4.2.5.4Vertical

IDD Management Organizations

Multi-site operators consolidating IDD service delivery platforms.

Market snapshot

These figures describe Intellectual & Developmental Disabilities (IDD) (4.2.5), the segment that IDD Management Organizations sits within — not IDD Management Organizations on its own.

Market size
~$38B
Growth
~6.2%CAGR (2017–22, nominal)
Companies
~35,800
FragmentationConsolidatingEstimate

U.S. Census Bureau 2022 CBP/Economic Census, NAICS 623210 (Residential IDD Facilities); largely Medicaid-funded.

Business model & economics

Revenue model

Medicaid per-diem and waiver-based reimbursement

Key economics

Recurring revenue
High

long-term support services

EBITDA margin
10–18%

rate- and labor-constrained

Capex intensity
Moderate

Characteristics

  • Predominantly Medicaid-funded long-term support.
  • Direct-care workforce shortages are a key constraint.
  • Shift to community-based care supports demand.

Geographic concentration

AlabamaAlaskaArizonaColoradoFloridaGeorgiaIndianaKansasNew JerseyNorth CarolinaNorth DakotaOklahomaPennsylvaniaSouth DakotaTexasWyomingConnecticutMissouriIllinoisNew MexicoArkansasCaliforniaDelawareDistrict of ColumbiaHawaiiIowaKentuckyMarylandMichiganMississippiMontanaNew HampshireNew YorkOhioOregonTennesseeUtahVirginiaWashingtonWisconsinNebraskaSouth CarolinaIdahoNevadaVermontLouisianaRhode IslandMaineMassachusettsMinnesotaWest Virginia

IDD services concentrate in states with the most developed community-care systems — Minnesota, West Virginia, Massachusetts, and Maine — where Medicaid waiver programs are deepest.

MinnesotaWest VirginiaMassachusettsMaine

U.S. Census Bureau — 2022 County Business Patterns (establishments by state), NAICS 623210. Concentration shown by location quotient.

M&A deal context

Deal activityModerate

Who’s acquiring

  • Multi-state IDD platforms
  • PE-backed services consolidators
  • Home- and community-based operators

What’s driving deals

  • Consolidation into multi-state platforms.
  • Medicaid-rate and workforce dynamics.
  • Shift toward community-based care.

Find IDD Management Organizations acquisition targets

Search Acquisera’s index for companies classified under IDD Management Organizations (4.2.5.4) and build a targeted deal pipeline.

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