It isn’t going unnoticed.   MITSLOAN Management Review recently published an article by some well-credentialed academics about on-site clinics and their benefits to everyone.   This was picked up on by the Baylor University News as well.   They pointed to a study done in 2011 by Towers Watson and the NBGH showing that 23% of larger employers already have on-sites and 12% more plan to open one this year.

The original article on the Sloan Review site states, simply and well:  “The centers we have described are successful because they were created for the right reasons:  to encourage an attitude of wellness, to offer convenient access to high-quality health care, to provide a medical home, to convey the company’s commitment to employees, to improve productivity and reduce turnover and yes, to better control health-care costs.”

So, to all of you “Do it yourselfers” out there – we tip our hat and encourage those of you sitting on the sidelines to jump in, the water’s fine.

This, of course, takes advantage of technology in ways which, 2-5 years ago, were unheard of.  In particular, the consultation process is fully integrated with the QuadMed facility EHR, making the patient’s record (before/history and after/diagnosis, treatment plan) immediately available to all who need it in a secure process.   Leading vendors in the on-site field are creating an ever-changing environment which only continues to get better – more efficient, more cost effective, more convenient, and higher quality.

Ultimately, the paper concluded that additional research would refine knowledge further to identify the models which will be most effective for specific groups of patients and sizes of practices.  To see the paper, follow our link.

Also interesting are many of the comments posted by readers of the article at Kentucky.com – the skeptics and cynics really make their voices heard.  What is unfortunate is that so little “education”  has been provided to the general public about all the positives associated with these clinics – improved health and well-being, cost savings which are passed along to employees through keeping premium sharing as low as it can possibly get, improved quality of care, incentives and encouragement in developing and maintaining healthy life-styles, no wait at the physician’s office (for me, that would be enough of an incentive to use 0ne – who hasn’t waited for an hour at a physician’s office for apparently no reason?).

Taxpayers could be better informed about how this works.   Any savings the governmental unit achieves are, in theory, savings to the taxpayers ultimately – at the very least it frees up dollars for other public services.

Birmingham (Alabama) Water Works will open a clinic, under a contract with HealthStat, in the first quarter of 2012.  They are projecting total savings of about $4,000,000 over a five-year period.

The Lee County school board (Florida) is exploring the concept of on-site clinics for their employees – up to potentially four sites (due to the size of the county and the employee population).  The board considered partnering with Lee Memorial Health System (which apparently has four clinics already for their own employees).  Ultimately, more planning must be done before a final model can be approved, but the County appears to be ready to take those steps.  (I think I sense an opportunity here for vendors.)

It was projected by Mercer that only about 15% of eligible participants would use the service in the first year, but approximately 25-30% have actually done so, a significant increase over expectations.

This is part of a recent movement by large employers to contract directly with large health systems for specific services in an effort to do as PepsiCo has done – predict costs and improve quality.  One of the barriers, of course, is getting employees to travel away from home for a medical procedure.   The financial incentive is that PepsiCo (and other employers) are waiving all copayments, deductibles, and funding the travel expenses.  Obviously, this must make good business sense for the employers to set-up these arrangements when you factor in the new costs the employer picks up and the initial expense of analyzing data and negotiating the contracts.

PepsiCo already uses Johns Hopkins to manage some of their on-site clinics.  The evolution of on-site care just continues.