Clinic Planning Guide


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The number of employers adding near-site or onsite clinics continues to climb, with over half (54%) offering the benefit in 2018. Both large and midsize employers are recognizing the benefits of lower costs, improved productivity and happier employees through customized onsite or near-site solutions. How can your workforce benefit? 

This comprehensive resource covers every stage of considering and implementing an onsite or near-site clinic - from researching benefits to goal-setting and measuring return on investment. 

 

1. Benefits of onsite or near-site employer clinics

Think about your last doctor's appointment. Chances are you waited a while to be seen, spent just a few minutes with your doctor and received a large (and likely confusing) bill afterwards. You're not alone. This all-too-common experience bring three problems to the forefront: 

  • Poor patient experience 
  • Fragmentation and time constraints that keep employees from getting the right care
  • Uncontrollable costs for employers and employees

These three problems together create a significant financial risk for employers. When employees dread going to the doctor, whether because of long wait times or costly bills, they tend to avoid necessary care. In fact, nearly one-third of respondents in a recent national survey reported avoiding going to the doctor, even those diagnosed with major health problems or were experiencing worrisome symptoms. 

This trend leaves self-funded employers at an increased risk for future catastrophic claims; for example an employee displaying symptoms of diabetes but does not receive care until emergency intervention is needed.

Furthermore, both employers and employees run the risk of overpaying for healthcare claims when transparent pricing data isn't available or considered in the referral process. It's common that employees are unnecessarily referred to more expensive care due to fragmented technology and misaligned referral structures between providers.

Employer clinics offer a comprehensive solution

Both near-site and onsite health clinics offer solutions to the problems facing employees and employers. Instead of spending valuable time away from work, waiting for an appointment and deciphering the bill that comes afterward, employees receive convenient, trusted care from a clinician or physician who knows your health plan and refers care accordingly. In a 2015 survey a nation-wide survey, employers reported their clinics were "successful" or "very successful" in key areas:

Onsite health clinics - Employer Guide

 

In addition, employers with clinics in place report the following:

  • Better access to high-value care: 

Employees receiving the wrong care at the wrong facility puts health and finances at risk. Clinicians and physicians become the point-of-contact for your employees, and refer and coordinate care with complete pricing transparency. Having the clinic onsite or nearby eliminates barriers like access and commute time, while day-of appointments and virtual visits make using the benefit easy.

  • More ability to control healthcare spend:  

Onsite and near-site clinics drive savings in a number of ways: reduced absenteeism, improved retention, reduction of catastrophic claims among the options. An immediate and significant benefit is the ability for clinicians and physicians to provide independent guidance to your network's most competitively priced facilities when needed.

  • Improved management of chronic conditions 
Almost 90 percent of healthcare spending can be attributed to chronic disease. In addition to managing episodic acute care, clinicians work with employees to manage diagnosed conditions and mitigate long-term risk for developing complications. This not only improves your bottom line, but helps employees stay well.

  • Increased productivity 
63% of employers say their clinic has successfully reduced lost work days. Between improving the overall health of your workforce to eliminating hours spent commuting and waiting at the doctor's office, these minutes add up.

  • Earlier intervention 
Earlier intervention is critical in managing spend and improving health outcomes. 77% of clinics offer biometrics screenings, and leading clinics use integrated data to aid in early identification and risk reduction.

  • Stronger competitive positioning 
Employer clinics help attract and retain top talent. Glassdoor’s 2015 Employment Confidence Survey found that nearly 80% of employees would choose additional benefits, the majority citing healthcare specifically, over a pay raise.

Additional resources:

 

2. Integration with existing benefits

Adding an onsite or near-site clinic can significantly strengthen your overall strategy, and can be done without switching carriers or benefits brokers. 

Employers often see near-site or onsite clinics as a welcome addition to their existing benefits, allowing them to further attract employees and gain control over healthcare costs.

Consult with your chosen onsite clinic vendor or benefits broker to explore how the clinic will impact a high-deductible health plan, health savings accounts and how you will want to integrate clinic outcomes into your ongoing claims analysis. 

 

3. Direct primary care (DPC) in near-site clinics

In the past, the benefits of employer health clinics were reserved only for those large enough to support a clinic onsite. Today, employers of all sizes are reaping the benefits by adopting a near-site approach, where direct primary care (DPC) is delivered by physicians in multi-employer or shared clinics located near participating companies.

The DPC model is anchored around an independent physician who creates a personal, trusted relationship with each patient, delivers quality primary care and lowers costs. Employers enjoy all of the benefits previously outlined, and are able to completely replace an ineffective primary care system with one that is completely focused on caring for your workforce.

The DPC clinic model is also cost-effective. It complements an existing group health insurance plan, and employers bypass insurance companies to pay for care directly. In addition to managing potential catastrophic claims in the future, employers can achieve up to a 20% reduction in total healthcare costs.

