Workplace Clinics

Interest in health care services being available at or near a place of employment has been very high for the last decade.  These facilities offer the potential for lower health spending, improved worker productivity and more convenient access for employees.  Many of these worksite clinics have a relatively full range of services, including pharmacies, lab tests and they often do chronic care followup and population health activities.  Research published in the American Journal of Managed Care reports on the experience of one large employer in North Carolina.  (AJMC Report)   Workers could use the clinic as their primary care provider and the researchers compared those employees who did so with those who only used the onsite clinic episodically and those who never used it.  The primary outcome of interest was total utilization and spending.  There were demographic differences among the groups, for example only 28% of nonusers were women, and the highest income workers were more than twice as likely to be nonusers, so the analysis was adjusted for these differences.

The number of total outpatient encounters was lower for the employees who used the onsite clinic as their primary care provider than for the other two groups, and this was true for both acute and preventive care visits.  There was no significant difference in hospital admissions across all three groups.  Pharmaceutical costs were higher for the major and casual onsite clinic users than for nonusers.  Casual users had annual costs $482 higher than those who used the clinic as their primary source of care.  Dependents who were major users also had lower annual costs, with outpatient claims responsible for most of the difference.  This is interesting since one supposed benefit of easier access to primary care is that hospitalizations and ER use may go down.  But  overall, at least this employer’s onsite clinic seemed to lower total spending.