WORKSITE CLINICS Presentation Goals: 1. Explain the purpose and - - PowerPoint PPT Presentation

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
• n-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 per visit CareATC AVG per visit AVG savings per 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

• ngoing support/involvement

Superior service delivery Strong privacy and confidentiality assurances Conducive plan design/incentives Culturally compatible with population Knowledgeable and enthusiastic clinicians Convenient location/appealing layout

Management Models

In-house Management Model Hybrid Management Model Outsourced Management Model

Staffing

Hired and paid by employer as its

• wn 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
• perations, center design,
• utcomes and specific contract

provisions

• Passes clinical risk to providers
• Experienced third-party vendor

manages health center design,

• perations, personnel, and
• utcomes
• 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.