Post on 15-May-2022
WORKSITE CLINICS
Presentation Goals:
1. Explain the purpose and roles of a worksite clinic
2. Discuss trends in the use of worksite clinics
3. Consider the cost and benefits of worksite clinics
4. Review various management models and service options
Worksite Clinics: What and Why
Common goals for implementing clinics:
1. Achieve greater employee engagement
2. Integrate wellness and worksite benefit programs
3. Improve care coordination and quality; realize better
health outcomes for employees, particularly in
chronic care management
4. Increase access and convenience of health care
services; reduce lost time and absence from work
5. Lower health care cost trends
6. Boost employee value proposition, retention, and
talent acquisition
7. Manage worksite injuries and illnesses
Worksite
clinics
provide
health care
services to
employees
at or near
the worksite
Prevalence of Worksite Clinics is Growing
• A 2015 survey showed that over 30% of large employers offer some form of
on-site, near-site, or mobile health services
• An additional 4% of employers are implementing a clinic in 2016
• 12% are evaluating them for 2017
• Employer size ranges from as small as 250 employees to very large
populations and dependents and retirees are often included.
• Employers are eager for new opportunities for high value care for their
workforce, while improving employee access to timely and convenient
medical services while enhancing engagement in worksite programs.
Services being offered within clinics are continuing to expand to accomplish
these goals.
Potential Savings
Case Study by QuikTrip Corporation
$185
$126
$59
$0
$20
$40
$60
$80
$100
$120
$140
$160
$180
$200
Retail AVG pervisit
CareATC AVGper visit
AVG savingsper visit
$88,623
$1,063,475
$0
$200,000
$400,000
$600,000
$800,000
$1,000,000
$1,200,000
AVG savings per month AVG savings per year
QuikTrip Corporation, 2016
Cost Savings and Academic Achievement
IBI Case Study 2015
Case Study by Metro Nashville Public Schools
Metro Nashville Public Schools found its onsite clinics and associated
programs:
• Generated savings of $2.8 million
• Has shown a correlation between teacher wellness ratings and
student scores on ACT national tests as it has been shown that
healthier teachers are associated with less employee absence and
better school performance.
Key Considerations in Choosing Clinic Model
Population: Employee only, Employee + dependents, Retirees,
Other
Staffing: Primary Care Physician, Nurse Practitioner/Physician
Assistant, Operations Manager, Medical Director
Hours of
Operation:
Monday-Friday, Part-time, Flexible, Evening, Weekend
Facility Design: Square footage estimates, Location, Layout, Parking,
Public access
Plan Design: Self-funded vs. Fully insured plans, Copayments for
PPO, Ensure Fair Market Value amount for HDHP with
HSA
Scope of
Services:
Preventive Care, Acute Episodic, Primary Care,
Pharmacy, Dental, etc.
Scope of Service Opportunities:
Acute Services Preventive Services Additional Services
Cold, Flu, Sore Throats Physical Exams Occupational Health
Fever / Infections Health Risk Screenings Safety
Skin Irritations Wellness Services Pharmacy
Bumps / Bruises Disease Management Dental
Sprains / Strains Lab Tests Vision
Cuts / Lacerations Immunizations Physical Therapy
Allergies Tobacco Cessation Telemedicine
Types of Worksite Clinics
Aon Hewitt, 2016
On-Site Near-Site Shared
Definition:
On-site of Single
employer
campus/location
Centralized location
determined by Geo Access
near Single employer
campus and/or most
employee homes
Multiple employers
sharing health center
Facility
Size:
600-1000 sq. ft.
per 1,000
employee lives
Depends on availability of
property; Larger than on-site
clinics; Frequently includes
more amenities
1,000-3,000 sq. ft.
for geographically
centralized
employee population
>900
Three Common Models
Factors Important to Success
Adopted from Willis Towers Watson, 2016
Effective communication of goals
with broad awareness
Strong leadership champions with
ongoing support/involvement
Superior service deliveryStrong privacy and confidentiality
assurances
Conducive plan design/incentives
Culturally compatible with
population
Knowledgeable and enthusiastic
clinicians
Convenient location/appealing
layout
Management ModelsIn-house
Management Model
Hybrid
Management Model
Outsourced
Management Model
StaffingHired and paid by employer as its
own employee
Contracted directly with a health
care provider (e.g., local physician
group or hospital)
Third-party vendor hires and
managed providers and clinic
staff
Pros
• High levels of control and
decision making
• Independence of health center
design, operations, and
personnel
• Employer has control of
operations, center design,
outcomes and specific contract
provisions
• Passes clinical risk to providers
• Experienced third-party vendor
manages health center design,
operations, personnel, and
outcomes
• Vendor accepts all clinical
liability
Cons
• Employer assumes all
management responsibility for
effective management
• Employer assumes clinical
liability
• Needs to invest and maintain
equipment
• May create employee privacy
concerns
-Employer has less control of
personnel decisions
-Conflict of interest: if provider
works for a system, may use
health center as “feeder” into their
system
• Improper selection of vendor
may lead to mismatch of
culture fit and needs
• Most vendors charge on cost-
plus basis: allocated plus
management fees typically run
about 30% on top of direct
costs
• Information on costs/benefits
may not be as transparent as
desired
Sample Clinic Design
World Wide Technology, 2016
Lab Exam Room
Sample Clinic Design
World Wide Technology, 2016
Procedure Room Procedure Room
Business Health Coalition’s Role
• Keep members connected and facilitate learning and best
practice sharing.
• Manage RFP, selection process, and master contract for
consultant feasibility study. Support members through the
process, particularly around shared clinic options.
• Identify clinic vendors and develop an inventory of their
key characteristics and strengths.
• Keep members connected and lend support through the
decision-making and implementation process.