Worksite Clinics: Missed Opportunities

Worksite clinics have become a staple of a robust self-funded benefits plan. The National Association of Worksite Health Clinics (NAWHC) says that 33% of employers with over 5000 employees have an onsite clinic and 16% of employers with 500-4999 employees have an onsite clinic with another 8% of the latter group saying they are adding one in 2019. The NAWHC goes on to state the following benefits of an onsite clinic:

• Offering convenient access to health care services will reduce lost productivity that results from a worker taking 3-4 hours to leave the worksite, travel, wait for and see health care providers and to obtain drugs and services
• Making first aid and acute services available at the worksite will reduce the use and cost of hospital emergency rooms – the highest cost setting for obtaining medical services – for non-emergency conditions
• Providing low or no cost resources and treatment will increase use of preventive and wellness services and programs, lessening the severity of common illnesses, augmenting management of chronic conditions that require regular checkups, improving medication compliance and patient outcomes overall
• Investing in well-being of employees with workplace ‘health and wellness’ benefits can help attract and retain employees – clinics are often viewed as the most popular benefit by workers
• Delivering medical, pharmacy and therapy services at the worksite will reduce overaIl costs, as there will be no required revenue margins placed on top of the services or products provided to patients at the clinic.

Working with our clients, we’ve seen the impact first hand. Employee satisfaction rates with onsite clinic access and services often reach 96%+ and employers reap the financial benefits of being able to more directly influence the cost of care for their employees.

Onsite Dispensing

Despite the broad success of the onsite care model, there are still opportunities for worksite clinics to bring more value to the employers funding them. One example of an opportunity for improvement centers on patient prescriptions. Including medications as part of an onsite clinic model has numerous benefits:

1. Patient medication adherence. Though estimates vary, the general consensus is that about 33% of patient prescriptions go unfilled. Access to medications onsite helps address part of the adherence challenge.
2. Cost savings. A well designed onsite formulary can save employer 25%-40% over similar meds filled in a retail pharmacy.
3. Higher utilization. Onsite medications drive clinic utilization.
4. Productivity. Onsite medications help patients get started on their therapy faster and help them avoid an additional stop at a pharmacy.

Many worksite clinics offer onsite medications as part of their service set. However, there are still sites that do not. If your clinic does not offer onsite dispensing, that is missed opportunity #1.

Missed opportunity #2 comes from sites that offer onsite medications but have such a limited formulary that the potential impact of in-office dispensing is greatly reduced. We often see this with clinics that only offer acute medications. There is still value but it is much less than what it could be.

Home Delivery

Another growing trend is linking the onsite clinic medication model with a home delivery pharmacy. Worksite clinics that marry onsite dispensing with home delivery of refills or extended formulary medications bring next-level value to their patients. Benefits include:

1. Even better medication adherence. Medication adherence is a key factor in reducing unnecessary hospital events. Studies have shown that 33% of hospitalizations for diabetics can be avoided with improved medication adherence.
2. Expanded savings. Ninety day fills and an expanded formulary enable a home delivery solution to bring additional 30%-50% savings on medications beyond onsite dispensing alone.
3. Improved clinic productivity. Worksite clinics that blend onsite dispensing with home delivery are able to reduce refill-only visits in the clinic and increase medical visit time for clinic staff. For busy clinics, this can be critical to providing high levels of patient service.

Does your worksite clinic provide patients with a home delivery option? If not, that is missed opportunity #3.

Missed Opportunities

Additional worksite clinic missed opportunities related to prescription management center on services. Here are a few:

• High cost drug targeting. Smart worksite pharma management programs enable employers to leverage wholesale buying on specific medications to secure them outside of the cost-burdened benefit system.
• Pharmacist access. High value prescription management includes access to a pharmacist – for clinic staff as well as the patient.
• Specialty packaging. Unit dose compliance packaging for patients on multiple medications can be a major factor in improving adherence when the timing of taking medications becomes confusing.
• Chronic care coordination. A robust worksite pharmacy management program includes targeted services around chronic conditions to help improve outcomes. One example is diabetes care. We’ve seen great success with worksite clinics that offer onsite counseling coupled with tailored diabetes care kits to help patient more effectively manage their diabetes.
• Telemedicine coordination. The growing need to get to patients that don’t have easy access to an onsite clinic will only increase as our distributed employee populations continue to grow. Can your worksite treat remote employees and follow up with a Rx to their door?

For self-funded employers that have an onsite clinic or those that are looking to add worksite care, the pharmaceutical aspect is often a check-box on a list. The reality is that the medication element of the onsite solution is absolutely critical to improving outcomes, driving utilization, and maximizing the employer ROI. What is your clinic missing? Are you getting the most from your worksite prescription management program?

Whether you manage your own worksite clinic or leverage a third party clinic manager to operate it, chances are that there are some missed opportunities for to further leverage it. A robust prescription management program quarterbacked by your worksite medical team is a powerful tool to help self-funded employers reduce healthcare costs and improve employee health. That is an opportunity too good to pass up.