Behind the Deal: Agenda Health and Behavior Genius CEO Break Down SF Bay Area Acquisition

by | Mar 7, 2025

Agenda Health

Behavior Genius, LLC, a growing provider of Applied Behavior Analysis (ABA) services, announced that it has bolstered its presence in California through the acquisition of Bay ABA in the San Francisco Bay Area. The deal, facilitated by Austin, Texas-based Agenda Health, a healthcare-focused M&A advisory firm, underscores the ongoing consolidation trend in the ABA sector.

Announced in early 2025, this transaction aligns Behavior Genius with a provider that’s built a solid presence in the region, opening the door to broader service coverage across the state. To unpack the dynamics of this deal, the LevinPro HC team spoke with Randy Decko, Senior Advisor at Agenda Health, and Portia C. James, M.A., BCBA, Chief Executive Officer of Behavior Genius, about what drove the acquisition and what it signals for the broader behavioral health landscape.

Bay ABA, based in San Mateo, has been delivering ABA therapy with a focus on client outcomes since 2017, operating across the Peninsula, South Bay, San Francisco and East Bay markets. Behavior Genius, an Ontario, California-based company that provides behavior treatment services for individuals with special needs across home and community settings, saw Bay ABA as a strong match.

“Bay ABA stood out as an acquisition target because of their strong clinical leadership and established presence in the Bay Area market,” James said. “Their commitment to quality care and positive outcomes aligned perfectly with our vision at Behavior Genius.”

That shared focus made Bay ABA a natural fit for Behavior Genius’s growth plans. The deal came together after months of talks, with both sides eyeing a bigger impact in California’s autism care landscape.

“Before the acquisition, Bay ABA demonstrated consistent growth and maintained strong client relationships across multiple regions,” James continued. ” They had successfully expanded from Peninsula into South Bay, with emerging presence in SF and East Bay markets.”

Agenda Health stepped in after locking down an exclusive listing agreement with Bay ABA’s sellers, handling the sell-side advisory role.

“We witnessed lots of compromise and patience by both parties, which significantly contributed to the success of this deal,” Decko said.

The focus on give-and-take points to a familiar thread in M&A: it’s not just about the price tag. For Behavior Genius, Bay ABA’s operational setup was a big draw, and James plans to keep what works while tapping into Behavior Genius’ resources.

“Our integration strategy focuses on preserving Bay ABA’s operational strengths while enhancing capabilities through Behavior Genius’s resources,” James noted. “We’re already seeing great synergies in clinical operations, with Aaron Nystedt stepping into the VP of Clinical Operations role.”

“Key focus areas include expanding services throughout California, introducing inclusive care models and strengthening our revenue cycle management systems,” added James.

The deal announcement comes amid a busy stretch for the behavioral health care (BHC) sector, especially in autism services. Autism treatment providers have made up about 30% of all BHC transactions announced so far this year—five out of 17 deals as of March 5, 2025—making it the busiest specialty in the sector.

That’s a sharp contrast to last year, when only nine BHC deals were announced between January 1 and March 5, 2024, with none involving autism. For all of 2024, 70 BHC deals were announced, including 13 in autism, while 2023 saw 83 BHC deals and 11 autism transactions. This year’s pace has kicked off strong, with January 2025 logging 14 BHC deals worth $835 million—the most active month since November 2021, when 19 deals hit $181.6 million. Autism deals were a big driver, showing the pull for providers like Bay ABA.

For Behavior Genius, this transaction isn’t just about adding locations—it’s a play to tackle some real hurdles in the field.

“The ABA industry faces challenges in scaling quality care delivery and maintaining consistent service levels across regions – especially in underserved communities,” James said. “This acquisition helps us address these by combining Bay ABA’s proven clinical model with our operational infrastructure.”

The deal will provide Behavior Genius with a chance to stretch further without dropping the ball on standards. According to James, that balance was a large reason why this deal clicked for them. She also had some tips for others eyeing similar moves.

“My advice for others considering acquisitions would be to prioritize cultural alignment and take time to understand each organization’s strengths,” said James. “Focus on how the combined entity can better serve clients and support staff growth. Clear communication and building a genuine relationship throughout the process is crucial.”

Agenda Health, meanwhile, is betting on more action to come.

“We anticipate strong ABA M&A activity these next few years, barring any major macro level changes that would reverse current M&A tailwinds,” Decko noted.

The firm has already wrapped up four ABA deals in 2025, with more in the works, which tracks with the bigger picture in BHC—demand for autism services keeps climbing, pushed by more diagnoses and better insurance coverage. Still, staffing shortages and reimbursement headaches linger, making deals like this a key way to grow smart. With autism deals driving the BHC M&A wave in 2025, this transaction shows how providers are working through a crowded, shifting market to keep up with demand.

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