Can Worksite Health Services Benefit Everyone?

Caution! Your health insurance premiums are likely to go up next year, perhaps dramatically.

Now, if only this kind of news was a rarity, an actual surprise, or a headline that was hard to find in current news media.

Truth is, every year you and I hope our health insurance premiums don’t go up. In my case, the company I work for, KLAS, is usually gracious to absorb most of the increasing healthcare costs. But maybe your company is not quite as generous, I hope they are.

Whatever the case may be, the majority of Americans get health insurance through their employer. On a personal level, you may seek healthcare from a primary care physician, at an urgent care facility, or (rarely, I hope) in an ED.

In the background, your employer just has to hope that you and your coworkers make (very) wise healthcare decisions so that the company’s insurance premiums can stay at an already expensive minimum.

Can’t things be better?

Worksite Health Services

In recent years, companies have been looking to innovate changes. Enter worksite health services (WHS). Instead of the traditional approach of paying premiums to a health plan, many companies (especially large ones) take on risk themselves and become self-funded.

Through becoming self-funded and by offering employer-sponsored clinics and health services (i.e., WHS), an employer organization actually becomes a payer and provider. Several of my KLAS colleagues and I have been eagerly learning all we can about WHS from industry associations, employers, and vendors, and we we've recently published a free report.

The approach most employer organizations take to WHS is to hire a services firm to run an on-site clinic on the employer’s premises (or at a near-site location). With this arrangement, employee Joe can literally stop by the healthcare clinic on his way to or from the office instead of driving across town for primary care.

He may even be able to pick up his medication on-site; many WHS setups have on-site pharmacies. Urgent care is also fairly common, and offering on-site laboratories, health coaches, and even fitness rooms is all part of what some employer organizations do.

The convenience of these clinics would be hard to overstate.

But it’s not just about convenience for the employees. Employer- run healthcare also makes a lot of sense for the employers themselves. Thousands and thousands of self-funded American companies already take on risk for their employees and by default have a vested interest in the health of their employees.

Here are three of the (many) reasons company executives look into WHS.

1. Reduced Cost

No one needs me to detail the rising costs of healthcare, medication, and healthcare insurance. Payroll is a company’s largest expense, and health insurance is a huge piece of that expense.

Through self-funding and WHS, a large employer could reasonably save $1,000 per employee per year. —For a company with 50,000 employees, those savings would add up to $50 million per year!

2. Increased Productivity

Employers know that healthy employees usually make up the most productive employees. KLAS won’t get much work out of me when I’ve got the flu, and they’d get even less from me if I had an unmanaged or poorly managed chronic condition.

This is one reason that many employers are already getting engaged in what I call “captive population health”—the employer organization’s population to keep healthy is already within their realm of influence and is already known by the company. That’s not to say that motivating or keeping an employee population healthy is an easy thing, but the opportunity to do so and the knowledge of who the population is right before you.

Small and large companies who hire WHS firms can have closer oversight and a play a larger role in their employees’ healthcare, thereby keeping employees in peak working condition.

3. Employee Incentives & Loyalty

The likelihood of an employee listening to their employer is higher than it is to a third-party organization they don’t know well. The natural incentive (at least for most workers) is clear: being responsive and responsible to the organization they work for is a top priority.

Whereas taking a call from an unknown staff at a provider or a health plan medical is not likely to be received warmly, if I were to get a message or call from employer, I would probably be incentivized to listen and act—especially if an additional motive is provided where acting on a health issue (i.e. getting a flu shot) meant a financial contribution to my health savings account.

An employer tends to have influence over its employees in ways that healthcare entities do not, thus providing an additional (or even sometimes primary) avenue to spur its employees into healthy habits. In turn, employees recognizing how the company encourages their health often return the good deed with company loyalty and more productivity.

Driven by a Mission

I recently had a discussion with a provider friend who works as a doctor at an employer worksite health clinic. A couple decades ago, he was working in a typical healthcare setting and, as he expressed it to me, hated his job.

He felt mandated to rush through patients, driven by a clock and insufficient time window to provide care in a way he disagreed with. Now, this doctor can spend much longer with his patients, advise them, and be the caregiver he wants to be. He feels that he actually contributes to keeping people healthy.

Through extensive research KLAS has done in the healthcare provider market at large, we’ve seen many organizations (slowly and sometimes very painfully) learn that population health isn’t really about running deeper analytics.

That’s a big part of it, but population health is about keeping people healthy so that we don’t have to overspend on healthcare. From what we have so far seen, most of the company executives, services firms, and physicians involved in WHS get into this market with the goal of improving the delivery and costs of healthcare for everyone.

These leaders aren’t out to make a dollar—they’re out to make a difference—and they feel that WHS gives them a channel and new opportunity to do so.