Everybody has a trade association and they usually put out some useful information. In the 1950s large companies often had medical facilities on site. The trend faded with the growth of private insurance, but has re-emerged in the last decade as employers saw the convenience, productivity and cost benefits of having a health clinic at offices and plants. These centers have increased not only in numbers but in sophistication, beginning to offer not just primary care, but some specialty services, diagnostic tests, ancillary services like vision or dental, monitoring chronic diseases, providing prescription drugs and even offering some therapies. The National Association of Worksite Health Centers surveyed employers to learn more about their onsite clinics. (Survey) The survey included 255 companies, 116 of which had a health center. Most of the clinics were at employers with over 1000 employees and they were found across all segments of the economy, but particularly at manufacturers, where they may also assist with workers’ compensation needs. The top reasons for having a clinic were cited as reducing medical costs, improving worker health, increasing productivity and increasing engagement in health. Low-rated reasons were to reduce the use of specialists, to reduce the use of outside occupational health and medical services and to reduce pharmacy costs.
Almost all clinics are located at the worksite, but a few are nearby, usually within two miles. Most centers are open more than 40 hours a week and most are open during work hours. The HR department oversees the clinic at over 70% of employers. About 80% of the centers offer acute care, emergency or first aid, occupational health, wellness services and preventive services. Most are staffed by a nurse practitioner or physician assistant, although most very large employers have a physician present. About 50% have a full retail pharmacy and another 50% offer prepackaged medications. Telemedicine is also used by many for behavioral health and wellness services. Most employers waive copays for use of the onsite clinic. Larger employers are likely to contract with a provider to run the center, companies under 10,000 employees are more likely to contract with a vendor or self-manage. Claims from the clinic are often not submitted to a health plan. Many do not say that the clinic achieved goals like reducing utilization or medical costs, most find that there was reduction in time off to visit providers and saw reduced ER use. But almost all felt that their wellness and health improvement objectives were met.