Employers have been trained to treat double-digit healthcare increases as weather. They aren't. They are the predictable output of a plan nobody is actively running. ASF Strategies builds self-managed health plans — and then manages them, every week of the year.
Built for self-funded and self-managed employers with hundreds of employees.
Illustrative view of the analytics layer.
Healthcare means something different depending on where you sit. Tell us where that is and we'll show you the version that matters to you.
Turn your second-largest controllable expense into a strategic asset instead of an annual apology to the board.
Margin · Talent · Certainty See your view 02Own the trend, not the negotiation. Line-of-sight into every dollar, a forecast you can defend, and auditable ROI.
Trend · Forecast · ROI See your view 03Stronger benefits and happier employees — without one more thing landing on your desk.
Benefits · Retention · Time See your view 04A real person in your corner when healthcare gets hard, confusing, or expensive.
Advocacy · Access · Cost See your viewA renewal negotiation moves a number by a few points. Plan management changes what produces the number in the first place. These are not the same job, and only one of them compounds in your favour.
Four capabilities that only work together. Construction without analytics is a guess. Analytics without intervention is a report. Intervention without access is a phone call nobody returns.
A self-managed plan is a set of decisions: how it is funded, who administers it, how care is accessed, how pharmacy is purchased, how catastrophic risk is covered. Made deliberately, those decisions leave a plan that can be managed. Inherited as a pre-assembled bundle, they usually do not.
Claims, pharmacy, and financial data read together, continuously, rather than reviewed once a year. The point is to see price outliers, site-of-care gaps, and emerging high-cost situations while the plan year is still running — because that is the only window in which a decision changes the outcome.
An analytic finding nobody acts on is just a report. Intervention means the expensive situation gets addressed while it is still happening: identifying the opportunity, working with the treating physician and the member on a clinically appropriate alternative, and coordinating the change with the plan’s administrator and vendors before the money is spent.
The strategies and vendor relationships that very large employers take for granted are structurally out of reach for a plan with a few hundred employees — not because they would not work at that size, but because nobody brings them. Bringing them is a large part of what we do.
This is the clearest illustration of the whole idea, and it is the kind of situation active management exists to catch. Nothing here requires the member to accept less. It requires somebody to notice in time.
A member on long-term biologic infusion therapy is receiving it in a hospital outpatient department. The drug is not what makes the claim expensive — the setting is. A hospital outpatient department carries facility overhead and a markup that a lower-acuity setting does not.
The analytics compare what the plan is paying against what the same drug, dose, and protocol costs in other settings. That comparison happens while the therapy is ongoing, rather than in a claims review after the plan year has closed.
This is a medical decision and it belongs to the treating physician. Many infusion regimens can be delivered safely at home or in an ambulatory setting; some cannot. Nothing moves unless the prescribing physician supports it and the member wants it.
Where it is appropriate, we work with the plan’s administrator and vendors to make the change happen — the authorisation, the provider, the schedule. Same drug, same dose, same physician overseeing the therapy.
A hospital infusion is most of a day: travel, parking, check-in, waiting, then hours in a chair. A home or nearby ambulatory visit is scheduled around their life. Because the setting costs the plan less, the plan has room to reduce or remove what the member pays as well.
None of this works retroactively. Once the sessions have been billed at the hospital rate, that money is gone. The only version of this that changes the number is the one that happens during the plan year.
The differential between a hospital outpatient department and a clinically appropriate alternative setting is large enough that it is worth waiving the member’s cost-share to make the alternative easy to choose.
An illustration of the kind of situation active management is built to find. It is not drawn from a specific client engagement, and the size of the differential varies by drug, market, setting, and contract. Bar widths are conceptual.
Nearly every cost-containment strategy sold to employers is subtraction. Raise the deductible, raise the contribution, narrow the network. Nothing was fixed — the bill simply moved from the company to the household. We work the other side of the ledger.
A higher deductible raises the member’s share of the left-hand side. It does nothing at all to the right-hand side — which is the side worth attacking, and the harder one to reach.
A conceptual distinction, not a measured split. The proportions differ for every plan.
Better Care.
Better Cost.
Better Outcomes.
Three things employers have been told they must trade off against each other. They don't, once someone is actually managing the plan.
No binder. No annual meeting where you find out what happened. A construction phase, then a management rhythm that doesn't stop.
What the plan spends, where it goes, and which of those dollars are buying care rather than covering someone else’s margin.
The construction decisions — funding, administration, network access, pharmacy, stop-loss — made so that cost can actually be influenced later.
Claims and financial trends read as they develop, so an expensive situation is visible while it is still in motion.
Address what is expensive while it is happening, rather than explaining it after the plan year has closed.
No. Employers come to this from fully insured and level-funded arrangements as well. What matters is whether a self-managed structure makes sense for your balance sheet and your risk tolerance, and that is something to work through honestly before anything changes.
In most cases we take on the advisory relationship and then keep working through the rest of the year, which is the part a renewal-focused engagement does not cover. Some employers keep an existing relationship in place for other lines of coverage.
The model is built for self-funded and self-managed employers with hundreds of employees — the range where large-employer strategies genuinely apply but are almost never offered. Whether it fits your plan specifically is a question about your claims profile, not just your headcount.
That is the premise we reject. The savings come from how care is purchased and where it is delivered, not from what the plan covers or what members are asked to pay. In many situations the member’s share goes down, because a less expensive care pathway leaves room for it to.
Construction changes take effect when the plan structure changes. Anything addressed during the plan year shows up in that year’s spend rather than in a post-mortem. A full year-over-year comparison, naturally, takes a year.
Not a quote, and not a renewal projection. The useful conversation starts with your own plan — what it spends, where that money goes, and how much of it is buying care rather than buying waste. Everything else follows from that.
