New study highlights benefits of on-site clinics for school districts

Worksite clinics have proven effective for businesses, in reducing healthcare costs and improving productivity. A recent study conducted by the RAND Corporation and published in the Journal of Occupational and Environmental Medicine, demonstrates that on-site clinics are also beneficial to school systems when the healthcare option is provided to teachers by the school district.

In the first study ever to examine the effects of on-site clinics for teachers, RAND initially set out to “examine the impact of worksite clinics on healthcare utilization and cost, self-reported health status, and student achievement growth in a public school district.” Although they were not able to identify any change in student achievement, the study did reveal that the use of on-site clinics reduces healthcare costs for teachers and improves their absenteeism rate.

RAND used “insurance claims, health risk assessment, and student achievement growth data for active teachers during 2007–2015” for the study. In their research, they found that, when compared to teachers’ use of a community-based clinic, “using a worksite clinic was associated with significantly lower inpatient admissions (53 vs. 31 per 1,000 teacher years), annual healthcare cost ($5,043 vs. $4,298 in 2016 US dollars, a difference of $62 per teacher per month), and annual absent work hours (63 vs. 61).”

The study examined healthcare provided for teachers in a large school system, the Metro Nashville Public Schools, that includes 120 schools and approximately 6,000 teachers. Harry Liu, a RAND policy researcher and the study’s senior author, said “Our findings suggest opening onsite health clinics may be one promising action that school organizations can take to help lower their health care costs.”

In the case of the Metro Nashville district, “on-site” was defined as a healthcare clinic that was accessible within a 15-minute drive. Typically, in a business setting, on-site clinics are located on the company’s property. On-site clinics are designed to provide accessible, convenient healthcare, encouraging the use of primary care and preventive services.

Roy Steiner
July 3, 2018


On-site preventive care market drivers

The number of on-site employer-sponsored healthcare clinics is increasing and is projected to continue increasing over the next several years. Employers have realized the benefits of providing on-site clinics for their employees, including healthier employees, increased productivity, and an added incentive for recruiting and retaining talent. Employees enjoy the convenience of on-site healthcare and tend to use it more frequently because of that available access.

A study recently published by Future Market Insights (FMI) “On-site Preventive Care Market: Global Industry Analysis (2012-2016) and Opportunity Assessment (2017-2027),” points out that on-site healthcare incorporates “Wellbeing screenings (e.g. hypertension or cancer), vaccinations, routine physical exams to screen wellbeing and survey future risk of developing conditions, instruction about legitimate nourishment and exercise, administration of existing conditions to expand personal satisfaction and decrease risk of future entanglements.”

The FMI study also identifies anticipated major growth drivers for the on-site preventive care market, including the “increasing incidence of life-threatening diseases such as cancer, cardiovascular and infective diseases.” Other factors identified include the “growing number of on-site preventive care centers worldwide, extending medical applications at workplace, increasing number of qualified physicians for on-site preventive care, expanding aging demographics etc.”

Particularly with rising healthcare costs, employees who are able to take advantage of the less expensive options of on-site healthcare are also 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. Likewise, employees with chronic or complex conditions have access to convenient healthcare to treat illnesses that could otherwise become more significant issues for them and for their employer.

As the report states, “The global market for on-site preventive care is expected to flourish over the forecast period of 2017-2027 due to increasing awareness about physical, social and psychological, needs of patients with life-threatening diseases and their families.”

Nick Dealtry
June 29, 2018


What is the value of on-site clinics?

Value can be calculated in a number of ways. Employers typically calculate value in terms of their bottom line. Employees may view value in terms of how something benefits them or makes their life better. The value of on-site clinics can actually be calculated both ways.

As the National Association of Worksite Health Centers (NAWHC) states, “Leading employers are beginning (to) realize that by offering the services that force employees to leave work, they can reduce the cost and better manage the health of their covered populations, while improving productivity, since they’ll have reduced the number of situations and the time off the job by workers seeking medical care.”

In addition, “onsite clinical staff increase the engagement of their workers in the multiple preventive and condition management programs they offer. This type of population health approach effectively identifies unnecessary services, gaps in care, opportunities for savings and quality variations to be addressed.”

