Report drafting fell from six hours to two, while the clinical judgment stayed with the BCBA.
A growing ABA practice usually measures its capacity in BCBAs, and when the caseload outpaces the team, the instinct is to hire another one.
Autism West Behavior Partners looked at the work first. Its eight BCBAs each complete three to four initial assessments and three to four reassessments a month, and each report took about six hours to draft. Cory LaFlair, the practice’s Chief Operating Officer, could see those hours multiplied across the team and pulled away from the caseload, from supervising a growing staff, and from the families waiting for services. He wanted the time back without asking a single clinician to cut a report short. The practice found it in how the report gets built.
Report production was consuming the hours the caseload needed
At six hours per report and six to eight reports a month, drafting had become a second job for every BCBA on the team.
A BCBA carrying a full monthly load of initials and reassessments spends a large part of that month at a desk, turning completed assessments into documents a payer will read as complete. The assessments themselves run on schedule. The drafting afterward is what runs long, and it runs long for every clinician at once.
The cost compounds as the practice grows. Each new learner adds another report to the queue, and each report pulls senior clinical time into document assembly. Growth that should have expanded access to care was on track to lengthen the queue instead.
Most of an assessment report is assembled from information the BCBA already has
Carrying goals forward, rewriting assessment results as narrative, and formatting for the payer take longer than the clinical reasoning they support.
A typical reassessment starts with goals and baselines from the previous authorization period, often written in a different platform. Skills and behavior assessment results get translated into narrative. The full document gets shaped to what the payer expects to see. Somewhere in that process is the part only a BCBA can write: what they observed, what changed, and what the learner needs next.
That clinical section is the reason the report exists, and it is usually the smallest share of the time spent on it. The rest is production, and production is the part a better process can take off the BCBA’s plate.
Knowing Where Your Own Report Time Goes
Three recent reassessments will show how much of the work is production and how much is clinical judgment.
Start with the reports you already have. Pull your last three reassessments and highlight every sentence that was copied, retyped, or reformatted from an earlier document or an assessment output. Leave everything that came from new observation or clinical reasoning unmarked.
The highlighted share is the work your BCBAs can hand off without handing off their judgment. If it covers most of the page, the report process is what’s limiting your team’s capacity, and it is worth fixing before the next hire.
How Autism West Behavior Partners handed off assembly and kept clinical control
Assessment Builder builds the base draft from the records clinicians already have, and the BCBA reviews it, adds their clinical reasoning, and signs off.
Clinicians at the practice give Frontera’s Assessment Builder the skills assessment, the behavior assessment, prior reports, and any supplemental notes. Assessment Builder pulls the goals and metadata out of those records, regardless of the platform they were originally written in, and assembles a base draft. The BCBA then reviews it, adds the direct observational detail a PDF can’t capture, and signs. The clinical reasoning and the signature never leave the clinician.
For Alexa Susemichel, a BCBA at the practice, the first difference was having everything in one place. “The biggest difference is having it all in one place instead of moving around trying to find different things,” she said. “Once it’s pulled together in one form, going through it is so much easier.”
The team’s hesitation was the one every BCBA shares, and it faded once they used it. “It sounds a little scary at first. As BCBAs, we like to have control over everything,” LaFlair said. “But when you give up that piece of control, it’s really not that bad. It still gives you the autonomy to individualize the goals and the criteria that matter.” The practice rolled Assessment Builder out in phases, and the full team was comfortable with it in about a month.
What the practice got back
Drafting time fell from six hours to two per report, and the recovered time went into treatment plans, assessments, and the caseload.
Autism West Behavior Partners reports that drafting time dropped on average from about six hours per report to two. With eight BCBAs each writing six to eight reports a month, those four hours come back dozens of times over, every month. The practice put that time back into families, sessions, and the behavior techs who need a BCBA’s oversight, the clinical work only a BCBA can do.
The quality of the reports improved along with the pace. “It makes things far more efficient and gives the clinical quality a boost,” said Ryan Ferguson, a BCBA at the practice. “We have the ability to make sure that those assessments are done accurately, and it makes things much more effective for payer purposes and for medical necessity.”
What a report assembly workflow has to do before a practice relies on it
Four requirements to check any system against before your team hands it the first draft.
Any workflow that builds assessment reports for your BCBAs has to do four things:
- Read prior reports in whatever format they were written, including reports from other platforms
- Pull from the skills and behavior assessments your team already runs
- Leave every section editable by the BCBA, with the BCBA signing the final report
- Produce output structured for medical necessity review and first-pass acceptance
Assessment Builder was built against these requirements, which is why Autism West Behavior Partners could hand it the first draft without handing over the clinical decisions. The BCBA decides what the report says, and the platform handles the production around it.
Fix the report process once, and every BCBA on the team spends those hours on learners and families instead of formatting. That is what LaFlair set out to recover. “It’s giving back time to the things that you want to do,” he said.
Run the highlight exercise on your own last three reassessments. If most of the page is production, a walkthrough of how Assessment Builder assembles a report will show you what handing it off looks like. Request a demo or download the full Autism West Behavior Partners case study (PDF).
