U.S. Families' Use of Workplace Clinics, 2007-2010

NIHCR Research Brief No. 10 | October 2012 | By Ellyn R. Boukus and Ha T. Tu

Despite growing employer interest in workplace clinics as a tool for containing health care costs, only 4 percent of American families reported visiting a workplace clinic in 2010 -- the same proportion as in 2007, according to a national study by the Center for Studying Health System Change. The severe 2007-09 recession likely dampened employer investment in workplace clinics, and job layoffs reduced the number of workers with access to existing facilities.

Who Has Access to Workplace Clinics

Workplace clinics were concentrated among large, self-insured employers with stable workforces and high concentrations of employees at individual locations. Only a subset of American families had realistic access to these facilities. Among families most likely to have access -- those with ties to large firms and government employers -- clinic use was considerably higher, reaching nearly 11 percent in 2010. For the broader population, workplace clinics remained an unfamiliar care setting.

Services Sought and Reasons for Use

Health policy experts generally argued that workplace clinics could deliver the greatest cost savings through prevention and early diagnosis of chronic conditions -- catching diabetes, hypertension and other manageable diseases before they required expensive treatment. However, the study found that clinic users most commonly sought vaccinations and other minor, routine services rather than the preventive and chronic disease management services that held the most potential for long-term savings.

Nearly seven in 10 workplace clinic users cited convenience as a major reason for choosing the clinic over other care settings -- the clinic was right there at work, easy to reach during the day and required no travel time. About four in 10 cited lower costs as a motivating factor. These findings suggested that workplace clinics functioned primarily as a convenient substitute for routine care rather than as a platform for the intensive prevention and disease management that employers hoped would generate significant cost savings.

Limitations as a Cost Containment Strategy

The structural requirements for operating a viable workplace clinic -- a large employer with low employee turnover and a critical mass of workers concentrated at a single site -- meant that these facilities were unlikely to provide a broad-based solution for controlling health care spending or improving care delivery nationally. Most American workers were employed by smaller firms or at dispersed locations that could not support an on-site clinic. The research concluded that while workplace clinics offered real benefits to the specific employee populations they served, their potential as a system-wide cost containment tool was inherently limited.

Sources and Further Reading

This analysis was originally published as NIHCR Research Brief No. 10 by Ellyn R. Boukus and Ha T. Tu through the National Institute for Health Care Reform, affiliated with the Center for Studying Health System Change.