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In 2007 Donna Milavetz, a primary care physician, embarked on an “experiment” with Susan Johnson, CEO of Futura Industries: The two created an onsite medical clinic for the employees of Futura. Would it be financially feasible—or, even better, financially advantageous? Would it improve the health and wellbeing of employees? Would employees even use it? The answer to all those questions was a resounding yes.
Seven years later, that experiment has evolved into OnSite Care, Inc., which operates medical clinics for 15 companies in Utah and Arizona.
Indeed, onsite clinics are becoming something of a trend nationwide, says Ross Fulton, operations officer of central services for Intermountain Medical Group. He says large companies in particular “are going to take a hard look and probably gravitate toward this model in the future.”
Does Size Matter?
Intermountain Healthcare operates onsite health clinics for six employers in the state, and it recently launched a clinic for its own employees as well. Fulton says companies need at least 1,000 employees to make an onsite clinic financially feasible.
Additionally, the companies should have a self-funded insurance plan. “If they’re paying premiums to an insurance company, it’s probably not in their interest to engage in an employee clinic, because if you’re fully insured, you’re not at risk—it’s the insurance company that’s at risk. So you’re paying for the cost of the clinic, plus you’re paying premiums,” explains Fulton.
Milavetz, who is now CEO of OnSite Care, says she can implement a clinic for companies with as few as 200 employees. In that case, she says, the clinic will be staffed by a part-time physician and a mid-level practitioner.
“We always like to have a physician presence in most of our clinics,” she says. “If it’s on the lower scale—meaning less than 500 employees—we tend to use more of a mid-level/physician model. If it’s more than 500 employees, we can very easily slot in a full-time physician.”
Intermountain, on the other hand, relies more heavily on mid-level practitioners, which Fulton says is typical for onsite healthcare clinics across the country.
Another consideration is geographic location. If a company is spread out over multiple locations, an employer-based health clinic will be less convenient for outlying employees.
But Milavetz has found a way to overcome this obstacle as well: She developed an employer network. For example, one of OnSite’s clients is RC Willey, which has several stores along the Wasatch Front. RC Willey employees can visit the clinic at Futura Industries in Clearfield, the Flying J clinic in Ogden, the Blendtec clinic in Utah County—or any of the other OnSite clinics spread along the Wasatch Front.
Overcoming employee reluctance to visit an employer-sponsored clinic is the biggest hurdle to launching a worksite clinic, says Milavetz. “We know it’s kind of creepy to come to work and take off your clothes,” she laughs.
To assuage fears about privacy, the OnSite clinics have outside entrances and soundproof examination rooms—and very short wait times to minimize the chance of running into a co-worker in the clinic.
“We make a large push in both the pre-marketing launch as well as post marketing to put a huge Chinese HIPAA wall around the practice,” says Milavetz. “That’s why you have a vendor. That’s why OnSite exists. Because RC Willey or Futura could go out and hire their own provider—but then it would be within their family and not separate from it.”
Milavetz says the onsite care model benefits everyone involved: the employer, employees and the physicians, who are no longer chained to a fee-for-service payment model. Indeed, without that pressure to bill for services, providers can spend 20 or 30 minutes with a patient, rather than a brisk, but more typical, seven minutes.
For the employer, medical costs stabilize or even go down. Futura Industries’ premiums have been fairly stable over the seven-plus years the clinic has operated there, says Milavetz.
After a client launches an onsite clinic, “we immediately see emergency room and urgent care visits plummet,” she says. Instead, patients are more likely to visit the clinic for routine illnesses and to better manage chronic conditions.
“If you’re having a problem, why wouldn’t you walk down the hall to ask your question?” she says. “We take away those two biggest touch points [access and cost] that create the inability to follow up on long-term care.”