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.