For Partners
For self-insured employers
If you run a self-funded plan, direct contracting gives you a predictable, transparent price on your most expensive claim category — orthopedic and spine — usually at a significant saving, with $0 out-of-pocket for your employees on in-scope care. It’s additive: it sits alongside your current plan, no full restructuring required.
Why it saves you specifically
Your plan, not an insurer, pays the claims — so when a bundled rate replaces hospital chargemaster pricing on a surgery, the savings are yours. And because the rate is set before care, you can actually forecast your highest-variability costs instead of bracing for them.
What employees experience
For in-scope services, covered employees typically pay nothing, and they get multi-specialty care under one roof — fewer handoffs, one record, faster answers. Lower cost for you, better experience for them.
How implementation works
A typical path: a short discovery call to understand your plan and claims; a custom savings model built from your anonymized claims data, with a full rate exhibit you can review; agreement and BAA execution with your TPA; then go-live, with savings showing up on your claims reporting.
What to bring to a discovery call
A sense of your plan structure, your TPA, and your recent claims profile (no PHI needed for the first conversation). The savings model does the rest.
Frequently asked questions
Do we have to drop our current network?
No — it’s additive and non-exclusive. Aptiva becomes a preferred option for in-scope services.
What size plan does this work for?
A range of self-funded plan sizes; the savings model is built to your plan.
Is there risk to trying it?
The savings are modeled from your own claims before you sign, so the projection is documented up front.
See what it could mean for your plan.
Start an employer discovery call → aptivahealth.com/direct-contracting-employers.
General information, not legal, financial, or tax advice.