Baker Tilly and Moss Adams Merge to Create $7B Powerhouse

The Merger

CHICAGO, ILLINOIS, Baker Tilly and Moss Adams announced their planned combination on April 21, 2025, and closed the transaction on June 3, 2025. The Wall Street Journal reported the merger valuation at approximately $7 billion, making it one of the largest accounting firm transactions in U.S. history. The combined firm operates under the Baker Tilly name, with Baker Tilly US, LLP handling attest services and Baker Tilly Advisory Group, LP managing business advisory, tax, and consulting services. Both entities remain partnerships, with all principals holding equity alongside PE investors Hellman & Friedman and Valeas Capital Partners.

Jeff Ferro, CEO of Baker Tilly, served as CEO of the combined firm through the transition period, with Eric Miles, formerly Moss Adams’s Chairman and CEO, assuming the CEO role on January 1, 2026. The leadership transition underscores the merger’s positioning as a combination of equals, Baker Tilly contributed its national and global advisory network, while Moss Adams contributed its deep West Coast market presence, technology sector expertise, and 110-year history of middle-market advisory.

Hellman & Friedman, which had invested in Baker Tilly in February 2024 with approximately $1 billion, made a meaningful additional strategic investment as part of the Moss Adams combination. H&F’s involvement signals that private equity views the combined Baker Tilly as a platform for continued consolidation and capability expansion in the professional services market. Barry Melancon, former longtime AICPA CEO and independent chair-elect of the Baker Tilly International board, described the combination as a reflection of how the CPA and advisory profession requires firms to operate effectively at the local, national, and global levels.

The Behavioral Health Practice

Baker Tilly’s healthcare practice explicitly includes a dedicated behavioral health capability, one of the few among the large national advisory firms to brand a behavioral health-specific offering. The firm’s healthcare website describes its behavioral health practice as helping organizations navigate complex and changing regulations to achieve compliance and financial sustainability. This positioning directly addresses the regulatory environment facing ABA providers, where accreditation mandates, Medicaid rate reforms, and federal audit scrutiny are creating compliance and financial challenges that require sector-specific advisory expertise.

The firm’s healthcare ecosystem approach spans providers, health plans, life sciences, senior services, dental, and behavioral health. Baker Tilly frames its healthcare advisory as taking a holistic approach to the industry by understanding the intricacies and connection points between all sectors. For ABA providers that operate within the broader behavioral health ecosystem, often alongside mental health, substance use disorder, and developmental disability services, this cross-sector understanding is relevant to both operational consulting and transaction advisory.

Baker Tilly is one of the few large national advisory firms to brand a dedicated behavioral health practice, explicitly addressing the regulatory navigation, compliance, and financial sustainability challenges that define the ABA provider landscape.

Transaction Advisory Capabilities

Baker Tilly’s transaction advisory services team provides due diligence, valuation, capital sourcing and markets advisory, project finance, and post-transaction support for clients across industries. The firm identifies transaction risks through analyzing financial performance, synergy opportunities, and quality of earnings assessment. The due diligence practice evaluates quality of earnings concerns, operations, market trends, culture issues, and other areas to assess risks and determine a company’s true value.

The firm’s healthcare transaction advisory specifically supports clients through each stage of the transaction lifecycle, from pre-planning to execution on mergers, acquisitions, capital sourcing, project finance, due diligence, and valuations. Baker Tilly’s managed care advisory services evaluate compensation and secure competitive reimbursement rates for healthcare provider organizations, a capability directly relevant to ABA providers negotiating Medicaid managed care contracts and commercial payer arrangements.

Baker Tilly also provides value-based care consulting that helps healthcare providers navigate reimbursement model transitions. As Medicaid programs increasingly explore outcome-linked reimbursement for behavioral health services, ABA providers face pressure to demonstrate clinical outcomes and cost-effectiveness. Baker Tilly’s value-based care advisory capability helps providers prepare for these transitions, work that informs the firm’s due diligence when evaluating whether an ABA target’s clinical model and data infrastructure can support outcome-based reimbursement requirements.

The Moss Adams Heritage

Moss Adams brought 110 years of professional services history and approximately 4,800 professionals across more than 30 markets to the combination. The firm was particularly strong on the West Coast, where significant ABA provider activity exists, California, Washington, Oregon, and Arizona all have substantial ABA markets with distinct Medicaid programs and regulatory environments. Moss Adams’s healthcare consulting practice provided business solutions, strategy and integration advisory, revenue cycle management, and health information technology consulting for healthcare organizations.