On-site clinics help to increase employees’ health as well as their satisfaction with their job. The added benefit of convenient access to healthcare encourages them to become more engaged in their own health management. Employees who visit the on-site clinic for preventive services, well checks, immunizations, and other basic primary care services spend less time out of the office and more time focused on their health outcomes.

For those employees who do not have a primary care physician, the on-site clinic can serve as such. For those who do, the clinic staff can share information that leads to a more integrated and more effective healthcare treatment plan for employees. As the NAWHC states, “Worksite centers need to connect and share patients data with a patient’s own physician. It also offers a source of primary and acute care for those 40-60% of employees who don’t have a personal physician.”

On-site clinics provide value to both employer and employee, offering cost savings, convenient access, and incentives for a healthier workforce.

Roy Steiner
June 26, 2018


On-site preventative care is set to grow steadily

Workplace clinics have been steadily growing in popularity among employers and employees over the past several years. A recent report published by Future Market Insights (FMI) states the number of on-site clinics, particularly those providing preventative care, will continue to increase among businesses throughout the US, at least over the next ten years.

The FMI report, “On-site Preventive Care Market: Global Industry Analysis (2012-2016) and Opportunity Assessment (2017-2027),” states 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 increase of workplace illnesses has “made it an obligation for employers to follow employee safety codes and adopt on-site preventive care.”

Increased productivity, reduced costs, and even improved morale are being realized by companies that offer their employees on-site preventative care. The enticement of this type of return on investment (ROI) has led more companies to offer their employees on-site preventative care. According to the FMI report, “the global on-site preventive care market is expected to witness a CAGR [compound annual growth rate] of 7.1% from 2017 to 2027. The market was worth around US $16,135 Mn [million] in 2017 and is likely to touch a valuation of $32,063 Mn [million] approximately by the end of 2027.”

Workplace wellness programs, including smoking cessation and fitness classes, are also becoming more popular. When employees need basic preventative services, such as immunizations and well checks, the convenient access to on-site care is a significant factor in their decision and their ability to secure such services. As FMI states, “on-site clinics provide employees with the necessary support without having to leave their work and plus the clinicians also work together with the patients in a cohesive environment to address their various health related issues.”

Roy Steiner
June 15, 2018


The next generation of on-site, near-site employer health tools

Employers who offer on-site and near-site healthcare clinics for their employees are typically in search of innovative solutions to workplace challenges such as absenteeism and low productivity. They may also be looking for a way to improve morale, to recruit quality talent, and to retain valuable employees. On-site and near-site employer healthcare clinics help to solve many of these challenges. The more progressive employers also take advantage of the next generation of health tools available to them and their worksite vendors.

Dr. Jonathan Spero, CEO of InHouse Physicians, suggests that the next generation of on-site and near-site employer health tools include:

  • Predictive modeling and population health management
  • Price and quality transparency services
  • Patient advocacy services
  • Proprietary narrow networks of high performance providers
  • Negotiated, bundled case rates for high cost drivers
  • Contracts with centers of excellence
  • Telemedicine

Teams specialized in delivering each of these tools will add to the value offered by the on-site and near-site clinics for the employer, significantly increasing their return on investment (ROI). Dr. Spero writes that “Gone will be the days when the singular focus was on the care delivered in the clinic. An equally keen focus will have to be on steering specialty care to value based providers and coordinating care in a medical home model.”

Reinforcing the need for the next generation of employer health tools is a recent study of 255 employers, conducted by the National Association of Worksite Health Centers (NAWHC), with support from PwC US. The study found that:

  • Employers offering clinics are also seeing enhanced integration of health management services and higher employee engagement in health management programs.
  • Telemedicine is an emerging trend for many using onsite clinics, especially in the areas of acute care, wellness and behavioral health.
  • Acute care, emergency or first aid, preventive and wellness are among the top services offered at employer clinics.

Roy Steiner
June 12, 2018


KLAS insights on worksite health services

From the company doctor to a full range of health and fitness amenities, the worksite clinic has evolved significantly over the past several years. The number of on-site, employer-sponsored clinics has also increased, as employers realize the many benefits of worksite health services, for themselves as well as for their employees.

