The doctor is in — in your office, that is, and the result is better health
March 1, 2018 | Shari Rudavsky | IndyStar
Getting her weekly allergy shot used to take Lynne Corydon away from work for hours. She would have to drive to her allergist’s office, wait for her appointment, get the shot, wait around for a bit more to make sure she was not having a reaction and drive back to work.
Now, Corydon needs only walk through the halls of the MacAllister Machinery campus where she works to the on-site medical clinic. There she knows that she will immediately be taken back to one of the three exam rooms, receive her shot, wait a bit to make sure she has no reaction and then head back to her desk within about half an hour.
In an effort to bring better health care to employees, MacAllister hosts an on-site health clinic that provides easy access to primary care. The two providers there develop close relationships with their patients, helping them set and achieve health goals, as well as providing urgent care.
MacAllister’s clinic is one of 42 clinics that Activate Healthcare operates the country, many on-site of large employers such as MacAllister, which are self-insured which means they pay health care claims themselves rather than going through a third-party insurer.
Such clinics are increasingly gaining in popularity. Earlier this week, CNBC reported that Apple has plans to launch its own version of the on-site clinic to improve employee health.
Activate bills its on-site clinics as helping to save overall costs through improving employee health.
MacAllister had an innovative wellness program for employees about five years ago when it heard about Activate, an Indianapolis-based company that operates the clinic. But Christopher MacAllister, the company’s president and chief operating officer, wanted to take it one step further.
“The relationship that the clinic has with our folks is a differentiator,” said MacAllister, the third generation to run the family company. “To change behaviors, you have a better chance if you have a relationship with a health provider.”
When the clinic opened in repurposed office space in MacAllister’s former headquarters on the east side. When MacAllister moved to a brand-new headquarters on the south side last fall, though, the new campus included a space specifically designated for the clinic.
The new clinic looks much like a regular doctor’s office, albeit a small one with three exam rooms and one shared provider’s office. Two medical assistants staff the small reception area.
Although all the clinic employees work for Activate, not MacAllister, the clinic has tight ties to the company. When it came to hire a new physician for the clinic about a year and a half ago, Chris MacAllister also interviewed the doctor, Aaron Kalinowski, and now sees him for his own care.
“I view Dr. K as part of our team,” MacAllister said.
Employees do not pay to see the providers in the clinic, which is open five days a week. The clinic has a small pharmacy that dispenses the most common medications for a $4 co-pay. The clinic also offers free basic lab work, such as cholesterol and A1C tests, tests for urinary tract infections, and rapid flu tests. And should anyone on site go down with a heart attack, as has happened, the on-site providers can be there immediately to resuscitate them.
Activate providers have the luxury of not having to see a set number of patients a day. That means they can take the time to talk with patients and make suggestions about steps those patients can take to improve their health.
Gene Cosler, a MacAllister used equipment supervisor, would stop by the clinic frequently at the beginning or end of his work day to pick up prescription refills or just say hello to his provider, physician assistant Karen Johnson.
The convenience and basically non-existent cost drew him at first but he also appreciated the care that Johnson provided. Not only did she help him deal with pesky sinus problems, she also urged him to maintain healthy habits.
“Karen will keep me on track and that’s good,” Cosler said. “People can become complacent and sometimes you need a little boost to keep you on track.”
In some regards, the on-site clinic fits the model of what providers call “a medical home,” a site through one siphons all of one’s health concerns.
But there are some key differences, notes Dr. David Claud, Activate national chief medical officer. The Activate clinics operate independently, so if a patient needs a specialist or imaging services, the Activate doctor will have no incentive to refer that person to a specific health system but will choose the referral that is best for that patient.
Other primary care clinics also do not have as uniform a patient populations as the Activate clinics do, Claud said. Activate operates 28 health clinics in Indiana and 42 nationwide, each with a specific patient population that may have specific health needs.
“Because of the nature of our model, our providers have a much better understanding of the problems their population has,” Claud said. “There’s interesting features of each population and our providers get to know and understand who their population is very well. … A medical home is not going to have such a clearly defined and unique population.”
For instance, while the MacAllister clinic does not perform drug screens, the two providers have gone through training to certify them to provide Department of Transportation physicals, required annually of the few hundred MacAllister employers who are drivers.
Other Activate clinics that require providers to perform such physicals include school systems or other industries with special licenses that require physicals, which otherwise might cost an employee or employer $150 a shot.
Activate keeps careful track of how employees’ biometrics change in the face of a clinic opening. The company promises that for every $1 the employer spends, the company will see $1.50 back. At MacAllister, the company has seen cholesterol levels reduce by 56 percent, blood pressure by 61 percent and employees’ body mass indices by 33 percent.
For now, Chris MacAllister said, he has yet to see the company’s health care costs go down but a number of factors could play into those calculations, including the rising costs of health care and the facts that improving health tends not to happen overnight.
“Risk factor management is long-term,” Kalinowski said. “I think it’s really hard to quantify savings.”
Activate calculates that its clinic for Monroe County government employees has saved the county $8 million over what their health care trend would have been without opening a clinic six years ago.
“That’s the long-term play,” said Nathan Mowery, president of Activate Healthcare of Indiana. “We’re putting in place building blocks to address that.”
As for MacAllister, he has no complaints about the clinic in his company.
“We don’t have any doubt that the clinic … more than pays for itself,” he said.