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The Workplace Doctor Is In

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At Coors Brewing Co., a 20-year-old health clinic for employees is expanding services to support the company's wellness programs. Cerner Corp., the Kansas City, Mo.-based healthcare information technology company, estimates its new health clinic will log 9,000 patient visits-and save Cerner $1.2 million by increasing worker productivity-during its first full year of operation in 2007. And Toyota Motor Corp. spent $9 million to open the new Toyota Family Health Center with a vast array of health services in San Antonio in November 2006.While the employee health clinic is not a recent invention, a growing number of on-site facilities carry expectations that constitute a relatively new phenomenon. No longer relegated to just workplace injuries and flu shots, today's in-house clinics aspire to be the healthcare home for workers and their dependents. And by opening such clinics, employers hope to wrestle some control of the healthcare system from traditional physician practices and hospitals. "The Healthe Clinic is transforming Cerner's healthcare process," says Bill Wing, vice president of new transactions, of Cerner's facility, which uses electronic medical records for all patients and pays claims on a real-time basis. That kind of transformation is what Cleveland-based Whole Health Management Inc., one of several companies serving the on-site clinic market, is selling. Whole Health, which will open its 70th corporate clinic this year, says the on-site locations make it easier for patients to take care of their health while reducing lost work time, which immediately saves money for the employer. And by increasing the likelihood that staffers receive preventive and primary care, the clinics theoretically improve workers' health status, leading to lower healthcare costs in the long run."We're finding that most people don't have a primary-care physician," says Sara Crate, senior vice president of business development for Whole Health. "They're not uncovering things that are percolating that are going to cause long-term health problems." But employers that open clinics also hope to attract workers who do have a primary-care physician. Cerner's clinic, for example, provides free primary care and many lab services, and staffers avoid waiting-room downtime because they are notified at their desks when the doctor is ready. At Toyota's San Antonio clinic, dental and optometry services are available along with family practice, pediatrics, radiology, lab and other services.What all this means for hospitals remains to be seen. But a cautionary anecdote comes from Whole Health, which competed with a local hospital when it bid on one major corporate clinic. "We align the incentives of the employer, the provider and the patient," Crate says. "Those incentives really aren't aligned with hospitals' incentives because of the inherent need for them to use their hospital services and fill the beds." As on-site clinics proliferate, they are showing up in smaller venues. Mark Barta was risk manager for the city of San Angelo, Texas, when he opened an on-site clinic as a way of curbing that city's healthcare costs. "The first year we cut ER visits by 85 percent," he says.Now representing Brentwood, Tenn.-based CareHere LLC as a consultant, Barta travels throughout Texas promoting on-site clinics to counties, school districts and other government entities. He says clinics can be opened in as little as 500 square feet and save money for employers with just a few hundred workers."The key really is how many visits you can divert off your self-funded health plan to pay for your clinic," he says.Whole Health, which markets to employers with at least 1,000 workers at a location, estimates that less than 10 percent of the market has been penetrated to date. In other words, its sights are set on 7,500 on-site clinics-a market opportunity it forecasts as $4.5 billion-waiting to be opened. -Lola Butcher