Guest Post: 3 Key Reasons Companies Should Embrace Corporate Clinics

September 26th, 2017 by Rob Indresano, COO, Barton Associates

A number of large corporations are taking a unique approach to healthcare by employing a resident physician, nurse practitioner or physician assistant to tend to the needs of workers and their families.

Models range from small clinics, such as the CVS Minute Clinic, to larger facilities that offer a full array of primary care services. While many companies opt to house the clinics on-site, some organizations have partnered with internal branches or outside firms to provide healthcare services at off-site locations.

For companies and employees alike, corporate clinics are an attractive option. These clinics keep costs in-house, giving companies greater control of healthcare expenditures. Corporate clinics can also reduce the time employees take off work to receive basic medical care, encouraging workers to seek routine care more regularly. In turn, this leads to better overall employee health and fewer sick days.

Better yet, these in-house clinics are available to employees as well as their dependents. Corporations spend less money to provide employees and their loved ones with more and better care. It’s a win-win situation.

The corporate clinic movement stems from a dramatic rise in overall healthcare costs and the amount of time employees aren’t at work for minor medical issues. The movement stuck because employees and their families became healthier and happier, with productivity booming for companies that adopted the model.

As corporate clinics became more popular, many factors combined to guarantee their success. Locum tenens, for instance, made it possible for corporations to seamlessly launch and staff corporate clinics as the need arose. Telemedicine continues to grow in popularity — Kaiser Permanente reported 52 percent of its 110 million patient visits in 2015 were done via telemedicine — making it possible for corporations to expand the scope of care while driving down costs.

Making the Case for In-House Care

The average American spends more than 90,000 hours at work over the course of her life. As the Centers for Disease Control and Prevention has noted, personal and family health problems cost companies about $226 billion annually in lost productivity. It’s easy to understand why a healthy work environment is vital to a happy and productive workforce.

Some companies already enjoy the benefits of on-site clinics. The clinics bring employees everything from primary and preventive healthcare to physical therapy, pharmacists, dentists, optometrists, and more. These clinics help lower insurance costs, improve health and job satisfaction, and increase productivity.

Toyota in 2007 opened a $9 million corporate clinic at its San Antonio truck manufacturing plant. The company has reported a 33 percent decrease in specialist referrals and a 25 percent drop in employee visits to urgent care clinics and emergency rooms.

Intel had similar goals when the technology titan launched its own corporate clinics in 2011. Company officials hoped workers would be more likely to visit the in-house doctors, ideally curtailing chronic issues such as heart disease and diabetes in the process. The company paid about $1 million to build and another $1.5 million to operate each clinic, though Intel has since managed to break even on those operating costs.

Employers enjoy short-term benefits such as greater control over direct costs for specialist visits, prescriptions, and trips to the emergency room. In the long run — and perhaps more important — corporate clinics can help establish new healthcare policies and wellness programs to promote healthier lifestyle choices for employees.

How Corporate Clinics Will Change the Business World

With perpetually increasing healthcare costs and a tremendous potential for return on investment, the corporate clinic model is set to alter healthcare and business in three important ways:

1. Reduced healthcare spending. Corporations with on-site or near-site health services spend less money on healthcare. It’s as simple as that. HanesBrands, for example, reports saving about $1.40 for every $1 the company spends on its in-house clinic. Companies can then take that savings and instead invest in other business-related purposes.

2. Healthier, happier, and more productive employees. Rather than taking time off work to visit a doctor or risking lost income, employees often forgo care for relatively minor issues. This becomes problematic, considering the chronic diseases doctors often detect through repeat visits account for 75 percent of U.S. healthcare spending. Easy access to primary care services means employees are willing and able to see on-site providers for more routine health concerns they might have otherwise neglected.

3. Greater transparency regarding treatment costs. Almost everyone has received a bill from his insurance at some point listing a litany of codes and featuring a hefty amount due at the end. On the flip side of that coin, most physicians are kept in the dark about the costs of treatments so they can prioritize patient care above all else. Corporate clinics can alleviate some of the secrecy surrounding healthcare costs by being transparent about employee treatment. This can actually lead to improved care and lowered costs, with on-site physicians working in tandem with company leaders to drive down expenses.

As more companies find value in corporate clinics, an increasing number of large corporations will likely bring medical services in-house to help drive down bloated healthcare costs. Mid-sized businesses might also be tempted to explore the possibility of creating their own clinics given the potential cost savings. The shift will help foster a culture of health in the United States that benefits employers, employees, and communities.

