Impact of Workplace Health Centers on Health Care Spending and Utilization Among Plant Workers in California’s Central Valley

Abstract

Employers are becoming more active in strategies to reduce health care spending while maintaining or improving health outcomes for employees. Workplace wellness programs (WWPs) are popular, but the research is mixed on their efficacy in reducing spending and unnecessary utilization. Workplace health centers (WHCs), onsite clinics providing primary and additional care, are a viable alternative for self-funded, large employers. This study’s client, a $4.6B privately held agribusiness, opened its WHCs in late 2015 at two of its largest worksites. Analysis of health care-seeking employees with and without access to the WHCs found that access is associated with reductions in total health spending and utilization. The company’s WHCs also disproportionately benefited employees with chronic conditions, causally reducing non-emergent utilization for those with hyperlipidemia and diabetes. Links between WHC access and reduced spending, fewer ER visits, and fewer hospitalizations were also observed for other chronic conditions. By positioning WHCs as a substitute to traditional office visits and urgent care, company leadership can encourage employees to seek care “in house” and therefore have narrower external networks, resulting in cost savings. The chronic conditions population should continue to be the company’s focus in its health and wellness initiatives. Other large, self-funded employers considering WHCs should design their services to replace non-emergent care and cater to employees with chronic conditions.