The doc­tor will see you now... at your of­fice

Work­place clin­ics mak­ing a resur­gence

Modern Healthcare - - Special Report -

Em­ploy­ers are in­creas­ingly get­ting into the busi­ness of pro­vid­ing di­rect health­care to their work­ers through on-site clin­ics af­ter a sev­eral-year hia­tus when the deep re­ces­sion and un­cer­tainty about na­tional health re­form made most of them gun-shy.

Just in the past six months, ex­perts say, large to mid-size em­ploy­ers—and even some smaller com­pa­nies—have dusted off pre­vi­ously shelved plans to launch clin­ics at the work­place where em­ploy­ers can re­ceive pri­mary and some­times spe­cialty care.

Tech­no­log­i­cal ad­vances, in­clud­ing elec­tronic health records and telemedicine, have made the prospect cheaper and more ap­peal­ing for em­ploy­ers that seek to pro­mote well­ness and preven­tion within their walls.

What’s more, some em­ploy­ers are jump­ing into the fray in or­der to lock down providers that will ex­clu­sively serve their work­ers in ad­vance of 2014, when fed­eral health re­form is ex­pected to ex­tend ac­cess to mil­lions of Amer­i­cans who are now unin­sured, po­ten­tially trig­ger­ing a provider short­age.

“Health­care re­form co­in­cided with the re­ces­sion,” says Mike La Penna, prin­ci­pal of La Penna Group, a health­care con­sult­ing prac­tice based in Grand Rapids, Mich. “Em­ploy­ers were com­mit­ted to the idea of work­place clin­ics, but they needed to find out how all these fac­tors would im­pact them. Work­place clin­ics are sen­si­tive to uti­liza­tion, and with work­forces fluc­tu­at­ing dur­ing the re­ces­sion, the busi­ness case be­came softer.”

The resurg­ing trend also re­flects im­pa­tience about the de­liv­ery sys­tem, ac­cord­ing to ex­perts.

“It ex­presses dis­sat­is­fac­tion that the de­liv­ery sys­tem is not do­ing what it is sup­posed to do,” says Dr. Bruce Hochstadt, part­ner at the con­sult­ing firm Mercer and na­tional work site health prac­tice lead.

Work­place clin­ics have been around for decades, largely serv­ing as oc­cu­pa­tional health cen­ters for man­u­fac­tur­ers. All that has changed in the past five years, as more em­ploy­ers seek to build clin­ics as hubs for well­ness pro­mo­tion— pro­vid­ing pri­mary care, phar­macy, spe­cial­ist care or re­fer­rals, and even phys­i­cal ther­apy, nu­tri­tion coun­sel­ing, fit­ness and acupunc­ture.

“A lot of our clients view these clin­ics as a re­minder that we do have a cul­ture of health,” Hochstadt says. Some even shun the term ‘clinic,’ pre­fer­ring to call the on-site care a “healthy liv­ing in­sti­tute” or a “well­ness cen­ter,” he adds.

Take Cisco Sys­tems’ LifeCon­nec­tions Health Cen­ter, lo­cated at the in­for­ma­tion tech­nol­ogy gi­ant’s San Jose, Calif., head­quar­ters. The cen­ter opened in 2008 and of­fers pri­mary-care, lab­o­ra­tory and ra­di­ol­ogy ser­vices, a Wal­greens phar­macy, vi­sion care, chi­ro­prac­tic medicine, disease man­age­ment and other ser­vices. A fit­ness cen­ter and day-care cen­ter serv­ing 400 chil­dren are also on-site.

“We have a pri­mary-care model of a med­i­cal home that is ex­tended to in­clude acupunc­ture, men­tal health ser­vices and health coach­ing,” says Sharon Gib­son, di­rec­tor of the health­care prac­tice at Cisco. “Ours is an at­tempt to get em­ploy­ees en­gaged.”

The clinic serves em­ploy­ees and their fam­i­lies, who have in­surance through one of three health plans. Kaiser Per­ma­nente has a physi­cian and sup­port med­i­cal staff on-site at the clinic, while em­ploy­ees with Cigna or Unit­ed­Health­care plans see other on-site providers. The clinic there­fore uses two sep­a­rate EHR sys­tems de­pend­ing on the in­surer.

Cisco’s LifeCon­nec­tions Health Cen­ter, lo­cated at the com­pany’s San Jose, Calif., head­quar­ters, of­fers a wide ar­ray of health­care ser­vices.

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