The Rise of On-site and Near-site Clinics

On-site clinics are inclusive health and wellness centers that are located on the employer's premises and designed for employees who work at that location.

Near-site clinics are health and wellness facilities positioned close to the employer's work site, in an area that is convenient for a geographically dispersed workforce and their spouses and dependents.

A growing trend

On-site clinics have been around since the 1860s. Back then, railroad and mining companies used on-site clinics to better treat work-related injuries so that employees could remain on the job. On-site clinics grew in popularity during and after World War II, as shipyards and steel mills started implementing the program. By the 2000s, on-site clinics became even more visible, while near-site clinics began to emerge, as employers sought ways to compete for talent, improve their health care spending and enhance employee well-being.

The National Business Group on Health states that over half (54 percent) of employers will offer on-site or near-site clinics in 2018 — and that figure could rise to almost two-thirds by 2020.

In a survey by the National Association of Worksite Health Centers, most respondents said that they were reaping financial rewards from their on-site clinic, reporting a reduction of 64 percent in medical expenses, an almost 70 percent drop in lost time — since employees dont have to leave the premises to seek health care — and a 63 percent decline in the use of emergency room services.

Employee services

The services provided at on-site and near-site clinics vary according to the employer's needs, with physician assistants, nurse practitioners and registered nurses being the main providers. Among the most common services are:

• Primary care (physical exams, pharmacy, lab testing, disease management, etc.).
• Preventive care (health risk evaluations, biometric screenings, vaccinations, etc.).
• Urgent care (cold, flu, stitches, asthma, sprained ankle, etc.).
• Occupational health (work-related injuries, drug testing, medical surveillance, etc.).

Which is best for your employees?

Larger employers — especially those with a high concentration of on-site employees — are most likely to implement on-site clinics. Studies show that employers with around 500 to 700 employees in the same location tend to see optimal success with on-site clinics.

Smaller employers have reportedly expressed interest in on-site clinics, but these companies usually find it difficult to withstand the initial capital investment and ongoing operational costs that come with launching an on-site clinic. For this reason, near-site clinics are usually a more viable option for smaller employers, such as those with 100 or more employees.

Near-site clinics typically offer a shared clinic network, which is accessible by multiple employer clients, thereby resulting in cost savings. (These clinics are also frequently used by large employers with a distributed workforce.)

Both on-site and near-site clinics have been shown to greatly lower out-of-pocket medical costs, transportation expenses, lost work time and absenteeism while improving employees' health.

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