In this chapter, the evolution and growth of worksite clinics is discussed. Worksite clinics are not a new phenomenon. Prior to the 1980s, many large employers operated onsite company clinics to treat work-related injuries. However, many of these clinics closed in the 1980s and 1990s because of the decline in heavy industry and manufacturing sectors and the reduction in workplace hazards. Recently, there has been a significant resurgence of worksite clinics. The new generation of clinics is markedly different in that their main focus is on primary care, health promotion, and wellness rather than occupational injuries. The authors discuss in-depth the operations, stakeholders, and outcomes of care in worksite clinics. They predict that worksite clinics seem to be well positioned to thrive in a post-reform healthcare environment.
Worksite health clinics appear to be the next big thing, with clearly evident benefits and high satisfaction among employers and their workers. Their presence will increase, and insurers will have to figure out how to treat them. Vendors of clinics already appear to be positioning themselves as network providers, and are likely doing so to take advantage of coming healthcare reforms that will reduce barriers to their use. A worksite clinic’s intimate understanding of an employer group suggests it will rank as a high efficiency provider, and insurers should anticipate having to reimburse them at their highest rates. — Rick Byrne, 2009
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One of the unique aspects of the U.S. healthcare system is employer-sponsored insurance (ESI). Most Americans under the age of 65 obtain their health insurance coverage through an employer, whether that is their own employer or the employer of a family member to whom they are related as a dependent. Companies have traditionally offered healthcare coverage as a benefit to attract and retain top talent. The latest estimates suggest that about 159 million Americans are covered by employer-sponsored insurance (Robert Wood Johnson, 2013). However, the costs of providing that coverage to employees have steadily increased in the last ten years. Costs have grown faster than inflation and now constitute 15% and 40% of the average single and married employee’s total annual compensation, respectively (Fuld & Company, 2009). As a result, many employers have dropped or reduced coverage to their employees, while some employees have declined ESI even when offered due to high premium costs. Average annual premiums for employee-only coverage more than doubled from $2,490 in 2000 to $5,081 in 2011. Family premiums have also increased from $6,415 to $14,447 in the same time period. Consequently, the percentage of Americans receiving health insurance through their employer has fallen from 69.7% in 2000 to 59.5% in 2011 (Robert Wood Johnson, 2013).