Onsite Clinics: Lessons from a Virtual Care Pivot During the COVID-19 Pandemic
By Maria Henderson, MS, CDMS
VP, Workforce Health Strategy and Innovation,
University of Pittsburgh Medical Center
By Kristin Hasley, MHPE
Sr. Director, Health & Productivity Integration
University of Pittsburgh Medical Center
The COVID-19 pandemic has accelerated the utilization of virtual care at an unprecedented pace — creating demand and opportunity for new applications and solutions.
Before this, adoption of telemedicine had been slow despite technology advances that moved telemedicine into high-volume, everyday uses such as a convenient doctor visit through a phone app. It took a spreading pandemic to elevate telemedicine to a key healthcare gateway — largely due to its scalability and effectiveness for social-distancing patients.1,2 We have a unique window of opportunity to leverage telemedicine’s popularity and efficiency to dramatically expand access to onsite clinics and improve the total population health of the workforce and their families.
Understanding the Complexity of Accessibility
The federal Healthy People 2020 program holds that access to health services involves three distinct steps:3
- gaining entry into the healthcare system (usually through insurance coverage);
- accessing a location where services are provided (geographic availability); and
- finding a provider who the patient trusts and can communicate with (personal relationship).
For employers that have invested in onsite clinics to improve workforce health and productivity outcomes, access has become an increasingly complex topic.
The Financial Aspect
Most employers provide insurance coverage, but the out-of-pocket cost of care can still place a significant financial burden on your workforce — especially on entry-level or lowest-wage earners. Although many employers are now paying a high entry-level wage such as $15 per hour, a one-time $500 healthcare bill still equals more than a full week’s pay after taxes for those workers. And even before the COVID-19 economic impact, a 2018 survey found that 58% of Americans have less than $1,000 in savings.4
It is important to analyze the financial impact of your healthcare plan design on your workforce’s most vulnerable segment: the lowest paid, especially those with chronic conditions who have ongoing expenses. In value-based healthcare models, providing access to no-cost or very low-cost preventive and primary care services can reduce unnecessary emergency room visits and preventable hospitalizations. Conversely, delays in receiving appropriate care can lead to higher rates of disability and absenteeism; in some environments, it can motivate employees to shift medical costs over to workers’ compensation where 100% of services are covered.
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