Ian Santus Transitions from ABA Veteran to Startup Founder

The Accidental Behavior Analyst

ANN ARBOR, MICHIGAN, Ian Santus did not plan to work in Applied Behavior Analysis (ABA). He planned to be a pilot. A vision impairment ended that path, and what followed was a two-decade career in behavioral health that took him through every level of the industry, from registered behavior technician to BCBA case supervisor to clinical director to regional director to executive director to director of learning and development, before he launched his own company in 2023.

That company is Akoya Behavioral Health, a Michigan-based ABA provider that Santus co-founded with Yitz Miller, an entrepreneur with a background in outpatient mental health. Akoya saw its first patient in November 2023. By late 2025, the company employed approximately 185 people and operated two clinics serving families in the Grand Rapids and Detroit metropolitan areas. Santus serves as co-founder and chief operating officer. His LinkedIn describes him as a dedicated and driven behavior analyst with experience in both clinical and operational positions, a researcher, author, speaker, motivator, mentor, but above all, a learner with far too many hobbies.

The trajectory from first patient to 185 employees in under two years is aggressive by any standard, but particularly notable for a company that is not backed by disclosed private equity capital. Akoya’s growth has been self-funded and revenue-driven, built on the thesis that a clinician-led startup with the right operational infrastructure can compete in a market dominated by PE-backed platforms, if it gets the staff experience right.

Twenty Years in Other People’s Organizations

Santus’s resume reads like a map of the Applied Behavior Analysis (ABA) industry’s institutional landscape. He holds a Master’s degree in Applied Behavior Analysis from the Sage Colleges (2012–2013) and an undergraduate degree from Western Michigan University, one of the field’s most prominent ABA training programs. His NPI registration as a behavior analyst dates to April 2011, placing him in the field for well over a decade before founding Akoya.

His career stops include Autism Concepts Incorporated, BlueSprig, one of the largest PE-backed ABA platforms in the country, Willow ABA Services, and Springtide Child Development, where he served as Director of Learning and Development. At BlueSprig, which operates clinics across multiple states and has built one of the industry’s largest BCBA internship programs with more than 200 interns becoming certified BCBAs through the program, Santus would have had front-row exposure to the operational mechanics of a high-growth, PE-backed ABA platform: rapid center openings, standardized training protocols, utilization management, and the staffing pressures that define the field.

That exposure appears to have shaped both what Santus wanted to replicate and what he wanted to do differently. In an October 2025 interview with Behavioral Health Business, he described a recurring pattern he had observed across employers: companies that did not take the time or make the space to let employees explain themselves and their wants and needs. The turnover that followed, he suggested, was not inevitable, it was a design failure.

“I have a lot of experience with handling employee turnover, and I find that a lot of companies didn’t take the time or make the space to let employees explain themselves and their wants and needs.”, Ian Santus, Co-Founder and COO, Akoya Behavioral Health (Behavioral Health Business, October 2025)

Building the Employee-First Thesis

Akoya’s staffing strategy is the centerpiece of its operating model. In a field where RBT turnover rates range from 45 to 75 percent and BCBA burnout affects an estimated 70 percent of practitioners, Santus has structured the company around what he describes as an employee-centered platform. The term is ubiquitous in Applied Behavior Analysis (ABA) recruiting materials, nearly every provider claims to prioritize staff well-being, but Akoya’s implementation appears to go beyond messaging.

The company uses a high-commitment training model designed to function as both a quality filter and a retention tool. Santus told Behavioral Health Business that Akoya’s closely monitored training program, particularly for RBTs, serves a dual purpose: it elevates the skill level of the staff who complete it, and it identifies early which candidates are not aligned with the company’s clinical expectations. The attrition that occurs during training, in this framework, is intentional, a feature of the system rather than a failure. By investing more in training upfront, Akoya aims to reduce the costly mid-tenure turnover that plagues most providers.

