Ask ten owners who buys IDD services companies and most will name the one buyer who has already called them. That’s understandable, and it’s also how owners end up selling to the wrong buyer at the wrong price. The market for providers serving people with intellectual and developmental disabilities (IDD) is wider than it looks from the inside, and each buyer type wants something different.
This guide walks through the five kinds of buyers active in 2026, what each one pays for, the real deals behind the trend, and how to decide which fits your goals.
Key takeaways
- Five buyer types are active: private equity platforms, platform-backed add-on buyers, large national operators, nonprofit systems and regional operators.
- Deal volume is strong. The Braff Group counted a record 31 IDD transactions in 2025 (source).
- Consolidation is real at the top. The FTC required Sevita to divest 128 ICFs before closing its $835 million deal for BrightSpring’s IDD business (FTC).
- The “best” buyer depends on your size, your timeline and how much you care about mission and staff continuity, not only on price.
Who buys IDD services companies?
Five types of buyers acquire IDD services companies: private equity firms building new platforms, PE-backed platforms buying smaller add-ons, large national operators, nonprofit human services systems, and regional providers expanding in their state. For most owner-operated providers, the realistic buyers are add-on buyers and regional operators.
That last point is worth sitting with. Headlines are dominated by big platform deals, but the everyday market is a platform or a regional operator buying a provider with a few homes, a day program and a strong reputation in one county. If that describes you, you have more potential buyers than you probably think.
Why buyers want IDD right now
Three things are drawing capital into IDD services, and understanding them helps you pitch your business the right way.
Steady demand. KFF found more than 600,000 people on Medicaid home and community-based services waiting lists in 2025, and about 74% of them have intellectual or developmental disabilities. People with I/DD waited 37 months on average. Buyers see long-term, needs-based demand that doesn’t swing with the economy.
Resilience through the cycle.The Braff Group noted that IDD deal flow “pretty much kept pace” with pre-pandemic levels through 2022 and 2023, when most of the sectors it tracks slowed down. It then hit a record 31 deals in 2025.
A fragmented market. IDD services are delivered by a long tail of small and mid-sized providers, many of them operating in a single state. That’s the raw material for consolidation. As Kevin Taggart said in Mertz Taggart’s Q2 2026 report, “ABA and I/DD are still where the most consistent buyer interest is,” and he expects more combinations over the next 18 months.
The headwind is Medicaid. KFF estimates the 2025 reconciliation law will cut federal Medicaid spending by about $911 billion from 2025 to 2034. Buyers haven’t walked away, but they’re more selective, and they pay more for providers in states with stable rates and for businesses with clean, well-documented operations.
Who buys IDD services companies in 2026: the 5 buyer types
1. Private equity platforms
A platform is the first investment a private equity firm makes in a sector, usually a larger provider with strong management that becomes the base for further acquisitions. Mertz Taggart named new platform formation as one of the drivers of Q2 2026 activity.
What they pay for: scale, a management team that can run a bigger business, systems that can absorb acquisitions, and a presence in states with good rates. This is where the highest multiples sit. HealthFMV reported that larger IDD platforms with more than $5 million of EBITDA have traded at 6x to 10x EBITDA.
The catch: most owner-operated providers are too small to be a platform. And PE owners typically plan to sell again in several years, which means growth targets and reporting you’ll feel if you stay on.
2. Platform-backed add-on buyers
Once a platform exists, it grows by buying smaller providers, called add-ons, often in the same state or a neighboring one. This is the most common buyer for a residential habilitation provider acquisition or a waiver services company acquisition of modest size.
What they pay for: density near their existing homes, entry into a new county or state, a service line they lack, and good staff. Add-on buyers can often pay a solid price because they can cut overhead and spread management across more homes.
The catch: you’ll likely be folded into their systems and brand. Ask directly what happens to your name, your managers and your policies.
3. Large national operators
A small number of national companies operate IDD services across many states. The most important recent deal shows how large this group has become. In January 2026 the FTC cleared Sevita’s $835 million purchase of BrightSpring’s ResCare Community Living business only after requiring Sevita to divest 128 intermediate care facilities in Indiana, Louisiana and Texas to Dungarvin Group. The FTC also barred Sevita from acquiring ICFs in those same areas for ten years without prior notice.
What they pay for: strategic fit in specific markets, licenses and capacity, and operations they can plug into existing regional teams.
