YES → Proceed with collaborative plan NO → Engage in shared decision-making
This course covers the clinical and ethical dimensions in detail with structured learning objectives and CEU credit.
Bixpli Presents: Using the R.AI.S.E. Platform to Target Your Next Clinic Location in Under a Week — Lani Fritts · 1 BACB General CEUs · $0
Take This Course →We extended this decision guide with research from our library — dig into the peer-reviewed studies behind each approach, in plain-English summaries written for BCBAs.
280 research articles with practitioner takeaways
258 research articles with practitioner takeaways
239 research articles with practitioner takeaways
1 BACB General CEUs · $0 · BehaviorLive
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.