For Government & Public-Sector Plans
Stretch every taxpayer dollar without cutting employee benefits. Aptiva Health direct contracts deliver bundled, transparent pricing that cuts high-cost surgical claims by 50–70% — with documentation built for council, board, and commission disclosure.
Download the government partnership overview — Government Partnership Overview
See what your plan could save — Savings Estimate Form
Schedule a meeting today!
Public-Sector Healthcare Costs Are Rising Faster Than Budgets
Local government budgets, school district funding formulas, and public-agency appropriations are not keeping pace with medical inflation. Orthopedic and spine procedures — the highest-cost claim category for nearly every self-funded plan — combine hospital facility fees, separate surgeon and anesthesia charges, and aggressive chargemaster pricing to produce six-figure claim variability that wrecks a budget cycle when one or two cases hit in a year.
For a self-funded city, county, school district, or public agency, that variability is also a transparency problem. Council members, school board trustees, and finance committees increasingly expect the plan administrator to explain, in plain language and in a public meeting, why a single claim spiked the plan's loss ratio. Direct contracting fixes both problems at once: one bundled rate, negotiated directly with the plan, published in full to the plan sponsor before signature, and defensible line-by-line in any public-meeting disclosure.
What Direct Contracting Typically Saves a Public-Sector Plan
Hospital ranges reflect regional facility-fee averages and published chargemaster comparisons. Savings ranges shown are illustrative of outcomes seen across our current direct-contract partners; your actual savings will depend on your negotiated rate schedule, plan design, and case mix. Each Aptiva direct contract is custom-built for the entity it covers, with the full rate exhibit disclosed in advance for public-meeting review.
Built for Government — Four Things That Matter
1 · Procurement-Compatible by Design Aptiva direct contracts are structured to work within Kentucky Model Procurement Code and Indiana public purchasing requirements. We respond to formal RFPs, support sole-source justification where applicable, and can be added to existing cooperative purchasing arrangements. Each engagement begins with a procurement-pathway review so the contract route is confirmed before legal review begins.
2 · Public-Meeting Transparency Every rate in every direct contract is disclosed to the plan sponsor before signature. The rate exhibit is built to be presented in a council, board, or commission packet — bundled service rates by procedure, projected plan savings, methodology, and effective dates — with no redactions required and no hidden side agreements.
3 · Collective Bargaining Compatible Direct contracting works alongside any collective bargaining agreement. Aptiva is designated as a Tier 1 / preferred-cost-share option inside the existing plan design; bargained benefit levels are preserved. The savings flow to the plan as a whole, which strengthens the plan sponsor's position at the next bargaining cycle without reducing the employee benefit.
4 · Retiree & Medicare Population Support Medicare-eligible retirees in the entity's group health plan access Aptiva services under the same contract terms as active employees, with Medicare as primary payer where applicable. For retirees who have moved to a Medicare Advantage plan, Aptiva remains accessible through standard MA pathways. Plan sponsors with large retiree populations see compounding savings as that population ages into the highest-utilization claim categories.
Service Lines in Scope
A direct contract gives your plan access to Aptiva Health's full multi-specialty footprint across Kentucky and Indiana. In-scope service lines include:
Orthopedic Surgery — total joint replacement, sports medicine procedures, fracture care, hand and foot
Spine Care — cervical and lumbar disc replacement, microdiscectomy, SI joint fusion, minimally invasive fusion
Interventional Pain Management — epidural steroid injections, radiofrequency ablation, joint injections
MRI & Diagnostic Imaging — Siemens MAGNETOM Espree 1.5T at every imaging-equipped location; $350 cash-pay reference rate published on
/mriPhysical Therapy — direct-access PT, one-on-one treatment time, in-house at every Aptiva location
Sports Medicine — non-operative and operative care, return-to-play and return-to-work pathways
Concussion Care — led by Dr. Lisa Manderino at the Aptiva Concussion & Sports Medicine Institute (particularly relevant for public school district plans covering athletic programs)
Immediate Injury Care — same-day evaluation for sprains, strains, fractures, lacerations, and on-the-job injuries
Geography: 14 locations across Louisville, Lexington, Elizabethtown, Mt. Washington, Hebron (Northern KY / Greater Cincinnati), and Indianapolis. Map of every location at Locations.
Excluded from direct contract scope: Workers' compensation claims and auto / PIP injury claims. Aptiva's workers' compensation pathway is already in-network with the major public-sector WC managed care organizations — Coventry, One-Call, Department of Labor — so the same Aptiva practitioner coordinates care across all three claim types.
Entities We Serve
Cities & Municipalities Self-funded city employee plans covering police, fire, public works, parks, and administrative staff. High orthopedic and spine claim utilization in safety-services workforces makes direct contracting particularly valuable.
Counties County government plans covering courthouse staff, county roads, sheriff's department, and county-operated facilities. Multiple-employer cooperative arrangements are supported.
Public School Districts Plans covering teachers, administrators, support staff, and athletic department employees. Concussion care, sports medicine, and physical therapy line up directly with district health priorities.
Public Universities & Community Colleges Faculty and staff plans plus athletic department coverage. On-site PT, sports medicine, and imaging at Aptiva locations serve the same use cases as university-adjacent providers without facility fees.
Special Districts & Authorities Water and sewer districts, airport authorities, port authorities, transit authorities, and other public-purpose entities operating self-funded plans.
Inter-Local & Cooperative Arrangements Multiple government entities pooling under a single direct contract for volume rate improvement and administrative consolidation.
Why Public-Sector Plans Trust Aptiva
Independent. Aptiva is not owned by, contracted exclusively to, or controlled by a hospital system. That means no facility fees, no chargemaster pricing, and no incentive to push patients toward higher-acuity sites of service that inflate claims. For a plan sponsor accountable to taxpayers, independence is the most defensible structural feature available.
