Small businesses, hospitals eye workplace medical clinics

Hospital systems afraid of losing patients to these third-party vendors are also striking up partnerships with local employers to staff their workplace clinics, though often mostly with larger employers.

For several years, Nashville-based Vanderbilt Health has partnered with Metro Nashville Public Schools to provide teachers and other employees convenient access to primary-care clinics so they can be more effective in the classroom. Employees can visit any of the five exclusive healthcare centers available at no cost. Four of the clinics are located in repurposed mobile classrooms at different locations in the metropolitan Nashville area.

The advanced nurse practitioners who staff the clinics provide primary-care services and help patients manage chronic diseases. The school district added a 26,000-square-foot brick-and-mortar clinic and fitness center last year, where employees can access more services including physical therapy, behavioral health and a pharmacy.

David Hines, executive director of benefits for the school district, said the clinics see 500 patients a week and are the medical home for about 35% of active employees. The district pays the entire cost of operations, plus a negotiated percentage as Vanderbilt’s earnings for the services provided, he explained. So far, the clinics have produced savings.

A RAND Corp. study of the school district clinics published in June found that teachers who used the clinics instead of a community-based provider had lower total healthcare costs and were less likely to be admitted to the hospital. On average, the use of the work site clinics saved the district $62 per teacher per month in healthcare costs, according to the study.

David Posch, executive vice president for population health at Vanderbilt, said partnering with employers enables the provider to take a proactive approach to keeping patients healthy and managing chronic conditions.

In return, Vanderbilt develops relationships and fosters loyalty among the employer and staff to use its health system. The clinics, which use the same electronic health record as the rest of Vanderbilt, are able to keep patients in the system by making referrals to Vanderbilt specialists when necessary.

Posch said Vanderbilt is experiencing growing demand among employers for on-site clinics and other arrangements.

“We continue to redesign our healthcare delivery system to achieve value,” Posch said. “On-site clinics and partnerships with employers are part of that effort to look at how we improve healthcare value for the patient and the payers.”

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