BCBAs make data-informed decisions every day. They track behavior, measure progress and adjust treatment based on what the numbers show. When Ashley Creem, Ph.D., BCBA-D, LBA, opened her own ABA practice, she realized she needed to hold the business to that same standard.
We sat down with Ashley, Executive Director of IRIS Behavioral Health Services in Connecticut, alongside our partners at AlohaABA. She talked about the jump from clinical leader to business owner, what finally pushed her to ask for help with her finances, and what she wishes she had done sooner.
From BCBA to business owner
Ashley was drawn to ABA for the same reason as most clinicians. “What I love about this field is the clients and the families and the ability to make a meaningful difference,” she said. “I saw the power ABA had to transform lives, and I really fell in love.” She went on to earn her BCBA certification.
Over the years, she held several clinical leadership roles. She led small, family-owned ABA companies and served as a clinical director at a private equity-backed organization. In 2023, she started IRIS with a clear mission: “to create an ABA organization that prioritized compassionate, quality services, supported our clients, and empowered and valued our staff.”
She went in prepared. “I did my homework. I did not jump in as a new BCBA. I’ve been certified for 10 years,” she said. But running a company still brought surprises.
“Being strong clinically, even as a clinical leader, and running your own financially stable, successful ABA company are two completely different skill sets.” - Ashley Creem, Ph.D., BCBA-D, LBA, Executive Director, IRIS Behavioral Health Services
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Running on a hamster wheel
Ashley set up the operational side early. She brought on AlohaABA as her practice management system when she got her first client. She knew CPT codes inside and out and had a general understanding of billing, so the clinical and operational work felt manageable.
The financial side was different. “That’s not my strong suit. That’s not my expertise,” she said. “It’s really understanding those numbers, how to get those numbers, and then using them to make financial decisions. That’s where I struggled the most.”
As IRIS grew, the workload grew faster than she could keep up with. And the practice was only one part of her life. “I’m also a mom, and I coach cheer, so I have all these other things going on that are equally as important to me as this business is,” she said. “I just felt like I was on a hamster wheel.” She added, “The systems required my personal involvement, and I couldn’t keep up. I was working insane hours, and things were still slipping through the cracks. So I said, something’s got to change.”
On the financial side, Ashley leaned on family. Her sister, an accountant, kept the finances in a set of spreadsheets, alongside multiple platforms. It helped, but Ashley was spending hours trying to maintain files she didn’t fully understand, and calling her sister on weekends with questions. “I really needed to take some of that ownership back,” she said, “and create financial clarity that was understandable to me, so that I could be empowered to make my own business decisions.” In the meantime, spending decisions often came down to gut feel.
"I was kind of just saying, okay, I think I can afford it, or I think we can do this, rather than really understanding the numbers and making data-informed decisions, which we as BCBAs do every day."
Getting clarity with Flychain
Ashley came to Flychain through a colleague’s referral, and it turned out to be the most seamless onboarding she had ever experienced.
Her reason for choosing Flychain came down to specialization. “I went with Flychain because it was really customized to ABA practices,” she said. “I felt like it could help me understand the numbers associated with running an ABA practice.”
The timing mattered. Ashley was already stretched thin and worried that a new system would mean more work. “It occurred for me at a time of overwhelm, and I felt like I couldn’t take on more. And it didn’t feel like I was taking on more,” she said. “I met with the Flychain team, gave them the information, and they got everything set up. Then I had this beautiful picture of where my company was performing.”
Today, she uses Flychain’s CFO Hub dashboard to answer the questions that used to keep her guessing:
- What percentage of revenue comes from each payer
- How much goes to BTs, BCBAs and administrative staff, and whether she can afford it
- What a new hire will cost and how it will affect profitability
- Where net profit stands this month
“I can quickly sign on to the dashboard and see where my net profit is this month, how I’m doing, how my business is performing,” she said. “It’s so much easier than having to open up reports, pull all the numbers and try to figure it all out on my own.”
How Aloha and Flychain work together
Ashley sees the two systems as having distinct jobs. Aloha runs the day-to-day operations of the practice. Flychain takes the numbers those operations produce and turns them into a clear financial picture.
“Aloha is much more the day-to-day operation,” she said. “From client and staff intake through their lifetime with the company, billing, scheduling, authorizations, invoices, payments. Flychain is pulling those numbers, what our billing is, what our payroll is, and helping us really organize and interpret all of that data.”
That split has paid off on both sides. On the operational side, Aloha’s note syncing meant IRIS went through a recent Medicaid audit without missing a single piece of documentation, and its weekly timesheet workflow keeps billing on schedule. On the financial side, Flychain gives her the view she needs to plan growth.
“Working with both Flychain and Aloha has just been such a sense of relief, and has taken so much off of my plate.”
For more on how practice management and financial tools fit together, see our guide to building the right vendor stack for your healthcare practice.
What’s next for IRIS
Ashley plans to keep growing IRIS, at a pace the practice can sustain. “I’m looking forward to growing sustainably and being able to adhere to the reasons I started IRIS,” she said. “Maintaining the clinical quality and the support for our clients and our staff, while running a financially profitable and sustainable business.”
What she’d do differently
Looking back, Ashley’s biggest lesson is about timing. Many clinician-owners wait until the practice feels big enough to need business systems, and by then they’re catching up. She set up the operational side with her very first client and saw it pay off in the Medicaid audit. “We would have been in huge trouble had we not had that safeguard in place,” she said.
The financial side came later, and Ashley says it was reactive. If she were starting over, she would put both in place from the beginning, while there’s less to untangle.
If parts of Ashley’s story sound familiar, you’re in good company. The long hours, the spreadsheets, a family member helping out on weekends and the decisions made on gut feel are all common among BCBA-owners.
Most clinicians open a practice because they love the clinical work, and nobody teaches the business side in grad school. Reaching out for support with it is a normal part of building a practice, and it frees up more of your time for the clients, staff and family who matter most.
Flychain is the financial operating system for independent, clinician-led healthcare practices, trusted by 400+ ABA practices, with bookkeeping, benchmarking and financial insights tailored to specialties like ABA.
Through our partnership with AlohaABA, practices like IRIS get clinical operations and financial clarity working together.
Start your practice with clear numbers, not gut feel
Ashley’s advice is to set up your financial systems early, while there’s less to untangle.
See what Flychain can do for your practice.
