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If Amazon follows through with plans to build clinics for its workers, it would join a parade of large employers putting health centers at the worksite.
The first Amazon clinic would be at its Seattle headquarters, according to CNBC, which said the online retailer “is starting small with a pilot, but is looking to expand the effort early next year.”
Other employers are further along than Amazon with one-third of employers with at least 5,000 workers now offering “a general medical clinic to their employees,” Mercer ’s 2017 National Survey of Employer-Sponsored Plans shows. That’s a big jump from five years when only 24% of large employers offered medical clinics for their workers and just 15% a decade ago, Mercer data shows.
Exactly what Amazon comes up with is captivating the employer community and the healthcare industry given Amazon is pushing deeper into the healthcare space on several fronts. Jeff Bezos’ Amazon, Warren Buffett’s Berkshire Hathaway and JPMorgan Chase & Company announced in January plans to create an “independent company” to improve healthcare and lower costs for their more than one million employees.
Amazon and its partners also hired Dr. Atul Gawande to lead the new company and he’s known for his efforts to promote value-based medical care and population health to make sure people get treated in the right place, at the right time and with the right amount of care. Worksite clinics would be in keeping with the mission of Gawande’s Ariadne Labs where he’s been founding executive director of an organization that says its mission “is to create scalable health care solutions that deliver better care at the most critical moments of people’s lives, everywhere.”
The idea for worksite clinics is to make it easier for employees to get primary care treatment and make sure they are getting regular treatment in the first place. Compliance has long been a problem in the U.S. even for Americans with health coverage.
“Worksite clinics offering primary care services have the potential to cost-effectively address other pressing problems with current US health care: poor access to routine care, pharmacy cost, lack of coordinated and patient-centered treatment models, fee-for-service payment mechanisms that reward quantity over quality, and even low rates of childhood immunizations,” Mercer’s worksite clinic consulting group leader David Keyt said.
Worksite clinics vary across the country, but often involve a local healthcare provider managing or staffing the worksite clinic. In northeastern Wisconsin, for example, the local healthcare system Bellin Health has a clinic on site at the big shipbuilder Fincantieri that provides an array of health services from physicals and immunizations to “health coaching.” Bellin executives have said that the clinic helps its workers, which include a lot of men in their 40s and 50s make sure they are seeing a doctor or other healthcare provider and getting preventive quality care.
Increasingly, worksite clinics are providing a wider array of healthcare services beyond occupational care.
“Where worksite clinics once focused on treating work-related illnesses and injuries, employers are increasingly using them to provide a wide array of primary care services,” Keyt said. “These offerings range in scale from a single nurse to comprehensive patient-centered medical homes. Worksite clinics are also increasingly offering ancillary services, including chronic condition management, physical therapy, chiropractic care, mental health, pharmacy, and more— without shifting undue cost to workers.”
Amazon could also be using the worksite idea to study a new approach to retail healthcare given brick-and-mortar rivals like Walgreens Boots Alliance, CVS Health and Walmart have for years been offering healthcare services staffed by nurse practitioners and other primary healthcare providers at retail health clinics inside their stores.
But not all employers have worksite clinics and part of the reason could be their budgets for healthcare given smaller employers haven’t flocked to the worksite clinic trend as quickly.
Mercer data shows growth has been slower among employers with 500 to 4,999 workers with 18% providing a “general medical clinic.” That compares to 13% of employers who had clinics 10 years ago, Mercer said.
