Employer health clinics and value-based care

Employers are constantly looking for ways to reduce costs. In the prevailing move toward value-based care, those employers are also searching for innovative strategies to help their employees become healthier and maintain their health. On-site and near-site clinics have been shown to be a viable solution for both challenges.

A report from the Duke-Margolis Center for Health Policy and the Robert Wood Johnson Foundation cited the connection between population health management and workplace clinics, stating that, in particular, the employer programs help manage employees’ chronic conditions. Approximately 90 percent of US healthcare costs are related to chronic conditions such as diabetes or high blood pressure.

The report states that “Employers have targeted this issue in a number of ways. 62 percent of large employers and 38 percent of small employers offer health risk assessments, with an even larger percentage providing programs like smoking cessation, lifestyle coaching, and weight-loss management. In another survey, 20 percent of employers report having opened onsite clinics, and 8 percent have near-site or multi-employer clinics, with a larger percentage of employers considering it.”

Larger companies such as SAS, National Public Radio (NPR), USAA, Goldman Sachs, and Capital One Financial offer their employees basic primary care services through on-site or near-site healthcare clinics. Additionally, companies such as Apple, Amazon, Berkshire Hathaway, and JPMorgan & Chase have announced plans for internal healthcare ventures that will provide health and wellness services to their employees.

The Duke-Margolis Center report details the importance of offerings such as employer health clinics as they relate to value-based care. “Employer-sponsored health insurance coverage accounts for 49 percent of insured Americans. If the U.S. health system is to be transformed into one that rewards value, then employers must not only participate in the transition, but play a leading role.” The report continues to explain that “Employers have an interest in the value of care not only because they help pay for their employees’ health insurance coverage, but also because better employee health means fewer missed days of work and better productivity.”

Employers need healthy employees to help reduce their own costs, to maintain a quality level of productivity, and to reduce absenteeism. In general, the current transition to value-based care is welcome news to most employers, with its focus on quality care at the physician’s office and cost containment for both employer and employee.

Roy Steiner
December 14, 2018


The benefit of direct care for on-site and near-site employer health clinics

Employers are as concerned about healthcare costs as their employees and, as such, search for alternatives to traditional healthcare plans for those employees. The direct care model has been proven to offer benefits as the provider of employee healthcare at on-site and near-site employer health clinics.

One company, in particular, that recognized the potential for those benefits conducted a case study of a group of its employees before offering on-site direct care as a company-wide employee healthcare plan. DigitalGlobe, based in Colorado, conducted its study from June to December 2015 by offering the direct model to its Colorado employees. The company also has employees in Tampa, Florida, and Herndon, Virginia.

Company leaders had reviewed information about the direct care model and recognized that it saved businesses and their employees a significant amount of money while providing high quality healthcare. DigitalGlobe searched for a direct care provider and conducted their study with three goals in mind:

  1. Improve the overall health of employees.
  2. Provide employees a more positive healthcare experience.
  3. Reduce healthcare costs for the employees and the company (a self-insured entity).

Employees, in general, realized a number of benefits from their direct care healthcare. The ability to communicate directly with their provider by phone, text, and email was particularly valuable to them. In addition, they were appreciative that they did not have to wait long when they visited the doctor and did not feel rushed during the appointment.

Another benefit came about because of the closer relationship and the focused nature of the provider visit in the direct care on-site model. The company’s report on their study indicated that “there were several instances in which serious health issues (specifically, pre-cancerous conditions, pre-diabetes, and early stage liver cirrhosis) were discovered during a routine checkup or an unrelated treatment—healthcare encounters that the participants readily admit might have been postponed or neglected in the past.”

In addition, the direct care on-site physicians were able to focus on more personal challenges with the company’s employees, such as stress management, dermatological concerns, and weight loss. Many employees “reported that the added level of accountability … was a significant factor in achieving health and wellness successes in those and other areas.”

The company also realized cost savings during the very brief study period. For example, the company estimated “a diversion of costs averaging $54.31 per-member per-month and additional care prevention of $99.99 per-member per-month, for a total savings of $221,442 over the seven months.”

Roy Steiner
December 10, 2018


Understanding what kind of companies can benefit the most from on-site, near-site employer care

Most of the discussion around on-site healthcare clinics highlight larger companies that offer the benefits to their employees as incentives for recruiting, retention, and improved health. In reality, however, there are different options available for on-site and near-site employer care that are appropriate for companies of all sizes.

Larger companies that have the resources can benefit significantly from on-site healthcare clinics. Establishing a clinic on the company’s premises may require hiring staff, investing in a facility, and funding all the necessary expenses of a private clinic. The rewards for the employer are seen in improved productivity and a healthier, happier workforce.

