Going Mobile: On-Site Clinics Hit the Road for Employee Health Screenings

Leaders at Dallas-based Energy Future Holdings decided to invest in mobile health treatment after they unearthed a troubling fact.

Three-fourths of employees working for a subsidiary, roughly 1,000 based in rural East Texas, hadn’t gotten any urgent or preventive medical care during the prior three years.

That lack of prevention sometimes ended in tragedy, says Cyndie Ewert, director of benefits and human resources services at Energy Future Holdings, whose subsidiaries include energy company Luminant, where the 1,000 employees work.

“I saw a number of early deaths, men in their late 40s who should have survived a heart attack or a stroke,” Ewert says.

So Energy Future Holdings introduced a 40-foot mobile health clinic last year, one of the latest corporate trends in employee health outreach.

On-site clinics have become an increasingly common workplace sight, with 23 percent of U.S. employers offering one by 2011, according to an annual survey of 588 employers by Towers Watson & Co. and the National Business Group on Health. But mobile clinics offer an alternative for reaching geographically scattered workers. This spring, Mooresville, North Carolina-based home improvement retailer Lowe’s Cos. added three more mobile clinics to the two that already provide health screenings at stores across the country.

“Having a van makes a lot of sense,” says Helen Darling, president and CEO of the National Business Group on Health. “For the most part, unless you have a really big location, it’s hard to justify an on-site health center.”

To get medical care, Luminant’s 1,000 East Texas employees face multiple hurdles, Ewert says. Ninety percent of the employees, who work at power plants and mines, are men, a gender not prone to regular doctor visits. Plus, in rural areas, doctors can be scarce and reaching one can consume half a work day, Ewert says.

Driving to the office one day in 2010, Ewert had a “What if?” brainstorm. “What if I took the clinic to them?” she recalls wondering.

The result has been MobileDoc, which rotates among a handful of Luminant’s East Texas sites each month. The interior includes two exam rooms, a compact waiting area and lab space, among other features. It’s regularly staffed by a physician assistant and an emergency medical technician, who can treat maladies from allergies and infections to sprains and minor burns, along with preventive measures.

Clinic visits are free for employees and family members on company insurance, Ewert says. Other employees and dependents pay $75 per visit. And the employee is not docked for missing work. “We did not want any disincentive for people to go,” she says.

Meanwhile, managers fretted about employees malingering in the clinic, when they should be on the job, she says. But word spread about medical conditions that had been diagnosed, from diabetes to prostate cancer. By early this year, the clinic averaged seven to nine visits daily, Ewert says.

“The management team is ecstatic because the guys aren’t gone for half a day. They’re gone for 30 minutes.”

Ewert declined to share how much it cost to purchase the 40-foot vehicle, built by San Jose, California-based Legacy Transportation Services, or any related costs, saying that the information was proprietary. But the clinic is already demonstrating a good return on investment, she says.

The mobile approach typically requires a lower upfront investment than an on-site clinic, says Ha Tu, a senior health researcher at the Center for Studying Health System Change in Washington, D.C., who authored a 2010 research brief on workplace clinics. Quantifying return on investment for any workplace clinic can be complicated by the other factors that influence medical costs, such as changes in employee insurance coverage, Tu says.

Some vendors who develop these clinics can make “very high claims” in terms of return on investment, Tu cautions. A more conservative rule of thumb, based on Tu’s research and related vendor interviews, is that a workplace clinic might not break even for at least a year. After that, an employer potentially can save $1 to $2 in direct medical costs for every $1 invested, she says.

Lowe’s hasn’t calculated a hard return on investment figure for its mobile clinics, says Kyle Wendt, the company’s director of benefits. But the two original vehicles, which reached more than 55,000 employees in the first two years, has identified a higher rate of employees with high-risk conditions than in the general Lowe’s workforce, he says.

Perhaps, Wendt speculates, store employees are more likely to leave work for a few minutes—they aren’t docked for the lost time—in part because a vehicle seems less intimidating than a doctor’s office.

Of those employees screened, more than 7,000 were referred for a worrisome result, including 1,700-plus employees for high blood pressure. “We certainly had cases where folks’ blood pressure was so high that they called the ambulance for them right then and there,” Wendt says.

Energy Future Holdings is considering whether to broaden its mobile outreach by purchasing a second clinic, Ewert says. Regardless, company officials plan to monitor employee usage moving forward, along with the clinic’s cost effectiveness both in terms of boosted productivity and, ideally, better health.

Charlotte Huff is a freelance writer based in Fort Worth, Texas. To comment, email editors@workforce.com.

In 2011, the National Association of Worksite Health Centers was launched to highlight research and trends in the field. The Chicago-based trade organization, formed by the not-for-profit Midwest Business Group on Health and the La Penna Group, a consulting firm, is compiling numerous related resources online.