The Beginner's Guide to Onsite Clinics

Onsite clinics are revolutionizing healthcare delivery at work. This modern healthcare model is distinctively different from traditional care, focusing on improving access, convenience, personalization, and cost-effectiveness. Gone are the days of scheduling difficulties and long waits to see a doctor. Instead, quality healthcare is right at your fingertips.

These clinics offer comprehensive healthcare services that address preventive care, chronic disease management, and general health and wellness. For many employees, navigating the intricate healthcare system is daunting. In fact, approximately 80% of employees use few, if any, medical services in a year (Berk, 2017). The appeal of onsite clinics lies in their simplicity and straightforwardness.

Definition of Onsite Clinics: Onsite clinics are healthcare facilities located within or near a workplace, offering a range of medical services to employees and, in some cases, their families. They are designed to make healthcare accessible, convenient, and personalized to meet the specific needs of a workforce.

Types of Onsite Clinics:

1. Full-Service Clinics: These offer a comprehensive range of healthcare services, from primary care to wellness programs and occupational health.
2. Near-Site Clinics: Located near, but not within, the workplace. These clinics serve multiple employers and provide a convenient healthcare option for employees.
3. Shared-Site Clinics: Designed for organizations that want to share the costs and benefits of an onsite clinic with other nearby businesses.

Key Services Typically Offered:

• Primary Care: Routine check-ups, chronic disease management, and health screenings.
• Urgent Care: Immediate attention for non-life-threatening conditions.
• Preventive Care: Immunizations, health risk assessments, and wellness coaching.
• Wellness Programs: Nutrition counseling, smoking cessation, and stress management programs.

Onsite Clinics vs. Traditional Primary Care

You might be wondering, "My employee already have access to primary care through their health plan. How are onsite primary care clinics different?"

It's true. Health plan members can access primary care services in their community, but have you been to a doctor's visit lately? Co-pays and deductibles, long wait times, and feeling rushed during an appointment don't exactly make it a pleasant experience. And that's if you can schedule an appointment right away. In fact, the average wait time to see a new patient for a primary care appointment is 26 days, according to the AMN Healthcare/Merritt Hawkins 2022 Survey of Physician Appointment Wait Times. 

Onsite clinics are redefining traditional healthcare in many ways. Here are the key reasons why an onsite clinic is a brilliant compliment to an existing health plan. 

• Improved Access to Healthcare: A survey by the Society for Human Resource Management revealed that 76% of employees view onsite clinics as a valuable benefit that improves access to healthcare (SHRM, 2020). By eliminating barriers such as long wait times and scheduling conflicts, onsite clinics ensure prompt and convenient access to healthcare services.
• Enhanced Convenience: Mercer's 2021 study highlighted that 52% of employees with access to a worksite clinic used the clinic within the year (Mercer, 2021). This statistic underscores the convenience onsite clinics offer, allowing employees to receive care without taking time off work. This can significantly reduce disruptions to productivity and improve work-life balance.
• Personalized and Comprehensive Care: Unlike traditional healthcare settings, where patients often feel like just another number, onsite clinics provide personalized and comprehensive care tailored to each employee's individual needs. This approach not only fosters a deeper relationship between healthcare providers and patients but also enhances the effectiveness of treatments and preventive care.
• Cost Savings: Onsite clinics help employers reduce their financial burden by cutting down on expensive offsite treatments and emergency room visits. Based on CareATC’s 2019 client data, members who engaged with CareATC primary care services cost 25% less than non-engaged members. Drivers for the cost difference include 38% less ER utilization, 64% fewer hospital admissions, and 67% fewer hospital bed days. Employees benefit from significantly lower out-of-pocket expenses for routine care, making healthcare more affordable and accessible. Engaged members spend 33% less out of pocket and cost employers $2,209 less in overall health plan costs.

By integrating healthcare services within the workplace, organizations boost employee satisfaction and loyalty and contribute to a healthier, more productive workforce. Onsite clinics are not just a facility; they represent a progressive shift toward meeting the evolving needs of the modern workforce. 

Section 2: Benefits of Onsite Clinics

What is the role of onsite clinics in a modern benefits plan? For starters, attracting and retaining top talent is essentially in today's workplace. One effective strategy gaining traction among forward-thinking companies is the inclusion of onsite clinics in their benefits packages.

As we've covered, onsite clinics provide essential healthcare services and boost employee satisfaction and productivity, proving to be formidable tools in talent acquisition and retention.

It's nice to know that employees love this benefit, but what's in it for employers?

Here's a breakdown of of the benefits of onsite clinics for employers and employees.

