This article is sponsored by Inperium and based on a Behavioral Health Business discussion with Jay Deppeler SEVP & Chief Development Officer, Inperium, Inc., and George Contos SEVP & Sr. Advisor to the Founding Chairman & CEO, Inperium, Inc. CEO APIS Services, Inc. The discussion took place on May 14th, 2026, during the AIS West Conference. The article below has been edited for length and clarity.
Jay Deppeler: I’m the Senior Executive Vice President and Chief Development Officer for Inperium. We are headquartered in Reading, Pennsylvania, and currently have affiliates in 24 states across the United States.
What we’re going to talk about during this half hour is the affiliation model we offer primarily to nonprofit entities in the health and human services space, although we also offer opportunities for for-profit organizations.
George Contos: I’m a colleague of Jay’s at the Inperium level and also an SEVP. I also serve as CEO of APIS Management Services. APIS is Inperium’s management services organization, and we provide the back-office infrastructure for all of our affiliates.
To build on what Jay mentioned, Inperium is essentially a consolidator. We are effectively a passive holding company. We look for opportunities to partner with nonprofits, although there is also a for-profit component.
Fundamentally, we work with nonprofits that are interested in joining our constellation of organizations. The Inperium model is 10 years old, and it has steadily scaled. Over the past decade, we’ve grown to about 35 affiliates, operating in 24 states, with consolidated revenue approaching $1 billion.
Our primary service verticals include intellectual and developmental disability (IDD) services, behavioral health services (BH), substance use disorder (SUD) services, and children and family services.
From an APIS standpoint, our MSO currently supports only the affiliates under the Inperium umbrella. Scale and efficiency are not our mission — they are tools. What we do is provide organizations with infrastructure and operational support so they can focus on the programmatic aspects of their work.
That means we provide IT, HR, legal support, onboarding, payroll, and other operational functions. On the Inperium side, we provide overall strategy and financing.
We are active in the tax-exempt capital markets. In December 2024, we completed our first tax-exempt bond raise, securing $176 million from institutional investors. The offering was oversubscribed 11 times, which tells us investors are very interested in our model. We’re returning to the bond market next month to refinance and recapitalize some of the transactions we’ve completed over the past few years.
We understand this model is not for everyone, but our perspective is that we help organizations become sustainable. I differentiate between viability and sustainability. Viability means an organization is surviving and continuing its mission. Sustainability means evolving with the times, pursuing growth, and having the infrastructure and capital needed to do more with less.
That’s where the Inperium and APIS models come into play.
Before I hand it back to Jay, I want to mention that we intentionally chose not to have a moderator today. If anyone has questions or comments at any point, feel free to interrupt. We’d rather have a conversation than a lecture.
Deppeler: Absolutely. If questions come up along the way, please throw them out there. We want this to be as beneficial and interactive as possible.
Also — we have a booth outside with socks that I’m currently modeling. If you want swag for your kids, spouse, or yourself, stop by. We also have popcorn from one of our affiliated entities, Popcorn for the People, where all the popcorn is made, packaged, and sold by individuals with autism.
We also partner with the Eagles Autism Foundation, and the popcorn is sold at Lincoln Financial Field, home of the Philadelphia Eagles. If you’ve traveled through Philadelphia International Airport and gone through Terminal C, you’ve probably seen it sold there as well.
We think it’s a unique and meaningful business model that could potentially benefit providers here in the room.
So, what is Inperium?
Inperium is a nonprofit supporting organization that strengthens human-centered service providers. We are a 501(c)(3), 509(a)(3) supporting organization designated by the IRS.
In many ways, we’re often compared to private equity because we sponsor affiliated organizations, but unlike private equity firms, we don’t have owners or an exit strategy. We have an endurance strategy.
When affiliates join our network, we help them access lower-cost capital so they can pursue and deepen their missions in their local communities.
Our core values are collaboration, excellence, transparency, diversity and innovation. We use a sole-member governance model that enables alignment without overreach. Typically, an Inperium representative is appointed as the sole member representative on the affiliate’s board.
That structure allows us to add enterprise-level infrastructure, institutional capital, and strategic discipline, often through APIS Services, George’s organization.
We are built to advance mission through performance — not simply sustain it.
Contos: One thing we’ve found is that mission and infrastructure need to work in lockstep.
Whether you’re nonprofit or for-profit, large or small, many of these services are non-optional. Every organization needs infrastructure, and infrastructure costs money.
At our scale — nearly $1 billion — we’re able to create efficiencies that organizations operating independently often can’t achieve.
For example, our data warehouse runs on Palantir Technologies. Our ERP system is built on Oracle, and we’re implementing UKG as a replacement for our previous ADP platform.
These are multimillion-dollar investments that smaller organizations can’t realistically afford on their own. Through our model, affiliates gain access to those enterprise-level tools.
Most importantly, when organizations save money through these efficiencies, those savings stay within the affiliate organization and are reinvested into programming and mission delivery rather than administrative overhead.
