May 31, 2012
The doctor is in…my office
In my last post, I shared the results of a research project into the relationship between health risks factors and health care utilization and costs. This relationship is especially pertinent for employers as they look at ways to contain health care costs, which continue to rise. The study showed that reduced health risk factors are associated with decreases in both health care utilization and cost. Basically, the healthier you are, the less care you’ll require.
The question for employers now becomes how to help their employees get healthy and stay healthy. One way that employers are pursuing this is by offering on-site care through clinics and pharmacies. It is important to note that on-site care has many advantages, but also responsibilities and risks. Employers need to ensure that the clinics abide by all applicable laws and regulations. At the request of one of our national employer clients, I worked with Ross Miller, MD, MPH, on the Cerner Employer Services team, and others to perform a review of the literature to evaluate legal compliance and risk management strategies of on-site clinics, and understand the consequences for noncompliance from a risk management perspective.1
Among the compliance topics identified and assessed, patient privacy was the most often reported, followed by employers inappropriately influencing provider treatment decisions. Consequences for noncompliance included fines, civil actions, loss of licensure and, potentially, criminal charges, as well as employee mistrust and lowered standards of care. All can jeopardize onsite clinics’ ability to demonstrate a return on investment.
But do on-site facilities really make a difference to patients? Research into medication adherence suggests yes. Low medication adherence rates contribute to poor health outcomes, decreased quality of life and increased health care costs. On-site health centers may improve medication adherence through convenient, high-quality and cost-effective care. In another recent study, Dr. Miller and I, along with our colleagues, found that patients who used Cerner’s on-site clinic, especially those who filled prescriptions at our pharmacy, generally had higher medication adherence than those who used offsite facilities. In particular, medication adherence was statistically higher among participants in our condition management programs compared with patients not enrolled. These results further support the value of on-site health centers and condition management for Cerner associates and our clients.
1Gorman K, Miller R., Managing the risks of on-site health centers: a review for employers. AAOHN. 2011;59(11):483-490.
Kathleen M. Gorman, MPH, is a scientist with Cerner LifeSciences and has been involved with a variety of projects that promote best practices and evidence-based medicine. Increasingly, she has been focused on researching the value of employer-sponsored wellness initiatives. Prior to joining Cerner, she was a researcher at The Parkinson’s Institute. Ms. Gorman holds a BS from the University of California, Santa Cruz and an MPH from the University of California, Los Angeles.