Onsite Clinics as a ‘Business Strategy’

Onsite clinics have shifted from a wellness strategy for improving health to onsite clinics as a business strategy for improving the performance of the entire company, according to Larry Boress, executive director of the National Association of Worksite Health Centers.

Boress, who is also the president & CEO of the Midwest Business Group on Health, spoke at a recent Onsite Clinic User Group meeting for Alliance members who offer health services to employees in the workplace.

Eleven Alliance members now offer onsite clinics. The Alliance has more than 200 members who self-fund their employee benefits.

Onsite Clinics as a ‘Business Strategy’ – A National Movement

“We’re finding that this is a growing movement that you are part of,” Boress told the employers. He quoted a Towers Watson-NBCH study showing that  companies that offer onsite clinics are high-performing companies both financially and based on stock prices.

Boress said companies that successfully launch onsite clinics start with data about employee health. Data helps these companies understand what onsite clinics can achieve in their workforce based on objective measures of the factors and conditions that lead to high health costs.

Representatives of Alliance companies with onsite clinics added that it’s essential to adapt onsite clinics to reflect what will work with your workforce and your business culture. For example, one company stated that beginning small with limited services reduced the clinic’s credibility with workers and led to limited usage.

In contrast, another company said that starting small allowed people to get comfortable with the concept of the onsite clinic and learn to trust that health care providers would maintain confidentiality and respect patient privacy. As services expanded, this led to rapid growth.

Building Trust

Cultural differences also impact decisions about the name of the clinic. Some companies believe it’s best to use the employer’s name as part of the onsite clinic’s name, while others avoid using the
company’s name while they build trust among clinic users.

“You must determine whether employees feel better if the name is linked to the employer or not,” Boress said.

Many of the Alliance members participating in the meeting said they are expanding their onsite clinic services with more space and additional hours of service. Some plan to expand to provide services to spouses and dependents as well as employees.

Onsite clinics are also adding new types of services, such as chiropractic care, eye care, behavioral medicine, physical therapy, occupational therapy and counseling for fitness and nutrition.

One company said it was hesitant to add some services because some providers might promote unproven medical theories or treatments. For example, some chiropractors question the value of flu shots, while employers often encourage employees to get flu shots to reduce absenteeism and promote being proactive about health.

That was countered by a health professional at the meeting, who noted that his worksite clinic has found ways to “peacefully co-exist” with chiropractors and other caregivers despite some differences in approaches to care. For the employer, the savings still make it worthwhile, since paying a chiropractor’s hourly rate to provide care at the worksite clinic is a considerable savings over paying for chiropractic office visits through a self-funded insurance plan.
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What’s Ahead

Employers plan to emphasize communicating with employees about onsite clinics and the value of health benefits in the year ahead. They are also keeping a wary eye on the Affordable Care Act,
although Boress noted the only ACA reference to clinics relates to how the value is displayed on the worker’s W-2 tax form.

Boress suggested that companies look for opportunities to integrate data about onsite clinic patients with other health plan data, perhaps by working with a third party administrator.

Several companies that successfully offer onsite clinics said they are struggling with how to effectively deliver similar services to employees at multiple worksites. Borress noted that telehealth services are growing and gaining acceptance.

“Explore that if you want to look for ways to reach your remote or small offices,” Boress said.

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