There has been a push by some large, single-campus employers in recent years to develop onsite clinics for occupational medicine and health/wellness (including urgent and primary care). The typical model has employers paying all costs associated with the clinic, as well as a set fee to the management company. In an industrial setting where an RN can provide first aid for workplace injuries and track compliance towards OSHA regulations, the model can be justified. But in office settings in which workplace injuries are unlikely to occur, and in which medical surveillance generally isn’t needed, the ROI in terms of group health insurance savings has been very difficult to prove—especially when there are in-network insurance benefits offered under the employer’s plan (meaning the employer is paying for care twice) and also when “dummy” claims have to be submitted to the plan to track utilization (negating any savings advantage). Also, many employers lack scale to run these centers efficiently, and many employees are hesitant to mix their personal and business lives due to privacy concerns. Further, it’s generally not primary care that’s driving up employee health costs, but hospitalizations and complex needs treated by specialists. And even if employees utilize the onsite center for primary care, dependent family members on the company’s insurance are still going to the local pediatrician, family practice or urgent care, not to the insured’s workplace for care.
Embedded “private label
” employer clinics with an urgent care center could be the antidote to these problems. Such facilities leverage the operational efficiencies of the urgent care’s providers and clinical support team. Swedish American Immediate Care of the University of Wisconsin, for instance, partnered with Woodward Governor (a manufacturing company) to add an employee clinic within Swedish American’s urgent care facility. There are two entrances with a front desk and waiting room—one for the general public and one for Woodward employees, both supported by an extra-large back office that shares providers, clinical staff, x-ray, and lab. Scale efficiencies are gained with the provider and clinical support staff in this model. And, because it’s at an off-site location, it’s more inviting to dependent family members and workers who may be more privacy-minded. In addition, a “near site” can be shared with other employers (becoming an “employer shared-site”), enabling a sale of this service to employers with insufficient employee headcount to justify their own on-site clinic.
Employer near-sites can be a way for an urgent care center to expand its business and solidify relationships with local employers and payers, while also negating potential competition from onsite clinics.
Alan A. Ayers, MBA, MAcc
VP, Strategic Initiatives, Practice Velocity, LLC;
Practice Management Editor,
JUCM—The Journal of Urgent Care Medicine