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: Worksite 1. Achieve greater employee engagement clinics 2. Integrate wellness and worksite benefit programs provide 3. Improve care coordination and quality; realize better health care health outcomes for employees, particularly in chronic care management services to 4. Increase access and convenience of health care employees services; reduce lost time and absence from work at or near 5. Lower health care cost trends the worksite 6. Boost employee value proposition, retention, and talent acquisition 7. Manage worksite injuries and illnesses
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 $1,200,000 $200 $185 $1,063,475 $180 $1,000,000 $160 $140 $126 $800,000 $120 $600,000 $100 $80 $59 $400,000 $60 $40 $200,000 $88,623 $20 $0 $0 AVG savings per month AVG savings per year Retail AVG per CareATC AVG AVG savings visit per visit per visit QuikTrip Corporation, 2016
Cost Savings and Academic Achievement 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. IBI Case Study 2015
Key Considerations in Choosing Clinic Model Population: Employee only, Employee + dependents, Retirees, Other Primary Care Physician, Nurse Practitioner/Physician Staffing: Assistant, Operations Manager, Medical Director Hours of Monday-Friday, Part-time, Flexible, Evening, Weekend Operation: Facility Design: Square footage estimates, Location, Layout, Parking, Public access Self-funded vs. Fully insured plans, Copayments for Plan Design: PPO, Ensure Fair Market Value amount for HDHP with HSA Preventive Care, Acute Episodic, Primary Care, Scope of Pharmacy, Dental, etc. Services:
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 Three Common Models On-Site Near-Site Shared Centralized location On-site of Single determined by Geo Access employer Multiple employers near Single employer Definition: campus/location sharing health center campus and/or most employee homes 1,000-3,000 sq. ft. Depends on availability of 600-1000 sq. ft. for geographically Facility property; Larger than on-site per 1,000 centralized Size: clinics; Frequently includes employee lives employee population more amenities >900 Aon Hewitt, 2016
Factors Important to Success Effective communication of goals Culturally compatible with with broad awareness population Strong leadership champions with Convenient location/appealing ongoing support/involvement layout Knowledgeable and enthusiastic Conducive plan design/incentives clinicians Strong privacy and confidentiality Superior service delivery assurances Adopted from Willis Towers Watson, 2016
Management Models In-house Management Outsourced Management Hybrid Management Model Model Model Contracted directly with a health Third-party vendor hires and Hired and paid by employer as its Staffing care provider (e.g., local physician managed providers and clinic own employee group or hospital) staff • Experienced third-party vendor • High levels of control and • Employer has control of manages health center design, decision making operations, center design, operations, personnel, and • Independence of health center Pros outcomes and specific contract outcomes design, operations, and provisions personnel • Vendor accepts all clinical • Passes clinical risk to providers liability • Improper selection of vendor may lead to mismatch of • Employer assumes all -Employer has less control of culture fit and needs management responsibility for personnel decisions effective management • Most vendors charge on cost- • Employer assumes clinical -Conflict of interest: if provider plus basis: allocated plus liability Cons works for a system, may use management fees typically run • Needs to invest and maintain health center as “feeder” into their about 30% on top of direct equipment system costs • May create employee privacy • Information on costs/benefits concerns may not be as transparent as desired
Sample Clinic Design Lab Exam Room World Wide Technology, 2016
Sample Clinic Design Procedure Room Procedure Room World Wide Technology, 2016
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.
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