Santus’s LinkedIn posts reinforce this philosophy. In mid-2023, before Akoya had seen its first patient, he was publicly recruiting BCBAs and RBTs by describing the company as forward-thinking and employee-centered, looking for passionate, creative problem solvers to help build out systems on the ground level. By late 2025, the company was posting high-energy recruitment content and featuring its 16 BCBAs in team videos, an unusual level of public clinical visibility for a company its size.

Navigating Michigan Medicaid County by County

One of the most revealing details about Akoya’s growth is its approach to Medicaid contracting in Michigan. For roughly the first year of operations, the company was commercial insurance only, a common starting point for Applied Behavior Analysis (ABA) startups that want to establish revenue before taking on the administrative complexity of public payer contracts. Around mid-2024, Akoya began pursuing Medicaid contracts, starting with small counties on the west side of the state near Grand Rapids.

Michigan’s Medicaid system requires providers to contract county by county, each with its own credentialing rules and administrative processes. Santus described this to Behavioral Health Business as a deliberate, incremental approach: dip the toes in, learn the process, and scale from there. By early 2025, Akoya had secured Macomb County and Wayne County contracts on the east side of the state, the Detroit metro, after roughly a year of work. The west side of Michigan, Santus noted, is virtually 100 percent Medicaid, meaning that serving the full population in Grand Rapids requires ABA providers to be Medicaid-contracted or accept that they are only reaching a fraction of the families who need services.

This county-by-county Medicaid strategy illustrates a broader challenge for ABA startups. Commercial insurance contracting is faster, pays higher rates, and involves less administrative burden. But Medicaid covers a disproportionate share of children with autism diagnoses, particularly in lower-income communities. A provider that operates exclusively on commercial insurance is effectively choosing which families it can serve based on their payer status. Santus’s decision to pursue Medicaid, despite the complexity, signals an intent to serve a broader patient population, a strategic choice that carries both clinical and financial implications.

The Research and Teaching Dimension

Unlike many ABA startup founders whose credentials are primarily operational, Santus has maintained an active research and academic presence. He is a co-author on a November 2024 book chapter titled Clinical Decision Modeling as an Effective Technology for Achieving Best Practice Standards for Treatment Intensity, alongside Kristen L. Byra and Kailie Kipfmiller. The chapter addresses how decision modeling can be applied to Applied Behavior Analysis (ABA) treatment planning, a topic that intersects clinical practice with the kind of operational efficiency thinking that characterizes Santus’s approach to running a company.

He has presented at conferences, appeared on the Hi Rasmus and Friends podcast sharing the personal story behind his career pivot from aviation to ABA, and his company’s website describes him as having published books on a wide range of topics. This dual identity, clinician-researcher and operational executive, is relatively rare in ABA leadership. Most BCBA founders are primarily clinicians who learn operations on the job. Most PE-installed operators are primarily business executives who learn clinical context on the job. Santus appears to operate in both domains simultaneously, a position that may give Akoya a distinctive advantage in clinical program design if it can be sustained as the company scales.

The Technology Bet

Akoya’s operational infrastructure is built on Lumary, a Salesforce-based ABA practice management platform. The choice is notable because most Applied Behavior Analysis (ABA) providers of Akoya’s size use industry-standard tools like CentralReach, Catalyst, or Rethink. Lumary’s Salesforce foundation gives Akoya CRM-level data architecture, unified dashboards, real-time reporting across clinical and financial operations, and the ability to track performance across every part of the organization from a single platform.

Santus has spoken publicly about the impact of this choice. In a Lumary case study, he described the pre-Lumary state as one of constant uncertainty about where the source of truth was. With Lumary as the company’s CRM, he said, Akoya could report on data, analyze it, and make quick decisions. The platform also handles revenue cycle management, which proved critical for navigating Michigan’s complex Medicaid billing requirements. Santus credited Lumary with giving the company confidence in managing Medicaid billing as a true partner, particularly for the county-level compliance demands that had previously been a major barrier.

