The Worksite Clinic Conundrum

We Have a Problem

The worksite health space has exploded as employers have jumped at the opportunity to take control of many aspects of their healthcare expense and positively impact the health of their employees.  Occupational health, wellness, acute care, and primary care were put in place and we’ve been pretty effective at reducing some costs and improving access. Alas, the big costs sit downstream: episodic events, chronic disease, and Rx spend.

For the clinic, the challenge to demonstrate value has increased as costs continue to increase. For employers sponsoring onsite or nearsite clinics, it has become more and more difficult to justify the investment in the clinic itself.  

What Have You Done for Me Lately?

We are now entering the 4^th wave in the evolution of the worksite clinic. If you are new to the clinic model, you’ll cross the initial value threshold. If you’ve been at it for a while, you may be in the 2^nd, 3^rd, or 4^th renewal of your investment in a health center. With each passing year, the question: “What have you done for me lately?” emerges. Whether you sponsor the clinic or manage the clinic, it is the same. How do you show that it is continuing to be relevant in making a difference?

We Can’t Sit Still. We can’t Chase Everything.

We can’t keep doing the same things and expect improvement. Healthcare expenses continue to climb. The 2020 expected increase of 12% will likely grow dramatically due to COVID-19. What worked before remains necessary but it won’t increase the clinic’s value in the future nor help us move the dial on costs. We all know this.

In the pursuit of higher value for the clinics in which we’ve invested, we’ve turned to “shiny objects” and started sprinting after anything that looks new. ”Point solutions” have appeared and many of them may be decent programs. However, in the quest for new we’re now being “PEPM’d” to death and it is clear that we cannot afford everything on the menu. Often, these point solutions are hard to evaluate and difficult to validate.

What We Need

Through all of the challenges, we find an ongoing hunger for something better. For those of us serving these employers, we hear recurring laments about complexity and trust. Self-funded employers aren’t asking for too much, they just want:

• More trust, less uncertainty.
• More innovation, less me-too.
• More insights, less obfuscation.
• More impact, less excuses.

Relationships are shifting as employers look for new ideas and more options. They recognize that healthcare is not their business yet it has become strategic to their business. Everyone wants partnering relationships that help solve problems, save money, and make a difference. For providers of onsite and nearsite clinics, there is a tremendous opportunity to be a trusted advisor in your client’s search for value.

The Worksite Clinic Opportunity

What is the opportunity for worksite health centers? Properly implemented, the onsite/nearsite clinic can become a nexus of care for employees. As a nexus of care, the clinic then becomes a center of value. What does it mean to be a center of value? As a nexus of care, the health center can impact costs, outcomes, and the general wellbeing of the employees. The claim has been made for years but progressive clinic groups are just starting to bridge into the rare air of being a care nexus and for most, it remains an elusive objective.

As an organization that specializes in driving clinic value while improving patient outcomes, we see medications as the ideal vehicle for helping the worksite clinic transform into a nexus of care. How? Follow the money. Prescription spend for self-funded employers has grown to nearly 30% of overall healthcare expenses. The typical worksite clinic offering onsite dispensing impacts 5% of the total prescription spend. What happens if the clinic expands prescription influence to more of the overall spend?

Prescription access is one of the key draws for patients visiting an employer sponsored onsite/nearsite health center. When the clinic enables patients to access almost all of their prescriptions onsite or through home delivery, it moves itself closer to a nexus of care. Bringing High Impact Rx into the clinic value proposition increases ROI, decreases medication costs, improves patient medication adherence, improves outcomes, and enhances the employee experience. Here, the health center becomes a center of value.

High Impact Rx for Worksites

Offering access to more medications is a great start but it isn’t enough by itself. The clinic manager needs a comprehensive pharmacy solution that incorporates access to expensive brand or specialty products. The next step from there are targeted programs designed to impact the really large costs associated with chronic conditions. Today, most onsite/nearsite clinics have barely scratched the surface of their potential impact on their clients’ pharmacy spend and the promise of chronic care coordination. The opportunity is hiding in plain sight but it takes the right partner and solution to make it reality.

From what we are seeing in the market, self funded employers are done with:

• the same old ideas and options
• low value supplier relationships – “we need more than just a vendor”
• siloed point solutions – “death by PEPM”
• opaque incentive arrangements
• one size fits all

Here’s what they really want:

• trust, ideas, and innovation
• broad views of options, including High Impact Rx
• strategic partners “solutionizing”
• integrated strategies and programs
• clarity and transparency
• help in beating the “rebate” game
• custom, flexible solutions
• true progress on improving outcomes

The time is right. The opportunity is now. There are powerful options for innovators looking to put a dent in their self-funded clients’ healthcare costs and make life better for patients. How do we know? We’re helping them do it.