NC Medicaid, ABA and the Alliance Health and Cortica Deal
A North Carolina Medicaid plan is moving away from sole reliance on ABA. Here is what that means for clinicians and the providers who hire them.
Market intelligence · Last reviewed October 2026 · Take a Seat People editorial team
Why is North Carolina changing how Medicaid pays for ABA therapy?
What happened
On 6 August 2026, Alliance Health announced a partnership with Cortica, a physician-led autism services provider. Alliance is a North Carolina Tailored Plan, a specialty Medicaid managed care organization, so its choices directly shape how autism care is funded in its region.
The partnership brings Cortica's model to children with autism and other developmental differences in Raleigh and Charlotte. Cortica's CEO is Neil Hattangadi, MD, MSc. Alliance describes the goal as an integrated, whole-person approach that improves quality, reduces sole reliance on Applied Behavior Analysis and addresses costs that rose sharply over the past two years.
Why spending became the issue
Behavioral Health Business reported that autism therapy spending in North Carolina Medicaid, nearly all within ABA, rose very quickly, and that it was a major factor in the state's wider Medicaid funding adjustments. Alliance's leaders have been open that the trajectory was not sustainable.
Alliance's CEO Rob Robinson said the plan is "not solely reliant on fraud, waste and abuse prevention to address spending concerns." In other words, the response is a different care model, not only tighter checks. The company post also pointed to tighter rules forming around provider networks and approvals.
What the Cortica model looks like
Cortica organizes care across four areas and tracks progress across all of them with shared data:
- Medical care
- ABA
- Developmental therapy, such as speech and occupational therapy
- Family support
What it means for clinicians
If more funders follow this direction, the most sought-after clinicians will be those comfortable working alongside physicians, speech-language pathologists and occupational therapists, sharing goals and data rather than running isolated caseloads.
For BCBAs and RBTs, ABA skills stay central, but coordination, clear documentation and collaboration become part of the job. For SLPs and OTs, integrated autism programs open more roles in settings that used to be ABA-only.
What it means for providers
Providers in North Carolina should expect closer scrutiny of ABA authorizations and a stronger case for showing outcomes across disciplines. Staffing plans may need to include allied therapists and clinical oversight, not only more technicians.
This is also a chance to improve treatment coordination and clinical supervision, which tend to help with keeping staff as well as with outcomes.
Questions people ask
- Who is Alliance Health?
- Alliance Health is a North Carolina Tailored Plan, a specialty Medicaid managed care organization that funds behavioral health and developmental disability services.
- What is Cortica?
- Cortica is a physician-led autism services provider that combines medical care, ABA, developmental therapy and family support in one plan.
- Does this mean ABA is being replaced in North Carolina?
- No. The stated aim is to reduce sole reliance on ABA. ABA remains one of the four parts of Cortica's model.
- Where does the partnership operate?
- Raleigh and Charlotte, North Carolina.
Sources and method
- Alliance Health: Ensuring access to quality, cost-effective care for children with autismAlliance Health
- Alliance Health and Cortica partner (press release)PR Newswire
- North Carolina MCO Alliance Health taps CorticaBehavioral Health Business
- CorticaCortica
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Pay figures last reviewed August 2026