Multi-Specialty Under One Roof. Covered employees and retirees don't move between vendors for orthopedic, spine, imaging, PT, and pain care — they stay inside one credentialed group, with one medical record and one care plan. That keeps episode costs predictable and member satisfaction high. For unionized workforces, member experience is as important as cost savings.
Transparent Pricing — Disclosed in Full. Every rate in every direct contract is published to the plan sponsor before signature, in a format ready for public-meeting presentation. There is no hidden pricing, no balance billing, and no repricing on clean claims. What you present to the council, board, or commission is what the plan delivers in production.
A Proven Model Across Kentucky and Indiana
Aptiva Health has been delivering direct-contract care to self-funded plans across Kentucky and Indiana since [YEAR — flagged for verification]. Quarterly savings reporting is provided to every direct-contract partner, formatted for plan-sponsor disclosure to elected officials and oversight bodies. The same operational model that has produced documented mid-year savings for private-sector partners applies, unchanged, to public-sector plans.
Frequently Asked Questions
Does Aptiva Health work with city, county, and school district employee benefit plans?
Yes. Aptiva Health partners with self-funded employee benefit plans sponsored by cities, counties, school districts, public universities, special districts, and other public-sector entities across Kentucky and Indiana. Direct contracts are structured to meet the documentation, transparency, and rate-disclosure standards expected of public-sector plan sponsors.
Can a government entity use an Aptiva direct contract under Kentucky or Indiana public procurement law?
Yes. Aptiva Health direct contracts are designed to be compatible with Kentucky Model Procurement Code and Indiana public purchasing requirements. We support standard procurement pathways including responses to formal RFPs, sole-source justification documentation where applicable, and cooperative purchasing arrangements. Each engagement begins with a review of the entity's specific procurement requirements to confirm the appropriate contract pathway.
How does direct contracting interact with collective bargaining agreements?
Aptiva direct contracts work alongside any collective bargaining agreement. The contract designates Aptiva as a Tier 1 / preferred-cost-share option within the existing plan design; bargained benefit levels are preserved. Because direct contracting reduces plan costs without reducing employee benefits, it is typically additive to CBA terms rather than in conflict with them. We routinely supply plan-sponsor counsel with the documentation needed to confirm CBA compatibility before signature.
Are Medicare-eligible retirees covered under an Aptiva direct contract?
Medicare-eligible retirees enrolled in the entity's group health plan can access Aptiva services under the same direct-contract terms as active employees, with Medicare as primary payer where applicable. For retirees enrolled in a Medicare Advantage plan rather than the entity's group plan, Aptiva can be accessed through standard Medicare Advantage pathways. We work with the plan sponsor to map retiree access by population.
How are direct contract rates disclosed for public-meeting transparency?
Every Aptiva direct contract includes a full rate exhibit disclosed to the plan sponsor before signature. The rate exhibit is structured for public-meeting presentation: bundled service rates by procedure, total projected plan savings, methodology, and effective dates. Plan sponsors may publish the rate exhibit in full as part of council, board, or commission packets without redaction.
Can multiple government entities pool into a cooperative direct-contract arrangement with Aptiva?
Yes. Aptiva supports cooperative purchasing arrangements where multiple government entities — for example, a city and its adjacent county, a group of school districts, or a regional inter-local agreement — share a single direct contract. Cooperative arrangements typically improve rate terms through volume aggregation and reduce administrative overhead at each participating entity.
How does an Aptiva direct contract interact with KEHP or the Indiana state employee health plan?
Local government entities and school districts in Kentucky that participate in the Kentucky Employees' Health Plan (KEHP), and Indiana public-sector entities participating in the state employee health plan, retain those affiliations. Aptiva direct contracts work alongside KEHP and state plan participation rather than replacing them. For self-funded local entities that have elected out of state plan participation, an Aptiva direct contract becomes a primary cost-management tool inside the entity's own plan.
What is the minimum group size for a government direct contract?
There is no minimum group size. Aptiva's Direct Medical Services Agreement is structured to work for public-sector groups from a few hundred to several thousand covered lives, which covers the full range of city, county, school district, and special-district plan sizes across Kentucky and Indiana.
How does implementation align with government fiscal year budget cycles?
Aptiva implementations typically run 30 to 45 days from agreement signature to first eligible claim, which allows a direct contract to align with either calendar-year or fiscal-year plan cycles. For Kentucky entities on a July 1 fiscal year and Indiana entities on a January 1 calendar year, the recommended engagement window is 90 to 120 days before the target plan-year start date to accommodate budget approval, council or board review, RFP timeline if required, and TPA coordination.
Are workers' compensation claims for government employees included in the direct contract?
Workers' compensation claims are excluded from the direct contract — they are billed under Aptiva Health's separate workers' compensation pathway, which is already in-network with major public-sector workers' comp managed care organizations including Coventry, One-Call, and Department of Labor networks. An Aptiva practitioner coordinates care across both the direct contract and workers' comp pathways so member experience remains consistent.
Bring Aptiva Health to Your Plan
Send a short note describing your entity — type (city / county / school district / agency), approximate covered lives, current plan year, and whether you currently have a self-funded structure — and we'll schedule a 20-minute introduction call with your plan administrator, benefits consultant, or both. We can also respond to formal RFPs through standard public procurement channels.
HIPAA notice: Do not include protected health information in this form. Aptiva Health will execute a Business Associate Agreement before any PHI is exchanged.
Public Records notice: Communications with Aptiva Health may be subject to the Kentucky Open Records Act, the Indiana Access to Public Records Act, or equivalent statutes in your jurisdiction. We respond to records requests through the plan sponsor.