KLAS Research recently published their findings on worksite health services, as they focus on exploring “areas in which new trends and opportunities are reshaping how healthcare is accessed and delivered.” As part of their study, KLAS has defined “worksite health services” as “employer-sponsored healthcare delivery (i.e., on-site clinics) and prevention services done at or near the employer worksite.”

Their study examined the way employers approach and implement worksite health services for their employees and provides a list of worksite health services vendors. The report resulted from “discovery and scoping work done by KLAS” as well as “KLAS interviews with vendors, industry associations, and employer organizations.”

The research found that employers typically take one of three different approaches to providing healthcare services for their employees:

  • Engaging with a third-party vendor to provide healthcare services in a clinic setting.
  • Resourcing their own clinical staff in a kind of “do it yourself” approach.
  • Putting together a hybrid approach in which some healthcare services are provided by a third party and some provided by in-house staff. This approach may also involve contracting with a local healthcare facility for some services.

In addition, the research study determined that three goals are often “top of mind” when employers decide to contract with a third-party vendor for healthcare services for their employees. Employers generally want to:

  • Improve employee health
  • Reduce healthcare costs for themselves and their employees
  • Encourage employee engagement and loyalty.

The approach to worksite heath services may differ, depending on the employer size and capabilities, but the fact remains that on-site and near-site healthcare clinics are on the increase. Employers and employees alike are realizing their many benefits, including convenient access to healthcare and cost savings.

Nick Dealtry
May 22, 2018


Wall Street Journal features on-site clinics

A doctor who sees patients in their office instead of his own is featured in a recent Wall Street Journal article that explores the growing trend among employers of providing on-site clinics for their employees. On-site clinics are becoming more popular as a way to ensure employees have the appropriate healthcare while saving the employer and the employee money. Employers are also finding that on-site clinics are effective incentives for recruiting and retaining employees.

Goldman Sachs, based in New York and the focus of the article, hosts a clinic for employees who can “access an emergency physician any weekday and see rotating primary-care physicians and specialists including a dermatologist and a gynecologist, as well as Dr. (Stephen) Fealy, the orthopedic surgeon. There are physical therapists on hand as well as a visiting physiatrist, a specialist in rehabilitation medicine.”

Another major company offering on-site healthcare to its employees is Cisco Systems, Inc., based in San Jose, California. As the Wall Street Journal points out, Cisco “offers both an acupuncturist and a chiropractor, along with primary-care physicians and pediatricians” for its employees in California, North Carolina, and India.

On-site clinics save employees and employers money, provide employees with convenient access to healthcare, and are an attractive benefit for potential recruits. With healthcare costs rising, employers are realizing cost savings as well as returns on their investment, as the rate of absenteeism decreases and employees become more engaged in their own healthcare.

The National Association of Worksite Health Centers director, Larry Boress, cited several studies in the article that point to the growth of on-site clinics. The article states that “A 2014 study by his organization estimated that 30% of American businesses of all sizes had on-site medical care for employees. By 2018, around 50% will offer the service.” A more recent industry study found that “an additional 11% of firms were considering establishing clinics by 2020.”

Dr. Fealy, the orthopedic surgeon who sees patients in their Goldman Sachs office says that he feels a bit like doctors who used to make house calls. As the article states, though, “Now, when employees all but live at the office, it makes sense to see them there.”

Nick Dealtry
May 8, 2018


Employees and patient engagement at employer health clinics

Increased participation and increased value in workplace wellness programs for employees are two of the findings in a recent Alight/National Business Group on Health Consumer Health Mindset study on employees and healthcare engagement. In fact, the study found that the number of employees who think they are doing “everything possible to maintain a healthy lifestyle” is up eight percentage points since 2014.

Employees are now more likely to advocate for and engage in their own healthcare decisions. They tend to comparison shop more in regard to their options for employer-provided healthcare plans and continue to ask questions about deductibles and co-pays, so they can be better informed.

The study found that employees are more likely in 2018 than in 2014 to conduct their own research and bring their questions to their primary care physician visits. They are also more likely to question prescribed medications and recommended healthcare treatment plans, to ensure they are appropriate and adequate.

