Latest News & Info

Latest News & Info

What does an On-Site Health Center do for my company?

On-site Health Centers save the organization money on healthcare costs:
“Montgomery County has saved over $4,000,000.00 in four years and lowered our healthcare trend significantly.” –Scott Kramer, Risk Manager Montgomery County.

On-site Health Centers help employees get healthier:
“Our employees are healthier, more productive and not as concerned about costly chronic conditions.” –Scott Kramer, Risk Manager Montgomery County.

On-site Health Centers save your employees money:
“The clinic has saved me about $45 on average per month for medical doctor co-pays and prescription costs.” –Employee with access to on-site health center.

On-site Health Centers cut down absenteeism:
“Now when I have a health concern, I do not have to miss time at work to address it.” –Employee with access to on-site health center.

On-site Health Centers help employees catch and control chronic disease:
“I don’t think I would have found out about my diabetes diagnosis in a timely manner. Thanks to the HRA’s it was caught in time for me to try and reverse it.” –Employee with access to on-site health center.

And MUCH More

Unhealthy Habits of Employees.

What percentage of your employees smoke or do not have an exercise routine?
According to the CDC, 19.3% of the population 18 and over smokes (Prevention, 2007).
According to a 2007 CNN study, 22 percent of adults exercise three to four times per week (CNN, 2007).
According to a study in the medical journal The Lancet, 68% of Americans are overweight or obese (The Lancet, 2011).
These studies tell us that your employees are still smoking, not exercising and are overweight which lead to hypertension, high blood pressure and diabetes. All three of these conditions have an impact on the bottom line. Those employees who smoke are not only causing themselves to grow unhealthier but also they are contributing to the cost of presenteeism by taking productive time out of their day with smoke breaks. They may also be causing other employees to get sick through second-hand smoke. The CDC estimates the costs of an employee who smokes to be $3,391 per smoker per year in direct medical costs and lost productivity. So, if you have 1,000 employees and the CDC says that 19.3% smoke (round it up to 20% for this example), then you would have 200 smokers in your employee population (Prevention, 2007). If 200 people smoke and it costs $3,391 per employee per year, then your yearly EXTRA cost for those employees is $678,200.
There is also a cost associated with those employees who do not exercise regularly. The costs are related to diseases like high blood pressure and diabetes and can also affect presenteeism through employee depression for those who are overweight. In fact the CDC states that “regular physical activity is one of the most effective disease prevention behaviors.

Physical activity:

• Reduces feelings of depression
• Improves stamina and strength
• Reduces obesity particularly when combined with diet
• Reduces risks of cardiovascular disease (e.g., high blood pressure and
cholesterol, stroke, and type 2 diabetes)” (Center for Disease Control and Prevention)
If your employees are not exercising appropriately, their health could be at risk and your bottom line may be at risk.
Most on-site primary care clinics have a wellness program built in which has programs for smoking cessation, healthier eating and exercise among others. These programs can help reduce smoking and improve wellness which can help the company save money over the long term and have healthier employees. Many companies have their own wellness program but without a clinic attached to the wellness, you are only getting ½ of the solution. The clinic adds the aspect of a physician to refer employees to these programs and monitor them through their completion along with annual health risk assessments to track progress.

Chronic Disease Management

Do your employees have a Primary Care Physician who manages their chronic conditions?

How many of your employees suffer from Diabetes?

How many of your employees suffer from Hypertension?

How many of your employees are battling Cancer?

The answer to each of these questions may surprise you and lead to catastrophic claims on your group insurance. An even more important question is: Do the employees who are suffering from these ailments or may suffer in the future have a primary care physician to help them manage the chronic disease? Obviously, having a primary care physician helps the employee learn how to take medicine and monitor the disease along with tracking lifestyle changes that need to be made in order to control the progression of the disease. What percentage of your employees actually has a primary care physician? A nationwide worksite clinic study found that 21% of employees have not seen a doctor in 10 years and 50% have not been in 2.5 years. Employees who have not seen a doctor in so long may not realize if they have a chronic condition and will not know how to manage it. There is also a cost associated with employees who may be aware of a condition but do not have a physician to manage it.  According to a Health Management Associates Study from November 2008, most of the cost associated with chronic disease management comes from hospitalizations, re-admissions, emergency room use (Jack Meyer PHD, 2008). Having a primary care physician who can manage a program of intervention will help reduce these costs dramatically. By putting together a program for the employee to adhere to, the primary care physician can have an impact on the health of the employee and the bottom line of the company. When the employee does not go to the doctor or uses the retail market where they see different doctors each time they go, they risk getting sicker and using the hospital and emergency room more often.

Having an on-site primary care clinic at your business allows your employees to have a primary care physician who is accessible and has time to work on a personal plan for disease management. The clinic also has a tool that provides a report which stratifies the population into risk groups that can be targeted by the clinic for group preventative education and behavioral change initiatives. That tool is a proprietary 28 panel Health Risk Assessment. Many clinics see an 80-20 acute-chronic split in the first year of appointments but an 80-20 chronic-acute split in the second year of appointments which tells you that employees come to the physician with acute issues until they get comfortable with the physician and ask them to manage their chronic conditions. Managing chronic diseases on the front end allows the employee to live a healthier life and allows the company to save money on catastrophic claims.