The catch: national operators can be selective, and in markets where they’re already large, antitrust scrutiny can make some combinations harder.
4. Nonprofit systems
Nonprofits are active and growing buyers, and they’re often overlooked by for-profit owners. The largest transaction of Q2 2026 in any behavioral health sub-sector, according to Mertz Taggart, was Merakey’s affiliation with Boundless, an Ohio nonprofit IDD provider. The combined organization projects more than $1 billion in annual revenue, over 11,000 employees and services to more than 50,000 people across 12 states. Mertz Taggart noted Boundless itself had grown from $20 million to $200 million through five acquisitions over seven years.
What they pay for: mission alignment, quality, community relationships and geographic reach. Nonprofits can be attractive partners when continuity of care and culture matter most to you.
The catch: nonprofits may not match the top price a financial buyer will pay, and board approval can lengthen the timeline. If you’re a nonprofit considering this route, our guide to IDD deal structures covers affiliations and member substitutions.
5. Regional operators and peers
Well-run regional providers, often family-owned themselves, buy competitors to grow in their home state. Mertz Taggart highlighted Doma’s acquisition of MPA Services, an Ohio I/DD provider, as one of the quarter’s deals.
What they pay for: local density, referral relationships, staff and state knowledge they already understand. Regional buyers can move quickly because they know the rules and the rates.
The catch: their capital is more limited, so deals may include more seller financing or earnouts. The upside is that they tend to keep local teams and culture intact.
How the buyers compare
The table below sums up who buys IDD services companies, what each type is looking for, and where the trade-offs sit. Use it as a starting point for your own short list, not a ranking.
| Buyer type | Typical target | What they value most | Strengths for a seller | Watch out for |
| PE platform | Larger providers, often $5M+ EBITDA | Scale, management, systems | Highest multiples, rollover equity | Growth targets, later resale |
| Add-on buyer | Small and mid-sized providers | Density, new geography, services | Strong prices, fast integration | Loss of brand and autonomy |
| National operator | Strategic fits in their markets | Capacity, licenses, regional fit | Deep resources, certainty | Selectivity, antitrust limits |
| Nonprofit system | Mission-aligned providers | Quality, reach, community ties | Continuity of mission and staff | Price, board timelines |
| Regional operator | Local competitors | Density, referrals, staff | Keeps local culture | Less cash at closing |
What do buyers look for in an IDD company?
Buyers look for stable adjusted earnings, full homes and steady referrals, low staff turnover, a clean survey and incident record, licenses that will transfer, management that doesn’t depend on the owner, and operations in states with dependable Medicaid rates. Real estate and lease terms that suit their model matter too.
Whoever buys, the diligence list looks similar. Here’s the checklist most buyers work through, in roughly the order they care about it:
- Earnings quality. Recast EBITDA, trends over three years, and how much depends on one-time items.
- Rates and payer mix. Which states, which waivers, how rates have moved, and what’s coming.
- Workforce. Turnover, overtime, wages and tenure. The 2024 NCI workforce survey put average DSP turnover at 37%, so that’s the bar you’ll be compared to.
- Census and referrals. Occupancy by home, time to fill vacancies, and where referrals come from.
- Compliance. Surveys, plans of correction, incidents and any audits.
- Licensing and transferability. What moves to the buyer and on what timeline.
- Management depth. Who runs the business day to day if you step back.
- Real estate. Owned or leased, lease terms, condition, and compliance with HCBS Settings Rule requirements.
For how these translate into a price, see our IDD business valuation guide.
Private equity or nonprofit: which buyer is the best fit?
Choose private equity if you want the highest price and are open to rollover equity and a period of growth under new owners. Choose a nonprofit if continuity of mission, culture and staff matters more than the last dollar. Regional operators often sit in between. Running a process with several buyer types lets you compare real offers.
It helps to be honest about your priorities before you talk to anyone. Three questions sort most owners:
- How long do you want to stay? PE platforms and add-on buyers often want the owner for one to three years. Nonprofits and regional operators may not.
- Do you want a second payday? Rollover equity with a PE-backed buyer can pay off if the platform sells well later. It’s also risk you’re choosing to keep.
- What must survive the sale? Your name, your managers, your approach to care? Put those in writing early, and judge buyers on their answers.
What happens to your staff after the sale?
It depends on the buyer, which is one more reason to know who buys IDD services companies before you pick one. Most buyers want to keep direct support staff and house managers, because replacing them is expensive and risky. Head-office roles are where changes usually happen, especially with add-on buyers who already have finance, HR and billing teams.
