Dec. 9, 2010
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Employers view workplace clinics as a tool to contain medical costs, boost productivity and enhance their reputations as employers of choice, according to the study funded by the Robert Wood Johnson Foundation’s Changes in Health Care Financing and Organization Initiative, which is administered by AcademyHealth.
Many experts interviewed for the study said most workplace clinics try to achieve a “trusted clinician” primary care model that offers much shorter appointment and in-office wait times and much longer clinician-patient encounters. Experts said that longer clinic visits allow the clinician—sometimes, but not always, a physician—to listen to patients, diagnose their conditions and discuss different treatment options with them. In addition, the clinician has time to screen for other problems unrelated to the immediate visit.
Estimates of clinic prevalence vary, with some recent employer surveys indicating that more than one-third of large employers offer onsite or near-site clinics, while another survey reported one-fifth of large employers doing so. According to HSC’s 2007 Health Tracking Household Survey, 8 percent of American families had at least one family member who had ever used a workplace clinic, and 4 percent had a family member who had used a clinic in the past year.
The availability of simple, routine care at work can be a valued perk for employees, but most experts observed that clinics’ direct cost-saving potential for employers is limited, if it exists at all. Instead, experts noted that what generates savings for employers is the ability to change practice patterns, such as drug prescribing, ordering of tests and procedures, and specialist referrals, along with the potential for early diagnosis and treatment to avoid emergency department visits, hospitalizations and other costly downstream complications.
“While well-designed, well-implemented workplace clinics are likely to achieve positive returns over the long term, expecting clinics to be a game changer in bending the overall health care cost curve may be unrealistic,” said Ha T. Tu, M.P.A., an HSC senior health researcher and coauthor of the study with Ellyn R. Boukus, M.A., an HSC health research analyst; and Genna R. Cohen, a former HSC health research analyst.
Based on a literature review and more than 35 interviews between February and July 2010 with workplace clinic industry experts and representatives of benefits consulting firms, clinic vendors and employers sponsoring onsite clinics, the study’s findings are detailed in a new HSC Research Brief—Workplace Clinics: A Sign of Growing Employer Interest in Wellness—available online at http://www.hschange.org/CONTENT/1166/. Common themes emerging from the interviews with industry experts and employers sponsoring workplace clinics include:
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded in part by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research.