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


Corporate wellness trends for 2018

Employer-sponsored healthcare clinics began as a way to treat employee injuries on-site, so those employees could get back to work quickly. Today, on-site and near-site clinics generally also provide basic preventative care, including immunizations and well checks, for employees and their families. Going forward, corporate wellness may take on an entirely new profile, incorporating technology with a new focus on keeping employees healthy.

TechTarget reports that there are seven potential trends for corporate wellness in 2018:

Corporate wellness programs are becoming holistic: Technology-enabled devices such as wearables are becoming popular but true corporate wellness will depend on involving employees in more diverse ways to monitor and track their progress. For example, SAP “recently began offering employees app-based health and diet coaching via mobile coaching app Kurbo and a program that uses molecular medicine and big data to determine the best treatment for employees diagnosed with cancer.”

Consumer tech keeps influencing corporate wellness: Likewise, technology that is popular on the consumer level will find its way into employer-sponsored healthcare programs as those wearables and even advanced technologies like virtual reality pods become more widely used.

Employers are using wellness to keep talent happy: The good news for employees is that the unemployment rate has dipped to just over 4%. For employers, however, that means they have to keep employees happy, and offering them ways to stay healthy can help contribute to employee retention in the future.

More employers are offering DNA kits: Interest in DNA testing is rising among consumers and the corporate healthcare trend is following that lead. Employers are offering discounted DNA testing kits, but also have to offer assurances that the results of those tests will remain confidential and will not be available to the employer.

Incentives are boosting participation: The trend toward third-party rewards for wellness activities is increasing. Employees “who meet certain agreed-upon health or activity goals can be rewarded with gift cards from retailers such as Whole Foods and REI.”

Chatbots are supporting wellness: Interaction with chatbots and voice bots online and through devices like Amazon’s Alexa is becoming more popular for everyday activities. Employers are looking to these options for engaging employees in their own healthcare as well.

Sensors are enabling corporate wellness advances: Devices such as watches that can provide an EKG reading are being offered to employees at a discount, so they can monitor their health privately and effectively. In fact, TechTarget advises that employees should “expect a growing use of internet of things sensors in the workplace to enable greater productivity, elevate mood, reduce stress and promote healthful behavior.”

Nick Dealtry
March 23, 2018


Large companies like Apple embrace employer clinic model

As healthcare costs increase and discussion over the Affordable Care Act (ACA) is in flux, many large employers are considering how best to provide healthcare coverage for their employees. Their concern is for the health of their staff as well as for the health of their financials. Larger companies are beginning to look at unique options to embrace the employer clinic model.

Companies of all sizes have been providing on-site healthcare for their employees for decades. Recently, the leaders of Amazon, JP Morgan, and Berkshire Hathaway announced they are planning to “form an independent venture that’ll be focused on healthcare for their US employees.” Amazon’s CEO Jeff Bezo acknowledged that they were up for a challenge, but then added that “reducing healthcare’s burden on the economy while improving outcomes for employees and their families would be worth the effort.”

Likewise, Apple has announced an employer clinic model in the form of a group of clinics providing healthcare for its employees and their families. The venture, called AC Wellness, is scheduled to launch in the spring of 2018. Apple’s “new primary care group — a group of clinical staff that is run independently from Apple but is dedicated to Apple employees — will initially only serve Apple’s employees in Santa Clara County, where its headquarters are located.”

These large companies recognize that it is less expensive to provide preventative primary care services for their employees than to provide coverage for treating illnesses and injuries. In addition to the cost of treating employees, the Centers for Disease Control and Prevention (CDC) reports that “health problems result in 69 million workers reporting missed days each year, reducing economic output by $260 billion per year.”

Apple is exploring other options for helping employees stay healthy, in addition to the on-site employer clinic. One of those options is determining whether their own Apple watch “can detect irregularities with the heart’s rhythm, an effort that would benefit from a huge population of healthy and sick patients.”

Roy Steiner
March 21, 2018


ROI vs VOI: Which is better for worksite employer clinics?

Most employers are concerned about financial returns on their investments. If they purchase new equipment, for example, they want to know when that new equipment will begin to pay for itself and then reap rewards in terms of additional profit. The same is true for the healthcare options companies offer their employers.

Employers want to know if investing in a worksite clinic will produce significant financial returns on investment (ROI). There is also a more intangible measurement used when discussing employee wellness and that is the measurement of the value on investment (VOI).

Often, ROI on employee healthcare is difficult to measure. A recent Mercer study found that only 41% of those participating had solid numbers to show their specific ROI data. However, 63% of those responding to the survey stated that they were realizing reduced lost work days, which is a specific number related to their worksite clinic ROI.

When reviewing their VOI, employers take into consideration less measurable information such as “employee morale, decreased use of sick days, increased productivity, positivity and talent retention.” These are certainly important factors when evaluating the success of a worksite clinic, particularly as it impacts the employer’s investment, but they are factors that cannot readily be calculated on a financial spreadsheet.

Which is a better measurement for an employer’s worksite clinic? It truly depends on whether the employer is more interested in having its employees reach health-related goals, becoming healthier overall, or whether the employer is focused more on the actual returns on its financial investment, in terms of productivity numbers or reduced healthcare costs.

