The casino operator’s decision to run a company clinic illustrates a national trend. As health care costs continue to rise, increasing numbers of large employers are operating job-site clinics in the hopes that easy access will lead workers to get preventive care and avoid medical meltdowns that lead to long absences from work and big insurance claims.

The concept of offering health care at work is not new, but many firms are moving away from an “occupational health” model that focuses on tasks such as treating on-the-job injuries.

Now, the clinics are acting as employees’ primary-care doctors, doing everything from vaccinations to caring for chronic diseases like diabetes.

Las Vegas-based Harrah’s owns the Grand Casino, Horseshoe and Sheraton properties in Tunica and with more than 5,500 workers is the biggest employer in the county. It’s in a position to have a big impact because the area’s health care system is weak.

The Mississippi Legislature and Tunica County’s leadership approved riverboat gambling in the early 1990s, leading to the creation of docked casinos and thousands of jobs. The health care infrastructure has grown much more slowly. The county, once one of the poorest in the nation, still has no hospital and only a handful of doctors.

Some Harrah’s employees are completely dependent on the clinic for health care, said Dr. Bobby Young Joe, who works there full time.

“They wouldn’t go anywhere if there wasn’t a facility like this at their site, accessible to work,” he said.

The Harrah’s clinic means convenience for people like Willie Jones, who works on a team that removes money from slot machines at Grand Casino.

Jones said he learned at a company-sponsored health fair months ago that he has high blood pressure and low blood sugar.

The heavyset 32-year-old with glasses and hair in tight braids came to the clinic this week for a follow-up visit and went through an electrocardiogram test. He said the staff told him he had a slow heart rate and should exercise and lose weight.

He’s insured through Harrah’s, and the costs of the visit will be deducted from his paycheck. The charge is $10 in most cases.

Jones, who lives in Horn Lake, said he appreciates the service.

“You don’t have to go all the way all the way to the doctor in Memphis or to the hospital in Horn Lake,” he said. “You can just come from right across the street.”

Harrah’s started job-site clinics at sites like Atlantic City and Las Vegas around 2005, said Jeff Shovin, a human resources executive for the firm. Employees of Cleveland, Ohio-based Whole Health Management Inc. run the clinics.

In Tunica, Harrah’s made casino purchases and inherited a medical program from a predecessor company. The clinic moved to its current location in an administrative building in 2006 and expanded late that year.

Shovin said Harrah’s clinics nationwide have led to more preventive care and fewer emergency room visits. He said the program is paying for itself, but declined to provide numbers.

There are some gaps: Harrah’s part-time and temporary employees don’t have health insurance. The company doesn’t let them use the clinics because of federal tax issues, but Shovin said the firm is looking for ways to make it possible.

Other firms are making their own clinics. Twenty-three percent of large businesses surveyed by the nonprofit National Business Group on Health said in late 2006 they had on-the-job clinics, and another 6 percent said they planned to create them in 2008, said Helen Darling, the president of the organization.

“I think the demand is going up dramatically,” said Stu Clark, executive vice president of Comprehensive Health Services Inc., a Vienna, Va. consulting firm which runs job-site clinics for clients including Nissan North America Inc. in Smyrna, Tenn.

Clark says his firm tells clients it can save them two to three dollars for every dollar they invest by reducing absenteeism and emergency care. But companies only recoup their investment in building and maintaining clinics if there are at least 1,000 workers in one location, he said.

The Tunica clinic handles everything a doctor’s office would, plus a few extras, including physical therapy and a small pharmacy.

It’s staffed six days a week by professionals including Joe, a 53-year-old former emergency room physician from Clarksdale, Miss., plus a part-time doctor and a staff of administrators and nurse practitioners, who have authority to diagnose and treat patients.

Joe said the clinic frequently discovers conditions like cancer and heart disease that can kill if left untreated.

“I think it’s admirable that Harrah’s has done such a great job on health care for employees,” he said.

JOB SITE CLINICS

Nationally, firms including American Express and Merrill Lynch & Co. operate job site clinics, according to the National Business Group on Health.

In Memphis, International Paper has a clinic staffed by nurses from Methodist Le Bonheur Healthcare, spokeswoman Amy Sawyer said.

FedEx Corp., which employs about 30,000 people in Memphis, does not have job site clinics. Spokeswoman Sally Davenport said the firm believes its work force is too spread out geographically for the approach to work.

Source: TradingMarkets.com
Original Publication Date: January 14, 2008