focus on primary care, workplace wellness
screenings, disease management and acute
colds and pains,” Rybicki says. “It’s like a
quick care or primary care center, although
we have an aggressive disease management
and prevention aspect.”
As part of that goal of disease management
and prevention, physicians work to identify
conditions such as high blood pressure,
asthma, heart disease and diabetes —
chronic conditions that can be managed and
monitored — and treat them. Managing
these conditions by regularly checking
cholesterol, blood sugar and blood pressure
reduces emergency room visits and can help
prevent more serious conditions, such as heart
attack and stroke, from occurring.
The clinic’s pharmacist manages all of the
pharmacy benefits and counsels the clinic
on everything from formulary to medication
compliance reports. Medications are also
delivered on-site, so employees don’t have to
leave work to pick up prescriptions.
Providing results
The on-site HealthLink clinic model has
produced identifiable results. More than 90
percent of the clinic’s patients are at their
goal medical condition levels, meaning their
blood pressure, blood sugar, cholesterol, etc.,
are at desirable levels, and the clinic has seen
significant decreases in these levels across the
board. This has reduced the number of health
care claims for emergency room visits and
treatment for more serious conditions, saving
the employer money. Rybicki uses these savings
for further health and wellness initiatives, such
as hiring a fitness trainer once a week.
Because of the built-in employee incentive,
98 percent of employees participate in the
program. Two weight loss programs resulted
in 900 pounds lost. Use of generics has risen
to 87 percent. And bimonthly expenditures
decreased more than 18 percent.
In addition, workers with minor ailments
receive care on-site, eliminating the need to
take time off work to visit the doctor. The
clinic also cares for patients quickly, reducing
both absenteeism and presenteeism, defined
as when an employee is present at work
but not feeling well, resulting in reduced
productivity. For follow-ups and ongoing
6 •The Link
Because of the built-in
employee incentive,
98 percent of
employees participate
in the [on-site]
program.
disease management, employees can visit the
clinic on their breaks.
“It’s convenient and keeps people at work
so they can continue to be productive,” Rybicki
says. “It also gives employees a sense of good
will that management cares about them from
both a recruiting and retaining perspective.”
The on-site clinic is self-funded by the
employer. While this means the employer
takes on all of the risk for paying claims,
it also allows it to reap all the savings. In
addition, the clinic is not subject to many
state mandates and regulations. Self-funded
plans, for example, are not subject to MLR
reporting, which requires carriers to issue an
annual premium rebate if they do not spend
at least 80 percent of premiums on health
care services. In addition, self-funded plans
are not subject to the $8 billion federal tax on
carriers that took effect this year.
“A self-funded program provides the
company flexibility in the design of its
program,” Rybicki says. “While it still needs
to comply with some aspects of health care
reform, the company makes the decisions,
and it designs its own goals and strategies.”
HealthLink also works with the employer,
the clinic and any third-party administrators
to set up the right plan for the employer’s
needs. To keep things on track, invested
parties meet every month to evaluate the
program and discuss potential improvements.
The bottom line
As more companies realize the value of
hosting an on-site clinic, and as more
individuals enter the health care system as a
result of health care reform, Rybicki expects
the model to continue to grow.
“As employers become more aware of what
can be done to improve the health of their
employees and decrease the number of claims,
our on-site models will become better,” he
says. “The easy access is attractive, and this
model makes sense for employers, which can
save them a lot of money.” :
For more information about building
an on-site clinic model, contact
Erin C. Davidson at Erin.Davidson@
wellpoint.com or 314-925-6134.