Overview
The landscape of IDD and behavioral health care is shifting fast. Agencies are navigating stagnant reimbursement rates, workforce shortages, and increasing regulatory pressure, often with fewer resources and more complexity. In this environment, strategic mergers, acquisitions, and affiliations have become less about expansion and more about survival with integrity.
As highlighted in a recent press release from Consulting for Human Services (CFHS) and Giv, more providers are turning to M&A as a way to stabilize operations, extend their mission, and stay compliant in a changing funding landscape. But smart growth requires more than a signature. It demands shared values, clear systems, and a deep understanding of what it takes to integrate cultures, compliance, and care.
Why M&A is on the rise in IDD and behavioral health
The shift toward M&A in human services is not just a trend. It is a response to the realities agencies face every day. Shrinking margins, increased documentation requirements, and the rise of managed care have made it harder for small and mid-sized providers to compete.
In this environment, scale offers stability. Merged agencies can pool resources, negotiate better contracts, and build infrastructure that supports sustainable, long-term growth. But not every merger works. The most successful partnerships begin with operational alignment, not just mission overlap.
Growth with purpose, not just size
In the IDD field, growth must be more than a business decision. M&A impacts individuals, families, staff, and service continuity. That’s why the best mergers are grounded in shared values and clear integration strategies.
The new Giv + CFHS eBook, Mergers & Acquisitions in IDD: What to Know Before You Grow, emphasizes that mission alignment alone is not enough. Agencies must assess whether their documentation systems, billing platforms, waiver environments, and staffing models can work together. Without that clarity, even the most promising deal can lead to confusion and care disruption.
Real examples from the field
In Ohio, the 2023 merger of I Am Boundless and Koinonia Homes created the state’s largest IDD provider. With CFHS guidance, the two agencies expanded reach, improved clinical services, and addressed leadership transitions while staying true to their shared mission.
In Maine, three providers came together to form a statewide organization capable of meeting complex compliance and workforce needs. Their success was not just in scale. It came from ego-free collaboration, unified branding, and deep cultural alignment.
These examples show that when M&A is done with care, it strengthens services and expands access without sacrificing identity.
Get the free M&A resource for IDD providers
To help agencies approach growth with confidence, Giv and CFHS created a free strategic guide:
Mergers & Acquisitions in IDD: What to Know Before You Grow
Inside, you’ll find:
Signs your agency might be ready for a strategic partnership
What questions boards should ask before approving a deal
How to assess operational alignment and system compatibility
Why waiver and billing differences can derail integration
Examples of real-world mergers that worked and why
Whether you are actively exploring M&A or simply preparing for the future, this resource will help you lead with clarity, not pressure.
Partnering with experts makes a difference
Mergers aren't just operational—they're emotional, cultural, and deeply personal for the individuals and teams involved. Having the right guidance can mean the difference between a rushed decision and a thoughtful transformation. That’s why so many agencies are turning to CFHS for strategic support.
Consulting for Human Services (CFHS) brings decades of experience leading successful mergers, affiliations, and partnerships in the IDD and behavioral health space. From board strategy to cultural alignment, they help agencies navigate change with clarity and compassion.
If your agency is exploring M&A or simply wants to understand its options, CFHS offers the strategic partnership you need to move forward with purpose. Learn more about CFHS.
How Giv helps during and after a merger
Technology plays a crucial role in successful M&A. When agencies merge without aligned systems, the result is often duplicative work, compliance gaps, and missed claims. Giv helps prevent that.
Our all-in-one IDD platform brings together documentation, billing, EVV, eMAR, scheduling, reporting, and outcomes tracking. This makes it easier to unify operations and stay Medicaid-compliant across newly combined teams. With Giv, agencies can scale without sacrificing visibility, accuracy, or care quality.
If your agency is preparing for a merger or wants to be ready, Giv is here to help you grow with confidence and clarity. Explore our product here.