For Employers:

• Reduced Healthcare Costs: By providing direct access to care, employers can lower overall healthcare expenses, minimize emergency room visits, and reduce claims on their health plans.
• Improved Employee Productivity and Morale: Employees with easier access to healthcare are more likely to stay healthy, take fewer sick days, and feel more satisfied with their workplace benefits.
• Lower Absenteeism and Turnover Rates: Convenient access to care leads to fewer missed days and helps retain top talent who value health and wellness benefits.

For Employees:

• Convenient Access to Care: Employees can receive medical care quickly without leaving the workplace, minimizing disruptions to their workday.
• Reduced Out-of-Pocket Costs: Many onsite clinics provide low or no-cost services, making healthcare more affordable for employees.
• Enhanced Well-Being and Health Outcomes: Access to preventive services, early intervention, and personalized health coaching helps employees lead healthier lives.

As you can see, integrating onsite clinics in the workplace signals a commitment to employee well-being, fostering loyalty and engagement. Onsite clinics meet direct workforce needs, improve health outcomes, and enhance job satisfaction. This positions a company as a preferred employer and is a vital investment in building a productive, engaged workforce.

So far, we've covered how onsite clinics promote a proactive approach to health, helping employees address health issues promptly without the delays often associated with traditional healthcare services.

Adopting onsite clinics is a strategic move towards a healthier, more productive workforce and a more sustainable healthcare budget, creating a win-win solution for employees and employers alike.

But before implementing an onsite clinic, it's important to understand your organization's unique needs and goals. Here are some key factors to consider:

• Understanding Your Organization’s Unique Needs: Every organization is different. Factors such as employee demographics, workplace culture, and specific health risks should be considered when planning an onsite clinic.
• Assessing Employee Demographics and Health Risks: Use data to identify common health conditions or risk factors within your workforce. This information will guide decisions on the types of services your clinic should provide.
• Determining Clinic Size, Location, and Scope of Services: Consider the size of your employee population and their geographical distribution to decide on the clinic's size and location.
• Evaluating Costs, Budgeting, and Potential ROI: Calculate potential savings and return on investment by analyzing current healthcare costs, absenteeism rates, and employee turnover.

Considerations for Self-Insured Employers vs. Fully-Insured Employers

Onsite clinics benefit self-insured and fully-insured employers differently due to the distinct nature of their health insurance models:

Cost Savings:

• Self-Insured Employers: Directly benefit from reduced healthcare costs as they pay for employee medical claims out of pocket. Onsite clinics help lower expenses by reducing the need for external medical services like emergency room visits and specialist consultations¹.
• Fully-Insured Employers: Do not see immediate cost savings since they pay fixed premiums to insurance carriers. However, over time, improved employee health from onsite clinics can lead to lower premiums².

Customization and Flexibility:

• Self-Insured Employers: Have more control over the design and implementation of onsite clinics, allowing them to tailor services to meet specific employee needs³.
• Fully-Insured Employers: Have less flexibility as they rely on insurance carriers to manage healthcare plans and services⁴.

Risk Management:

• Self-Insured Employers: Can directly manage and mitigate health risks within their workforce, leading to potentially significant long-term savings¹.
• Fully-Insured Employers: Risk management is primarily handled by the insurance carrier, limiting the employer’s direct involvement⁴.

Employee Productivity and Satisfaction:

• Both: Benefit from increased employee productivity and satisfaction due to convenient access to healthcare services².

By integrating onsite clinics, self-insured employers can achieve more immediate and direct financial benefits, while fully-insured employers may experience gradual improvements in overall healthcare costs and employee well-being.

References:

1. Why Onsite Clinics are a Game-Changer for Self-Funded Employers 

1. Onsite Health Clinics: Who Should Consider Them? 

1. Self-Funded Insurance Plans 101 | Self-Insured Vs. Fully ... - Aetna 

1. Difference Between Fully-Insured vs. Self-Funded Health Plans 

1. Case Study: The Impact of Onsite Clinics on Self-Funded Employers ... 

 

You've evaluated all of the key considerations and you've determined that an onsite clinic is right for your organization. There are four key steps to take to make your onsite clinic vision a reality.

Step 1: Conduct a Needs Assessment

• Gather Data: Collect data on employee health needs, current healthcare costs, and utilization rates. Conduct surveys to gauge employee interest and identify potential barriers to participation.
• Engage Key Stakeholders: Include representatives from HR, management, finance, and employees in the planning process. Their input will be crucial for ensuring the clinic meets everyone's needs.

Step 2: Choose the Right Vendor/Provider

• Evaluate Potential Vendors: Look for a provider with experience in managing onsite clinics, a comprehensive range of services, and a patient-centered approach. Assess their technology solutions, clinical expertise, and alignment with your organizational goals.

