Caring for workers

With health insurance one of an employer’s top costs — if not the top cost — businesses are constantly on the lookout for ways to save money. For some businesses, the answer may seem counterintuitive — expanding their medical offerings available through onsite employee clinics.

During a recent three-month span, the Kimberly Area School District estimates it saved more than $30,000 — or 53 percent — in health care costs with employees using the district’s clinic instead of them seeing their regular health providers, says Dawn Ludwig, director of human resources for KASD.

The KASD Health & Wellness Center, which is located in a building near the district’s headquarters, opened three years ago. Staffed by Ascension Medical Group employees, the KASD health and wellness center offers free primary care, urgent care, physical therapy, health coaching, lab work, chronic care management and other services to district employees and their families covered by KASD’s health insurance plan. An estimated 1,400 people are eligible to use the clinic.

“Our aim was to improve the health and quality of life for our employees and their families and also reduce the cost of health care and related costs over time,” Ludwig says.

An onsite clinic is an offering that employees appreciate, says Erik Ellingson, an employee at Waupaca Foundry, who has used the company’s clinic.

“In both of my circumstances, they were on the spot and got me in and out and it was a great experience in that sense,” he says. “The clinic is a wonderful asset because you show up on time and they take care of you on time. That’s not the normal experience for me with medical appointments.”

KASD and Waupaca Foundry are not alone. A third of U.S. companies with more than 5,000 employees have their own onsite or near-site clinics, according to a Mercer survey on worksite medical clinics. Another 16 percent of those with 500 to 4,999 employees have their own clinics.

Some hospital systems have corporate wellness departments dedicated to increasing these numbers.

“We’ve always said we’re trying to bring whatever services we can from our clinic onsite or near site to companies to offer better access, control their costs and ultimately reduce health care risks,” says Mark Hillesheim, Prevea’s director of corporate health and wellness.

Prevea’s average corporate partner site includes two to five rooms, two health professionals at any one time and often a receptionist. Onsite health professionals can include chiropractors, dietitians, physical therapists, nurses, health coaches, physician assistants and doctors.

Some Sheboygan corporate sites also have begun offering mental health services a few hours a week, and Prevea recently launched its mobile mammography unit at some of its corporate sites.

While Hillesheim says most corporate clients have their clinics onsite, some have them at another location, such as a nearby clinic, or share a location with other businesses. For example, in Sheboygan, five businesses share a site located in a strip mall.

Just as each employer is different, so is each clinic. At the KASD clinic, in addition to providing clinical services, the center’s health coach holds programs on wellness such as smoking cessation.

“Right now, they’re doing one for people with high blood glucose,” Ludwig says.

The KASD clinic is open about 24 hours per week, including before school and early evenings. It averages an estimated 150 visits per month.

“Our hours of operation really align well with our staff members, and it really allows that availability to go before or after school,” Ludwig says. “Those
hours make it really convenient.”

PAYING FOR CARE

Waupaca Foundry teamed with ThedaCare At Work to offer a clinic at ThedaCare Medical Center-Waupaca for its employees, retirees or their families.

Most businesses that opt for an employee clinic are self-insured, which means their health care costs  come out of their budget directly.

“We accept the risk of the volatility for health care, versus a fixed-cost insurance program where the insurance company would accept and bear the risk; there’s usually a premium above what a self-insured plan would be,” says Rob Johnson, Waupaca Foundry’s chief financial officer. “We pay every claim. Whether an average employee spends $12,000 or $15,000 per year on average, we absorb that cost.”

If Waupaca Foundry was not self-insured and used an insurance company, Johnson says it could cost the company more in the end.

Prevea’s Hillesheim says businesses save when they contract directly for services versus paying through an insurance company.

“There’s a considerable cost difference between what they paid for services with us versus what they would have paid in the regular health care system,” he says.

Johnson says Waupaca Foundry researched clinic options for a year before making a decision. “It’s not a process where you just go and within a month or two it’s in. There’s a lot of planning that needed to be done,” he says.

With health care costs rising, offering the clinic seemed like an advantage to both the company and employees, Johnson says. “It’s kind of a win-win situation,” he says.

When it comes to how businesses pay for the services at the clinic, it is based on the number of hours a clinic is open and what professionals work there rather than the number of patients. If a physical therapist is scheduled at a site, for example, the fee is the same whether one patient or 10 patients come through.

Waupaca Foundry leaders hope the free clinic will improve overall employee health, which will lead to a more productive workforce and lower health costs overall, Johnson says.

“Over a long period of time, that is going to make the employee and their dependents healthier and save money for both the employee and employer because you’re recognizing (a problem) at an earlier stage rather than later when it’s more expensive and more difficult to deal with,” he says.