Rob Indresano, Chief Operations Officer, Barton Associates

About the Author: Rob Indresano is president and COO of Barton Associates, a national recruiting and staffing firm based in the Boston area that specializes in temporary healthcare assignments. Rob is responsible for managing operations as well as the company’s strategic vision. Before joining the Barton team, Rob was vice president and general counsel for Oxford Global Resources Inc. and corporate counsel for Oracle Corp.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

Empathy Interviewing Elicits Patient’s ‘Story,’ Uncovers Social Determinants of Health

September 26th, 2017 by Patricia Donovan

social determinants of health

Healthcare must mitigate patient risk factors outside of the hospital, referred to as social determinants of health (SDOH).

If healthcare hopes to move the needle on runaway expenses and improve the health of its communities, it must first focus on patients’ social and environmental circumstances, also known as social determinants of health (SDOH).

That’s the advice of Cindy Buckels, director of population health for TAV Health, which helps healthcare organizations navigate the challenges of SDOHs.

“When we don’t address these issues as we’re addressing someone’s health, we get high readmissions, negative outcomes and dissatisfaction. There’s also increased cost and increased risk,” noted Ms. Buckels during Social Determinants of Health: Using Empathy Interviewing To Help Care Teams Understand Factors Impacting Patient Health, a September 2017 webinar now available for rebroadcast.

To encourage individuals to open up about economic, educational, nutritional, or community deficits they face that drive 60 percent of their health outcomes, TAV Health recommends care teams employ empathy interviewing, also known as motivational interviewing (MI).

“With motivational interviewing, you’re entering into a relationship with a person, not as the expert, but as a partner coming alongside to help them find their own strengths, and affirming them as a person in order to affect positive change,” said Ms. Buckels. Her presentation included a review of the four core skills of motivational interviewing (“Listen for that positive nugget,” she urges), as well as ‘back pocket’ questions to ask when the conversation stalls.

Finally, she outlined traps for care teams to avoid during an MI session, such as the urge to give advice. “Always ask permission to give information or advice. Don’t just assume that’s something that you can do, because you’ve picked up the phone and called them.”

It may take time to master, but ultimately, motivational interviewing is more effective than healthcare’s typical “Chunk-Check-Change” education approach in transforming patient ambivalence and effecting positive behavior change, she said.

Information gleaned from motivational interviewing, even minor details like a patient’s nickname or the presence of a cherished pet, should become part of the patient’s record so that every person along the care continuum who ‘touches’ that patient can access it.

“For example, if a patient’s legal name is Charlene, but she goes by Michelle, if you really want to build a relationship with her and gain her trust, you start by calling her what she goes by, which is Michelle.”

In closing, Ms. Buckels outlined a patient-centric workflow connecting all supportive organizations, healthcare providers, community organizations and family and friends within the patient’s circle of care, which places more eyes and ears on the individual. With communal oversight to report anything worrisome, the likelihood is much less that a socially supported patient will visit the ER or be admitted to the hospital.

Listen to Cindy Buckels explain the advantages of motivational interviewing over the “Chunk-Check-Change” educational approach.

Infographic: The Healthcare IT Journey

September 25th, 2017 by Melanie Matthews

Healthcare is undergoing a digital transformation as a growing number of organizations leverage emerging technologies to create care models that are more patient-centered, according to a new infographic by Insight.

The infographic explores seven key stops on the consumer-driven healthcare IT journey and illustrates how technology is supporting this evolution.

2016 Healthcare Benchmarks: Digital HealthDigital health, also referred to as ‘connected health,’ leverages technology to help identify, track and manage health problems and challenges faced by patients. Person-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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Infographic: Using Technology-Enabled Communications To Address Revenue Cycle Challenges

September 22nd, 2017 by Melanie Matthews

Healthcare providers are missing opportunities to drive timely payments, grow revenue and maximize reimbursements, according to a new infographic by Televox.

The infographic examines the revenue opportunities that healthcare providers are missing and how providers can avoid penalties and earn additional reimbursement.

Since the January 2015 rollout by CMS of new chronic care management (CCM) codes, many physician practices have been slow to engage in CCM. Arcturus Healthcare, however, rapidly grasped the potential of CCM to improve patient outcomes while generating care coordination revenue, estimating it could earn up to $100,000 monthly for qualified patients treated in its four physician practices—or $1 million a year.

Medicare Chronic Care Management Billing: Evidence-Based Workflows to Maximize CCM Revenue traces the incorporation of CCM into Arcturus Healthcare’s existing care management efforts for high-risk patients, as well as the bonus that resulted from CCM code adoption: increased engagement and improved relationships with CCM patients.

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SNF Visits to High-Risk Patients Break Down Barriers to Care Transitions

September 21st, 2017 by Patricia Donovan

For patients recently discharged from the hospital, a SNF visit covers the same ground as a home visit: medications, health status, preparing for physician conversations and care planning.

