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Page 1: Worksite Clinics -


Page 2: Worksite Clinics -

Presentation Goals:

1. Explain the purpose and roles of a worksite clinic

2. Discuss trends in the use of worksite clinics

3. Consider the cost and benefits of worksite clinics

4. Review various management models and service options

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Worksite Clinics: What and Why

Common goals for implementing clinics:

1. Achieve greater employee engagement

2. Integrate wellness and worksite benefit programs

3. Improve care coordination and quality; realize better

health outcomes for employees, particularly in

chronic care management

4. Increase access and convenience of health care

services; reduce lost time and absence from work

5. Lower health care cost trends

6. Boost employee value proposition, retention, and

talent acquisition

7. Manage worksite injuries and illnesses




health care

services to


at or near

the worksite

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Prevalence of Worksite Clinics is Growing

• A 2015 survey showed that over 30% of large employers offer some form of

on-site, near-site, or mobile health services

• An additional 4% of employers are implementing a clinic in 2016

• 12% are evaluating them for 2017

• Employer size ranges from as small as 250 employees to very large

populations and dependents and retirees are often included.

• Employers are eager for new opportunities for high value care for their

workforce, while improving employee access to timely and convenient

medical services while enhancing engagement in worksite programs.

Services being offered within clinics are continuing to expand to accomplish

these goals.

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Potential Savings

Case Study by QuikTrip Corporation















Retail AVG pervisit

CareATC AVGper visit

AVG savingsper visit










AVG savings per month AVG savings per year

QuikTrip Corporation, 2016

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Cost Savings and Academic Achievement

IBI Case Study 2015

Case Study by Metro Nashville Public Schools

Metro Nashville Public Schools found its onsite clinics and associated


• Generated savings of $2.8 million

• Has shown a correlation between teacher wellness ratings and

student scores on ACT national tests as it has been shown that

healthier teachers are associated with less employee absence and

better school performance.

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Key Considerations in Choosing Clinic Model

Population: Employee only, Employee + dependents, Retirees,


Staffing: Primary Care Physician, Nurse Practitioner/Physician

Assistant, Operations Manager, Medical Director

Hours of


Monday-Friday, Part-time, Flexible, Evening, Weekend

Facility Design: Square footage estimates, Location, Layout, Parking,

Public access

Plan Design: Self-funded vs. Fully insured plans, Copayments for

PPO, Ensure Fair Market Value amount for HDHP with


Scope of


Preventive Care, Acute Episodic, Primary Care,

Pharmacy, Dental, etc.

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Scope of Service Opportunities:

Acute Services Preventive Services Additional Services

Cold, Flu, Sore Throats Physical Exams Occupational Health

Fever / Infections Health Risk Screenings Safety

Skin Irritations Wellness Services Pharmacy

Bumps / Bruises Disease Management Dental

Sprains / Strains Lab Tests Vision

Cuts / Lacerations Immunizations Physical Therapy

Allergies Tobacco Cessation Telemedicine

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Types of Worksite Clinics

Aon Hewitt, 2016

On-Site Near-Site Shared


On-site of Single



Centralized location

determined by Geo Access

near Single employer

campus and/or most

employee homes

Multiple employers

sharing health center



600-1000 sq. ft.

per 1,000

employee lives

Depends on availability of

property; Larger than on-site

clinics; Frequently includes

more amenities

1,000-3,000 sq. ft.

for geographically


employee population


Three Common Models

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Factors Important to Success

Adopted from Willis Towers Watson, 2016

Effective communication of goals

with broad awareness

Strong leadership champions with

ongoing support/involvement

Superior service deliveryStrong privacy and confidentiality


Conducive plan design/incentives

Culturally compatible with


Knowledgeable and enthusiastic


Convenient location/appealing


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Management ModelsIn-house

Management Model


Management Model


Management Model

StaffingHired and paid by employer as its

own employee

Contracted directly with a health

care provider (e.g., local physician

group or hospital)

Third-party vendor hires and

managed providers and clinic



• High levels of control and

decision making

• Independence of health center

design, operations, and


• Employer has control of

operations, center design,

outcomes and specific contract


• Passes clinical risk to providers

• Experienced third-party vendor

manages health center design,

operations, personnel, and


• Vendor accepts all clinical



• Employer assumes all

management responsibility for

effective management

• Employer assumes clinical


• Needs to invest and maintain


• May create employee privacy


-Employer has less control of

personnel decisions

-Conflict of interest: if provider

works for a system, may use

health center as “feeder” into their


• Improper selection of vendor

may lead to mismatch of

culture fit and needs

• Most vendors charge on cost-

plus basis: allocated plus

management fees typically run

about 30% on top of direct


• Information on costs/benefits

may not be as transparent as


Page 12: Worksite Clinics -

Sample Clinic Design

World Wide Technology, 2016

Lab Exam Room

Page 13: Worksite Clinics -

Sample Clinic Design

World Wide Technology, 2016

Procedure Room Procedure Room

Page 14: Worksite Clinics -

Business Health Coalition’s Role

• Keep members connected and facilitate learning and best

practice sharing.

• Manage RFP, selection process, and master contract for

consultant feasibility study. Support members through the

process, particularly around shared clinic options.

• Identify clinic vendors and develop an inventory of their

key characteristics and strengths.

• Keep members connected and lend support through the

decision-making and implementation process.

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