Workplace Clinics

Workplace Clinics and Employer Managed Healthcare, A Catalyst for Cost Savings and Improved Productivity by A. Michael LaPenna, CRC Press, 2012

A smart book for intelligent, broad-based healthcare delivery, Workplace Clinics delivers practical proven approaches to corporate healthcare, especially creating and supporting wellness.  The author is committed to education as a key component in anyone’s healthcare plan.  In Chapter 10, for example,  LaPenna emphasizes that although we now have potent technology and medication solutions, “the most important and impressive technology that can be applied to patient care and intervention is personalized education.”

But for us, the most credible and useful piece of this foundation guide is Appendix D, the On-side Provider Listing that includes a partial list of workplace healthcare sites visited and/or  sampled by the author.  Possible workplace sites were “focused only on those companies with some kind of track record;” updates to the original list are available at http://www.onsitesclinics.org.  For this book, the list includes 24 sites, including Walgreens/Take Care Health Systems Inc. headquartered in Chadd’s Ford, Pa.  LaPenna describes Walgreen’s site as “the giant of the on-site provider industry… they have it all – community outlets, pharmacy and PBMs, brand awareness, industry intelligence critical mass, capital, etc.”

Walgreens/Take Care Health Systems are in fact the group that distributes volumes of flu shots to employees across the country.  Their website at https://www.walgreens.com/pharmacy/flushotcalculator/flu_shot_calculator.jsp#calBoxId offers employers a quick cost savings estimator to calculate the expected savings from a $1.00 flu shot.  The company has pioneered other more complex healthcare solutions services, including managing over 400 Healthcare Clinic at select Walgreens in cities throughout the country.  Take Care Employer Solutions manages primary care, health and wellness and occupational health centers at over 370 employer campuses across the country.

What can we learn from the experiences of Walgreens/Take Care and the other providers included in LaPenna’s book?  Given the inevitable churn and confusion in healthcare, the author makes several predictions about the on-site healthcare industry:

·         Consolidation in the industry will continue

·        New forms of access will mature – think retail

·        New forms of access will emerge – think remote

·        Companies will change vendors

·        New pricing practices will emerge

·        Specialized accreditation and licensing will evolve

·        Standardization will occur, company to company and vendor to vendor

LaPenna warns that setting up workplace clinics may require more than normal new product launch work.  There will be politics, education, purchasing challenges, but it’s clear that LaPenna believes in this solution.

Readers will find the Foreword by Dr. Ford Brewer, former (now with CHS) Medical Director of Toyota Motor Manufacturing of North America most telling and informative.  Brewer was asked in 2003 by Toyota to review the way the company delivered healthcare to its employees and to “look at all possible ways to improve… that process.”  Brewer’s team implemented a healthcare system at Toyota’s new San Antonio assembly plant and he credits LaPenna’s consulting resources with big contributions to that plant’s success. 

But along the way Brewer’s team learned much about the potential for providing better on-site healthcare –

“We are buying healthcare without any clear understanding of how to value healthcare.  We need to take a step back and ask ourselves, as we have with many other production inputs, whether we can simply make it better than we can buy it.  Once we have formulated the question, we will realize that there is no single or simple answer.  We will, I believe, come to realize we have to rethink our entire healthcare purchasing scenarios and collaborate with all of the elements of the healthcare system to ensure short-term efficiencies and near-term effectiveness.  I believe an on-site clinic is a key element of that process, but it is only one element.”