On-site employer healthcare clinics typically work well for large companies that have a limited number of facilities. Employees who work at satellite locations or other off-site facilities may not be able to take advantage of the employer clinic located on the campus of the main worksite. Most employers offer the on-site clinic services to employees’ families as well, so the on-site care will also benefit those employees who live relatively close to the company’s main site.

Large companies with multiple facilities and smaller companies may benefit more from offering their employees healthcare at a near-site clinic. As discussed in a recent article in Employee Benefit News (EBN), “For smaller, self-funded companies that do not have large budgets for additional benefit options, near-site clinics are certainly a more affordable option.”

Near-site clinics are run by an independent staff and require no start-up investment on the part of the employer. The clinics are shared by a number of employers, who generally pay a monthly fee to the clinic for providing healthcare services to their employees. Near-site clinics work well for smaller companies that do not have the resources to build a clinic on-site and for larger companies that have employees (and their families) scattered in various locations.

Roy Steiner
November 12, 2018


Global on-site care market is growing

Employers in the US are recognizing the benefits of on-site healthcare for their employees in growing numbers. Companies benefit from cost savings, improved productivity, and reduced absenteeism. Employees benefit from the convenience of accessing basic healthcare services such as preventive care, immunizations, and well checks, without losing time at work. Treatment for illness or injury is also made more expedient with on-site clinics.

The growth of on-site healthcare facilities is growing across the world as well. Future Market Insights (FMI) recently published a report, “On-site Preventive Care Market: Global Industry Analysis (2012-2016) and Opportunity Assessment (2017-2027)” that examines the global on-site care market. According to FMI, the compound annual growth rate (CAGR) of on-site preventive care is expected to grow 7.1% from 2017 to 2027.

In its report, FMI points out that the “standards set in the workplace for the safety of workers and the need to adhere to workplace norms have triggered the demand for on-site preventive care.” In addition, “the increasing incidences of workplace illness has also made it an obligation for employers to follow employee safety codes and adopt on-site preventive care.”

Over a third of the global on-site preventive care market share is held by North America. Western Europe follows closely. Within the North American market, the US market is growing as a “mature market,” in which many employers have adopted workplace wellness programs in addition to providing on-site healthcare clinics for their employees. Programs to help employees stop smoking, lose weight, and general maintain their health contribute significantly to the benefits of on-site care.

On-site healthcare clinics also help employers stay competitive across the globe. The benefit of on-site healthcare is used to attract and retain quality talent. Particularly in the US, where the unemployment rate is low and qualified workers may be challenging to recruit, the added benefit of on-site health, coupled with wellness programs, can be an enticing incentive to potential new hires.

Roy Steiner
November 5, 2018


How smaller employers are taking advantage of on-site and near-site employer healthcare

On-site healthcare clinics have traditionally been a workplace benefit provided by larger employers. These clinics are typically located on company property and the clinical staff may actually be employed by the business. In fact, a recent survey conducted by the National Business Group on Health found that almost 50 percent of large employers, with over 5,000 employees, offer those employees the healthcare benefits of an on-site or near-site clinic. That number is expected to rise to at least 67 percent by 2020.

Smaller employers can also take advantage of the on-site or near-site clinic for their employees. The costs of building a facility and contracting or employing clinical staff, along with the increased liability issues, may seem prohibitive to small employers, but there are some creative solutions available.

Healthcare companies such as The Working Clinic are offering smaller employers a turn-key solution that eliminates the extra costs of building and maintaining an on-site clinic. According to The Working Clinic’s own description, it provides “convenient access to board-certified physicians for clinical examinations and on-demand doctor visits, occupational medicine services, and an on-site health coach and general medical liaison” with no start-up costs or build-out expenses for the employer.

Near-site healthcare clinics are another viable option for smaller employers. The services of a near-site clinic are also available with no start-up or build-out costs for the employer. Near-site clinics are generally already established healthcare facilities that contract with the smaller employer to provide primary care services, immunizations, and treatment for injuries or illnesses. In fact, the employees may find near-site healthcare clinics are more convenient for their family members, as many have multiple sites.

Smaller employers have several options available to them to enable them to take advantage of on-site and near-site healthcare for their employees. Instead of investing large sums of money in their own facility, they can either contract with a healthcare company that provides on-site services or with a near-site clinic. Either option provides healthcare benefits for their employees and cost savings for the employers.

