Ameriflex
Benefits Made Easier

Affordable healthcare is becoming increasingly difficult for many Americans to obtain, and more of a challenge for many employers to offer to their employees. According to Bart McCollum, Ameriflex President and COO, given the fact that nearly 55 percent of the U.S. population gets healthcare benefits through an employer, any meaningful change to the healthcare system must consider the employer’s perspective in terms of how healthcare is paid for and delivered. Anne Richter, Ameriflex Chief Strategy Officer and business leader for one of the company’s emerging business lines, Accresa, explains that through its core business and new divisions like Accresa, the organization and its team has focused on making it easier for employers to offer exceptional benefits to employees, so that more Americans have access to affordable healthcare. Their approach has leveraged the company’s deep expertise in payments technology and benefits administration systems, along with a strong understanding of an employer’s unique needs and compliance requirements acquired over the course of a twenty-year history helping tens of thousands of employers across the country manage and improve their employee benefits solutions. In an interview with CIO Applications, McCollum and Richter discuss Ameriflex’s successful journey bringing value to clients through the years, and anticipating future opportunities for innovation.

What offerings does Ameriflex present in the HR landscape?

Bart McCollum: Ameriflex offers a variety of employee benefits products and services, including consumer-driven accounts and COBRA administration. Since our inception, we’ve always looked for opportunities to innovate upon these otherwise conventional solutions—we were the first, for example, to offer access to benefits through prepaid debit cards, and pioneered electronic payments on benefit plans in the late 90s. Today, we’ve developed new proprietary solutions to facilitate everything from special plan billing services to non-discrimination testing. In short, we help employers offer better benefits and help individual American employees reduce their own healthcare spend by enabling more efficient payment processes.

Anne Richter: Accresa is a byproduct of the broader Ameriflex commitment toward innovating better healthcare payments technology, and ultimately better employer benefits solutions. It evolved from our R&D team and was built to make direct primary care (DPC) and other emerging healthcare models accessible within the framework of a workplace benefits plan. We saw the market opportunity and recognized that we had a unique advantage both with respect to our existing technological infrastructure and to our understanding of what an employer requires in order to implement and manage any new benefit program. This is something that sets Accresa apart from many other early-stage healthcare tech startups. We believe that employer-sponsored healthcare in the U.S. is here to stay, and that the evolution toward more cost-effective, value-based models that realign incentives within the system represents the next area of opportunity for employer benefits. It was a logical application of our core Ameriflex expertise to a growth market that can help bring a better healthcare experience to more American families.

What differentiates Ameriflex from similar companies and keeps you ahead of the competition?

Bart McCollum: Ameriflex is the only company focused on both the employer’s needs when it comes to offering quality, affordable, and compliant benefits solutions, as well as the employee experience and ease-of-use when it comes to accessing and taking advantage of those benefits. In many cases, there can be a natural conflict of interests between the requirements of the health plan and the consumer experience— because keeping a plan in compliance with the many regulations that come into play doesn’t always allow for the convenience and flexibility that most consumers expect from their service providers today. We see this a lot with claims made to healthcare spending accounts—which we, as administrator, are required to manage according to the rules of the employer’s plan and the language of the law. But the process to ensure that a transaction made against funds from an individual’s health spending account is eligible, under their plan, can sometimes require an extra step or extra documentation from a participant - which is obviously a frustrating experience. Understanding that this was a huge pain point for our customers, we’ve worked tirelessly to prevent this from happening whenever possible - and through our sophisticated card technology and our state-of-the-art auto-adjudication process called “MyPlanConnect,” we now see more than 95% of such claims being automatically validated, with zero impact to the consumer, and in a manner that ensures compliance for the employer’s plan.
How do you ensure data security for employers and HR professionals?

Bart McCollum: As a participant in the healthcare ecosystem and a steward of sensitive employer and employee data, we view data security as paramount to everything we do, and have invested heavily in our commitment to such. In addition to having more than 500 individual data security controls in place, we monitor industry standards and requirements and then look to how we can not only meet, but exceed them—engaging in ongoing voluntary security audits, pursuing levels of certification around security protocol beyond what is required of us today, and ensuring that every Ameriflex employee is fully trained and aware of all the internal rules and procedures that are necessary to safeguard private healthcare information.

Can you provide a case study to illustrate the benefits provided by your solution?

Anne Richer: Although it’s a relatively new model for employers, Accresa is starting to see some pretty amazing results in terms of what effective implementation of a direct primary care model can accomplish for an employer-sponsored health plan. We piloted the program three years ago for our own employee population and experienced a 27 percent reduction in claims cost in the first year alone, with health insurance premiums flat over the three-year period. It has proved what most in this space believe to be true, which is that better access to personalized, high-quality primary care can deliver immediate and significant financial results - and better health outcomes. We saw a drastic reduction in ER and urgent care visits, and reduced absenteeism amongst employees - and these results appear to be consistent across the majority of employers in this nascent market who have implemented similar programs. Most employers, and most individuals, for that matter, are under investing in primary care, and if we can enable better flexibility and access, I think we’ll start to see meaningful change across the system at large.

What does the road ahead look like for the companies?

Bart McCollum: At Ameriflex, our unique real-time payment authorization system, which we will be deploying this year, allows employers to contact employees while they are making a purchase, and we can ask for the automated receipt immediately, preventing paperwork later. It’s about getting closer to the transaction, and to the end-user experience, so we can adapt our processes to be convenient and flexible to how they use our services.

Anne Richer: Integration across the full healthcare delivery stack—between direct primary care and similar models all the way up through the payer system—is the next phase, I believe. We see employers seeking solutions that truly integrate the best delivery models and payments mechanisms—with full transparency into real-time data that can help identify areas for improvement and greater efficiency. While we share in the desire to foster stronger, more direct relationships between patients and doctors, we also don’t disregard or underestimate the critical role that payers and employers must play in terms of how healthcare is obtained and paid for—and seek to enable a system where carriers and employers are facilitators in that relationship, and not barriers to it.