Onsite 2.0: Part 4: The Resurgence of Onsite Clinics
In the previous article, we looked at the limitations of the Onsite 1.0 Model. This segment explores the resurgence of onsite clinics and what types of organizations are getting finding value in onsite and near-site care.
With employers, health plans and unions pushing for ways to reduce costs and improve employee health and benefit plan design, the number of companies offering onsite clinics with more comprehensive primary care services is growing dramatically. The National Association of Worksite Health Centers claims that 45 percent of all employers offer some sort of onsite clinic, and Mercer reported a 20 percent increase in just one year among employers with more than 5,000 employees offering general medical services.
Among the employers in the Mercer study, 49 percent say their members are allowed to select the clinic as their primary care provider, and 26 percent use their worksite clinic as a medical home with full-service care and chronic disease management services. This is up from 13 percent three years ago, and another 11 percent claim to be considering the medical home option.
With the rapid growth of the onsite clinic industry, this opportunity is no longer confined to just manufacturing giants. Today, just 30 percent of all clinics are run by manufacturing companies, with the other 70 percent comprised of financial services institutions, healthcare providers, government agencies and others. While larger employers still do account for the bulk of onsite clinics, one third are operated by organizations with less than 3000 employees.
The scope of services offered at workplace clinics continues to expand. David Keyt, national leader of Mercer’s Onsite Clinic Center of Excellence describes the trend as follows:
“Our clients are looking to optimize their sites to meet the needs of their population, whatever they may be. They’re moving away from flu shots and preventive services to a more proactive program around lifestyle management and coaching.”
The list of services offered by workplace clinics continues to expand. Immunizations, acute care, phlebotomy and wellness services are nearly ubiquitous, but over half are now offering primary care, specialist referral management, chronic disease management and physical therapy.
In addition to expanding services, existing operators are expanding centers and operating hours. Nearly 40 percent of companies offering onsite healthcare plan to open additional clinics in the next two years. Plus many centers offer employees access beyond the standard work day. 55 percent open before 8:00 a.m., 32 percent remain open after 5:00 p.m., and 16 percent are open on weekends. A growing number allow 365 x 24 x 7 phone access to providers and/or telemedicine hotlines.
The fact that employers continue to invest more and more in their onsite health clinics, is reflective of the payback they are experiencing. According to the Mercer study, 45 percent of employees with access to onsite care used the services in 2014. Nearly half of respondents (48 percent) with a general medical clinic don’t require any copayment for clinic services, and 25 percent require a lower copayment than the employee would pay for comparable services under the company health plan. Employers surveyed rate their programs a success on a wide variety of metrics from employee satisfaction to productivity and cost reduction.
One study went so far as to quantify the actual convenience factor of onsite care comparing the time employees save on doctor visits, lab tests and more in the onsite setting versus leaving the workplace for care.
There is clearly momentum in the onsite clinic arena but while newer programs have evolved from their occupational health roots, they still haven’t addressed many of the limitations outlined in our previous article. Next in our series on Onsite Clinics 2.0, we will explore the emergence of a new model for includes expanded access, improved outcomes and greater impact on healthcare costs. To learn more, download the whitepaper.