Employee Presenteeism

Do your employees come to work when they are sick?

Business Know How defines Presenteeism as the practice of employees reporting to work when ill and not operating at their usual level of productivity. An estimate of the cost of presenteeism to U.S. Employers ranges from $150-250 Billion annually which is about 60% of the total cost of worker illness. A study by the Harvard Business Review looked at Lockheed Martin and found that 28 conditions where people came to work and were not well cost the company approximately $34 Million Annually. The chart below from the report shows the amount of lost revenue based on condition. (Hemp, 2004)

Condition

Prevalence

Average productivity loss

Aggregate annual loss

Migraine

12.0 %

4.9 %

$434,385

Arthritis

19.7

5.9

865,530

Chronic lower-back pain (without leg pain)

21.3

5.5

858,825

Allergies or sinus trouble

59.8

4.1

1,809,945

Asthma

6.8

5.2

259,740

GERD (acid reflux disease)

15.2

5.2

582,660

Dermatitis or other skin condition

16.1

5.2

610,740

Flu in the past two weeks

17.5

4.7

607,005

Depression

13.9

7.6

786,600

Source: Debra Lerner, William H. Rogers, and Hong Chang, at Tufts-New England Medical Center

When employees come to work with these conditions, they are not working at 100% and are therefore costing your company money. They could also be coming to work while contagious therefore infecting other workers causing absenteeism rates to increase dramatically. Any way you look at it, presenteeism is a big factor in lost revenue for the company. Are there appropriate ways to deal with presenteeism? Awareness of the problems and knowing your employees are the first steps but having a method to make sure that employees are properly diagnosed when sick plays a large part in combating the problem of presenteeism.

An on-site primary care clinic provides employees a place to go when they do not feel right and get diagnosed by a physician without having to pay a co-pay. The lack of out of pocket expense takes away a barrier that stands between employees and proper treatment plus it provides ease of access to a physician. When employees know what is wrong and the proper way to treat an ailment, they can get healthy and therefore more productive on the job. On the other hand if employees do not feel right but hesitate to go to a doctor due to cost or difficulty of access, they can get sicker or less productive. The on-site clinic also allows employees to quickly get checked and get back on the job (average appointment times range from 20-30 minutes) as opposed to going to the retail market and sitting in a waiting room for 1-2 hours. The ease of access and quality treatment put together make for a more productive use of company resources and healthier employees.

Employee Absenteeism

How much work time is missed when employees go to the doctor?
How do employee absences affect the bottom line of the company? A Mercer study from 2008 entitled “The Total Financial Impact of Employee Absences” determined that the full cost of employee absences was 36% of payroll. These costs can be broken down into direct costs, indirect costs and administrative expenses. The direct costs consist of benefits and wages that are paid to the employee even while they are absent. The indirect costs consist of lost productivity from having to replace workers who are absent with people who must “cover” for the absent employee. The administrative costs consist of internal staffing and overhead to cover the absence. In this area, we will focus on direct and indirect costs. In the Mercer study, they found that incidental unplanned or extended absences accounted for 9.2% of payroll or more than half the cost of healthcare, measured at 15.4% of payroll in. This fact says that employers have an opportunity to control healthcare costs by spending more effort in managing absences than just focusing on the hard dollar cost of healthcare. Incidental unplanned absences result in both direct costs for paying the employee when they are not at work and indirect costs of having someone fill in for them. In the Mercer study employees across all classes averaged 5.3 employee absence days per year. (Mercer, 2008) If you take the average pay per day per employee, you can come up with direct costs of employee absences. When an employee is absent, do you bring in a temporary or move their responsibilities to another employee? How does this impact productivity? How many times per year do employees use their sick days for non medical issues? How is your sick day program put together? Many companies are looking at their plans to determine how to manage employee sick pay and to make sure that the system is not abused costing the company more money.
How does an on-site medical clinic help this situation? First, having a clinic on site allows for the employees who are sick to get to the doctor quicker and get back to work. Another advantage to on-site primary care clinics is that there are no co-pays for people to go to the doctor. This encourages employees to get issues taken care of instead of self-medicating or not going to a doctor based on their costs. The object of the clinic is to help employees get and stay healthy so that they can be present on the job.

Are catastrophic claims around the corner?

What percentage of your employees has a chronic illness that even they are not aware of?

Recent Health Risk Assessment (HRA) statistics for a company using an on-site primary care clinic show that:

  • Out of 1201 HRA participants for one employer.
  • 221 people (18%) were pre-diabetic (glucose level of >= 105) and were not aware of that condition. There were 10 people who were Type II Diabetics and were not aware of that.
  • 539 people (45%) had hypertension (a systolic blood pressure of >=140) and were not aware of that condition.

