What are the benefits of creating a health center?

Applying a Healthy Approach to Employee Investment

While retaining and hiring quality employees continues to be a top priority for employers, presenting generous benefits and perks is critical and may require creative ideas and thinking big.

One company in Prince George, Virginia, chose to extend a common service to its employees by investing in their health care beyond health insurance. Service Center Metals (SCM) opened a health center on its premises on May 1, 2022, giving employees the gift of free preventive and nonpreventive health care for them as well as their spouses and dependent children. The 950-square-foot center, staffed with a full-time nurse practitioner, also includes a gym and access to a licensed fitness trainer.

The health center is a primary care facility offering health service which includes acute and episodic care, health coaching, chronic disease management, telemedicine, and standard laboratory services such as blood draws.

Providing these services acts as a hiring tool, speeds up the pre-employment process, strengthens company morale and creates a healthier workforce at SCM, an aluminum extrusion manufacturing plant with two buildings located on 30 acres. The company will soon finish construction of a 320,000 square-foot addition which includes a remelt plant and extrusion plant. When the new plants open, the company will increase its workforce to 350 total employees.

A Positive Outcome of the Pandemic

SCM began gathering information for establishing a health center at the end of 2020 during the COVID-19 pandemic. With many people sick and unable to seek immediate medical attention with their primary care providers, management began realizing how advantageous an on-site health clinic could be.

To cultivate excitement among employees and their families when the clinic first opened, SCM organized a Family Day to roll out the program and to sign up employees and their family members for their first visits to the center. Photo Credit: SCM

The company’s director of engineering, its human resources manager and Evan Neale, SCM’s environmental health and safety manager, first reached out to CareATC, a third-party health care services provider that often does business with companies of similar size to SCM. CareATC recommended that Neale and Sam Wang, director of engineering and IT, visit a facility that houses one of its health centers to experience hands on how it is run. So, they visited Banker Steel close by in Lynchburg, Virginia.

The visit opened their eyes to the key for having a successful clinic: a good nurse practitioner. “We got a really good vibe from one of the nurse practitioners there,” Neale says. “I said, if we can hire someone just like her, we will be golden.” He explains that she was very down to earth and knew how to talk to the employees. She treated them with respect, and they respected her in return.

After the trip, the SCM team pursued buy-in from its vice president of operations and the CEO. Upper management then presented the idea to its parent company, The Riverstone Group.

“The advice from Riverstone was if you are going to build it, build it right,” Neale says.

CareATC then met with the company a couple times to pitch a proposal and explore the facility. The health care provider explained the cost of startup, including the equipment necessary to supply the clinic. Construction could be managed by CareATC or by SCM, and SCM chose to do it themselves.

At that point, plans to move forward with the health center at SCM were underway. The beginning of this project marked one positive outcome of the pandemic for the company.

Location, Staff and Services

SCM decided to house the health center in its existing horizontal log casting plant where about 100 employees work. Initially, the project included transforming the existing break room/kitchen into the health exam room. But the plan quickly escalated to converting the entire front office into the health center, which included a lobby/waiting room with new furniture, an exam room, gym, bathrooms and a shower.

When it came to staffing the clinic and establishing hours of operation, CareATC guided SCM’s decision-making process. The health care provider also anticipated and continues to anticipate the health center’s needs for medical care equipment as well as supplies such as gauze, bandages and vaccines. Other items inside the center such as snacks and coffee are also managed by the health care provider.

“Based on our population of our company along with the employees’ dependents, CareATC advised that one nurse practitioner would be enough,” Neale says.

Unlike many on-site health centers at other companies, SCM provides care for its employees’ family members as well as the employees. Nicole Cole (left), the center’s well-liked nurse practitioner, takes time to care for each individual who walks through the health center’s doors. She also goes out of her way to accommodate their needs. Photo Credit: SCM

But not just any nurse practitioner would do. According to Neale and Joseph Sanderson, SCM’s human resources business partner, it is essential to staff a nurse who meshes well with the workforce at hand. Nicole Cole, the nurse practitioner who was assigned to SCM’s health center, is a shining example of that person. They say she is an excellent fit for the company and its culture.

One SCM employee writes, in a post-appointment evaluation of Cole, “She is a fantastic nurse. You can see how much she enjoys her job and helping people.”

Another employee reports that Cole always goes “above and beyond” what is expected of her. For example, she went out of her way to call different pharmacies to find the lowest price for a prescription drug for this patient.

Overall, Cole receives a 99% patient satisfaction rating, according to surveys given to each employee who visits the center.

Although Cole writes prescriptions when needed, there are no prescription medications or pharmacy on-site. However, SCM’s health insurance provides a prescription plan that covers the cost of many prescription medications. Also, the health center offers free vaccines to adults, including vaccines against shingles and COVID-19.