Ray Baumruk, vice president of consumer experience research and insights at Alight Solutions noted that “As we look at the qualitative data around this, we’re continuing to see the mindset shift of the accountability toward personal health.”

When asked specific questions about their employers’ health and wellness programs, a significantly higher percentage of employees (from 2018 to 2014) indicated that they felt the programs:

  • Are a good business investment
  • Make the company more attractive
  • Are one of the reasons the employees stay at their current jobs

A growing number of employers are offering on-site and near-site clinics as well as workplace wellness programs, as incentives to recruit and retain quality talent. These workplace offerings have also been found to be an effective way for employees to improve and maintain their own health, reducing absenteeism and presenteeism (going to work when feeling ill) for employers.

Nick Dealtry
April 25, 2018


The cost of medication non-compliance and how on-site health clinics can help

When an independent physician prescribes medication for a patient, there is no guarantee that the patient will actually fill the prescription or take the medication as directed. Medication non-compliance – or non-adherence – costs the healthcare system and employers a significant amount of money when patients are adversely affected by not following their physician’s directives.

Recent studies have revealed that the cost of medication non-compliance in the US healthcare system is “between $100-$289 billion every year in direct costs” when patients don’t take their medications correctly. In addition, “Losses in productivity due to health related factors could multiply that by 2.3 times.”

Studies have also shown that “after a health care provider writes a prescription … 20-30% of patients never fill their prescriptions and about 50% of patients don’t take their medications as directed.” Why do some patients decide not to fill a prescription or take their medication? Major factors include the cost of prescription medicine and a lack of understanding as to the need for consistently taking a prescribed medication, particularly for chronic conditions.

Employers might be able to help improve the rate of compliance, reducing the costs of additional healthcare for these patients, especially through their on-site health clinics. One solution is providing a prescription drug plan with a lower deductible or a lower cost per prescription filled, which can help encourage patients to fill those prescriptions.

On-site clinics who use a team approach to healthcare can also contribute to an increased rate of medication compliance. Using technology to send reminders to patients about filling and taking their medication appropriately, particularly for employeepopulations with specific diseases requiring on-going medications for intervention, education, and assistance in maintaining medication regimen compliance” can also help significantly.

Reducing costs, educating patients, and communicating consistently with patients are tools employers can use to help employees better understand why they need to take their medication and to better afford to fill their prescriptions. An increased rate in medication compliance can result in improved benefits for employee and employer, through increased productivity rates and reduced long-term healthcare costs.

Roy Steiner
April 11, 2018


Addressing mental health at an on-site or near-site employer health clinic

Mental health is a challenging subject for employers, particularly when they offer their employees on-site or near-site healthcare. The stigma of mental issues affects both employer and employee. Employers understandably want to be informed as to whether an employee is dealing with a mental health concern, but all healthcare services provided to the employee are confidential even when provided by an employer sponsored clinic.

Likewise, employees may be hesitant to access mental health services provided by an employer out of fear the employer will discover their issue. Often, an employee who needs mental health services may not even realize that those services are provided as part of the on-site or near-site employer health clinic services. A recent study found that over half of employees did not know whether their company offered “mental well-being” services.

Employers are also not aware whether their employees are experiencing mental health concerns. In the Mental Health and Substance Abuse Benefits survey of 247 U.S. employers conducted by the International Foundation of Employee Benefit Plans “about 158 employers (64%) said that they thought that less than 30% of their workforce is affected by mental health or substance abuse issues.”

Mental health services are generally offered by employers as part of an Employee Assistant Program (EAP). Similar services may be just as effective, if not more so, if provided by an on-site or near-site employer health clinic that offers convenient access to those services.

Behavioral health issues can affect absenteeism and productivity as much as physical health issues. Providing access to behavioral health services in an on-site or near-site clinic and removing the stigma from such services can vastly improve the overall health environment in the workplace. Mental health issues can impact not only the employee but also others in the workplace, including the employer. Addressing the issues early can mitigate the impact of mental health for all concerned.

Roy Steiner
March 26, 2018