According to The National Institute of Health, Millman and MedStat statistics, by discovering these conditions in time and managing them appropriately, the company caught approximately $6,364,635 in catastrophic claims in the first year. That number consists of a figure of $10,683 per employee per year in savings for Diabetes (National Institute of Health) and $7,428 per employee per year in savings for Hypertension (Millman and MedStat Statistics).

Imagine the catastrophic claims that could come to your company if 20% of your people have Diabetes and 45% of them have Hypertension and they are not aware of those diseases. If you could be aware of the issues before they become claims, not only could you help your bottom line but also help your employees be healthier and happier. Does your organization have a plan in place to search out and effectively manage chronic health conditions before they surface or does it just leave it to chance. Having a wellness program is a step in the right direction but it is only part of the answer because it has so little input into the management of the chronic issue.

To solve this problem, you must not only identify the chronic health issues, you must also have integrated management of the conditions. With an on-site health clinic, you have a built in wellness program with Health Risk Assessments for each employee and their dependants and an on-site doctor who can work with the employee to manage the chronic condition. When the employee gets their HRA done and discovers an issue, they can sit down with a doctor for a consultation on how to manage the issue. After that consultation, the employee will have a plan in place with convenient monitoring and follow up to manage the issue which makes them healthier and saves the company money.

 

Medication Adherence of Employees

Do your employees take the medication given to them correctly?

According to The Journal of Applied Research people are not taking the medications correctly and it is cause for concern:

-14 to 21% of patients never fill their original prescriptions.

-60% of all patients cannot identify their own medications.

-30 to 50% of all patients ignore or otherwise compromise instructions concerning their medication.

-Hospital costs due to patient noncompliance are estimated at $8.5 billion annually.

– Approximately 125,000 people with treatable ailments die each year in the USA because they do not take their medication properly. (Albert I. Wertheimer, 2010)

 

What portion of your employees does not take medication prescribed to them at all or takes it incorrectly and ends up as a catastrophic claim in the hospital? Research shows that people who only take one medication a day have an adherence rate of approximately 80% which drops to 50% for people who take 4 medications per day. The economic impact of non-adherence is estimated to be $100 Billion annually according to PhRMA Statistics on Medication Adherence. (PhRMA, 2011) When your employees use the retail market for healthcare and are given a prescription from that doctor, do they follow instructions? Do they get multiple prescriptions from multiple doctors? Are the instructions clear? If your employees are not taking their medications properly or at all, your company is looking at possible catastrophic claims that could severely impact your bottom line.

As a self-insured employer, you can obviously see the need to monitor and encourage employees to adhere to their medications. This cannot be accomplished by the employer directly or through plan design. Having an on-site medical clinic can help solve this situation by allowing employees more time with a doctor to explain the medication and how it needs to be taken and for how long. The doctor also gives the medication directly to the patient while at the appointment. These two factors alone help increase medication adherence which lessens the amount and severity of a possible catastrophic future claim. We have also found that the clinic doctor typically becomes the primary care physician for most employees who builds a relationship of trust encouraging better overall coordination of medication and therefore overall health.

Prescription Costs for Employees

Is the rising cost of prescription drugs impacting your bottom line?

At 10% of total U.S. Healthcare spent, the cost of prescription drugs must factor into the problem of the rising cost of healthcare in your company.  There are several factors that cause the cost of prescriptions to increase nationally.

  • From 1995-2007, the cost of brand medications rose 66% to $119.51 per prescription and generic costs rose 57% to $34.34 per prescription.
  • The population of The United States is aging which increases the demand for prescription medication.  From 2000-2005 Medicare enrollment increased 6%.
  • The use of specialty or brand name drugs is increasing. From 1995-2007, the number of prescriptions increased 40% and 41% of that increase was brand name drugs.
  • In 2006, nationally we spent $217 Billion on prescriptions. Insurance paid $95 Billion or 44% of that cost. (Kaiser Foundation, 2009)

If your spending is primarily based on brand name medications, the money you are spending is affected by the patent laws which allow drug manufacturers to hold a patent for 20 years from the date of patent filing. Once the patent has expired other companies can manufacture the drug on a generic label. (Kaiser Foundation, 2009) This increases competition resulting in lower costs. Many companies are taking the step of encouraging employees to find generic or less expensive medications to take care of illnesses.

 

As a self-insured employer, you can see how your costs are increasing for medication for employees. The solution of a primary care health clinic on site provides cost containment through an on-site generic pharmaceutical dispensary. This helps hold down cost by making generics more convenient and allowing doctors to find alternative generic medications for employees who use the clinic.

 

The Retail Healthcare Model for Employees

Over the next 8 months, CME will be looking at factors that are causing your medical spending to increase and what you can do to combat this.

Does your company have a plan to control or stop the increasing healthcare cost trend for the year? Are there factors within your control that are causing medical costs to increase at that rate? This paper will focus on eight factors that increase the cost of your medical spending and provide you an alternative idea for controlling those factors. We will look at hard dollar savings and soft dollar savings both of which contribute to your bottom line. Before we get started, let’s look at several questions concerning the people who work for you that you depend on to be productive. Read More