Onsite Healthcare: An Interview with CareHere

We’re always looking for ways that employers can contain health care costs.  I recently met with Andrew Thetford from CareHere.  Based in Naashville, Tennessee, CareHere specializes in providing employer sponsored onsite healthcare to municipalities, state governments, and private employers from many industries.  They try to make healthcare easier, better and more affordable.  Andrew was kind enough to answer a few questions.  I hope you find this interesting.

PM: Hi Andrew.  Thanks for taking a few minutes to discuss Care Here.  Can you tell me what your company does and how it helps employers reduce health care costs and improve access to care?

AT: CareHere is a leader in the Onsite Healthcare industry.  For 16 years we’ve partnered with employer groups to create an Onsite/Near Site Health Center that will inspire employees and their families to become healthier. By providing private, work-site access to primary and preventive healthcare at no cost to employees and dependents, we remove many of the barriers that often prevent patients from seeking care in the first place.

Unfortunately, almost all Americans have multiple barriers to cross before receiving healthcare. The three main barriers of time, cost, and location are targeted and eliminated with our onsite model.

Here’s an example. Three months ago, my wife and I received a call from a cousin in Texas. At the age of 38 he had a life threatening heart attack. As a young seemingly healthy individual this was a shock to us. We began by asking him how it got to this point, why hadn’t he seen a physician? Turns out he hadn’t been to a doctor in 7 years. The time it takes to find a physician, make an appointment, take a day off work, pay the office visit, travel across town to the office, the barriers to healthcare became too daunting for his situation. Unfortunately, this story is like so many Americans. If the he had visited a physician before his heart attack, he and his employer would have avoided hospital bill, ER bill, ambulance ride, and overnight hospital stays.

Employers have been tasked with the job of “promoting” health and wellness to employees. Hoping that their employees seek healthy lifestyles and visit their physicians. We spin that around and offer employers the ability to take control and “provide” healthcare, rather than simply “promoting” it to their employees.

Benefits of having an onsite health center include: reduced absenteeism, retention, disease prevention, strategic referrals, labeling and treating chronic employees, convenience, and 78% of our employers have seen reduced lost days at work.

Here are 5 ways that an onsite health center delivers financial savings to an employer:

  1. Managing chronic conditions
  2. Redirecting primary care visits
  3. Reducing avoidable emergency room visits
  4. Keeping costly specialty referrals in check
  5. Controlling direct costs to labs and pharmacies by providing onsite.
  6. Onsite occupational health services, workers comp, drug screens, etc.

PM: How does onsite healthcare differ from direct primary care (DPC), and which is more effective in your opinion?

AT: As patients and doctors search for solutions in the chaotic primary healthcare landscape. Both onsite Healthcare and direct primary care offer solutions to ease the pain of navigating care. A DPC model gives employers an opportunity to join their employees into an already functioning primary care eco system. As opposed to an onsite health center that gives complete control of the healthcare initiative to the employer.

To analyze the difference in the models, let’s go back to the idea of “promoting” vs. “providing” healthcare. A DPC model is setup in the community with an employer granting their employees access to the solution. The employer than turns back into a “promoter” of the healthcare solution pointing their group toward care in the DPC model. This has been the typical frustrating position for most employers who have had no option but to promote and direct their employees somewhere.

What an onsite health center gives the employer is full control by “providing” their own health center onsite, and full control equates to more savings and custom care. Onsite centers are managed by the clinic vendor but owned by the employer or partnering employer groups. This allows the ability to scale operation when needed and offer services as needed by employee population. Any health initiative can be run through the physician onsite. Wellness plans, biometric screenings, vaccines, drug screens, if it is a healthcare cost in the market, the employer has ability to bring the service into their health center for their employees to utilize.

From a physician point of view, both DPC and onsite models relive the stress of the typical PCP model. But an onsite model is equated to a “small town doctor” with the employer group serving as the “small town.”  Seeing the same group of individuals and truly understanding their health and situation allows physicians to truly assist in and improve employee health and wellness. And with an onsite solution, you have more ability than ever to not only label chronics but provide the care they need right onsite in your own eco system.

If you’re an employer, both DPC and onsite clinics will help you in your quest. But only through the control of owning an onsite clinic can you experience the savings, chronic care management, and utilization we all dream of.

PM: In your experience, how much money can employers save once they have onsite healthcare up and running?  How long does it take to start to see the savings?

AT: Clients who have utilized an Onsite Health Center for 5+ years have experienced an average ROI savings ranging from $4 – $7 on every $1 invested. Some clients have seen much higher ROI. Onsite health centers typically begin seeing a leveling of a group’s claims trend.  Year 2-3 a decrease trend begins.

Typically Onsite health centers view clinical and financial outcomes from six perspectives:

  • Perspective 1 – Health center visit (marketplace cost avoidance):  Overall savings on a per visit basis as compared to the market averages. On average, the client will experience a 30-40% reduction for every visit that is brought from the market place to the CareHere Health Center.
  • Perspective 2 – Pharmaceutical savings: For each prescription dispensed at the health center, the cost is reduced by 50% by using generic medications.
  • Perspective 3 – Laboratory services (marketplace cost avoidance):  On average CareHere can provide a 60-70% cost reduction for labs as compared to the typical cost in the marketplace for the same lab.
  • Perspective 4 – High risk/chronic patient savings (marketplace trend reduction): CareHere anticipates a minimum of a 1% marketplace trend decrease per year as a result of our impact on the chronic population.
  • Perspective 5 – Productivity savings/less time away from work saving: Our health center average wait time is less than five minutes per visit. This is a key to getting the employee back to work quickly, as their average time away from the office is 30 minutes. This is compared to an average of 3 hours away for a marketplace visit (2.5-hour savings with onsite health center)
  • Perspective 6 – Direct contracting: CareHere can contract with local medical facilities so particular referrals can be made at a lower negotiated rate.

PM: What types of companies are a good fit for onsite health centers?

AT: Employers of all sizes and industries have ability to implement an onsite health solution. Groups that see the highest financial return are groups under a self-insured plan. Employers who have a brick and mortar onsite clinic are typically over 500 employees or more. But for smaller sized groups and remote employees, there are solutions to equip them with an onsite solution. Near site clinics are a solution that allow multiple employers to join in on a clinic and split up costs by sharing the location with other groups. With virtual eHealth visits, onsite is a nurse with virtual equipment, while an offsite physician virtually interacts with the patient. This creates a more affordable solution that doesn’t cut corners on quality of care.

PM: Can you give me an example of a clinic you’ve set up for a number of smaller employers in a particular geographic area?

AT: ¼ of all our health centers are multi-employer near site facilities. For example in Cincinnati/Northern Kentucky we have an initiative providing care to over 10 area employers. These employers range from 40 ee’s to 2,000 ee’s. The initial setup was one health center with 3 employers. It has since scaled to multiple health centers and over 10 employers. This strategy gives smaller employer groups ability to join an onsite health center by sharing with multiple groups.

PM:  Thanks Andrew.  This has been really informative!

We hope this was both enjoyable and informative.  If you’d like to discuss creative ways to reduce cost with your health plan, give us a call at (866) 724-0008 or click the link below.

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