Moss Adams served as a trusted advisor to more than 200 private equity firms for transaction guidance and support, according to the firm’s published materials. This PE advisory track record brings established relationships with the PE sponsors who drive ABA deal activity in the West Coast markets where Moss Adams had its deepest presence. The combined Baker Tilly inherits these relationships alongside Baker Tilly’s existing PE advisory network, creating one of the broadest PE relationship bases among non-Big Four advisory firms.

The Moss Adams legacy also includes membership in Praxity, a global alliance of independent accounting firms that served clients in 110 countries. With the merger, the combined firm operates under Baker Tilly International’s global network, expanding the firm’s cross-border advisory capabilities, relevant to ABA providers with international expansion ambitions or PE sponsors with global healthcare portfolios.

Where Baker Tilly Fits in ABA M&A

The combined Baker Tilly occupies a unique position in ABA transaction advisory: it is the largest PE-backed middle-market advisory firm with an explicit behavioral health practice and coast-to-coast geographic coverage. The firm competes with RSM, BDO, Grant Thornton, and CohnReznick for middle-market healthcare due diligence mandates, but its behavioral health branding and managed care advisory capabilities differentiate it from competitors that treat behavioral health as a subset of general healthcare advisory.

For ABA transactions specifically, Baker Tilly’s combination of behavioral health practice expertise, managed care reimbursement advisory, value-based care consulting, and traditional financial due diligence creates an integrated service offering that addresses the full spectrum of ABA provider complexity. The firm’s PE backing and aggressive acquisition strategy, Baker Tilly has acquired multiple firms since the Moss Adams combination, including KraftCPAs, Berkowitz Pollack Brant, and Hancock Askew, signal a firm investing in scale and capability expansion at an accelerated pace.

The combined Baker Tilly is the largest PE-backed middle-market advisory firm in the country with an explicit behavioral health practice, a combination of scale, sector expertise, and PE alignment that positions it squarely for ABA platform transaction advisory.

Baker Tilly International, the global network to which the combined firm belongs, provides access to professional services in major international markets. While this global reach is less directly relevant to domestic ABA due diligence, it positions Baker Tilly to serve PE sponsors with international portfolios and to support ABA-adjacent behavioral health transactions that involve cross-border elements such as international clinical research partnerships or technology vendor assessments.

The combined firm’s coast-to-coast coverage across all 50 states is a practical advantage for ABA due diligence engagements involving multi-state platforms. Each state has a distinct Medicaid program, different ABA reimbursement rates, different licensure and accreditation requirements, and different competitive dynamics. Baker Tilly’s ability to deploy professionals with local market knowledge in each state where a target operates provides diligence depth that national firms without similar geographic density cannot easily replicate.

The $7 billion valuation of the Baker Tilly/Moss Adams combination reflects investor confidence in the middle-market advisory sector’s growth potential. Hellman & Friedman’s additional strategic investment signals a PE sponsor that views the combined Baker Tilly as a platform for continued acquisitions and capability expansion. Baker Tilly has already announced multiple additional firm acquisitions since the Moss Adams combination, including KraftCPAs in Nashville, Berkowitz Pollack Brant in Florida, and Hancock Askew in Georgia, each adding geographic coverage, industry depth, and professional capacity.

The firm’s internal audit and enterprise risk management practice for healthcare organizations enhances compliance, manages risks, and improves financial stability. For ABA providers facing escalating regulatory scrutiny, including the HHS OIG’s nine-state ABA audit series and state-level accreditation mandates, Baker Tilly’s risk management advisory helps both operators and their PE sponsors assess and mitigate compliance exposure. This compliance advisory capability is particularly valuable during due diligence when evaluating whether a target’s billing practices, documentation standards, and supervision protocols meet the evolving requirements of federal and state regulators.

Baker Tilly’s healthcare IT consulting practice provides electronic health record implementation support, data conversion guidance, and technology strategy advisory for healthcare organizations. For ABA platforms undergoing acquisition or integration, EHR system consolidation is frequently one of the most complex and costly post-close workstreams. Baker Tilly’s healthcare IT expertise helps buyers evaluate the target’s technology infrastructure during diligence and plan for integration during the transition period.

Key Considerations for ABA Stakeholders

For ABA practice owners, Baker Tilly’s behavioral health practice and managed care advisory capabilities make it a particularly relevant advisor for sell-side preparation. The firm’s expertise in reimbursement optimization and regulatory compliance can help owners strengthen their financial and operational positioning before entering a sale process.

