Future Now
The IFTF Blog
Hey boss! Can I go see my PCP down the hall?
According to Brian Klepper's recent post on the Health Care Blog, onsite workplace health clinics "are re-emerging . . . at an astonishing rate." About one-third of Fortune 1000 companies already have in-house clinics; surveys indicate that one-third more will have them in place by the end of 2010. Many are at firms with more than 1000 employees, but some employers with as few as 150 employees have implemented them successfully. Klepper notes, "[T]hey are scalable when properly deployed."
By investing in an onsite clinic that provides comprehensive primary care,
the employer reduces health plan expenditures. This arrangement works best when the employer's health plan is self-funded. In fully insured plans, the savings would accrue to the insurance company rather than the employer. But even fully insured employers can benefit enough from occupational health savings and employee morale to more than justify a clinic. . . .
The effectiveness of onsite clinics is . . . related to their convenience and to the trust they’re capable of engendering in patients. These characteristics allow them to become fully-realized medical homes, places that patient feel comfortable turning to for care at any time . . .
Klepper goes on to discuss how CIGNA, a major health plan, itself opened clinics for its own employees in 2008 at four Eastern locations. Now it is encouraging clients with 1000 employees or more to do the same. He observes that CIGNA's embracing of primary care is significant:
If CIGNA paid primary care physicians more to spend more time with patients and to become engaged in their downstream care, it could trigger the boost that primary care needs. Providing leadership on this issue could begin the healing that primary care so desperately needs, and provide reason again for medical students to become generalists. The empowerment of primary care, and the hunger of PCPs to be allowed to practice more capably, could amplify CIGNA’s quality/cost management efforts.
Klepper confirmed with CIGNA's Chief Medical Officer that the company does see primary care and medical homes as key to improving health care, and is pursuing its onsite clinic effort as well.
I am a big believer in the long-term efficacy and efficiencies of having primary care physicians provide . . . well, primary care. Our health system is overrun by specialists and underserved by generalists. Perhaps CIGNA's efforts, and those of other employers, represent a meaningful shift in the right direction.