There’s a glimmer of good news for employer-sponsored healthcare programs. Near-site and on-site clinics offering primary care, often referred to as “employee health centers,” are bringing overall plan-cost reductions along with measurable member-health improvements

Plan managers closely studying plan performance are realizing two basic tenets of healthcare risk management: 1.) existing disease is always better when identified at the earliest possible time, and 2.) the greatest ROI comes from preventing negative health events before they happen. In response, on-site health centers are including primary care, occupational services, pharmacy, disease management, x-rays, and wellness services along with the employee benefits of zero copays, free screenings, free generic prescriptions, and increased physician face-time. 

See also: Building better wellness champions.

Consider these unique ways on-site health centers are improving the risk-management process:

1)    Removal of time and cost barriers:
Cost barriers include deductibles, coinsurance, and co-pays. On-site health centers typically require no out-of-pocket costs for office visits, and members have access to a multitude of free generic drugs via the on-site pharmacy component. Considering that a significant percentage of members are living on a paycheck-to-paycheck basis, a member may be discouraged to shell out $100 per doctor’s visit, thus, foregoing needed care. In addition to cost barriers, on-site health centers eliminate obstacles surrounding a lack of member free-time or proximity for office visits. Customarily a member must take off a half-day of work to see a physician. Employers with on-site health centers, however, allow members to visit the doctor during the workweek, many times without impacting pay or time off.

2)    Improved doctor/patient communications:
Health centers are usually staffed by a physician as well as other supporting medical staff.  In addition to providing primary care and chronic disease management, the medical staff provides health risk assessments and full-spectrum blood testing to identify emerging disease. Physicians practicing in employer-owned health centers are paid hourly and have the ability to allocate at least 20 minutes of time for each patient. These physicians are focused on health and medicine, as opposed to running a business and managing an office. You won’t find them busy with procedure codes, and they don’t spend time on-hold with insurance companies. They spend their time reviewing charts and caring for their patients.

3)    Lower overall healthcare costs:
Put simply, increased primary care exposure dramatically lowers overall costs. Conditions identified and managed by primary care physicians prevent and mitigate escalating severity of chronic-disease conditions. Inpatient hospital days, outpatient hospital procedures, and expensive specialty-office visits are all reduced through the installment of primary care at the worksite. Crowne Consulting Group operates employee health and wellness centers across Florida, serving over 50,000 employees, retirees, and dependents on employer-sponsored health plans. Mitigating risks early and keeping employees healthy have prompted positive financial results for Crowne Consulting Group’s clients, including: 10 percent reductions in plan costs, 15 percent decreases in prescription costs because of the ability to buy at wholesale costs, drastic reductions in sick time, and multi-million-dollar savings for organizations, cities, counties, and school districts. Many employers have identified cost-reducing metrics amazingly early following the adoption of on-site centers. For example, the City of Leesburg’s Employee Wellness Center saved the city $1.3 million within the first year of opening in January 2011, and that positive trend continued. 

4)    Workers’ compensation cost decrease:
On-site health centers have the ability to serve as a first report of injury center for workers’ compensation injuries. Members utilizing centers for workers’ compensation care receive appropriate care, without the common billing inflation produced by workers’ compensation offices. Through the help of onsite care and data-driven wellness programs, the District School Board of Pasco County Florida enjoyed a 50 percent workers’ compensation cost-reduction.

5)    Beneficial to both management and unions:
Unions understand the adoption of health centers to be an increase in benefits while lowering member cost. All health-plan members have access to immediate, high-quality, low-cost healthcare. Also, member responses to surveying indicate high levels of satisfaction. As for management, they recognize the health benefits plus value the long-term strategy to stabilize healthcare costs without pushing costs to employees.

True success for employers is often defined by the bottom-line, which proves to be impacted positively by on-site care. Early adopters are seeing three to five years of zero inflation in their entire health-plan. Moreover, member compliance to prescription drug therapy, evidence-based disease management practices, and wellness screenings show marked improvement. As the healthcare landscape changes, it seems on-site care is harvesting an ample return for risk managers, employers, and most importantly, employees. 

Daniel K. Ross is founder and president of Med-Vision LLC and Med-View LLC. 

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