Step 3: Design the Clinic’s Scope of Services

• Determine Services Offered: Based on your assessment, decide on the services your clinic will provide—ranging from primary care to specialized programs like weight management or mental health support.
• Plan Staffing Needs: Ensure you have the right mix of healthcare professionals, such as physicians, nurses, wellness coaches, and administrative staff.

Step 4: Plan for Launch and Promotion

• Facility Preparation and Logistics: Coordinate with facility managers to prepare the physical space. Ensure it’s welcoming, functional, and equipped with the necessary medical supplies.
• Promote the Clinic: Develop a communication strategy to inform employees about the clinic's services and benefits. Use email announcements, posters, and informational sessions to build awareness and excitement.
• Launch Day Activities and Beyond: Host an open house or health fair to introduce employees to the clinic staff and services. Continue to promote the clinic regularly to maintain engagement.

One thing we want to emphasize is that the selection of your onsite clinic vendor will make or break the success of your onsite clinic. You'll want to take the time to get to know your prospective vendors, setup site visits and ask for information on how they measure return on investment. Many employers choose to conduct a Request for Proposal (RFP) process, work with a benefits advisor or simply conduct evaluations directly.

What questions should you ask an onsite clinic vendor? Here are ten questions to guide your discussion:

1. What services will be covered? Determine if the clinic will offer only occupational health services or a broader range of general healthcare services.
2. How does the vendor plan to encourage employee participation? Ask about strategies to engage employees and ensure they utilize the clinic's services effectively.
3. Who will be the care providers? Understanding who will administer care is crucial. Ensure the vendor's staff aligns with your company culture and can handle a range of health issues.
4. What is the plan for measuring ROI? Inquire about how the vendor will track and report the clinic's return on investment, including health outcomes and cost savings.
5. How secure is the data? Ensure the vendor has robust data security measures to protect employee health information.
6. What are the clinic's hours of operation? Confirm if the clinic's hours align with your employees' schedules to maximize accessibility.
7. How will the clinic integrate with existing health plans? Understand how the onsite clinic will work with your current health insurance plans and providers.
8. What technology will be used? Ask about the electronic health records system and other technologies that will be implemented to ensure efficient and effective care.
9. What is the vendor's experience and track record? Inquire about the vendor's history, client testimonials, and case studies to gauge their reliability and effectiveness.
10. What is the cost structure? Understand the pricing model, including any hidden fees, to ensure it fits within your budget.

Getting answers to these ten questions can give you the essential information you need to select the best onsite clinic vendor. 

Investing in an onsite clinic is a strategic decision for any organization, but the real measure of success lies in its ability to deliver tangible results. From improved employee health outcomes to measurable cost savings, tracking the right metrics is key to determining the value of your clinic.

Whether you’re aiming to reduce absenteeism, control healthcare costs, or boost employee engagement, knowing how to measure success is essential to ensure that your clinic is meeting its goals. In this chapter, we’ll explore the most important performance indicators and provide guidance on how to assess the impact of your onsite clinic, so you can make informed decisions and demonstrate clear value to your stakeholders.

Here are six tips to encourage successful onsite clinic management and how to measure success:

• Daily Operations Management: An experienced onsite clinic vendor will help ensure smooth day-to-day operations with the appropriate staff, streamlining appointment scheduling, and maintaining medical supplies.
• Monitor Utilization and Performance Metrics: An experienced onsite clinic vendor will help track key performance indicators (KPIs) such as employee participation rates, health outcomes, and cost savings. Use this data to make informed decisions and adjustments.
• Engage Employees Continuously: Keep employees engaged by offering health challenges, wellness workshops, and regular updates on the clinic’s services and successes.

• Key Performance Indicators (KPIs) to Track: Monitor metrics like clinic utilization rates, employee satisfaction scores, health outcomes, and overall cost savings.
• Collect and Analyze Data: Use surveys, usage reports, and health outcome data to measure success. This data will help you understand the clinic’s impact and identify areas for improvement.
• Reporting Results to Stakeholders: Regularly communicate the clinic’s achievements to key stakeholders, including management, HR, and employees.

Measuring the success of your onsite clinic is not just about the numbers—it’s about the lives improved, the costs saved, and the long-term health benefits for both your employees and your organization. By focusing on key metrics such as utilization rates, clinical outcomes, cost savings, and employee satisfaction, you’ll be able to clearly see how your clinic is making a difference.

Remember, the success of your onsite clinic is a journey that requires ongoing evaluation and adaptation. With the right approach, you can ensure that your clinic continues to evolve and provide sustainable value for years to come.

