New models for access to non-urgent care are arriving. One can now see a physician or nurse practitioner in a drugstore, a grocery store or even a Wal-Mart. In a previous generation, the options included not only the family physician, but also the company doctor. Well, perhaps the old is new again.

Several major cities and counties in Tennessee, including Sumner County, Wilson County, Rutherford County and the City of Chattanooga have contracted to provide “company doctors.”

The organizer of these programs is CareHere, a Nashville company that currently operates 36 clinics in eight states for employers. A number of other health organizations, including Vanderbilt University, also offer health services to employers.

The initial reports are that these clients are experiencing a measurable and significant decrease in medical costs. The improvement is not only access to care, but also compliance with care.

Access is easier

It is easy to get an appointment, indeed a house call at your office, but it is also easy to get regular risk assessment, laboratory tests, health management programs for obesity, diabetes, high blood pressure and comprehensive health education.

Access to care is a common term in discussions about health reform. Massachusetts is completing its first month of implementing universal health care, and the first reports suggest there are not enough primary-care physicians to treat the citizenry.

One of the most interesting facts in the development of retail health-care structures is that at one time more than 60 percent of the patients who went to Wal-Mart health clinics were Medicaid eligible patients who were paying cash for services.

Those same customers could have been treated somewhere else for free, but they were willing to pay to be treated at Wal-Mart.

The principal payors of health care in America are the government (Medicare, Medicaid, SCHIP, etc.) or employers via private health insurance. Most individuals get their private health insurance from their employers, just as I have my entire professional life.

The prospect of having dedicated company doctors whose job it is to keep the work force healthy, engaged and compliant is a productive application of a time-tested theme.

It will be interesting to see how this alternative plays out in the pluralistic models of health-care access and delivery.

Source: The Tennessean
Original Publication Date: August 8, 2007