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Purchasing Guide for Selecting an On-Site or Near-Site Health Center Manager
Author
Joe VanDeGraaff
Author
Ruirui Sun
In response to the high and variable costs of local health care providers and the challenges associated with finding timely access to quality care, many employers (public and private) and unions are offering health centers on-site, near-site, or shared with nearby companies to better address the health care needs of covered employees and their dependents.
This report is a collaborative effort by KLAS Research and the National Association of Worksite Health Centers (NAWHC) aimed at offering guidance on the essential factors to consider when selecting a vendor to manage a worksite center. This guidance is applicable even when a third-party agency, such as a broker, is involved in the process. Best practices below come from KLAS and NAWHC research, including insights from employers and unions who have implemented health centers.
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Primary Drivers for Employers to Offer On-Site or Near-Site Health Centers
The value of successful employer-sponsored health centers comes from:
- Reduced health care costs, based on likely fewer visits to emergency departments or urgent care centers
- Improved quality of care and health outcomes
- Increased worker productivity, by helping reduce travel time to obtain care services, often resulting in reduced absenteeism
- Enhanced recruitment and retention from greater worker satisfaction with benefits and overall engagement
- Enhanced access and improved coordination of care
- Integration of benefits and data
- Reduction in occupational injuries and illness
- Higher engagement in other employer-sponsored benefit programs
Overview of the Market: Approaches and Current Market Landscape
The decisions regarding the management of on-site or near-site health centers hold significant importance. Employers have the option of either managing and staffing the center themselves or outsourcing these responsibilities to an external entity. Depending on the employer’s relationship with its workforce, opting for external management can be advantageous in fostering patients’ trust and ensuring confidentiality, which are crucial for maximizing utilization of the center. Patients may otherwise perceive health care providers in these clinics as employees of the employer or union. Optional management approaches are listed in the chart below:
Guidance and Best Practices
Below are suggested best practices and recommendations for selecting a health provider or third-party vendor to manage your health center:
Become familiar with the breadth of your options for health center management (even when working with a benefit advisor)
- Find a health benefit advisor with knowledge and experience in matching employers with the health center management model that best fits the culture of the firm, its objectives, and space and budget limitations.
- Don’t limit your search to just those vendors known by your health advisor or used by other employers—there are dozens of options in the market.
- Visit other employers’ centers and those operated by potential management partners to observe their operations and gather feedback from patients.
- Ask questions about the vendors’ long-term stability. Inquire about any recent or upcoming changes in ownership.
- Consider the healthcare technology solutions used by vendors—seek understanding of how they approach technology and their consideration of factors like data sharing and IT security.
Assess how well vendors align with your culture, benefit strategies, demographics, values, and goals
- Regardless of who manages your health center, interview the health providers who will be delivering services to your employees/members to ensure they understand the workplace environment, culture, and population and are comfortable providing the types of services you want in settings where you want care delivered.
- Conduct multiple reference calls for vendor finalists.
- Be picky about references—ask for a list of clients that are similar in industry, size, and potential staffing and scope of services.
Clearly define and align how the vendor calculates financial value and measurement of performance
- Ask these questions:
- What approaches and reports does the vendor provide to help you see value on investment and/or return on investment?
- How well do these approaches and reports align with your needs and what you want to measure?
- Do you have the technology, tools, and experience to measure all areas of performance required?
Determine the right health center location based on your needs
- Factors to consider:
- On-site, near-site, or shared site
- Distance from workplace, employee homes; ease of access
- Virtual versus in-person services
- Use of a mobile clinic, hosting care events
- Health care staff and licensure requirements in your area
- Location safety, security, and confidentiality so dependents can easily access services
- Possible tactics:
- Complete a geo-access study to determine where you can place the health center to get the greatest utilization by workers and their dependents.
- Conduct a survey and/or focus group of employees to see how far they are willing to travel to access the health center.
- Plan with growth in mind—assuming your health center is successful, you’ll need to address questions like what other services can be provided within the health center footprint or whether you can add more space to accommodate increasing demand.
Get a clear picture of the legal and regulatory considerations
- Work with attorneys who are experienced in the field of worksite health centers so you understand the many legal considerations and regulatory requirements (e.g., ERISA, COBRA, HIPAA).
- If appropriate, learn how Health Savings Account (HSA) plans or other high-deductible health plans will coordinate with your health center.
Common Challenges
Employee utilization:
Without strong utilization, a health center has little chance of succeeding. Continually market the services and benefits of the health center; share testimonials, including leadership endorsements. Make sure you have excellent health care providers. Incorporate all wellness and health programs into the health center. Offer incentives for using your health center.
Experience with providers:
Employee utilization and perception of the health center is closely tied to their experiences with providers. Providers should be aligned with the employer in terms of both cultural/personal fit and buy-in to the unique care model.
Ownership and accountability:
Without the right tools, motivation, and understanding of employer expectations, health center managers may find it challenging to achieve desired financial and health outcomes. Support accountability by requiring reports at appropriate times.
Peer Recommendations
Shared by members of the National Association of Worksite Health Centers
- Do an RFI before sending out an RFP to determine whether the vendors and providers you are considering will meet your requirements and expectations.
- Integrate all health and wellness data and programs. This helps avoid fragmentation, as does requiring all other health benefits vendors to share data with the health center vendor.
- Provide the vendor with access to your health plan and PBM data so (1) the manager knows the prevalence of high-risk conditions and health care costs, with the goal of supporting partnered outreach and clinic service offerings, and (2) providers can plan to address these effectively. Have the center submit zero-dollar claims to your health plan so they have a full picture of service utilization.
- Make sure your center is considered a network provider within your health plan’s network.
- Have any patient portal, health navigation tool, or advisor service list the center as the most accessible and affordable location for care to increase utilization and acceptance.
- Encourage patients to inform their personal physician of the center’s services and share visit data, labs, and other reports with the center.
About KLAS Research
Driven by a mission to improve the world’s health care, KLAS is a health care–focused research firm whose data helps provider, payer, and employer organizations make informed software and services decisions. Powered by insights and experiences discovered in the 25,000+ interviews with health care organization leaders and end users that KLAS conducts each year, KLAS’ work creates transparency in the health care market and acts as a catalyst for software vendors and services firms to improve their offerings.
About National Association of Worksite Health Centers
Formed in 2012, the National Association of Worksite Health Centers (www.NAWHC.org) is a not for profit, 501(c)3 organization focused on assisting public and private employers, unions and other sponsors of worksite health programs in getting the greatest return from their on-site, near-site, shared, mobile, and virtual health centers. NAWHC offers benchmarking, networking, and educational services, as well as the nation’s largest clearinghouse of information on worksite health centers and the marketplace.
NAWHC also provides opportunities for those vendors, suppliers and consultants that support worksite health facilities and programs to interact with and learn about employers who offer on-site and near-site centers.
Authors
Larry Boress
Executive Director, National Association of Worksite Health Centers
Joe Van De Graaff
Vice President of Digital Health & Security, KLAS Research
Ruirui Sun, PhD
Insights Manager, KLAS Research
Amanda Wind Smith
Senior Writer, KLAS Research
Jess Wallace-Simpson
Manager of Art, KLAS Research
Writer
Amanda Wind Smith
Designer
Jess Wallace-Simpson
Project Manager
Andrew Wright
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.