The Next Step

How to maximize the benefits of an on-site clinic

The on-site clinic model - a quick care center that focuses on primary care, workplace wellness screenings, disease management and any acute colds, pains, etc. - is still somewhat of an unknown for small and midsize employers.

Typically, on-site clinics are utilized by large employers, so employers with less than 1,000 employees may think it is too expensive or too much of a startup expense. But that doesn't have to be the case.

Dr. Ken Rybicki, an internal medicine specialist who runs several on-site clinics, says employers can put together an on-site clinic for less than they might think, while designing a plan that gets people to participate and become healthier. This in turn decreases claims and saves money.

"A business doesn't need a full-time clinic. I have a company with about 30 employees that I go to once a month and one with 75 I go to twice a month," Rybicki says. He also works with a company that has 600 employees and has a three-room medical center staffed 25 hours per week by himself or a medical assistant.

"It does not need to be a full clinic," he says. "I transport the things I need, like my blood pressure cuff. Companies don't need to spend a lot of money - as long as I have a room to use and computer access, I am good to go. You don't need to have 5,000 employees and a full-time medical clinic. There are ways to do it on a smaller scale and still provide what employees need."

How do on-site clinics benefit both employers and employees?

The big advantage is the clinic is right there for people. Minor ailments can be cared for on-site, preventing employees from needing to leave work to go to the doctor. If someone needs a follow-up, he or she can come in on a break, and these visits are at no cost to the employee. On-site clinics also are able to take care of people quickly, which improves work performance and stops absenteeism and presenteeism - being present at work but not feeling well.

On-site clinics are convenient and keep people at work so they can continue to be productive. It also gives employees the sense that the management cares about them from a recruiting and retention perspective.

What are some specific ways on-site clinics help cut health care costs?

On-site clinics allow you to get very aggressive about identifying conditions like high blood pressure, asthma, heart disease or diabetes, for health plan members. You can then take an aggressive stand on treating these conditions on-site to keep them healthy and manage their cholesterol, blood sugar, blood pressure and overall health targets with testing and management.

On-site clinics can be highly successful in terms of employees and spouses reaching their desired health parameters. And in doing so, that saves employers funds because it reduces health care claims. There are not as many emergency room visits, heart attacks, etc.

Beyond checkups and treatment, how do you recommend business owners take the next step with wellness and prevention?

Employers should work with their insurance broker. If they have access to a particularly good broker, the representative will know about those resources and can help tailor their plan. You want a flexible plan that is made to work for any individual company.

What's the best way to tie different health care management programs, like pharmacy, to an on-site clinic?

It can be done automatically. In my group, we have a pharmacist who looks at the pharmacy benefits and counsels us on everything from formulary to medication compliance reports. So, ideally, you want to choose a group that automatically does that as part of its on-site commitment. You can set it up so the clinic uses one pharmacist and medications are delivered on-site.

Do you have any other advice for employers?

You have to go a step beyond just doing a health fair -and checking people's blood pressure, blood sugar or cholesterol. You need to aggressively follow up and treat these conditions on-site. The only way to make a difference on cost and benefits is to get those under control, and you can't do that unless you have somebody right there working with employees.

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