The Onsite Clinic Planning Guide - Steps to Making Your Clinic Your Own
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An onsite clinic program boosts employee health, reduces claims costs, and promotes a culture of wellness. Your employee population has expressed interest. Senior leadership has bought in and are excited to see results. So where do you start?
It’s time to begin planning! While an onsite clinic may feel like a monumental task, breaking up the how and why into easy-to-answer questions is the first step. The helpful guide below will give you some actionable items to consider when laying out the fine details of your onsite clinic program.
Question 1: What is this Clinic Program Hoping to Achieve?
You might readily list off the benefits : better management of chronic conditions, improved productivity, reduced absenteeism, and so on. But don’t hesitate to go deeper here! Question 1 is truly the foundation and the source of what your onsite clinic program will look like, so it’s important to take time and care in considering what measurable goals you’d like the clinic to achieve.
Consider the benefits above as different ‘routes’ that your clinic might take. Some of these benefits might overlap in function and form (i.e. reduced absenteeism will generally result in improved productivity), but there are also some differences in goals that will very well determine what sort of programs your clinic will and won’t offer, or even what your clinician care team and clinic hours will look like.
Our advice: be intentional in considering all the benefits that an onsite clinic can provide and rank them in importance as an organization. Include measurable and specific goals. A year from now, what will clinic success look like? What about five years from now?
Question 2: What will Hours, Location and Staffing Look Like with our Clinic?
The implicit question here, and one that’s worth answering before you consider hours/location/staffing, is how many employees your clinic expects to serve.
Whether that’s all employees, all employees that are health plan members, or employees plus their dependents is up to you. But you’ll need an idea of your eligible population when it comes time to consider:
Question 2a: Hours
With a large population that works regular hours, a full-time clinic (open 8 am-5 pm) might be your best bet. If your workforce is on the smaller side (500 employees or less), a part-time clinic that’s open for part of the day or for certain days of the week might be a more economical choice. Or, you might have employees that work irregular hours, meaning a clinic that’s also open during the evening will produce the most bang for your (wellness) buck.
Question 2b: Staffing
Do you plan on staffing a general practitioner (MD)? Or will your clinic staff comprise mostly of nurse practitioners (NPs) and physician assistants (PAs)? Relatedly, will you have ancillary services that require health coaches, pharmacists, or specialty providers?
Question 2c: Location
Your onsite clinic program might not be ‘onsite’ at all: depending on the workforce that you plan to serve, your most competitive option might be a nearsite or sharedsite clinic that best suits smaller or more remote employee populations. Typically, clients with less than 500 eligible employees (including spouses and dependents) see the best results with near-site or shared-site options, where the costs of an onsite clinic program can be shared with another employer.
Question 3: What Kind of Care Will our Clinic Provide?
This question is somewhat straightforward, but it links closely to the consideration of how you’ve answered questions 1 and 2. For example, deciding to include urgent care services or occupational health services will affect what kind of staffing your clinic needs, which then might determine working hours or location(s).
Perhaps you’re thinking of considering services like physical therapy, nutrition counseling, or prescription dispensing. These services fall directly in line with the overall goals of your onsite clinic program.
Consider, then, the first three questions above as a sort of triangle that you might return to in considering the answers to all three.
Once the ‘Big Three’ are answered, the next series of questions are a great way to provide some needed detail into your onsite implementation plan. Starting with:
Question 4: How will the Clinic Enhance your Existing Benefit Package?
Your onsite clinic should serve as a hub for all the benefits related to employee well - being. Consider how to integrate your clinic with the existing wellness programs for seamless referral. You can maximize the benefit of your total wellness package.
In addition, Consider how to integrate clinic services with your current insurance plan. If you have a high deductible plan in combination with HSA you'll need to charge people with reasonable amount to use the Clinic and Healthstat can help you determine what that rate should be.
It is also important to consider if you open the clinic only to employees who are covered under your insurance plan or employees + spouse +/dependents, retirees, people who are covered under COBRA etc.
Question 5: What is our Clinic Budget?
Understand that the initial investment into an onsite clinic program can be substantial, but that the long-term return on investment expected with improved health and reduced claims will pay for the upfront cost of the clinic (and then some) in years to come. Knowing your clinic budget also plays a vital role in determining whether your organization is better suited to an onsite or near-site set-up and how that clinic set-up will be staffed.
Question 6: How Do We Plan to Drive Utilization?
A valuable vendor will assist in driving employees to your clinic through marketing, but it’s important to consider what benefits your workplace will most readily respond to. Perhaps emphasizing the convenience of the clinic’s location, or the increased time spent with a clinician, or the ability for no-copay. Maybe you want to advertise the option for same-day appointments and convenient prescription refills.
Nested within this question is the issue of both how you want to describe these benefits as well as what communication channels you’ll use. Again, a valuable vendor partner can assist in marketing these materials, but they’ll rely on you to best understand your own workforce’s wants and needs.
Perhaps the last question you’ll consider (but certainly not the least important) is one that demands a thorough answer:
Question 7: Which vendor will we Partner with to Achieve our Goals?
While considering and answering the previous six questions, you might have come across various vendors with different solutions to the challenge of population wellness. In deciding which vendor best suits your organizations own needs, consider these sub-questions:
Question 7a: What Does Long-term Success Look Like in our Partnership?
This success will most likely reflect how you answer question 1 above. But consider also how a potential vendor measures their own success. Does it align with your organization’s goals?
Question 7b: What Services and Infrastructure will our Vendor Manage?
There’s a fair amount to consider when it comes time to divvy up responsibilities between you and your vendor: staff recruitment and training, medical supplies, facility maintenance, data integration, and ROI reporting are just a few services and programs that your vendor may (or may not) be capable of managing. Ensure that this conversation lies at the forefront of all prospective vendor talks.
Question 7c: Does this vendor have any relationships that represent a conflict of interest?
A key benefit of workplace clinics is the assistance they can provide employees in navigating a complex healthcare system. In some cases, however, a vendor’s workplace clinics may have financial ties with, or be owned by, an entity that stands to benefit from referrals that come to it from the workplace clinic. It’s good practice to be upfront with a potential vendor and inquire whether there are any conflicts of interest that could affect the volume of referrals, treatment recommendations made, duplication of services, etc. Are there partnerships or unseen investments that influence their service model, or is their focus solely on providing the best possible patient-centered care?
The guide above will prove crucial in determining the initial shape of your onsite clinic program. Clinical staffing, types of available services, and vendor management are just a few questions to consider when drawing up the blueprint for what your workforce needs. In conclusion, an onsite or near-site clinic has the capacity to breathe life into your organization’s benefits program, regardless of size, location, or demographic. You just need to know which questions to consider before implementation.