Onsite clinics boost employee health
Employer integrates wellness, occ health
When an employee isn't feeling well at an Erickson Living retirement community, she or he pops into the on-site clinic. She also can go to the clinic for a mammogram referral, or a wellness checkup, or a weight-management class. And that's the same place they will go if she needs an injury treatment, return-to-work assessment or a flu vaccine.
The average time for anything but a complete physical is 30 minutes, and even that is less than an hour.
By integrating wellness, sick care and employee health, Erickson Living has saved and increased employee satisfaction. But the national provider of long-term senior living, which is based in Baltimore, MD, also has proven the feasibility of integrated employee health care.
Over the past six years, Erickson Living's employee health care costs rose only 3.9% compared to an average of 5.6% nationally, says Craig D. Thorne, MD, MPH, MBA, vice president and medical director of Employee Health & Wellness for Erickson, which is based in Baltimore. The lower costs keep the health benefits affordable to the company and employees.
"It's part of the health and wellness philosophy of our company. We recognize caring for the health and the well-being of our employees is not only the right thing to do, but it is also a good long-term company investment," he says. "It reduces our long-term health care costs. Also, it has a direct impact on the quality of the services we provide to the seniors that we serve".
"Healthy employees can provide a higher quality of services," he says.
Erickson Living launched the onsite health clinics in 2007. But having the clinics gives the company a unique advantage as the nation transitions to life under the Affordable Care Act, says Thorne.
The ACA creates incentives for preventive care and better management of chronic conditions. In accountable care organizations, networks of hospitals, doctors and other providers, payments will be linked to improved functional outcomes.
Clinics prevent ER trips
Employees have embraced the accessibility of the clinics. In 2012, there were more than 22,000 visits to 13 Erickson clinics; about four in 10 of those visits involved occupational health issues. (There are now 15 clinics and Thorne predicts higher total visits for 2013.)
The clinics ask employees where they would have gone if they didn't have access to Erickson Living onsite clinic; about 25% to 30% respond that they would have gone to an emergency department.
"Emergency rooms are three to four times the cost of an office visit. We're saving three or four times the cost by having the services done on site," says Thorne. "We're also saving at least three hours of lost work time which is important to productivity."
Employees don't need to pay a co-pay if they belong to Erickson Living's self-funded health plan. Other employees pay only a $20 flat fee for the services, including lab tests.
The clinics are staffed by nurse practitioners or physician assistants. "We don't consider ourselves to be their primary care provider," says Thorne. "If there's a serious or chronic health condition that's found, we help them find a primary care doctor."
They have uncovered numerous issues, such as arrhythmias, very high blood pressure, an evolving stroke and a leaky heart valve, enabling employees to get prompt treatment and avoid more serious problems.
The clinic services — and health insurance coverage — are available to all employees regardless of their insurance status, number of hours worked and duration of employment; and health insurance benefits are available to part-time and flex-time employees who work at least 30 hours per week, in keeping with the provisions of the Affordable Care Act.
Wellness incentives, too
Erickson Living has integrated its wellness program with the onsite clinics. A personal nurse health coach works with employees with chronic diseases or health risks, and health advocates help employees find a doctor and manage health insurance issues.
Every clinic has smoking cessation and weight management programs. Employees can receive a $10 discount every pay period off their health insurance premium cost if they are tobacco-free and participate in biometric screening and a health risk assessment.
They also can receive reimbursements of up to $240 per year for wellness expenses through their personal wellness fund for expenses such as gym membership, weight loss programs or home fitness equipment.
Another advantage of onsite clinics may become apparent as the nation's health care environment evolves under the ACA. An increase in the number of people with insurance and an emphasis on preventive care will place a greater demand on primary care, Thorne notes.
"Quick access to quality care will be an even greater benefit for Erickson Living employees," he says. And early diagnosis and treatment of disease will lead to lower health care costs for the employer.