Launching and managing an onsite clinic can significantly improve employee health and reduce organizational healthcare costs, but it's not without its challenges. From ensuring high employee engagement to managing clinic staffing and navigating regulatory requirements, many hurdles can arise along the way.

Understanding these common obstacles and how to effectively overcome them is key to maintaining a successful, sustainable clinic. In this chapter, we’ll dive into the most frequently encountered challenges and provide practical strategies to help you address them.

By staying proactive and solution-oriented, your clinic can continue to thrive, delivering lasting benefits for both employees and your organization.

Challenge 1: Low Employee Engagement

One of the most common hurdles for onsite clinics is low employee participation, which can significantly impact the clinic’s success and the return on investment. Even with the convenience of an onsite clinic, many employees may not take full advantage of the services available to them.

How to Overcome:

• Promote the Clinic Regularly: Create awareness through multiple channels such as email campaigns, company intranet updates, posters in break rooms, and word-of-mouth encouragement from leadership. Be clear about the range of services offered and how easy it is to access them.
• Offer Incentives: Encourage employees to engage with the clinic by offering incentives such as reduced healthcare premiums, gift cards, or wellness challenges. Employees are more likely to participate when there is an immediate benefit tied to clinic usage.
• Solicit Feedback: Regularly ask employees for feedback to better understand their needs and potential barriers to engagement. Are clinic hours not aligning with their work schedule? Do they feel uncertain about what services the clinic offers? Addressing these concerns can significantly boost engagement.
• Host Informational Sessions: Organize “Lunch and Learn” events or health fairs to educate employees about the onsite clinic’s offerings. This provides an opportunity for employees to meet the healthcare providers and build trust, making them more likely to use the services.

Challenge 2: Initial Setup Costs and Budget Concerns

Setting up an onsite clinic can require a significant initial investment, which may be daunting for organizations, especially those with tight budgets. These concerns can include costs associated with facility setup, equipment, staffing, and ongoing operational expenses.

How to Overcome:

• Partner with an Experienced Vendor: By partnering with an established clinic vendor, you can benefit from their expertise and existing infrastructure, helping to minimize upfront costs. They can guide you through budgeting, selecting the right services, and identifying cost-saving measures.
• Explore Shared-Site Models: For smaller organizations or those looking for a more cost-effective solution, shared-site clinics can be an attractive alternative. These clinics are typically located near multiple organizations and provide services to employees from several companies, helping to spread out the costs.
• Phase In Services Gradually: Rather than launching all services at once, consider phasing them in over time. Start with high-priority services that are most likely to provide immediate benefits (e.g., primary care or preventive screenings), and then add additional services such as specialty care or wellness programs as your budget allows.
• Calculate Long-Term Savings: While the initial costs may seem high, keep in mind the long-term financial benefits of reducing employee healthcare expenses, improving productivity, and lowering absenteeism due to better health management. Highlight these savings to stakeholders to build the case for ongoing investment in the clinic.

Challenge 3: Regulatory and Legal Considerations

Operating an onsite clinic introduces a range of regulatory and legal requirements that organizations must navigate to avoid compliance issues. These can include patient privacy laws (such as HIPAA), workplace safety regulations, and licensing requirements for healthcare providers.

How to Overcome:

• Work with Legal and Compliance Experts: Partner with legal professionals who specialize in healthcare and employee benefits to ensure that your clinic complies with all applicable federal, state, and local laws. This will help avoid costly fines or litigation down the line.
• Stay Up-to-Date on Industry Standards: Regulations surrounding onsite clinics can evolve, especially with changing healthcare policies or labor laws. Regularly review industry standards and updates to ensure your clinic’s operations align with the most current rules.
• Conduct Regular Compliance Audits: Implement ongoing compliance monitoring and audits to identify any potential risks or areas for improvement. These proactive measures can ensure the clinic remains in good standing with regulatory bodies.
• Establish Clear Privacy Protocols: Ensure that patient data is securely stored and managed, and that all employees are trained on confidentiality practices. This is particularly important for maintaining trust with employees who may feel uneasy about sharing personal health information at their workplace.

Every onsite clinic will face challenges, but overcoming them is what makes a program truly successful. By recognizing potential obstacles early on—whether they’re related to employee participation, staffing, or regulatory compliance—you can take the necessary steps to address them head-on.

The key is staying flexible, seeking feedback, and continuously optimizing your clinic’s approach to meet the evolving needs of your workforce. With the right strategies in place, these challenges can become opportunities to enhance your clinic’s effectiveness, ensuring long-term success and meaningful impact on your employees' well-being and your organization’s bottom line.