Bert, IB and Paul,
Most companies with over 500 employees are self insured and adding an on site clinic is rapidly becoming the norm (approximately a third of the companies on the East coast have on site clinics).
An on site clinic allows employees to clock out, have a clinic visit, and be back on the clock within 20 minutes. This compares to four hours at a traditional clinic when you include transit time etc. The routine preventive medicine (hypertension, hyperlipidemia, diabetes diagnosis and manaement, tobacco cessation and cancer screening)has been very cost effective. Estimates range in the 3 to 6 dollars per dollar invested. Additionally, the on site clinic has been the most treasured benefit of the employees and should significantly improve the employee retention.
We advocate annual history and physicals (the companies like to refer to them as health assessments) on the patients' birth month. We do quarterly general reports (no names)and guarantee to our patients that they will be seen on the day that they call if they are acutely ill. This is a model that allows for primary care autonomy. Many companies are interested in on site clinics to improve employee health and to control health care costs; I suggest offering a turn key deal (companies do not like surprises):
A fixed amount per employee per month to include spouses and all dependents.
The company supplies the office and utilities and you provide everything else: All employee salaries and benefits, all office furnishing and equipment (approximately $20,000 for me), all insurance, all routine lab including annual physicals, all EKGs, all office procedures (minor surgery, PAP smears etc.). The companies will also insist that you indemnify them for all liability.
In my opinion, it is important that the employer values the benefit to the employees as a priority over financial savings.
I am not much of an entrepreneur (I chair several not for profit public health committees as a volunteer), I do wish that I had discovered this model earlier in my career (I will be 60 next month).
Jim
