Onsite Employer Based Clinics: Managing Population Health

Promoting health, improving workplace productivity, reducing absenteeism and controlling workers compensation as well as short and long-term disability spend is a daunting task for US companies. Employers of all dimensions and business types, either fully insured or self-insured, are constantly assessing ways to reduce rising healthcare costs. The executive suite is looking at different strategies to the current healthcare delivery system. The implementation of an onsite workplace clinic is one strategy to reduce costs, improve population health outcomes and provide a happier and healthier workplace culture.

Onsite Clinic Growth
The awareness and execution of onsite, employer-based clinics has strengthened in recent years. The scope of services offered can vary considerably based on the employer’s objectives. Many clinics deliver occupational health, first-aid / primary care, specialty care, acute care, workers compensation and ancillary services, among other services. Many started as occupational health clinics, treating minor injuries and serving workplace health and safety needs, but have expanded into primary care and other areas.

Employers want return on investment, just in time access, quality of care and an integrated service delivery model.

Productivity and Presenteeism Impact
Treating acute conditions at the workplace can minimize time away from work to offsite healthcare providers or emergency department visits.   These employee encounters can take hours or even an entire day. Research has shown, workers that show up for work are oftentimes impaired with medical conditions and are not fully productive. Onsite clinics can play a significant role in managing population health risk and treating these medical conditions.

Employers of all sizes are transitioning to the onsite clinic model.

The National Association of Worksite Health Centers (NAWHC), an organization for employer sponsors of onsite clinics, surveyed 255 employers from 15 different industries across the United States. The benchmark report released in December of 2014 disrupts the notion that onsite clinics are just for large employers. The report also showed that more than 30 percent of surveyed employers were considering some form on onsite clinic as part of their cost-containment strategy.

Onsite Clinic Best Practice.

There are six main components to a successful onsite clinic operation.

1. A comprehensive electronic health record, integrated with current medical and pharmacy claims.
2. An employer culture-savvy onsite care provider(s) who is able to navigate coordinate the healthcare environment.
3. An employee-centric model, built with the health risk profile of the total employee population taken into consideration.
4. A long-term flexible strategic plan, predicated on data-driven intelligence.
5. An extensive, outcome reporting package and consistent review.
6. A tactically located clinic facility.

Staffing Options
There are multiple staffing options for those employers transitioning to an onsite model. Employers may turn to third party contractors with the turnkey expertise to manage operations and clinical personnel. While other options include partnering with local hospitals or insourcing the clinic with employer hired staff. There are numerous local, State and Federal regulations impacting an onsite clinic model. It is recommended to resource a legal advisor to help navigate the planning process.

The Value Model of Onsite Employer Clinics

• Increasing preventive care. Preventive care, such as vaccination for influenza, will lower costs by preventing the development of a healthcare condition. Management of chronic conditions, including assessment of compliance with medication so as to prevent complications, can be provided more effectively in an on-site clinic where there is easy access to care (Turner, 2010).
• Increasing diagnostic screening and early detection. On-site programs have been successful in working with employees to comply with evidence-based medical guidelines for diagnostic screening. Improved compliance is mainly attributed to a better patient–provider relationship, likely influenced by having the provider and employee working in the same place (Sherman & Fabius, 2012).
• Establishing wellness programs. Workplace wellness programs are another strategy adopted to reduce health costs through disease prevention. These programs are also a way to positively influence employee morale, retention, and productivity (Bolnick et al., 2013).
• Positive Return-on-Investment. On-site clinics that provide medical care are implemented to reduce healthcare costs for both the organization and the employees. Employees receive prompt medical services, pay reduced co-pays, decrease the amount of time away from work, and maintain work productivity (Tao and colleagues, 2009)

An onsite clinic initiative may be part of an employer’s long-term cost containment health strategy. An employer that sets the direction in managing their population health challenges will help drive a more engaged, productive, cost-effective and healthier workforce.

If you are interested in learning more about establishing an onsite occupational health clinic at your place of business, please contact EI’s Manager of Occupational Health Services, Mr. Joe Flynn at 800.717.3472 or [email protected].

Sources:

1. The role of employer-based onsite clinics: Total population management strategy, July 2015, Wells Fargo
2. ANA, American Nurses Association, Benefits of onsite clinics, Louise C. O’Keefe, PhD, CRNP, Faye Anderson, DNS, RN, NEA-    BC