Down with Costs, Up with Safety

On-site occupational health clinics mean savings. Improved injury outcomes, decreased claims, and increased support for the safety culture and programs result in significant reductions in workers' compensation costs. But are these savings just for large corporations? Not any more. Experienced work site partners with specialized training, clinical protocols, and software developed specifically for worksite services are making on-site clinics more accessible and easier to cost-justify for mid-size organizations with as few as 500 employees.

Why Work Site Clinics?
While large corporations have led the way in adopting work site occupational health clinics, the trend is rapidly expanding to include mid-size firms.¹ Why are mid-size firms investing in work site clinics, for the cost savings and improved health outcomes? They are investing now because experienced work site operators can scale clinic services to the needs of these mid-size companies. Now, savings from workers' compensation costs alone allow a mid-size company to cost-justify its investment. With the added benefits of improved productivity, employee satisfaction, and other "soft savings," it's no wonder more mid-size firms than ever are adopting work site health clinics with partners who have developed programs customized to their size.

Regardless of the size of the employer, the core concept behind on-site occupational health is the same: having a medical professional on site who is trained in work site health care and supported by proven systems to assess and treat injuries where appropriate and manage off-site referrals when needed. However, not all on-site occupational health is equal. Results are highly dependent on the tools and training of the clinician. Ineffective and unnecessary services can fail to generate savings; on the other hand, clinicians who are experienced in work site health—with resources specifically developed for that purpose—can decrease medical costs, boost productivity, and keep injuries from becoming unnecessary claims.

In 2013, more than 80 percent of injuries were resolved on-site at Medcor work site health clinics without off-site referrals.² In fact, specialized work site clinic services have been shown to add up to an average ROI of 1:5 to 3:5³ for mid-size firms in industries such as distribution and manufacturing.

Savings ultimately depend on the clinic services that are selected, how effectively the clinic operator can deliver these services, and how high the employer's costs were prior to setting up work site health. In any case, close collaboration between experienced work site partners and the employers they serve will yield the best results.

Now, let's break it down. Below, we take a deeper look into how work site health clinics can lower occupational health costs and increase safety.

Five Key Reasons for Work Site Occupational Clinics

1. Early Intervention and Treatment On-site
Experts agree that the best workers' compensation outcomes result from early intervention. And intervention doesn't happen any earlier than when occupational health clinicians are on site. With a work site health clinic, an injured employee can be triaged and treated immediately at the work site.

Confusion about the what level of care is needed (ER versus clinic) adds costs. An on-site health professional can triage injuries based on algorithms and extensive training. Specially trained occupational health nurses can handle most of the work requirements with physician oversight. Most injuries can be treated on site, which avoids unnecessary off-site claims. When claims are necessary, the right level of care is used, avoiding many costly ER visits.

Treating injuries on site also means less time spent off the job seeking care. This boosts productivity and reduces the need for overtime pay to cover absent workers. Mid-size employers with work site clinics reported a reduction in lost-time days of 65-86 percent while increasing alternative duty days by 57 percent.⁴

2. Smart Management of Off-site Referrals
When an injury does need to be sent off site, work site clinicians can refer in a smart, cost-effective manner. Trained work site clinicians can determine the urgency of the injury (e.g., immediate versus tomorrow), select the appropriate level of care (e.g., clinic versus hospital ER), and recommend in-network providers, based on preferred pricing, service levels, and outcomes. However, be aware that if the on-site clinic is run by the hospital that has economic gain from these referrals, there will be a conflict of interest.

3. Care Monitoring and Return-to-Work
Work site clinicians can serve as advisors to injured employees, relaying medical information back to them and facilitating return-to-work programs. As return-to-work liaisons, on-site health workers can answer questions and clarify restrictions for both employees and supervisors. Savings from incident follow-up and care monitoring can add 20-30 percent to total work site clinic savings.⁵

4. Increase Safety Culture
Working closely with safety personnel, an on-site occupational clinician can turbo-boost a company's safety culture. Collecting vital data on injuries—how and when they occurred, what was affected, where it happened—supports compliance and prevents unnecessary injuries from becoming claims. For example, a back injury from a worker not lifting appropriately calls for counseling and behavior change. But even three or four such back injuries indicate a broader problem that needs to be addressed. Clinic staff can work hand-in-glove with safety staff to focus on analysis and prevention of injuries, rather than simply data collection.

Mid-size employers with work site clinics report a significant decrease in work-related incidents, as well as a decrease in the percent of workers' compensation cases that become lost-time events.

5. Other Benefits and "Soft Savings"

• Improved Productivity: With an on-site clinic, employees do not have to go off site for a variety of occupationally related services, including drug testing, hearing conservation, respiratory protection, OSHA physicals, etc. On-site occupational testing is another way to improve productivity and reduce costs.
• Improved MOD Rating and Decreased OSHA Recordables: As the number of workers' compensation claims declines, so does the MOD rating on which insurance rates are based. Lower workers' compensation insurance rates translate into direct savings for the company. In addition, on-site health professionals following evidence-based guidelines can help to avoid situations in which minor injuries unnecessarily become OSHA recordables.
• Increased Employee Satisfaction: On-site clinics offer significant convenience benefits for employees. If an injury occurs, employees do not need to leave work and wait for emergency room care they may not need. In addition, a good on-site vendor can increase a clinic’s scope of services and make it viable for mid-size companies to offer specific wellness services to employees. Wellness programs improve morale and have been known to produce a return on investment of $2.71 for every dollar invested.⁶
• Increased Security of Sensitive Data: Experienced work site operators use software specifically developed for worksite clinics. This includes the use of HIPAA-compliant medical records and encryption of data during transmission and storage. These practices also include the ability to separate occupational health from non-occupational information for reporting purposes while still allowing the clinician to see the whole health picture.

Work site occupational clinics are an ever-more-popular and cost-justifiable option for mid-size companies. As specialized work site health partners develop models tailored to the realities of smaller companies, these firms can cost-justify their investment from lower workers’ compensation costs alone. In addition, they reap the benefits from increased productivity and improved employee morale. On-site occupational health partners who understand work site safety and workers' compensation now bring the savings and benefits—once reserved for large corporations—to the mid-size sector.

Curtis Smith is Executive Vice President at Medcor, Inc., a provider of work site clinics to employers of all sizes. Smith has helped Medcor implement and operate on-site clinics for employers across a broad spectrum of industries, including manufacturers and distribution and logistics firms. He helps integrate clinical, operations, and technology teams. He has nearly 30 years of experience in delivering heath care services, including emergency service, on-site services, in public and private sectors. He has worked with large and small clients, in rural and urban settings, with union and non-union labor, and with government agencies. Smith may be reached at [email protected].

Posted by Curtis Smith on Jul 10, 2015