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Greetings!
I guess spring is sprung and everything that is old is in some phase of renewal. This includes the renewal of clinic and program standards and, maybe, the renewal (or non-renewal) of contracts for service vendors. If this is something that your firm is considering, you are not alone. We continue to hear tales of programs that are changing vendors. We have also been contacted recently by a couple of programs that are exploring "going it alone." In our opinion, this is a confirmation of the value of on-site programming and an indication that the employers now understand that the performance of these programs can be enhanced or diminished by the manager. Program challenges and opportunities have to be under constant scrutiny by the employer,and sometimes things have to change in order to move to the next level. Once health care is "on-site" the program must continue to evolve. Some management groups get this and are out in front of important trends. Some do not and need nudging by their clients. |
| Association Created for ON-SITE Care | | |
 The month of April has been busy. When we are not reporting news, we are making it. MBGH, The Midwest Business Group on Health and The
La Penna Group have teamed up to form the National Association for Worksite Health.
Much more information to follow, but you can read the initial press release here.
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| Teaming Up | | |
In so many things in life, there are baselines that we know to be the threshold above which we can more likely predict success. Finish college, and you'll earn more; lean operating principles usually improve profit margins; and having a thousand or more employees usually is seen as a basic point at which on-site clinics become financially feasible.
We're aware of articles by experts promoting the sharing of on-sites by more than one employer - a joint venture model. Few have been done, insofar as we are aware; however, recently we've seen articles announcing two such cooperative efforts.
One such article announced that Central Louisiana Family Health and Wellness Center opened last month for use by the employees of the Martin Companies and Gilchrist Construction Company. This clinic will be managed by First Onsite.
This was followed by the receipt of an announcement by Marathon Health regarding a collaborative clinic that has been developed for Lincoln Industries and IMSCORP. These are both industrial companies, and their locations are adjacent. The new health center will be located on the Lincoln Industries campus, and construction will begin in May. The name of the program will be Health U, and its services will be designed around the medical home model.
Hopefully, these are a forerunner of many more such efforts. They are difficult. Differences in corporate philosophies, benefit policies, etc. can be seen as a significant barrier. However, with strong collaboration and technology, those differences can be successfully overcome and the benefits of on-site clinics extended to employers with smaller work forces in place.
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Old News Worth Reflecting Upon
| | | I just saw an article from June 2009 which seemed rather outdated, at least based upon publication date, but I reviewed it anyway. This was by the Healthcare Strategy Group in a publication they call "Physician Strategy News."
The article was about the evolution of on-site clinics and, for obvious reasons, went from a discussion of the background of the development of these clinics to how they might impact physicians and hospitals. I had recently done a presentation (in collaboration with MBGH) that looks at this same issue from the employer's perspective. (If you want to take a look at another view of working with hospitals and doctors, check out www.onsiteclinics.org for a monograph on working with local providers.)
All health care is regional, and all of us live in different health care systems. What is worth thinking about, however, are the points made towards the end of the article and how those points relate to your approach to vendor selection.
We believe that physicians should look at on-site clinics as an opportunity, and employers should view the local provider group as another resource. For physicians, a well-designed program is an opportunity to do what they have been well-trained to do but had little chance -- because of reimbursement. They can care for the patient, take their time, focus on education as well as diagnosis and treatment, and look at the whole patient, not just the reason for today's visit. Their goal is different when they are in a program that is patient-focused. They do not just "get 'em in, get today's issue fixed, and get 'em out." If a doctor and an employer can collaborate for patient well- being, rather than for the immediate need for a script for today's problem, it is a win:win for them (and for the patient!).
But, the Physician Strategy News article sees the development of on-site clinics as a "threat." One which can be capitalized upon - not for professional improvement or improvement in quality but improvement in market share, improvement in compensation, and improvement by virtue of what this brings to their own businesses alone. Here are some excerpts: "Non-participants might be left with the sickest patients and government payers." On-site vendors (i.e., physician groups) gain access to a ". . . preferred status [which] will position your organization to gain share in the lucrative private insurance market." And, of course, there's the benefit that "The focus on care of chronic patients and health improvement will provide invaluable insights, insights that can be applied to all your patients." I don't see one reference here to innovation, technology, improvement in quality of care, wellness, or any of the other concepts that are core to the value of an on-site clinic.
I believe physicians are the cornerstone of an excellent on-site program, but don't let your decision about a vendor be swayed by their "big name" or "local" presence, or dozens of other reasons that have nothing to do with whether they can do the job, or not. Have they got experience, and lots of it? Can they demonstrate real progress in clinical quality measures improvement (BEFORE they experiment with your dollars and your employees)? If they are part of a health care system, are they doing it for their own employees? If not, why not?
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For more on-site clinic news, visit our Web site at www.onsiteclinics.org |
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As always, check out the upcoming slate of events and conferences. More coming out every newsletter! Sincerely,
Mike La Penna
The La Penna Group, Inc.
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