The HR team at Neely Coble used one word going in: aggressive. They’d been pitched onsite care before and walked away thinking a 10% dent in spend was the realistic ceiling for a company their size. A 150-employee manufacturer isn’t who the big national clinic operators build for — those models need a thousand-plus lives to staff a full-time center — so “too small for onsite” was the answer they expected to hear again.
They didn’t. Twenty-eight percent came in the door in year one, and it stayed there.
The situation
A self-funded truck-equipment manufacturer in Nashville with roughly 150 employees. A blue-collar workforce that, like most, used the emergency room and urgent care as the front door to the health system — because between high deductibles and the friction of finding a doctor, that was the path of least resistance. Every one of those visits hit the plan at full freight, and the downstream referrals stacked on top.
The conventional read on a population this size: too small to justify a dedicated clinic, so route them to a virtual point solution or a high-deductible plan and hope utilization stays low.
What we did
Archer stood up a shared, part-time onsite clinic sized to the population — not a scaled-down enterprise build, but a model designed from the ground up for the 100-to-1,000-employee band. Real primary and urgent care on site. Medications dispensed at cost, on site or to the mailbox. Labs at negotiated rates. A provider the employees could message between visits instead of waiting weeks for an appointment that never felt worth taking.
The point wasn’t to add a benefit. It was to move the front door — to make the easiest, fastest, cheapest care also the best care, so the ER stopped being the default.
The results
- Year one: 28% reduction in total medical and pharmacy spend — nearly three times the ceiling the HR team thought was possible.
- Year two: member utilization above 306% — employees and their families using the clinic again and again, which is the leading indicator that the savings hold rather than spike-and-fade.
- Past $2.1M cumulative redirected back to the plan across the run — roughly $14,000 per covered employee.
Utilization is the tell. A one-year drop can be luck or a deferred-care mirage. Care people actually keep using is what turns a good first year into a durable cost curve — and that’s what year two showed.
How we know it’s real
This is the part that separates a case study from a brochure.
Most vendors hand an employer an estimated savings number — modeled from a book of business, delivered in a slide deck once a quarter. Archer’s figures here are calculated from Neely Coble’s own claims and clinical data, reconciled against actual plan spend. The 28% isn’t a projection. It’s what the plan didn’t pay.
And it’s visible as it happens. Through Archer Strata — a real-time, privacy-safe layer of structured clinical events — the employer and their broker could watch the cost curve bend in near real time, instead of finding out two quarters later whether the bet paid off. That’s the proof that funds the renewal conversation and gives a stop-loss carrier something concrete to underwrite.
The methodology behind every figure is laid out in the cost-redirection guide — every dollar is traced to a claim, not a model.
Calculated from employer claims and clinical data, employer-approved for publication. If you run benefits for a 100-to-1,000-employee company and want this modeled against your actual claims, start here.