Case study of successful work site clinic at CM Almy in Pittsfield, Maine.

1. ON-SITE MEDICAL CLINICS:
IT’S NOT JUST FOR LARGE
COMPANIES ANY MORE
Denise Dumont-Bernier, PT
Director, Workplace Health at MaineGeneral Medical Center

2. Poll:
 What is the value of an on-site clinic to a large
employer?
 What do you think the owner of a small employer
in Maine says is the value of their on-site clinic?

3. On-site at CM Almy : 79 Employees
Pittsfield, ME- Population 4000
www.almy.com

4. “They’re part of our team/family”

5. On-site service models are changing
 Focused on Worker’s
Comp mitigation
 Larger employers
with greater needs
and the ability to
afford
 Expanded services
 Work comp/Occ.
Health
 Wellness
Programs
 Non-occupational
health
care/disease
management
 Tele health
Traditional Contemporary

6. Workplace Injuries Trend Downward
Over Last Decade

7. Current Health Trends are NOT
Sustainable
 Rising premiums and health care spending
 Obesity rates
 Inactivity
 Chronic disease/Diabetes
 Aging workforce
 Lost time/absence
POOR HEALTH COSTS MORE

8. Healthy Employees are Good for Business

9. Make the Business Case: Are
Business Priorities Linked To Health?
 Safety/Worker’s
Compensation
 Health Plan Costs
 Absence/Lost
Productivity
 Human Capital
(Retention/Recruitment)
 Employee Engagement
Strategy
 Performance
 Business Reputation
 Sustainability
 Profitability
 Growth

10. Creating a Health Culture
 Wellness/Well-being (Health) is not “soft”
 Culture drives outcomes
 Contributes to business priorities
• Top line growth
• Not just controlling spend
• Investment in human capital
 Organize stakeholders
 Create a culture where people
want to be healthy and use available resources

11. A Healthy Workplace
GOOD WORK at a
GOOD COMPANY contributes to
GOOD HEALTH
Focus on Employee Engagement

12. Planning and Implementation

13. Assessing the Scope and Staff
 Mod rate
 OSHA log
 Worker’s Comp.
expenses
 Lost work time/Absence
 Distance to nearest OEM
specialist
 Age of workforce
 Health insurance costs
 Health Risks
 COHN/RN
 OEM MD/NP/PA-C
 EMT
 PT
 Health Coach
 Wellness RN
 Primary Care Provider
 Clerical support
 Management*
Assessing the Scope Meeting the need

14. On-site Clinic Scope: Occupational Health
Injury
Prevention,
Employee Health
& Safety
•Medical Surveillance &
Immunizations
•Ergonomics
•Prevention Education
•Safety
•Wellness
Work Injury &
Illness Care
Management
•Triage
•Causation
Determination
•Diagnosis
•Treatment
•Care Coordination
•Ergonomics
•Team Meetings
Rehabilitati
on
& Return to
Work, Case
Closure
•PT/OT
•Case Management
•Work Reconditioning
•Modified duty
Pre-
Placement
Employment
Screening
• Pre-placement
Medical Exams
• Physical Agilities
Testing (PAT)
• Drug Testing
• Baseline
Screenings
• Ergonomics
* From Hire To Retire

15. On-site Clinic Scope: Wellness Programs
Behavior change
model:
Centered on the
individual’s personal
needs and health
goals, and supported
by the organization

16. Scope: Wellness/Health Coaching
Comprehensi
ve Programs
•Culture
•Leadership
•Environment
•Policies
•Wellness
Committees
•Engagement
Strategies
•Promotion
•Assessment
•Outcomes

17. On-site Clinic Scope:
Non-occupational Care
 Routine Care
 Annual physical exams
 Blood work/Labs
 Early diagnosis
 Prevention
 Immunizations
 Referral for Screenings
 Chronic Condition Management
 Medication Management
 Coaching/Care Coordination
 Acute Care on scheduled on-site days

18. On-site Considerations
 Private space/room/office
 Furniture (exam table, desk)
 Medical equipment & supplies
 Connectivity to hospital EHR
 Budgetary investment
 Commitment to partnership long term
 Rollout and communications to employees
 Labs- courier service
 A process of developing, implementing, and
sustaining a successful on-site medical service-
vendor with proven track record
On-site clinic at
new Hospital construction site

19. A Full Time Operation Is Not Necessary
 Back up plan is needed for urgent care
 On-site staff hours will depend on:
 Scope of services
 Number of employees at site
 Injury rates
 Investment in prevention
 Health status of population

20. CM Almy On-site Clinic est. 2008
*Comprehensive Wellness Program added in 2011
(Health Coach 1 day per week)
Services provided:
•½ day per week- RN
•2 hours per week MD

21. CM Almy
Pittsfield, Maine based company
 60.2% reduction in WC premium after
implementing on-site MD and RN services
for manufacturing facility of 75 employees
 Eliminated $60K of lost productivity costs

22. CM Almy- Workplace Health
Business Partnership
 On- site medical staff are part of the culture
 Open door to all employees for any reason
 “We want them well”
 Approachable
 Trusted relationships
 Prevention
 Keeping people from getting worse
 Work comp injuries/safety
 Enhanced communications

23. Wellness Program Impact

24. Wellness Program Participation Rate

25. Serving Companies With On-site Services

26. On-sites in Maine

27. The Returns When Done Well
 Control of health spending-
 especially if employer has self-funded/experience
rated plan
 Lowered out of pocket costs for employees
 Healthier, happier, more engaged workforce
 Lowered worker’s compensation rates
 Less absence from work/improved productivity
 Improved bottom line of business
Success comes with a strong partnership

28. Thank you
Denise Dumont-Bernier, PT
MaineGeneral Medical Center
Workplace Health Department
15 Enterprise Drive, Augusta, ME
C: 207-242-3924
Denise.dumont-bernier@mainegeneral.org
Thayer Campus, Waterville, ME
MaineGeneral Medical Center, Augusta, ME