Asking The Right Clinic Questions Matters
Worksite clinics can be powerful platforms for health care clinical and financial risk management. A clinic should first be designed to be a comprehensive medical home - a place where patients can turn first for care - but also one where the staff is always thinking about and advocating for their patients. But ultimately it should become a platform for the execution of a full array of management tactics that can drive appropriate care and, more importantly, disrupt inappropriate care throughout the entire health system. Within three years post implementation, a good clinic can dramatically improve the health of both individual patients and the patient population, reducing net total health spend by more than 20%. It can also substantially enhance employee productivity, though that's more difficult to measure. Sponsors invest in a good clinic to get high multiple returns in better health and productivity, as well as significantly reduced health plan costs.
Choosing an effective clinic vendor is everything, but more often than not, that doesn't happen. A 2015 Mercer survey found that only 2 in 5 clinic sponsors could produce data showing that they saved more money than they cost, a damning indictment. This suggests that, unless they're seeing significant health outcomes improvements, most clinic sponsors are spending 8%-12% more than premium to get little additional benefit. This also means that most clinic vendor choices are driven primarily by advisors who lack much direct clinic experience and by factors other than performance and value. The result of less-than-optimal choices can be poorer patient health and substantially higher costs.
Worksite Health Advisors (WHA) offers highly experienced worksite clinics professionals, focused on what is best for patients and purchasers. We appreciate that understanding performance has to do not only with improved health outcomes and costs, but also with patient and purchaser satisfaction with the clinic. Effective clinics have to do with the often seemingly small design decisions about who leads the clinic, whether there are co-pays, the length of office visits, whether the clinic dispenses drugs, how referral decisions are made, how the clinic staff identifies patients who could benefit from intervention, where the clinic vendor is likable and so on. In other words, worksite clinics should be more than just a primary care practice on a sponsor's campus. They're about the totality of carefully thought-out decisions that are used to shape how that clinic vendor approaches the extremely complicated problem of appropriately managing care and cost in a system that is often bent on excess.
Thinking about getting a clinic for your business? Or want to evaluate the performance of your existing clinic? Call and talk with us. We're pretty sure you'll find it a refreshing discussion.
Clinic Feasibility Studies. By examining historical med/surg and Rx claims data sets, we can evaluate the potential impact of a worksite clinic in terms of its meaningful benefits to patients and the candidate sponsor.
Request For Proposal (RFP) Management. We customized the Request for Information (RFI) and Request for Proposal (RFP) processes to identify and vet appropriate clinic vendor candidates.
Sponsor’s Representative On Contracting and Site Development. Acting as the clinic sponsor’s representative, we assist facilitation of the clinic vendor contract and physical plant development.
Marketing and Implementation Assistance. We participate in operational activities, particularly including efforts to drive higher eligible-patient participation.
Problem Mediation and Resolution. We will actively engage as honest brokers to identify, work through and resolve conflicts with a minimum of disruption.
Ongoing Risk Assessment and Risk Management Recommendations. We continuously evaluate the sponsoring group’s risk profile, occasionally recommending niche solutions that can further improve health outcomes and/or reduce health care spending.
Ongoing Performance Analysis and Reporting. We will receive monthly med/surg and Rx claims dumps, to independently assess clinical and financial performance over time.
Clinic Audit. We will conduct an independent evaluation of existing health center clinical and financial performance, with recommendations for improvement.