Nick Dealtry
October 29, 2018


How to ensure employees are taking advantage of their benefits

For many consumers, healthcare has become complicated. There are various insurance plans with a range of deductibles and copays from which to choose. Employee benefits are often just as complicated, and many employees become confused as to what benefits are available to them and how to take advantage of those benefits. Even employees who have the benefit of an on-site or near-site healthcare clinic may not understand clearly how to use those services.

A 2018 Consumer Mindset Survey, conducted by Alight Solutions and the National Business Group on Health, found that “only 53% of individuals can understand and manage how they get health care services while just half understand and manage how to pay for these services.” In addition, the survey found that “a quarter of consumers say the health care system and benefits are so difficult that they give up and just hope for the best.”

The most effective strategy for ensuring that employees understand their options and take advantage of their benefits is clear and frequent communication with those employees. Communication designed to educate employees about the services provided by their on-site or near-site clinic and the costs involved can encourage employees to use those services more often. The employer-sponsored healthcare clinic may be a new concept to some employees who may not trust it or understand the extent of their benefits.

Communication and education can be accomplished in person or by taking advantage of technology. Face-to-face meetings, emails, an intranet page, and one-on-one sessions with a benefits counselor can help employees understand their benefits, encourage them to ask questions, and help ensure they take advantage of the benefits offered to them.

Taking the extra time and extra steps necessary to ensure full comprehension of the services offered by the on-site or near-site clinics, the family members covered by these benefits, and the costs (or lack of cost) involved in using the clinics can reap large rewards for the employee and the employer. When the employee takes advantage of the available healthcare benefits, the employer may see reduced costs and improved health among its employees.

Nick Dealtry
October 16, 2018


The convenience of on-site, near-site employer clinics

Two major challenges for healthcare are cost and access. Even when healthcare costs are made affordable for the patient, or perhaps covered completely by health insurance plans, access often becomes an obstacle to being able to seek care and treatment. When care is made more convenient, however, more patients will take advantage of the opportunity for well care visits, immunizations, and acute care visits.

Patients are used to scheduling their appointments based on the physician’s calendar, rather than their own. They also typically would have to take time off from work, whether paid sick leave or unpaid time off, drive to the physician’s office, and wait in the physician’s office for their visit.

On-site and near-site employer clinics offer the convenience employees and employers seek. Employees who have access to healthcare services conveniently located on or near their workplace are able to visit the doctor for preventive services or to treat an injury or illness, without having to take significant amounts of time away from their job. The practical benefits of on-site and near-site employer clinics can be seen in increased productivity and reduced absenteeism.

Employees also increasingly want convenience as a reflection of their increased use of technology that enables them to access many other services from their phones or other electronic devices. To make on-site and near-site healthcare services even more convenient for busy employees, many primary care physicians practicing in employer clinics also offer telehealth visits.

Younger employees, in particular, want to access healthcare services at their convenience, using their phones whenever possible. Employees who take advantage of telemedicine services can generally speak with a primary care physician or other clinician via a phone call, describe their symptoms, and receive a diagnosis and any necessary prescriptions, all from the convenience of their office.

Technology and convenience can improve access to healthcare dramatically. The on-site and near-site employer clinics are increasingly providing both, encouraging employees to take advantage of their services, which in turn results in improved health outcomes for those employees.

Nick Dealtry
October 10, 2018


Understanding On-Site Clinics

An on-site clinic is where an employer offers one or more medical and wellness services to all or most of their employee population and other individuals who are eligible. These services provided at the clinics are all delivered by licensed providers and are more often referred to as “health and wellness centers” because of the variety of care ranging from first aid, occupational health, acute, primary, specialty, condition management, wellness and ancillary services. The clinics originally started as occupational health clinics, where they treated minor injuries and served workplace health and safety needs, but have now expanded in to primary care.

On-site clinics are usually apart of the health benefits that an employer offers to its employees. The objective for companies to have an on-site clinic is to provide easy access and immediate attention, at little or no cost, for a variety of services and products that an employee would normally have to leave the work location to receive.

Due to the fact that having on-site clinics cut down on time employees take to go to their doctor’s appointments, meaning more time for work, these on-site clinics are quickly gaining in popularity; especially among mid-large employers of all industries. These facilities can be sponsored by public or private employers, union groups or other plan sponsors. Even smaller employers can have a nurse or other provider offer screenings, preventive care, coaching or minor services at minimal cost and still reap the benefits.