The care transitions intervention developed by the Council on Aging (COA) of Southwestern Ohio for high-risk patients starts off in the hospital with a visit by an embedded coach, and includes a home visit.

Additionally, to reduce the likelihood of a readmission, patients discharged to a skilled nursing facility (SNF) also can expect a COA field coach to stop by within 10 days of SNF admission. Here, Danielle Amrine, transitional care business manager for the COA of Southwestern Ohio, describes the typical SNF visit and her organization’s innovative solution for staffing these visits.

We conduct the home visit within 24 to 72 hours. We go over medication management, the personal health record (PHR), and follow-up with specialists and red flags. At the SNF, we do the same things with those patients, but in regards to the nursing facility: specifically, do you know what medications you’re taking? Do you know how to find out that information, especially for family members and caregivers? Do you know the status of your loved one’s care at this point? Do you know the right person to speak to about any concerns or issues?

We also ask the patients to define their goals for their SNF stay. What are your therapy goals? What discharge planning do you need? We set our SNF visit within 10 calendar days, because normally within three days, they’ve just gotten there. They’re not settled. There haven’t been any care conferences yet. We set the visit at 10 calendar days to make sure that everything is on track, to see if this person is going to stay at the SNF long-term. Our goal is to have them transition out. We provide them with all of the support, resources and program information to help them transition from the nursing facility back to independent living.

For our nursing facility visits, we also utilize the LACE readmissions tool (an index based on Length of stay, Acute admission through the emergency department (ED), Comorbidities and Emergency department visits in the past six months) to see if that person would need a visit post-discharge.

For our CMS contract, we are paid for only one visit. Generally we’re only paid for the visit we complete in the nursing home, but through our intern pilot, our interns do that second visit to the home once the patient is discharged from the nursing home. We don’t pay for our interns, and we don’t get paid for the visit. We thought that was a perfect match to impact these patients who may have a hard time transitioning from the nursing facility to home.

Source: Post-Discharge Home Visits: 5 Pillars to Reduce Readmissions and Engage High-Risk Patients

home visits

In Post-Discharge Home Visits: 5 Pillars to Reduce Readmissions and Engage High-Risk Patients, Danielle Amrine, transitional care business manager at the Council on Aging (COA) of Southwestern Ohio, describes her organization’s home visit intervention, which is designed to encourage and empower patients of any age and their caregivers to assert a more active role during their care transition and avoid breakdowns in post-discharge care.

Infographic: An Assessment of Acute Unscheduled Healthcare

September 20th, 2017 by Melanie Matthews

A healthcare model providing care at a high cost and with high rates of emergency department utilization, no matter the level of quality, is not sustainable, according to a new infographic by Phillips.

The infographic provides an assessment of acute unscheduled care, the demands on acute care providers, and use of the emergency department across 7 countries: Australia, Canada, Germany, the Netherlands, Switzerland, the United States, and the United Kingdom.

In the sphere of value-based healthcare, chronic care management (CCM) is a critical component of primary care and population health management. Targeting the Triple Aim goals of better health and care for individuals while reducing spending, CCM is viewed as a stepping-stone to success under Medicare’s Quality Payment Program that launched January 1, 2017.

2017 Healthcare Benchmarks: Chronic Care captures tools, practices and lessons learned by the healthcare industry related to the management of chronic disease.

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Infographic: Are Specialty Practices Prepared for MACRA?

September 18th, 2017 by Melanie Matthews

A growing number of specialty physicians, comprised mainly of oncologists and urologists, recognize that clinical, financial and operational changes are needed to be successful under value-based healthcare reimbursement models stemming from MACRA regulations. However, the majority has not yet invested in organizational, IT, or service improvements needed to achieve them, according to a new study by Integra Connect.

A new infographic by Integra Connect highlights the survey findings, including details on the barriers to MIPS success and practices’ plans to optimize MIPS success.

Under CMS’s “Pick Your Pace” choices for Year 1 Quality Payment Program participation, physician practices may opt for the minimum activity necessary to avoid a payment penalty in 2019 by simply submitting some data in 2017.

However, instead of delaying MACRA participation to the later part of this year, physicians should prepare and better position themselves today for MIPS success by analyzing their existing CMS data on their practices’ performance and laying a path now toward performance improvement.

Physician MACRA-Readiness: Mining QRUR and Other CMS Data to Maximize MIPS Performance describes the wealth of data analytics available from the CMS Enterprise Portal–Quality Resource Use Reports (QRURs) and other reports providing a window into practice performance under the Merit-Based Incentive Payment System (MIPS). MIPS is one of two MACRA reimbursement paths and the one where most physician practices are expected to align.

