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Clinics lower emergency room and inpatient facility use
Nearly four in 10 large U.S. employers with onsite health facilities plan to add new centers over the next two years, with the aim of improving the health and productivity of their employees, the Towers Watson 2015 Employer-Sponsored Health Care Centers Survey shows.
A majority of employers that already have onsite or near-site health facilities, or are planning to implement them, share these objectives for their centers:
• Increase employee productivity (75 percent).
•Reduce health care costs (74 percent).
•Improve employee access to convenient health care services (66 percent).
Nearly all of the centers report offering a similar range of primary care services. Topping the list are:
•Immunizations (99 percent).
• Care for acute conditions such as upper respiratory infections and urinary tract infections (99 percent).
•Blood draws (95 percent).
“For employers with a critical mass of employees in one or more locations, onsite and near-site health centers can be an integral component of a high-performance health care program,” said Bruce Hochstadt, M.D., senior consultant at Towers Watson, in a news release announcing the findings. “Encouraged by their experience to date, many employers with these centers believe providing convenient access to health services increases employee productivity by reducing time away from work.”
By 2018, two-thirds of survey respondents expect to expand or enhance the already-broad services they offer in the following areas.
• Wellness initiatives. Employers expect their centers to play an even greater role in managing employee wellness programs, which are currently provided at 86 percent of centers.
• Pharmacy benefits. Half of employer-sponsored health centers now offer some type of pharmacy services, a considerable increase from 38 percent in 2012. “Pharmacy services interest employers because they offer convenient access to prescription drugs for employees, encourage medication compliance, and help decrease overall medical and pharmacy spend,” said Allan Khoury, M.D., senior consultant at Towers Watson.
• Telemedicine. More than one-third of the centers (35 percent) offer telemedicine services, with another 12 percent planning to in the next two years. “Telemedicine and onsite health centers are perfect complements,” added Khoury. “They help employers make it easy for employees and other eligible members to see a doctor and get informed medical expertise—even on evenings and weekends. They also support an overall employer strategy of keeping workers productive and eliminating wasteful costs such as unnecessary emergency room visits.”
Outsourcing to vendors is the most popular option (64 percent) for managing staffing and services at the health centers. Roughly one-quarter of survey respondents report that they run the centers themselves, and almost one-fifth use local or regional provider groups or health systems.
Given cost-control pressures, more employers are now measuring their centers’ return on investment (ROI). Seventy-five percent of employers with onsite health centers calculate their ROI, up significantly from 47 percent in 2012. However, just 12 percent of employers have the analysis performed by an independent third party; 33 percent use their vendors, and 30 percent rely on internal staff analysis.
Employer-sponsored health centers’ ROI is highly dependent on employee use and staffing levels—for example, clinics increase preventive care costs while decreasing emergency department and inpatient use. Employees with higher health-risk scores are more likely to use the employer-sponsored health center, and using the center to refer them to a preferred network of specialists can lead to substantial cost-savings.
Other notable survey findings include:
• The more, the better. Of employers that sponsor onsite or near-site health centers, 40 percent have two to five centers.
• Staying power. More than half of employers (56 percent) have had onsite health centers for over five years.
• Accessibility is essential. Many centers offer employees access during extended hours: 55 percent are open before 8 a.m., 32 percent are open after 5 p.m., and 16 percent are open on weekends.
The survey was conducted with mid- to senior-level benefit professionals from 137 U.S. employers in February and March 2015.
Stephen Miller, CEBS, is an online editor/manager for SHRM.
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