Onsite Health Clinics THE PAST, THE PRESENT AND THE FUTURE
Session Objectives Understand the healthcare landscape Identify the trends in onsite healthcare Highlight the benefits an onsite clinic with employer driven scope of service
Dramatic changes in U.S. healthcare costs $$$$$$ $$$$$$ $$$$$$ $$$$$$ 9% increase in 2008 U.S. healthcare expenditures; costs expected to double by 2018 1 50% projected increase in total U.S. pharmaceutical spend to $355B in 2015 1 95% of every $1.00 spent in the U.S. on healthcare is for treatment; only 5% for prevention 1 27% shortage in primary care physicians forecasted by 2025 2 1. Centers for Medicare & Medicaid Services 2. Health Affairs 3
The importance of access Access to on-site care in a work environment can help offset challenges associated with care shortage. Access Absenteeism Presenteeism Time away from work Recovery length 4
Trends that are leading to employer challenges/opportunities Changing practice of medicine Refinement of patient care Legislative and regulatory uncertainty Health Technology Employee value proposition
Why an onsite clinic? Turnkey solution for an employer Aligned with benefit plan Employees face stressful workloads Unwilling to leave worksite for medical attention PCP shortage 6-8 minutes for provider visits Sick care delivery system Preventive care missing
Evolution of onsite services Occ health center safety driven Basic Acute & Episodic Care (NP or RN) Integrated Occ and Non-Occ MD staffed expanded PC Patient Centered Medical Home (PCMH)
Features of an onsite clinic Often evolve from legacy occupational healthcare Begin with a limited scope of services offering (safety/first aid) Non-occupational services introduced as urgent care and wellness Service expansion follows as demand and population needs shift May incorporate pharmacy or pre-pack Staffed with mid-level practitioners or a mix of physicians and mid-levels Increasingly driven by desire to reduce lost time and absence Provide access and convenience and generate financial returns / ROI Integrate care/health management (wellness, lifestyle and condition management) with care delivery Either dedicated onsite health coaches and educators Clinicians trained in motivational interviewing Towers Watson 2015 data
Occupational Health Scope of Services Injury diagnosis and treatment, musculoskeletal evaluation Emergency care services Medical surveillance, OSHA regulatory compliance & record keeping Ergonomic assessments Case management & Return-to-work Pre/post-employment exams Drug/alcohol testing; access to a Medical Review Officer PT & OT services Consultative discussions on services needs Non-occupational illness care and Preventative Care
Acute/Episodic Care - Scope of Services Acute healthcare, symptom treatment and management Lab work, immunizations, vaccinations and allergy management Preventive health examinations Travel medicine Health and wellness programs, including Preventive exams and biometric screenings Executive physicals Referral management for specialized treatment programs Allergy injections and immunization programming
The Patient Centered Medical Home Typical Services Acute & Episodic Care Preventative Services Treatment of chronic conditions with PCP Community Integration/Care Coordination Wellness Coach / Condition Management Nurse Occupational Health Support Ancillary Services
Impact of the Patient Centered Medical Home Stronger relationships = higher treatment plan adherence Fewer hospital days, fewer ER visits Higher satisfaction levels for patient, providers, staff Foundation of the Medical Home model of care focuses on: Patient and provider relationship Continuity of care Comprehensiveness of care Accessibility Quality
Benefits of an onsite health center Convenience for employees Mitigate Medical Cost Trend for Self Insured Employer Increase in productivity due to lower absence Health outcomes improvement Higher quality of care Employee recruitment tool and retention vehicle Serve as a hub for referrals and direction of care
What s next? Robust Ancillary Services radiology, dental, vision, behavioral Near Sites Telehealth
Questions?