The health center is also used for pre-employment evaluation, including drug tests that can all be done in house — making the hiring process faster and helping ensure the hiring of quality candidates. This evaluation includes a functional movement assessment that can be conducted by the company’s licensed fitness trainer.

SCM offers a gym for employees who are working with the licensed fitness trainer available through the health center. Photo Credit: SCM

The fitness trainer also works in the facility’s gym guiding only employees who need resistance training or muscle rehabilitation in order to do their jobs correctly. The gym includes two pulley systems, kettle bells, dumbbells, exercise balls and a weight bench. Currently, it is open to all employees under the fitness trainer’s supervision.

The health center, open during normal business hours Monday through Friday, provides 20-minute time slots to ensure enough quality time with patients. By scanning a QR code, going to the CareATC website or calling the clinic during office hours, employees can quickly and easily schedule an appointment, even same-day appointments. A patient portal is also available that enables employees to see their medical records from past appointments at the center.

Exceptional Benefit, Exceptional Employees

Neale points out that from the beginning of the health center project, the objective was to make a long-term investment in employees, no matter the cost. Providing this free service for employees and their families on-site is an exceptional benefit. In return, the company retains and attracts exceptional employees.

Not only does the company have a healthier workforce since establishing the health center but offering this service also fosters company morale. To cultivate excitement among employees and their families when the clinic first opened, SCM organized a Family Day to roll out the program and sign up employees and their family members for their first visits to the center. They promoted a fun, family atmosphere by setting up bounce houses for the kids and gave away door prizes and food.

The health center at SCM is a primary care facility which includes acute and episodic care, health coaching, chronic disease management, telemedicine and standard laboratory services such as blood draws. Photo Credit: SCM

Since its opening on May 1 last year, employees are using the clinic in increasing numbers, more so than the company anticipated. In the first month, there were 53 visits to the clinic, and in the second month there were 142 visits. In November 2022, there were 99 visits. Total visits from May to November were 678. These numbers are far higher than what CareATC has seen at comparable companies, according to Sanderson.

Most importantly for SCM, providing this free benefit has saved its employees hundreds if not thousands of dollars in primary care physician and specialist visits, and emergency room and urgent care visits, not to mention additional lab and vaccination fees.

Neale also says instead of employees using their days off to see a doctor, which can impact their production bonus when having to leave work for a sick visit, the employee takes 20 minutes out of his or her shift to visit the in-house health center. That is a win-win for both the company and its employees.

Neale believes that eventually the company will reap the benefits of employee retention, but right now he says it is too soon to see an impact on retention numbers.

Outside of company walls, the health center is receiving attention as well. “I had someone ask me, ‘You work at SCM? That is the place that has the free health clinic, right?’,” Neale shares. “If you want to become a preferred employer in your area, recognition like that is a huge win.”

For any company considering building a health center on-site, Sanderson recommends going for it. “The upfront cost can be steep, but overall it is a tremendous net positive for the company,” he explains.

5 Considerations for Choosing an On-site Clinic Vendor

These five questions provided by CareATC will help machine shops that are considering establishing an on-site health center determine which vendor will provide quality service and real savings.

Which type of clinician leads the clinic? Primary care physicians cost more, but nurse practitioners are effective as well. If a key objective is to create a “medical home” on-site, a clinical physician provides a greater breadth and depth of services to replace a primary care physician. Also, specialists are more apt to collaborate with physicians.
Does the vendor operate on a fee-for-service model? Fee-for-service reimbursement is when each service rendered by the vendor is marked up and submitted to the company for repayment. Vendors that profit from this are incentivized to provide more of it — irrespective of whether a product or service is truly needed. A better alternative is when the company pays for the clinic’s operating costs (labs, office supplies, medications and staff time) and then pays a separate management fee, thereby discouraging profit-driven care.
Do employees and their families have to pay to use the clinic? If it costs something out-of-pocket for employees and their families to use the clinic services, including labs and generic medications, patient participation will be low. By making it easier for employees and their families to receive preventive and disease management care, employers can eliminate costly rates of specialty referrals and emergency visits.
Are in-person disease management, wellness and prevention services available? It is important the clinic vendor in consideration has a comprehensive plan to provide in-person health and wellness services. In-person disease management practices — which encourage employees stay engaged in the clinic and their personal wellbeing — help organizations avoid major health plan cost drivers such as heart attacks and strokes.
Are web-based health information technologies used? Robust electronic health record systems have made it possible to manage and quantitatively measure effectiveness of population care. With these systems in place, companies can obtain valuable aggregate data that paints the full picture of the care continuum. Be sure to ask for sample reports. Are they understandable, complete and transparent?

When considering an on-site clinic vendor, be sure to request references, testimonials and quantitative data on historical performance. And don’t be afraid to ask questions.