On-Site and Near-Site Health Clinics for Employers: When They Fit and What to Ask
An employer clinic puts primary care, urgent care or screenings close to the workplace. It can work when many employees are in one area and use primary care often, and it rarely works for a small or scattered workforce. Check your claims, your headcount by location and the legal design before you ask any vendor for a proposal.
Three Ways to Offer Clinic Care
On-Site Clinic
A clinic at your own location, staffed by a vendor or by your own clinicians. It gives employees the easiest access and carries the most fixed cost.
Near-Site Clinic
A clinic near several employers that share it. It spreads the fixed cost, and employees travel a short distance.
Virtual or Hybrid
Virtual primary care with a local partner for visits that need an exam. It suits dispersed workforces where a physical clinic would be underused.
Four Signs a Clinic May Pay Off
Many Employees in One Place
A concentrated workforce is what keeps the clinic busy. A small group spread across sites usually cannot keep one at useful capacity.
Shift or Hourly Workers
Employees who cannot easily leave work for an appointment gain the most from care on site.
High Use of Urgent Care and Primary Care
Frequent use of costly urgent care or the emergency room for simple needs suggests a clinic could redirect visits.
Many Members With Chronic Conditions
A clinic can support follow-up care and care management for members with diabetes or high blood pressure.
What Drives the Cost
Fixed Cost
Staff, space, equipment and insurance are paid whether or not the clinic is busy. This is the main risk of a clinic.
Use and Ramp-Up
Use typically builds over time. Plan for the first year to run below capacity and ask the vendor for a use forecast.
Measurement
Compare the clinic cost with avoided claims and productive time saved, using a similar group or prior years. Define the measure before you sign.
Settle These Questions Before You Sign
Group Health Plan Status
Whether a clinic is treated as a group health plan or an excepted benefit depends on the care it provides. Confirm with counsel, because it changes which rules apply.
HSA Eligibility
Free or discounted clinic care can affect whether employees in a high-deductible plan remain eligible to contribute to an HSA. Review the design with your tax advisor.
Privacy
Clinic staff and vendors handle protected health information. Confirm who can see records and what is shared with the employer.
Common Questions
How many employees do you need for a clinic?
There is no single number. The test is whether enough employees use it to cover the fixed cost. Ask any vendor for the minimum use it assumes.
Can a small employer use a clinic?
Rarely on site. A near-site shared clinic or virtual primary care is the more realistic option for a small group.
Does a clinic replace our health plan?
No. A clinic adds access to routine and urgent care. Employees still need the plan for specialists, hospital care and prescriptions the clinic does not cover.
Will a clinic reduce our renewal?
It may change use of care over time, but the renewal reflects many factors. Treat savings as a hypothesis to measure, not a promise.
Where These Rules Come From
26 U.S.C. §223 (Health Savings Accounts)
29 U.S.C. §1104 (ERISA §404, Fiduciary Duties)
45 CFR §164.504 (Uses and Disclosures, Plan Sponsors)
CFH are licensed insurance brokers, not attorneys or tax advisors. This page is general information, so confirm your situation with your benefits attorney or tax advisor.
Related Guides
Population Health Management for Employers
How a clinic fits a wider prevention strategy.
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