Employees who are able to access healthcare through a worksite clinic will probably take advantage of those services in some form or another. Many employers go beyond the simple vaccinations and well checks to offer lifestyle management and additional wellness options. The employer must determine whether measuring VOI or ROI is more important to them, in terms of determining the success of those programs.

Roy Steiner
February 5, 2018


The evolution of worksite and employer health clinics

What began as a way to patch up workers and send them back to their jobs has evolved into an array of healthcare services, including fitness center and life management programs. Worksite health clinics have evolved significantly since the days of the “company doctor.”

Surprisingly, the interest in employee fitness began relatively early in the history of worksite and employer health clinics. Companies such as the Pullman Company and National Cash Register recognized the need to keep employees healthy and physically active in the late 1800s. For the majority of employers, though, the emphasis continued to be on treating injuries and illness so that employee productivity was not affected.

The evolution continued after World War II when several companies provided gymnasium facilities and instructors for their upper-level management employees. The fitness trend continued – and expanded to include all employees – throughout the next several decades. Towards the middle of the 20th century, employers recognized the need to provide healthcare for more than just treatment of injuries or physical fitness and further expanded their offerings to include the Employee Assistance Program (EAP).

A meaningful moment in the evolution of worksite and employer health clinics occurred with the establishment of the Occupational Health and Safety Administration (OSHA) in 1970. OSHA influenced a shift from treating injuries to preventing injuries. Workplace safety became a focus, and along with it preventative services became a concern of workplace healthcare.

Shortly after, the 1980s brought a wider, more holistic, view of employee health. At that point, worksite and employer health clinics expanded to include lifestyle management programs, including weight loss and smoking clinics, stress management programs, and other health-focused classes.

As part of their evolution, many worksite clinics have recently implemented the use of electronic health records (EHRs) that enable employees and their providers to view their medical data and track their progress more efficiently. Today’s employer health clinics now include a range of services, provided in person and online, designed to keep employees healthy, to keep productivity up, and to keep employer costs down.

Nick Dealtry
February 1, 2018


How employer health clinics are impacting the US healthcare system

Healthcare costs are rising. Concerns about the quality of healthcare services are growing. According to multiple reports, the US spends more money on healthcare than any other industrialized country, but the quality of that care has been inconsistent. Initiatives have been put into place to provide incentives for value-based care, but those often result in increased administrative burdens for independent physicians.

One segment of healthcare, the employer health clinic, has actually been changing the US healthcare system for the better as it continues to become more popular among employers. Worksite clinics offer benefits to employees in terms of convenience, access, and lower costs. These clinics also benefit employers in terms of healthier employees, improved productivity, and lower costs.

Improved access

Healthcare clinics located on-site offer employees convenient access to basic services such as flu shots and immunizations. Many worksite clinics have expanded to offer additional primary care services as well as lifestyle management, stress management, and fitness programs. Employees who enjoy the logistical convenience of visiting their provider, often without having to take leave from their jobs, will typically become more engaged in their own healthcare management.

Improved health outcomes

Employer clinics contribute to a healthier population base of employees and their families. Using technology solutions such as electronic health records (EHRs), providers at worksite clinics can track trends and develop a population health management strategy that can be a critical element in enabling providers in employer health clinics to proactively treat employees and their families more effectively.

Lower costs for all

Employer health clinics help reduce the costs of healthcare services for employees. Healthier employees reduce the costs of absenteeism for the employer, particularly when employer health clinics offer expanded services such as smoking cessation or weight management programs.

Overall, employer health clinics impact the healthcare system by providing consistent quality of care and improving everyone’s bottom line.

Roy Steiner
January 30, 2018


Worksite clinics are expanding their focus

Back in the day, way back in the day, workplace healthcare was focused on treating injuries and illnesses and returning employees to work. Company doctors were paid for their services by the workers themselves, either in the form of a cash payment at the time of treatment or by having the healthcare services deducted from their payroll. The company’s intent in providing a company doctor was primarily productivity.

Fast forward to today’s employers and into the future of workplace wellness. An expansion is taking place, both in terms of the types of services provided as well as the overall focus of the employer in providing those services. Productivity is still a primary concern and many worksite clinics offer programs designed to reduce absenteeism and prevent presenteeism (showing up for work when ill). However, the range and types of services provided at worksite clinics are becoming more holistic.

Wellness programs now include mental health services as well as lifestyle management programs. Workplace healthcare is expanding to include dentistry, obstetrics, physical therapy, and other clinical services that go far beyond the typical flu shots and well checks typically seen in a worksite clinic.

Employers are taking steps, literally, to help employees improve their overall health and fitness, rather than simply treat illnesses. More companies are offering “business class care,” including fitness classes, yoga, and dietician services.

Worksite clinics are also taking advantage of technology such as electronic health records (EHRs) that can help their providers track patient history and be more proactive in their treatment. Employees have access to their own health information through their EHR and tend to become more actively engaged in their healthcare programs. They enjoy the ability to communicate with their physician electronically, reducing the need to take time out of their workday to get answers or further clarifications.

The future of worksite clinic is focused on overall employee health and happiness, rather than simply treating injuries and illnesses, enabling employers to use the benefit to attract and retain quality talent in today’s competitive marketplace.

Christian Piuma
January 23, 2018