“We always worried about where the source of truth was. Who had the facts? Who knew the most recent information? With Lumary as our CRM, not only do we know we have the latest information, but we can report on it, analyze it, and make quick decisions.”, Ian Santus (Lumary case study)

What Comes Next

Santus was scheduled to speak at the Autism Investor Summit East in November 2025, an event that caters to private equity firms, strategic acquirers, and ABA operators evaluating investment opportunities. His presence at an investor-focused conference raises a natural question: is Akoya building to remain independent, or building to attract outside capital?

The answer may be both. A company that grows to 185 employees and two clinics in under two years, with a deliberate technology stack and a Medicaid contracting strategy that opens access to the largest payer pool in its market, is building the kind of operational foundation that PE sponsors look for. Whether Santus and Miller intend to raise capital, pursue an acquisition, or continue growing organically, the infrastructure they have built is designed to support any of those outcomes.

What is clear from the public record is that Santus is building Akoya as a BCBA who has worked at every level of the field and seen firsthand what large organizations get right and what they get wrong. His emphasis on employee experience, training quality, technology infrastructure, and gradual Medicaid expansion reflects lessons learned over 20 years inside other people’s Applied Behavior Analysis (ABA) companies. Whether those lessons translate into a durable, scalable business, or whether the same growth pressures that shape every ABA provider eventually force the same compromises, is the story that the next few years will tell.

The decision to build on Lumary rather than the industry-standard platforms reflects a broader strategic bet that Santus is making about where the ABA industry is heading. As payers implement more aggressive utilization management and demand more granular clinical documentation, the ability to generate real-time reports on authorization usage, session completion rates, and clinical outcomes becomes a competitive necessity rather than an operational nice-to-have. A Salesforce-based platform offers the customization and reporting capabilities that purpose-built ABA software often lacks, though it typically comes with higher implementation costs and a steeper learning curve for clinical staff accustomed to platforms like CentralReach or Catalyst by DataFinch.

Akoya’s geographic positioning in Michigan adds another dimension to its growth story. Michigan ranks among the top ten states for ABA therapy utilization, with a large insured population and a Medicaid program that covers ABA services through managed care organizations. The state also has a relatively high concentration of BCBAs per capita compared to national averages, which theoretically supports the recruitment pipeline that any scaling ABA provider needs. However, the county-by-county Medicaid contracting structure that Santus described creates administrative complexity that functions as a barrier to entry for smaller providers and a competitive moat for those willing to invest the time and resources to navigate it.

The broader context for Akoya’s emergence is an ABA industry that is increasingly bifurcating between large PE-backed platforms and smaller clinician-owned practices, with relatively little in between. The PE-backed companies, including the BlueSprig and Springtide organizations where Santus built his career, operate at scales of hundreds of clinics and thousands of employees. The clinician-owned practices typically remain small, serving one or two local markets with a handful of BCBAs. Akoya is attempting to occupy the middle ground, growing fast enough to capture market share and build operational infrastructure, but maintaining the clinician-led culture that Santus believes large platforms lose as they scale.

For the ABA industry, founders like Santus represent a potentially significant trend: experienced operators who have learned the playbook inside large organizations and are now building their own companies with the knowledge of what works and what does not. If Akoya can sustain its growth trajectory while maintaining the employee retention and clinical quality metrics that Santus has emphasized publicly, it will serve as a proof point that clinician-founded startups can compete effectively without PE capital, at least through the early scaling phase. Whether the company eventually takes on institutional investment, pursues acquisition targets, or remains independently financed is a question that its growth trajectory over the next twelve to twenty-four months will likely answer.

The employee retention metrics that Akoya achieves over the next several quarters will be the most important leading indicator of whether the company’s culture-first thesis translates into sustainable unit economics at scale.

AT A GLANCE

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