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Infographic: A Tale of Two Health Consumers: Millennials vs Boomers

September 15th, 2017 by Melanie Matthews

Millennials and baby boomers account for about half of the U.S. population. But as health consumers, they have little in common, according to a new infographic by Oliver Wyman.

The infographic compares the key differences between baby boomers and millennials in terms of healthcare services and costs.

Framework for Patient Engagement: 6 Stages to Success in a Value-Based Health SystemIntermountain Healthcare’s strategic six-point patient engagement framework not only has transformed patient care delivered by the Salt Lake City-based organization but also has fostered an attitude of shared accountability throughout the not-for-profit health system.

Framework for Patient Engagement: 6 Stages to Success in a Value-Based Health System details Intermountain’s multilayered approach and how it supports its corporate mission: Helping people live the healthiest lives possible.

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18 Success Strategies from Seasoned Healthcare Case Managers for New Hires

September 14th, 2017 by Patricia Donovan

Advice from case management trenches: “Don’t do more work for your patient than they are willing to do for themselves.”

What does it take to succeed as a healthcare case manager? For starters, patience, flexibility and mastery of motivational interviewing, say veterans from case management trenches.

As part of its 2017 Healthcare Benchmarks Survey on Case Management, the Healthcare Intelligence Network asked experienced case managers what guidance they would offer to new hires in the field. Respondents were thoughtful and generous with their advice, highlights of which are shared here.

It’s important to note that in total, a half dozen veterans identified motivational interviewing as an essential case management skill.

We hope you find these tips useful. We invite all experienced case managers to add your tips in the Comments below.

  • “It’s hard work but satisfying. It takes a good year to get all resources and process, so don’t give up.”
  • “Learn the integrated case management model and get ongoing coaching in motivational interviewing.”
  • “Listen, think, develop, coordinate, adhere to plan benefits, and be honest.”
  • “Communicating and developing a relationship with members are key.”
  • “Be aware of and utilize telemedicine.”
  • “Be prepared to help patients with non-medical matters. Develop a trust bond, almost as a family member, and your medical-focused concerns will be that much easier to handle.”
  • “Always remain flexible. Listen and meet the patient where they are at in their disease and life process.”
  • “Understand both the clinical and financial impacts of healthcare on the patient.”
  • “Establish a good working relationship with your manager. Ensure you understand job expectations and identify a mentor.”
  • “Time management is crucial.”
  • “Stay visible within the practice; interact regularly with the care team; share examples of success stories.”
  • “Compassion and empathy are a must.”
  • “Don’t become overwhelmed by all that needs to be learned. Strive for sure and steady progress in gaining the knowledge needed.”
  • “Don’t let a fear of the unknown hold you back. Learn all that you can.”
  • “Get a good understanding of the population of patients you are working with. Study motivational interviewing and harm reduction.”
  • “This is a wide body of knowledge. Each case is different. It takes six months to a year to be fully comfortable in the practice.”
  • “Establish boundaries with your patients, and don’t do more work for your patient than they are willing to do for themselves.”
  • “Earn the trust of your patients and providers. LISTEN to your patients.”

One respondent geared her advice to case management hiring managers:

  • “Hire for coaching mentality and chronic disease experience.”

Excerpted From: 2017 Healthcare Benchmarks: Case Management

2017 case management benchmarks

2017 Healthcare Benchmarks: Case Management provides actionable information from 78 healthcare organizations on the role of case management in the healthcare continuum, from targeted populations and conditions to the advantages and challenges of embedded case management to CM hiring and evaluation standards. Assessment of case management ROI and impact on key care components are also provided.

Infographic: Televisits Enhance Patient Experience

September 13th, 2017 by Melanie Matthews

Patients are twice as likely to have had a televisit with their primary care physician than through a telemedicine service, and a majority of patients are introduced to televisits by their physicians, according to a new infographic by the Health Industry Distributors Association.

The infographic examines televisit trends, including the top three reasons patients choose a televisit instead of an office visit; televisit adoption levels; and patient satisfaction rates with televisits.

UnityPoint Health has moved from a siloed approach to improving the patient experience at each of its locations to a system-wide approach that encompasses a consistent, baseline experience while still allowing for each institution to address its specific needs.

Armed with data from its Press Ganey and CAHPS® Hospital Survey scores, UnityPoint’s patient experience team developed a front-line staff-driven improvement action plan.

Improving the Patient Experience: Engaging Front-line Staff for a System-Wide Action Plan, a 45-minute webinar on July 27th, now available for replay, Paige Moore, director, patient experience at UnityPoint Health—Des Moines, shares how the organization switched from a top-down, leadership-driven patient experience improvement approach to one that engages front-line staff to own the process.

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