The experience provided through direct primary care is fundamentally different. A smaller patient pool (typically 800 depending on membership age) and lower administrative burden allows physicians to spend as much time as necessary with each patient – whether it’s a 45-minute discussion of multiple issues or a quick phone call. Clinics also accept same-day appointments.

 One story from a DPC clinic patient:

 

 

Additional resources:

 

4. Choosing your clinic type

While the goals and benefits of both DPC and onsite clinics may be the same, choosing the right onsite care model for your workforce will drive utilization, ensure buy-in and ultimately fuel cost savings. 

If you have a high concentration of employees in one location, you may consider a clinic that’s part of your worksite or campus. If employees are spread out among multiple locations, or if you have a smaller concentration of employees per location, a near-site clinic shared with other area employers may be the best fit. Depending on your workforce, multiple clinics or a blend of the two approaches may be the best strategy.

 Additional resources:

 

5. Goal-setting

Before launching your clinic, define your company’s health and financial goals. Use them to drive vendor evaluation and design clinic initiatives. 

Work with your human resources, financial and benefits teams to determine what matters most to your workforce. Possible goals for your clinic include:  

  • Reducing your company’s overall healthcare costs
  • Reducing your company’s risk for catastrophic claims
  • Improving productivity and reduce time away from work
  • Recruit and retain top talent that gives you a competitive edge
  • Improve lab values of your workforce
  • Reduce emergency room admissions
  • Increase the percentage of members compliant with preventive screenings
  • Improve medication adherence among those diagnosed with a condition

 Your team may also have goals for employee engagement, especially for highest-risk members. For reference, employees with chronic conditions visit Healthgram clinics an average of 5.3 times per year.

 Additional resources:

 

6. Employee experience

As we've covered, employee experience drives clinic utilization, which in turn drives savings. Building trust and rapport is critical.

One patient's story:

 
 
When it comes time to drive utilization of your clinic, consider the following tips:
 
Define what creates an exceptional clinic experience for your employees. Popular features and benefits include no wait times, having more time with their doctor, convenient access, same-day appointment and no co-pays.
 
When announcing or reminding employees about your clinic, use clear language that leads with these benefits and make the desired action clear. Make sure your clinic's location, phone number or physical location can't be missed.
 
It's also a good idea to take inventory of your existing benefits communication strategy to see how reminders about the clinic can fit in. Consider involving executive team members or department leaders. Personal stories and experiences are also always motivating.
 
Additional resources:

 

7. Measuring clinic ROI

It's well-documented that onsite and near-site clinics can help employers recruit talent and improve employee health. But recent research shows that 53 percent of employers sponsoring onsite health centers don't know or don't track ROI.

Determine how you will measure clinic success by reflecting on your goalsIf attracting talent is less of a consideration than cutting costs, focus on data illustrating how the onsite clinic impacts absenteeism, ER or urgent care utilization, hospital admission rates and referral savings; use that data to develop initiatives that will help improve those metrics. If improving employee health is the goal, focus on metrics such as the percentage of staff compliant with preventive screenings and track the long-term impact of an onsite clinic in improving health outcomes for the highest risk employees.

Common categories for measuring financial impact include:

  • Direct clinic services savings
  • Referrals avoidance
  • Employee productivity savings
  • Reduced employee absenteeism

As your vendor research develops, pay attention to how vendors measure financial and clinical outcomes. Their process will be pivotal to how you report a return on the clinic investment. Be sure you are confident in their methodology, and most importantly, that the metrics shown help you accomplish organizational goals. 

Regardless of which metrics are most important to you, it’s essential to ensure that data is accessible to your team so they can use it to create actionable objectives.

Additional resources:

 

8. Vendor selection

To ensure your clinic is a cost-saving investment in the health of your workforce and not an expense threatening the bottom line, it's essential to choose the right clinic vendor.

Conducting interviews with current clients and/or existing clinical staff will assist in supporting your confidence in a vendor’s service, support and success in achieving your goals. In addition, we recommend focusing your evaluation in three categories:

Defining success: How does this vendor measure success? Ensure alignment with your original goals.

Software and data: Which software platform will power your clinic? It's important that this platform is user-friendly for clinicians and comprehensive for you to see the impact.

Ownership and structure: Mergers and acquisitions continue to blur the lines in a consumption-focused healthcare landscape. Ensure alignment with your chosen vendor on ability to meet your defined goals.

Depending upon your internal decision-making process you may distribute a Request for Proposal (RFP) to select vendors. Access commonly requested materials and vendor interview questions in our printable clinic guide.

Additional resources:

 

Dive deeper into the details with our employer clinic planning guide. Download now:

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