For PE sponsors, Baker Tilly’s combination of scale, behavioral health expertise, and PE-aligned ownership structure makes it a natural partner for ABA platform due diligence and post-acquisition advisory. The firm’s geographic coverage across all 50 states following the Moss Adams combination ensures that multi-state ABA platform diligence can be conducted with local market knowledge in each state where the target operates.

For the ABA industry, the Baker Tilly/Moss Adams merger reflects the broader consolidation trend in professional services that mirrors what is happening in ABA itself, PE-backed platforms combining to achieve scale, geographic reach, and service breadth. The fact that a $7 billion advisory firm combination explicitly brands a behavioral health practice underscores the sector’s maturation as an institutional investment category.

The firm’s assurance practice provides financial statement audit services to healthcare organizations, creating deep institutional familiarity with healthcare accounting standards, revenue recognition rules, and regulatory reporting requirements. When Baker Tilly’s transaction advisory professionals evaluate an ABA target’s financial performance, they benefit from the firm’s broader assurance practice’s understanding of healthcare-specific accounting treatments, including the revenue recognition complexities associated with authorization-based Medicaid billing, multi-element payer contracts, and risk-based reimbursement arrangements that are beginning to emerge in behavioral health.

Baker Tilly’s capital sourcing and markets advisory capability provides ABA practice owners with access to financing solutions beyond traditional PE acquisition. The firm works with clients on debt financing, equity raises, and other capital market transactions that support organic growth, facility expansion, or ownership transitions. For ABA practice owners who are not yet ready for a full sale but need capital to fund clinic openings, technology investments, or geographic expansion, Baker Tilly’s capital markets advisory provides an alternative to immediate PE partnership.

Baker Tilly’s aggressive acquisition strategy following the Moss Adams combination reflects a firm that is actively pursuing scale and geographic density as strategic imperatives. Each firm acquisition adds local market relationships, industry expertise, and professional capacity that strengthens the combined platform’s ability to serve clients with increasingly complex advisory needs. For PE sponsors executing multi-state ABA platform strategies, Baker Tilly’s expanding geographic footprint and growing bench of healthcare-experienced professionals create a diligence partner that can scale alongside their investment portfolio.

The behavioral health practice distinction is particularly significant in the context of ABA transaction advisory. Most national accounting firms offer healthcare transaction advisory as a broad capability, with behavioral health treated as a subsector within the larger healthcare vertical. Baker Tilly’s decision to brand a dedicated behavioral health practice signals institutional commitment to the sector and suggests that the firm has invested in developing professionals with specific expertise in behavioral health regulatory environments, reimbursement models, and clinical operational dynamics.

Baker Tilly’s managed care advisory capabilities address one of the most complex dimensions of ABA provider economics. The transition from fee-for-service Medicaid billing to managed care contracting has fundamentally altered the financial dynamics of ABA practices in many states. Providers must navigate capitation arrangements, authorization management processes, denial resolution workflows, and network adequacy requirements that vary substantially across managed care organizations. Baker Tilly’s consulting in this area helps providers and PE buyers understand the true economics of managed care participation.

The Moss Adams heritage brings particular strength in serving technology-oriented and West Coast businesses, including healthcare technology companies that develop the electronic health record systems, practice management platforms, and data analytics tools that ABA providers increasingly rely upon. This technology sector expertise, combined with Baker Tilly’s healthcare advisory capabilities, creates a firm that can evaluate both the clinical service delivery operations and the technology infrastructure that supports modern ABA practice management.

For PE sponsors evaluating the Baker Tilly platform for ABA due diligence engagements, the firm’s own PE-backed structure creates natural alignment. Hellman and Friedman’s investment thesis for Baker Tilly centers on the same growth dynamics that drive PE investment in ABA: fragmented markets, recurring revenue models, demographic tailwinds, and the opportunity to create value through operational standardization and scale. A firm that is itself navigating PE ownership dynamics understands the investment committee questions, hold-period value creation planning, and exit preparation requirements that define the PE acquisition lifecycle.

The combination of Baker Tilly’s East Coast and Midwest client base with Moss Adams’s West Coast and Pacific Northwest strongholds creates a genuinely national advisory platform. For ABA providers and PE sponsors operating multi-state platforms, this coast-to-coast presence means a single advisory firm can handle diligence engagements involving practices across diverse state regulatory environments without relying on subcontractors or local affiliates.

AT A GLANCE

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