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Greetings!
In this newsletter edition we will be writing about two employers and their on-site efforts. One, the City of Lakeland, Florida, opened an on-site clinic for its employees using Healthstat as the vendor. The clinic just opened in 2007, and since then, many other Florida governmental units have followed suit. The second employer, Quad/ Graphics (whom we have mentioned numerous times in previous newsletters), opened its first on-site offering in 1990, 20 years ago.
We think there is value in talking about each of these clinics here. For those of you still on the fence or just dipping your toes in the water, look at what Lakeland has been able to do in just under four years. For those of you with more mature programs, or headed in that direction, the QuadMed model offers stunning evidence of how the evolution of the service has impacted employees and costs (an inspiration for those of you still in the Lakeland phase).
If you are interested in an on-site program of some kind, there is ample evidence to suggest that it works. If you have a program, now is the time to optimize it.
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| Governmental Units Opening More On-Site Clinics | | |
It was reported recently in the online publication, "Government Technology," that more and more governments are looking to on-site medical clinics as a strong means for reducing costs and improving employee health. Having tried all the standard things, like increasing the portion of the premium paid for the employee and switching to higher co-pay and deductible plans, employers have hit a wall in terms of what they can do to reduce or control healthcare costs. Voila! - enter the on-site clinic.
And that's what the city of Lakeland, Florida, did back in 2007. With the help of Healthstat, which now operates 300 clinics (of which 15% are owned by governmental units), they opened a clinic using a renovated conference room in an existing building. In the first year, a spokesman said that the clinic saved the city $1 million.
Now in it's fourth year of operation, the clinic performs pre-employment physicals, handles on-the-job injuries, and provides episodic care for acute needs, as well as wellness and preventive programs. However, the clinic remains ". . . a facilitator between our employees and medical facilities." The city does not operate the clinic (yet?) as a replacement for primary care.
Kudos for all these governmental units and other employers who have recognized the value of on-site services and are pursuing them in their efforts to ". . provide them (employees) with an avenue that is easily accessible and doesn't cost them anything."
The interesting thing about the governmental entities are that they move in herds. Once a city or a university begins to show performance, there are many who will follow. We have examples of school systems and Federal agencies, universities, and entire states (Tennessee). If there is a muncipal or a publicly-sponsored organization that is considering the process of on-site health, they will probably go the "vendor route," and a few of the vendors have begun to specialize in this area of development. This is a very interesting place for initiating health care services since some of the ERISA limitations may be applied differently. |
| Case Study: Organized Health Care Delivery System |
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The format of this newsletter will not allow us to completely review the 12-page case study referenced above which focused on the efforts of Quad/Graphics and its subsidiary, QuadMed LLC, to develop a full-blown, on-site service and patient-centered medical home for it's nearly 9,000 employees and dependents. However, we're going to give it our best shot and encourage you to review the entire study at the following link.
The Institute for Healthcare Improvement chose 15 health care organizations to study and serve as "prototypes" for what they call their Triple Aim initiative. By studying these 15 organizations, the Institute hopes to understand and share their experiences in promoting "transformation" in health care delivery. The Triple Aim itself has three objectives "which fosters innovative approaches to improving population health and patients' experience of care while lowering. . . the per capital cost of care."
So, what is it about Quad/Graphics, through QuadMed, that makes it worthy of study? Even back in 1990 when they opened their first clinic, one of the primary focuses was on prevention and developing and maintaining employee trust with respect to confidentiality of care. As their system has developed and matured, it has also focused on "evidence-based practices" (see our Web site for a recent study on the use of evidence-based medicine and its acceptance by patients) and managed to successfully implement its use. When comparing the acceptance and use of evidence-based care at QuadMed clinics with national benchmarks, QuadMed consistently has outperformed the national numbers for things like diabetes, hyperlipidemia, and hypertension. And during this development, the annual savings in health care costs per employee have gone from $500 per employee per year in 1991 to $2,500 per employee per year in 2008 when compared to the costs of other Midwestern employers.
QuadMed has used an electronic medical record and maintained their own care management department almost from day one. This - along with a professional staff that is compensated to provide the right care at the right time and to treat not just the patient's immediate problem, but the whole patient at each visit - has combined to position it as an "accountable care organization" capable of reforming the entire delivery of care system for its employees and their dependents.
Our commentary here does not begin to cover what employers like Quad/Graphics, Rosen Hotels, Perdue Chicken, and Pitney-Bowes have accomplished in the field of on-site medical care. But, we hope you get the message. You have to start somewhere (like Lakeland did) and there is much, much more that can be done over time.
There are great vendors out there who can help - but there is also the potential (like the companies we mentioned in the previous paragraph) who just move forward and do it themselves! |
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Conferences - Boston and San Diego |
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After a busy summer, future newsletters will highlight the many ideas and presenters from some of the conferences which have occurred that focused on the concepts of on-site, workforce-driven, healthcare. The topics ranged far and wide, but there were some common themes -the search for ROI, the impact of health care transformation, care management, employee engagement and clinic performance parameters.
I will make a quick comment here on participation at the recent conferences - the vendors have lost interest. Booths and sponsorships are down...interest by employers is not. The meetings do not seem to be enjoying the support that they once had from the provider community. This is to be expected, and it is actually a positive trend.
Attendance by interested employers at the conferences seems to be strong, however, with lots of new faces and new stories. In the next couple of newsletters we will start to share some great examples of what is happening out there. |
| For more on-site clinic news, visit our Web site at www.onsiteclinics.org . | |
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ON-SITE CLINIC NEWSLETTER