A 2015 survey of 255 employers by the nonprofit National Association of Worksite Health Centers (NAWHC) found that in an effort to control rising health care costs, employers are increasingly turning to onsite and near-site health care clinics. A majority of respondents reported a 64% reduction in medical care costs; almost 70% reduction in time lost by employees leaving work to see outside medical providers; and 63% reduction in the use of the emergency room. Acute care, emergency or first aid, and prevention and wellness are among the top services offered at employer clinics. More than 30% of onsite clinics now provide primary care services, and this number is expected to grow in the future (Better than a Coffee Break: Onsite Clinics Reduce Health Costs, May, 2016, Johns Hopkins Healthcare Solutions).
While these nonoccupational clinics can be a great platform to reduce costs, the NAWHC Survey's cost reduction claims are derived from a composite of different methodologies from its many participants. As part of developing its integrated employee health benefits program, ROI Health conducted the research and built a worksite clinic cost model. This provides for a more precise framework for projecting clinic health cost reduction that wasn't available in academic or industry studies. ROI Health can design and formulate financial projections for a variety of prevention, wellness and clinical interventions together with the requisite staffing configurations. While clinics indeed produce very positive returns for employers, the ultimate savings are dependent on a number of organizational factors, benefits program and clinic design.
In the formulation of our clinic model we expanded the scope of the clinic to include the handling of most occupational injury and illness components. The addition of worker's compensation to the clinic's mission led us to understand several things. Worksite clinics are in the unique position to serve as the nexus between employer representatives, community and specialty physicians, and worker's compensation and disability management personnel. Clinics are also positioned to provide meaningful support across the continuum of employee health risk reduction programs and can help create seamless data analytics between occupational and nonoccupational health and disability, helping to uncover important risk findings that are hidden by current benefits coverage silos. The clinic can become a true macro-integrator.
Cultural and operational barriers will be eliminated through a program that enables both the employer and employee to win. Optimum results occur because the interests of employer and employee become completely aligned. Occupational and non-occupational disputes are removed, and there's reduced litigation exposure.
A real production relationship can be established by clinics in administration, care management and claims processes across the entire benefits insurance spectrum. This will enable the marginal cost of producing an additional dollar of savings to fall over time. This differentiation will be achieved through event management, which serves as a funnel to triage all medical incidences and point them immediately to the appropriate level of care. Some occupational and nonoccupational treatments will become uniform resulting in improved outcomes across coverages. Duplication of medical services will be eliminated. Clinics control where the employee is going for treatment. This gives the employer much better sway over the medical and disability authorization process. SAW & RTW will be much more effective, since the clinic will serve as a locus between all administrative and medical personnel involved in a particular case. Integration will improve the quality and cost of care well beyond the existing coordinated medical management approach. And integrated administration versus coordinated administration will certainly improve upon claims administration costs in worker's compensation that can exceed group health by 15 times (California Commission on Health and Safety and Worker's Compensation, Integrated Care Fact Sheet, 2008).
Through changes to both product and process worksite clinics can further reduce operating costs by complementing single source administration, and decreasing loss costs and health costs per employee through more effective direction and management of medical events. By making integrated benefits a primary goal of worksite clinics, employers will have a way of creating the holistic healthcare delivery services and insurance platform that will end fifty-two years of health cost inflation.
It's all about establishing clinics to help create an optimal health and safety culture, so why bake half a loaf when you can have a whole one? Only integration produces the best strategy-culture interaction. The best illnesses and injuries are the ones that never happen. Healthy workers make happy workers who improve the bottom line. Companies that have occupational and nonoccupational health benefits programs which are the most comprehensive and come closest to achieving integration continually produce strong results (Goetzel R. et. al., JOEM, Jan. 2016, Vol. 58, Issue 1, p. 9-15; Busick J., EHS Daily Advisor, April 8, 2016). Just think about what these firms, and anyone else for that matter, could really do if things were actually coordinated and they could look across the coverage silos.