Case Study: Ameriflex Health Plan
The efficacy of DPC as part of a triple pillar approach to health care.
Background
Ameriflex’s primary mission is to help more Americans access quality healthcare. This commitment to better access also includes their own employees. Alongside traditional benefits, Ameriflex offers a self-insured employer plan called the Ameriflex Health Plan (AHP). It employs a triple pillar approach that consists of Direct Primary Care (DPC) powered by Accresa, intentional pharmacy management, and transparent cash-pay pricing.
Under the AHP, Ameriflex acts as a direct buyer of medical services. The plan covers employees and their families by focusing on wellness and upfront pricing. This approach removes the typical hidden fees that inflate modern corporate healthcare plans. For the past nine years, from 2016 through 2025, the company tested this custom model and observed very positive results for the organization and its employees.
The Challenges of Traditional Health Insurance Plans
Modern employers face a severe breaking point with standard health insurance. National healthcare costs hit an average of $17,496 per employee in 2025. These numbers represent a continuous 6% yearly increase, outpacing regular inflation and worker wage growth. Predictions show costs rising above $18,500 per worker in the near future.
Opaque pharmacy benefit managers (PBMs) drive these rising expenses by inflating drug lists. Massive hospital consolidations also give networks too much pricing power over employers. Insurance intermediaries and brokers also add expensive fees at every step.
Traditional plans shift these rising costs onto workers through higher premiums and deductibles. This cycle hurts employee retention and eats away at corporate profits. Ameriflex designed its strategy to break this cycle entirely.
How Ameriflex’s DPC Triple Pillar Strategy Addresses Healthcare Costs
Ameriflex solved the cost crisis by implementing three operational pillars. Each pillar targets a specific area of healthcare waste.
Pillar 1: Direct Primary Care and Preventative Medicine
In partnership with Accresa, Ameriflex embeds Telescope,a dedicated DPC physician network, directly into the plan as part of a bundle strategy (not independent memberships). Employees get unlimited, one-click access to their health care providers via text, call, or same-day visits. This relationship shifts care from reactive treatment to proactive preventative medicine. Doctors catch chronic issues early before they turn into emergencies.
Pillar 2: Intentional Pharmacy Management
The company bypasses traditional, PBM-controlled drug lists. Ameriflex runs an employer-directed formulary to control medicine costs. The plan enforces strict generic utilization and reviews expensive specialty drugs individually. This direct oversight keeps everyday prescriptions affordable for all members.
Pillar 3: Transparent Cash-Pay Pricing
Ameriflex leverages its self-insured structure to pay cash for medical procedures. The company avoids confusing insurance network rates. Instead, they negotiate fair, transparent cash prices directly with doctors and facilities. This eliminates middleman administrative costs and keeps savings within the organization.
What the Nine Year Results Revealed About Healthcare Savings
The data from the nine-year implementation proves that this model controls healthcare inflation.
- Massive Per-Employee Savings: Ameriflex achieved a total annual cost of $10,535 per employee in 2025. With the national average at $17,496, Ameriflex came under by $6,961, showing a 40% cost reduction.
- Flat Cost Trends: While national trends rose between 5 and 6% annually, Ameriflex maintained a flat cost curve for nine years.
- Lower Prescription Costs: By achieving an 87% generic utilization rate, the company kept the average prescription cost to just $30.
- Shared Financial Rewards: Transparent, cash-pay pricing generated $18,132 in direct shared savings in 2025.
- Fair Premium Splits: Ameriflex maintained a stable cost-sharing model without shifting burdens to workers. The employer pays 61% of the total cost while the employee covers 39%.
Actuarial data attributes 45% of the total savings directly to the DPC preventative medicine model. Pharmacy management drove 30% of the savings, while cash pricing generated the remaining 25%.
Other Key Statistics
- 40% Fewer ER Visits: Direct access to primary care—via text, call, or same-day visits—may reduce unnecessary emergency room visits by 40%.
- 20%–30% Fewer Hospital Visits: Consistent doctor-patient relationships and proactive preventive care may lead to a 20%–30% drop in hospitalizations.
- $125,000 10-Year Advantage: Maintaining a flat cost curve over a decade may result in ~$125,000 in savings per employee, which can be reinvested into wages or company growth.
“The Direct Primary Care benefit has transformed how employees access care by cutting wait times, reducing unnecessary office visits, and lowering overall medical claim expenses” says Brittany Hicks, Ameriflex’s Vice President of Human Resource. “We’re very proud of what Ameriflex has accomplished in these last nine years. We’ve seen real impact that has improved employee experience, retention, and our bottom line.”
- An employer looking for alternative ways to cut benefits costs
- A health system or physician who wants more information on Accresa can support programs similar to the ones leveraged by Ameriflex