You have more influence here than many owners realize. Before you sign a letter of intent, ask each buyer three things:
- Which roles do you expect to keep, change or combine in the first year?
- Will wages, benefits and paid time off stay the same or improve?
- How and when will you communicate with staff and families?
Good buyers answer these questions easily because they’ve done it before. Vague answers are a signal. You can also negotiate protections, such as retention bonuses for key managers funded from the purchase price, which often helps the buyer as much as your team.
How IDD market consolidation changes your options
IDD market consolidation cuts both ways for a smaller owner. At the top, the biggest operators are getting bigger, and the FTC’s action on Sevita and BrightSpring shows that regulators are paying attention to concentration in residential IDD services. In some local markets, that can limit who’s able to buy you.
Lower down, consolidation mostly creates demand. Every platform that forms needs add-ons. Every nonprofit that merges needs to build out its footprint. That’s why IDD industry trends point toward continued buying interest for well-run providers of every size, even as the Medicaid outlook keeps buyers careful.
The practical takeaway: when you ask who buys IDD services companies like yours, don’t assume the answer is the buyer who called you. Owners who test the market with several buyer types, confidentially, usually find more interest and better terms than they expected. Our guide on how to sell an IDD business explains how to run that process.
How do you get the right buyers to the table?
Build a short list of buyers across at least three types, approach them confidentially under NDAs, and share information in stages. Give them the same deadline to submit indications of interest. Competition between different buyer types, not just different firms, is what reveals your business’s full value.
A few practical points help:
- Lead with what makes you different. Low turnover, clean surveys, a strong management team or dense homes in one county.
- Know which buyers can’t do your deal. A platform that needs $5 million of EBITDA won’t buy a $600,000 provider directly, but its add-on team might.
- Prepare for group homes differently. If most of your business is residential, see our guide on putting a group home business for sale, which covers real estate and licensing at the site level.
Frequently asked questions
Is private equity buying IDD providers?
Yes. Private equity firms are forming new IDD and autism platforms and buying smaller providers as add-ons. Mertz Taggart cited new platform formation as a driver of Q2 2026 activity, and larger IDD platforms with more than $5 million of EBITDA have traded at 6x to 10x, per HealthFMV. Most PE buyers look for scale and strong management.
Who are the largest buyers of IDD providers?
The largest include national operators such as Sevita, which bought BrightSpring’s ResCare Community Living business for $835 million, and large nonprofit systems such as Merakey, which affiliated with Boundless in 2026. Private equity-backed platforms and regional operators make up much of the rest of the buyer pool.
Do nonprofits buy for-profit IDD companies?
They can, and some do, especially when a for-profit provider fits their mission and geography. More commonly nonprofits combine with other nonprofits through mergers or affiliations. A for-profit owner who values continuity of care should include nonprofit systems in the buyer list and compare their offers alongside financial buyers.
What is an add-on acquisition?
An add-on acquisition is when a company already owned by a private equity firm, called a platform, buys a smaller business to grow. For IDD providers, add-on buyers often look for homes near their existing operations, entry into new states, or services they don’t yet offer. They’re the most common buyer for small and mid-sized providers.
Should I accept an unsolicited offer for my IDD company?
Not without testing the market. An unsolicited offer tells you there’s interest, but a single buyer sets the price and terms. Getting a valuation and talking confidentially with several buyer types usually produces a better offer, or confirms the first one is fair. Either way, you’ll know rather than guess.
Does IDD market consolidation affect smaller providers?
Yes, mostly in a good way for sellers. Consolidation creates demand for add-on acquisitions, so well-run small and mid-sized providers attract more buyers. The catch is in local markets where a large operator already dominates, where antitrust scrutiny can limit which buyers can complete a deal.
Who buys IDD services companies: the bottom line
Who buys IDD services companies depends on who you are. A larger, well-managed provider can attract private equity platforms paying the top multiples. A strong regional business may do best with an add-on buyer or a nonprofit that values its reputation. The only way to know for sure is to talk to more than one kind of buyer, on your terms.
| Curious which buyers would be interested in your business? Get the IDD Exit Report newsletter for quarterly deal and buyer updates, or book a confidential conversation with the IDD team at Olympic M&A. Disclosure: IDD Exit Report is published in partnership with Olympic M&A, a healthcare M&A advisory firm. |
