Most agency founders focus on strategy, campaigns, and client growth. Rarely do they step into the operational trenches of the businesses they serve. Reece Epstein, founder and CEO of Reputation Elevation, is an exception. He did not just market ABA providers; he decided to run one himself. His decision to found Skyward Spectrum, an in-home ABA therapy practice, gave him firsthand insight into the challenges practices face every day. Operating an ABA practice reshaped how Epstein thinks about growth, risk, and responsibility in healthcare marketing.
The Motivation Behind Skyward Spectrum
Epstein had already achieved measurable success for ABA clinics through his agency work. Campaigns brought in new patients, stabilized staffing, and supported clinic expansion.
Yet some of his clients reached full caseload capacity very quickly and, due to challenges hiring more therapists, had to take a break from marketing.
This encouraged Epstein to consider what it would be like to have his own ABA therapy practice.
By operating a practice himself, he could enjoy the same benefits his clients were enjoying. Along the way, he would come to understand the nuances of patient care, staff management, and compliance in a way that no other marketing professional could.
Learning the Weight of Operations
Running Skyward Spectrum was an education in the complexity of ABA operations. Contracting and credentialing, recruitment and HR, billing and compliance – there’s a lot to learn. Epstein turned to a well-reputed consultant to guide him in starting Skyward Spectrum. In the end, most of the guidance provided by the “experts” was false. Epstein learned the hard way as his initial contracting, billing, and other processes turned out to need a great deal of work to support quality care for Skyward Spectrum patients. Growing an ABA practice would not be as straightforward as imagined.
Applying Operator Insight to Client Work
Operating a clinic transformed how Epstein approached his agency clients. He became able to advise clients on a lot more than marketing, as well as provide marketing advice informed by his broad expertise.
Thus, the lessons learned at Skyward Spectrum strengthened Reputation Elevation’s value proposition and allowed Epstein to offer guidance that was both strategic and practical.
Scaling Care With a Positive Work Environment and Respect for Stakeholders
Epstein sought to establish a work culture in which employees – whether clinical or administrative – would be happy and derive meaning from their work. The goal? Excellent clinical quality, high client satisfaction, and a positive work environment. Early patient enrollment was paced carefully, ensuring that therapists could handle caseloads and that families received high-quality care. Systems were carefully finetuned before more therapists and cases were brought on.
This approach reflected Epstein’s broader philosophy for ABA clinics: growth should never compromise care quality or staff well-being. By scaling responsibly, providers can expand while maintaining operational stability and patient satisfaction.
Final Thoughts
Reece Epstein’s decision to operate an ABA clinic demonstrates that credibility in healthcare marketing comes from lived experience. By founding Skyward Spectrum, he learned the challenges of staffing, billing, compliance, and patient care firsthand. This experience reshaped his approach to agency work, allowing him to offer guidance based on a greater depth of experience.
For Epstein, marketing is not just about generating leads. It is about building systems that support growth without breaking the clinic. His time as an operator taught him lessons that no metric or campaign could reveal. Clinics that work with him benefit not only from his strategic expertise but also from insights born from experience. In Epstein’s view, true understanding and credibility come from stepping into the work itself, seeing the challenges up close, and using that insight to create sustainable growth for others.
