Employer Sponsored Onsite Medical Clinics

Friday, July, 13 2012

Is the “company doctor” making a comeback? At one time in our history, the company doctor was a standard fixture along with the company store and company housing. In mill, mine, and factory towns all over 19th century American, employers provided workers with a doctor who was paid by the company to deliver medical care to its employees and their families. Sometimes the care was free to employees, at other times the employees paid a modest fee for medical services. Increasingly today, employers are rolling out job site medical clinics for employees as another tool in their battle over high health care costs. In some cases clinics are located on the employer’s property, at other times they are mobile facilities in the form of vans. Onsite clinics and mobile facilities are intended to provide a primary level of care and not to replace specialty or hospital care.

The advantage of an onsite clinic for employers and employees are several: Less down time away from the workplace for employees, ability to deal with medical issues on the spot, a degree of control over the care delivered, and the costs of that care. Onsite Clinics, a website focused on the topic of workplace medical care, reported in May, on a study conducted by Price Waterhouse Coopers (PWC) on trends in mobile health care. In the PWC report, “Healthcare unwired: New business models delivering care anywhere”, PWC explores emerging trends in how, when, and where health care is being delivered. The premise is simple: The technology that gave us the Internet and cell phones has the ability to deliver medical care in a similar manner. The how, when, and where of health care delivery could mean the workplace or the home or somewhere in between. Physicians often draw conclusions based on diagnostic tests which are performed in their offices. Onsite clinics and remote monitoring devices allow physicians to monitor medical parameters throughout the day under varying conditions of physical and mental stress.

In a March report on Bizjournals.com, Hospital Corporate of American (HCA) and Gaylord Entertainment, operators of Nashville’s Opryland and hotels in Florida, Texas and Washington, D.C., announced an agreement for HCA’s Health to You (H2U) subsidiary to provide onsite medical services to Opryland’s 4,500 employees their families and Opryland guests. H2U’s COE Yonnie Chesley, was quoted as noting both “convenience and productivity” as big incentives for Gaylord’s decision along with an expected ROI of $3-$2 to $1 projected by HCA. Along with “wellness, primary and urgent care”, the clinic is expected to deliver “occupational health, chronic disease management, labs, screenings, physicals and a pharmacy.”

Isleta Pueblo’s Hard Rock Hotel and Casino provides an onsite clinic to some 1,200 employees at its facilities located south of Albuquerque, New Mexico, which is operated by ABQ Health Partners. Without an onsite clinic, employees who became ill at work would face travel time to an urgent care facility or several hours waiting at an emergency room. The employee could face the loss of pay and the employer could face potential premium time pay for a replacement worker.

The level of care provided by onsite and mobile clinics is primary and urgent care; life threatening emergencies are referred to the appropriate facilities. InHouse Physicians, which manages various workplace clinics worldwide, provides services for worksite health centers, flu and adult vaccinations, medical support for meetings, biometric screenings, workplace wellness programs, certified health coaches, and employee wellness education.

As with any situation, all service providers must be fully vetted. While other employers may recognize significant costs savings with onsite and/or mobile facilities, each employer is different and should evaluate their economics on their own merits. Internet and cell phone technology has changed the way many everyday activities are conducted in today’s business. That same technology has the potential to make radical changes in the delivery of health care, for better or for worst.