With most industry sectors reporting the total cost of employee health care above $10,000 per employee and increasing at rates more than inflation doubled, the on-site clinic model would be a great investment. On-site primary care for all insured employees and their dependents combined with incentives for clinic use and better personal health are proving to save employers significant dollars, keeping their health care costs at or below inflation while reducing their employee’s point of care costs. The net results show that employers have more funds available to spend on retaining and recruiting quality talent and their current employees are healthier, happier and more productive.

Benefits of Having an On-Site Clinic:

  • Offering convenient access to health care services will reduce the lost productivity that results from a worker taking 3-4 hours to leave work, travel, wait for and see health care providers and to obtain drugs and services
  • Making first aid and critical services available at the work location will reduce the use and cost of hospital emergency rooms (highest cost setting for obtaining medical services)
    for non-emergency conditions
  • Providing low or no cost resources and treatment will increase use of preventive and wellness services and programs, lessening the severity of common illnesses, enhancing management of chronic conditions that require regular check ups, improving medication compliance and patient outcomes overall
  • Investing in the well-being of employees with workplace ‘health and wellness’ benefits can help attract and retain employees – clinics are often viewed as the most popular benefit by workers
  • Delivering medical, pharmacy and therapy services at the work location will reduce overaIl costs, as there will be no required revenue margins placed on top of the services or products provided to patients at the clinic

Nick Dealtry
October 1, 2018


Surge in investment in primary care and on-site employer health clinics

Recognizing that primary care can play a significant role in reducing unnecessary tests, specialty provider visits, and even hospitalizations, private investors are increasingly supporting primary care practices as well as on-site employer health clinics. With healthcare costs increasing for both patient and provider, reducing those costs by providing quality primary care that is easily and conveniently accessed can make a significant difference for everyone involved.

On-site employer health clinics have shown steady growth since 2008. In the past five years, the number has increased from 24 percent of companies with more than 5,000 employees offering on-site clinics to 33 percent. More employers are realizing that employees who have access to on-site preventive care are healthier, more productive, and more apt to remain with the employer longer term.

Private investors, such as Carlyle Group LP, also recognize these facts and are putting “large sums” into workplace clinics, according to a recent article in BenefitsPRO, an employee benefits publication. Carlyle is investing approximately $220 million in One Medical. According to BenefitsPro, the company will use the funds to “more than double the number of clinics it operates, from 72 currently. The company operates in eight cities, and plans to expand to more locations as it seeks to sign up more employers.”

A group of investors is also boosting the financial resources of Paladina Health, an on-site employer clinic provider. Paladina also plans to use the money to expand its reach, including possibly providing care for Medicare patients, and build new clinics. The clinic provider currently has 53 employer clinics in 10 states.

Employers are realizing that on-site healthcare clinics benefit them as well as their employees. Particularly with rising healthcare costs, employees who are able to take advantage of the less expensive options of on-site healthcare are more apt to seek out preventive care. That, in turn, helps to lower the rate of absenteeism and presenteeism (showing up for work when feeling ill or contagious) for the employer. Investors are likewise recognizing these facts and are indeed putting “large sums” of money into this growing trend.

Nick Dealtry
September 25, 2018


Key players and growth trends for on-site clinics

A study recently conducted and released by consulting firm HTF MI shows the predicted increase in on-site clinics globally and identifies nine of the most significant players in the industry. The market research report, Global On-site Preventive Care Market Size, Status and Forecast 2025, “studies the global On-site Preventive Care market size, industry status and forecast, competition landscape and growth opportunity.”

The largest on-site clinic market share in the study’s base year, 2017, was held by Healthcare Solutions Centers, followed closely by OnSite Care. RepuCare and Premise Health rank third and fourth, respectively. Globally, North America was the leader, with a share of 37.0% in the global on-site preventive care market. Western Europe followed closely behind.

Market segment by type was also included in the market study. Acute care accounted for 47% of the global on-site preventive care market share. Chronic disease management was identified as the second type of preventive care most provided in the global on-site market. Employees who are able to visit an on-site clinic for injuries or illnesses without having to leave their workplace are more likely to take advantage of the services provided there.

A research analyst from Future Market Insights states that the on-site market is growing considerably, given the convenience to employees, the “surging instances of chronic disorders among a growing working population,” and the “deepening penetration of various workplace wellness programmes.” FMI adds that “it is most likely that the market for on-site preventive care will experience robust growth in near future.”

Researchers at HTF MI further explain the growth of on-site clinics in terms of benefits for both employer and employee. “The services that are incorporated in on-site preventive care help reduce the risk of future illness among employees, addressing their present concerns, vaccinations, physical routines, screening of health issues such as anxiety, hypertension, etc., and identifying future risks.”

Nick Dealtry
September 21, 2018