Worksite Clinics a Popular Way to Control Health Care Costs

While large employers are still more likely to offer “old-fashioned” occupational health clinics (31%), according to Mercer’s National Survey of Employer-Sponsored Health Plans (see Employers Held Health Plan Costs Down by Shifting More to Employees ),14% offer a clinic to provide primary care services and an additional 10% indicated they were considering providing a primary care clinic by 2009.

“Employers that offer primary care services through a worksite clinic see an increasingly important opportunity to both control health benefit costs by providing a lower-cost care option, and to improve productivity by reducing the lost time of employees seeking care off site,” Mercer said in a press release.

Three-fourths of those offering primary care clinics are “satisfied or very satisfied” with their clinics, while just 2% are dissatisfied.

Among smaller employers, about one in ten respondents (11%) share their clinic with another employer, and another 13% would consider sharing, according to the press release. The smallest employers (those with 200 – 999 employees) were the most likely to share a clinic (25%).

The survey found employers in the health care industry are the most likely to provide occupational or primary care clinics (64% and 35%, respectively), followed by manufacturers (34% and 17%, respectively). Occupational clinics are also common among wholesale/retail employers, although relatively few in that industry offer primary care clinics (37% and 8%).

The majority of survey respondents offering an occupational health clinic (69%) report that fewer than 25% of employees with access to the clinic used it in the past year. While employers offering a primary care clinic measure success by a high utilization rate, this is less likely the case for an occupational clinic. However, 20% of respondents with an occupational clinic reported a utilization rate of 25% to 49%, and a handful – primarily employers in the health care industry – said that at least 75% of their employees visited the clinic.

According to Mercer's research, employers sponsor primary care clinics to meet a range of objectives:

• 86% said that "convenience (in terms of both time and effort) for their employees" was an important or very important objective;
• 77% cited "better access to preventive care" as important or very important;
• 75% cited "encouraging employees to make better use of health/wellness programs;" and
• 74% rated "control of overall health spend" as an important or very important objective in their decision to sponsor a clinic.

Respondents were asked to rate their primary care clinic and its programs based on specific measures of success. Employee satisfaction received the highest ratings (33% rated it a 5 and another 37% rated it a 4), followed by clinical quality (32% gave it a 5 and 46%, a 4). Nearly a fourth (24%) rated their clinic a 5 in terms of ROI/medical plan savings and 19% rated their clinic a 4 on this basis.

Primary care clinics most commonly offer screenings and immunizations (83% and 81%, respectively), followed by treatment of workplace injuries and other urgent care (64% and 62%). These four services were also considered by the greatest number of respondents to be the most valued services offered, Mercer said in a press release.

More than half of respondents (59%) say their clinics are linked to wellness initiatives such as smoking cessation and weight-loss programs, and 51% say they are linked to occupational health and safety services.

Chronic disease management is offered by 40% of employers with a primary care clinic. About a third of the facilities provide lab/X-ray and pharmacy services (36% and 32%). All other service types, such as behavioral health counseling or physical therapy were offered by less than a fourth of respondents' clinics. Some large employers have opened comprehensive onsite or near-site health centers that include pharmacy, dental, vision, lab/X-ray, physical therapy, and select specialties such as gynecology or pediatrics.

Approximately one-third of respondents allow retirees, covered dependent adults, and/or covered dependent children to use the clinic. Over two-thirds of respondents say that employees from other locations are eligible to use the clinic.

Mercer's Survey on Worksite Medical Clinics is available for $25 from Tara Lewis at 212-345-2451, or online at www.mercer.com .