Considering an onsite clinic.

• Author: Chan, Vickie
• Position: Solutions

A number of factors help determine whether or not an onsite clinic is a good option for your government. Onsite clinics are government-established medical offices that are in proximity to the workforce and offer less expensive and more accessible care than the typical commercial health provider. Governments that consider this option look at cost savings, of course, but they also have to consider whether an onsite clinic is a good option in the first place. Characteristics to examine include the size and age of the workforce, where those employees are located, how employees will be using the clinic, and the organization's overall commitment to wellness. But even examining these criteria won't guarantee success, so jurisdictions also need to integrate the practices that other jurisdictions have found the most effective.

COST SAVINGS

Under the right circumstances, clinics can generate substantial savings. According to one study, the average employer saves $1.60 to $4 for every dollar invested in an onsite clinic. (1) One local government's onsite clinic--in Anoka County, Minnesota (which has approximately 1,750 employees)--saw an average of 259 patient visits per month in 2014 with its "well@ work" program. The county spends approximately $280,000 per year to operate the clinic, for an average cost per visit of $89.88 for the visit, lab, prescription, and supplies. The county calculates that a similar offsite clinic would cost the county an average of $200 per visit. This equates to a savings of about $110 per visit, or $340,000 per year. For a clinic with a larger scope of services, annual operating costs might range from $900,000 to $1,200,000.

These calculations are limited to the costs paid directly for medical services, but the benefit isn't strictly financial. They can also make substantial contributions to productivity. Anoka County lost approximately 1.5 to 2 hours each time an employee went to an off-site medical provider, compared to an average of 20 to 30 minutes per appointment at the clinic. This translates into an immediate real-dollar impact for jurisdictions that have to pay for substitutes to cover employees' duties when they are out. In 2014, Anoka County estimated approximately $70,000 in savings realized from employees being out of work for shorter amounts of times when they visited the onsite clinic rather than going to a doctor's office offsite.

WHAT DRIVES SAVINGS

Knowing why a clinic can save money is as important as knowing knowing how much money it can save. Increased patient participation and compliance with treatment is a major factor. Travel is no longer a barrier to seeing a doctor or getting follow-up care. Nor are employees stymied by not being able to get an appointment, as these clinics generally accommodate walk-in patients. They can stay open on weekends and before or after work hours, minimizing emergency room visits. And since they're nearby, employees with chronic conditions are more likely to comply with their treatment plans, resulting in fewer specialist referrals and visits, emergency room visits, and inpatient hospitalizations. In Anoka County, directing...