Onsite Clinics Gaining Traction Among Employers

Are employers losing their fear of the much-ballyhooed Cadillac tax? A study from Mercer offers a bit of evidence that this just may be the case.

Mercer asked employers two years ago whether they offered onsite health clinics, and 24 percent said they did. When asked last year, that figure had jumped to 29 percent. This year, Mercer delved deeper into the trend to see how the clinics were working out.

Mercer said employers were motivated to open their own clinics by two primary factors: the desire to more closely manage employee health, and concerns over access to health care for their employees.

“Of the 134 respondents [that employed more than 5,000 workers], 72 percent of those whose clinics provide general medical services said that managing employee health risk and chronic conditions is an important objective for the clinic,” Mercer said.  “For more than two-thirds of survey respondents (68 percent), improving access to care was also an important objective.”

Employers indicated they were satisfied with their clinics — 85 percent said they were successful, although only 41 percent were measuring clinic operations on  a return-on-investment basis. Nearly half (49 percent) said they offer employees the option to select the onsite clinic as their primary care provider.

A possible damper on clinic expansion: recent Internal Revenue Service guidance that suggests the cost of an onsite clinic may contribute to Cadillac tax qualification. But the survey showed that these large employers generally aren’t convinced they’ll be hurt by the tax, particularly if the clinics offset penalties.

Another sign that onsite clinics are performing well and are here to stay: More employers are designing them as “medical homes.”

“The patient-centered “medical home” is a delivery model through which patients — often those who are high-risk or chronically ill — can have their care coordinated by a primary care physician, nurse practitioner, or physician assistant,” Mercer reported. “Using the worksite clinic as a medical home allows employers to offer a greater level of care to the higher-risk, medically challenging employees and dependents who typically account for the largest portion of health care spending. Three years ago, 13 percent of survey respondents with general medical clinics used their clinic as a medical home. That’s doubled, to 26 percent of the respondents to this year’s survey, with another 11 percent considering it.”