That’s one of the biggest differentiators of our model.
Deppeler: Our affiliates currently operate primarily across four verticals: intellectual and developmental disabilities, children and family services, behavioral health, and substance use disorder services.
That said, we are generally agnostic about sectors and have explored additional verticals, including arts and higher education, because we believe the model can provide similar operational benefits there as well.
Most recently, we affiliated with KidsPeace in Orefield, Pennsylvania, a large behavioral health hospital and services provider. That affiliation became official on May 1, 2026, bringing our consolidated revenue to roughly $1 billion.
We believe that growth demonstrates proof of concept. Inperium launched in January 2016 with about $35 million in gross revenue. Ten years later, we have 35 affiliated organizations operating across 24 states.
Our success in the municipal bond market is another major differentiator.
Contos: We’re also exploring opportunities with for-profit behavioral health organizations and are seeing that owners and operators are looking for ways to create liquidity events while potentially maintaining operational involvement.
To address that, we are working on a new model that can use tax-exempt municipal bond financing to acquire for-profit organizations, create liquidity for owners, and then convert those organizations into nonprofits.
We are actively looking for interested organizations to discuss potential transactions.
As part of the structure, we would act as the asset manager and oversee responsibilities required by the bond market, including EMMA filings, audits, governance and compliance oversight.
Audience Member: Who owes the bondholders?
Contos: We would, as the buyer.
One of the reasons this model is attractive is that we can often pay a premium because we’re financing acquisitions with 30-year tax-exempt debt. Our investment banker and underwriter is Cain Brothers, which also handled our 2024 bond offering.
Another benefit is the shift in optics. In the autism services space especially, there has been increasing scrutiny around private equity ownership. Having health and human services organizations operate within a nonprofit structure, seems to make stakeholders feel more comfortable than the for-profit alternative.
Not that nonprofits are immune from criticism, but the nonprofit framework can change how organizations are perceived.
Deppeler: Pivoting back to Inperium’s broader affiliation model, one of the most important aspects is that we do not want to homogenize our affiliates’ missions.
Mission sustainability comes first.
Historically, nonprofits have sometimes lacked strong business acumen, which can lead to operational instability or closure. Our goal is to strengthen their business infrastructure so their missions can survive and grow.
We know there are funding and reimbursement headwinds facing providers across the country. We believe our model offers a way for organizations to endure and deepen their impact.
Local leadership is also critical. Running an IDD program in Pennsylvania is very different from operating one in Texas. The cultural and operational realities differ significantly.
What can be centralized are back-office functions like finance, HR, legal, IT, and payroll. Economies of scale allow us to reduce overhead and reinvest those savings back into services.
Currently, all of our affiliates operate with general and administrative costs below 10%. Many organizations come to us operating at 15% to 25% overhead.
If a $100 million organization reduces overhead from 20% to 9%, that creates substantial savings that can be reinvested into staff compensation, recruitment, retention, and ultimately service quality.
Contos: That’s the difference between viability and sustainability.
An organization can survive indefinitely at 20% overhead, but it’s difficult to make meaningful progress that way. When overhead drops to 9%, millions of dollars can be redirected into programming and growth.
Most of our growth has been transactional, but we’ve also seen strong organic growth because affiliates have more resources to reinvest into their operations.
Deppeler: One of the unexpected benefits of affiliation has been collaboration among executive leadership teams across our network.
At least twice a year, we bring affiliate leaders together to share experiences, discuss challenges, and explore ways to improve services and create stronger continuums of care.
That collaboration was not something we originally anticipated, but it has become one of the strongest aspects of the model.
Another major benefit is the ability to advocate with a unified voice around reimbursement and policy issues. We’re stronger together than fragmented into smaller organizations competing for limited resources.
Contos: It can be lonely being a smaller provider.
This model is fundamentally about not operating in isolation. We believe the environment is only going to become more challenging, and organizations need access to resources, infrastructure, and strategic support to remain viable and become sustainable.
Deppeler: One barrier we often encounter in the nonprofit world is a belief in organizational exceptionalism — the idea that difficult market realities won’t apply to a particular organization.
Sometimes, leaders view joining a larger entity as admitting failure. I disagree with that. I believe affiliation is a strategic pivot.
Too often, organizations become the proverbial frog in boiling water. By the time the problems become obvious, it’s too late to react. We prefer to think about this not as consolidation, which can carry a negative connotation, but as a strategic evolution designed to preserve and strengthen essential services.
As for the affiliation process itself, full implementation can take up to 480 days. It typically begins with a non-disclosure agreement and an exploratory phase where we review high-level documents to determine whether there is mutual benefit.
We try to fail fast when necessary, so we don’t waste anyone’s time or resources. If organizations are interested, we’ll have conversations, bring in our investment bankers, and explore whether the model is a fit. And if you think we’re completely off our rockers, that’s okay too.
Inperium offers a wide range of resources to support your organization, creating greater financial security and helping your team focus on the people you serve. To learn more, visit: inperium.org.