Wake County plans employee clinic to cut health-care costs

mquillin@newsobserver.comApril 12, 2013 

— Wake County plans to open a pair of clinics this fall it hopes will help improve the well-being both of its employees and of its health-care budget.

The clinics, to be run by a private contractor, would provide primary care, disease prevention and management services at no cost to the more than 3,300 employees on the county’s health-care plan. To encourage use of the clinic, workers would be allowed to schedule visits without taking unpaid time off work.

Deputy Wake County Manager Johnna Rogers told the Board of Commissioners this week that the county could save about $200,000 in the first year of the clinic’s operation. Eventually, she said, the clinic could save the county between $500,000 and $1 million a year compared with current health care costs.

“You’re getting employees taken care of quicker and at lower costs; that’s the short-term benefit,” Rogers said. “But in the long term, you end up having a healthier workforce, which does nothing but bring down overall health care costs.”

Wake County is self-insured; employees pay a monthly premium to participate in the health plan, and the county budgets about $30 million a year to pay employees’ medical costs.

Rogers said the clinics would save money several ways: by reducing payments to private providers, by making it easier for employees to gain access to basic care when they need it – preventing bigger health-care issues down the road – and by reducing illness-related absenteeism and increasing productivity.

County commissioners are expected to vote on the proposal Monday.

A three-year trial

If approved, the plan would create two clinics that would operate with the same staff on alternating days. One would be in the county office building on Fayetteville Street, the other most likely on Falstaff Road, near WakeMed. Those two locations would be convenient to a large portion of the county’s workforce, Rogers said. The county would have to spend about $20,000 in renovations for each location, mostly to add sinks and an exam room.

The county would test the concept with a three-year contract with Marathon Health Inc. of Vermont, which runs on-site clinics for private companies around the country. Under the contract, the county would pay Marathon $447,046 a year to provide a nurse practitioner or physician assistant, and a medical assistant to help with paperwork and scheduling. The clinics should be able to see as many as 15 patients a day, according to Marathon CEO Jerry Ford.

Rogers said Wake County began looking into the possibility of opening on-site clinics following a trend that began a couple of years ago as county and municipal governments have looked for ways to reduce their employee health care expenses.

Corporations have used the model for decades. SAS Institute has had an on-site health care center at its Cary headquarters since 1984, and company spokeswomen Shannon Heath said more than 90 percent of employees use its services. The clinic has a staff of 58, with 10 nurse practitioners and four family practice physicians, along with nutritionists, nurses, pharmacists, pharmacy technicians, a psychologist and physical therapists. It has a full-service lab and pharmacy. Employee dependents also can use the clinic, Heath said.

Wake County could expand the services at its clinics to include a pharmacy, Rogers said, but in the beginning, clinicians will write prescriptions that patients will have filled elsewhere.

Seeing results elsewhere

Several counties in North Carolina have launched clinics.

Cumberland County opened one last fall as an expansion of its wellness efforts, which, like Wake’s, already included encouraging employees to get regular readings of their blood pressure, blood sugar, cholesterol and other biometrics. They are also encouraged to attend classes or see specialists to try to improve potentially troublesome areas.

County spokeswoman Sally Shutt said clinic staff are county employees, not private contractors. The clinic has a pharmacy and a classroom where it offers Zumba classes and programs on stress management.

Since it opened in mid-August, the clinic has had 1,138 patient visits. The county has about 2,500 employees and another 1,600 retirees and dependents who can use the clinic.

Nash County started its employee health clinic about 18 months ago. “Like everybody else’s, our costs were skyrocketing,” said County Manager Bob Murphy. After putting on a employee health fair, then hiring a wellness coordinator, putting a health clinic in the county office building in Nashville was the next logical step, he said.

The county hired Healthstat, one of Marathon’s competitors, to run its clinic. The county’s health care costs have stopped escalating over the past couple of years, Murphy said, and employees’ biometrics – which the county only sees in aggregate, to protect patients’ privacy – have improved as they get more regular health care and advice.

“I can tell you there are lots of people here who, working with a clinician, have quit smoking. They have lost weight. They have reduced their blood-sugar profiles. They have reduced cholesterol. And we know that over time this is going to have a significant impact on our claims.”

Shutt and Murphy said their clinics did not encounter significant distrust among employees, a potential issue for some Wake County commissioners when they heard the clinic proposal. Federal HIPAA regulations protect patient privacy, unlike in the old days, when manufacturing workers worried that going to company nurses and doctors might result in their losing their jobs.

On the contrary, Murphy said, “The vast majority of employees now consider it to be a benefit.”

Quillin: 919-829-8989

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