Jonathan Spero, M.D.
CEO | InHouse Physicians

American employers will be looking forward to another year of rising employee health costs.

Despite countless incremental solutions such as wellness programs, consumer driven healthcare, and provider payment reform there has been very little impact on both the quality and the price of healthcare for employers.

The fundamental problem is that the structure of  employee healthcare delivery is broken. And the reason for this is found in the malfunctioning of healthcare competition. All of the well-intended reform solutions have failed because they do not address the underlying issue of competition. It is time for a fundamental new strategy.  At its core is a need to maximize value for patients – “value based healthcare”.  Value based healthcare delivers the best patient outcomes at the lowest cost. And every stakeholder has a role to play including employees, employers, benefit consultants, providers, health plans, and integrative medicine vendors.

Neither the prevailing fee-for-service nor the managed care models promote value based care.  Fee-for-service has fueled higher volumes of procedures and services with no measures to control employee healthcare costs or promote higher quality of care. And managed care has given providers incentives to restrict care but has not been able to control costs because of the lack of improvement in quality of care and associated clinical outcomes.


The next generation of worksite medical clinics offers corporations an effective strategy for transforming the delivery of employee healthcare to a value-based platform.


According to the Bureau of Labor Statistics, the average cost to private employers of providing health insurance to their employees increased from $1.03 per hour worked in March 1999 to $2.00 per hour worked in March 2009, which represents a change from 5.4 percent of total compensation to 7.3 percent of total compensation.

In addition to providing evidenced based, cost effective holistic employee healthcare in the health clinic, the clinic becomes a resource for a number of innovative cost containment tools. These tools include integrative medicine, patient centered medical home, population health management, narrow networks of high performance providers, price & quality transparency, patient advocacy, and negotiated agreements with centers of excellence.

In this setting, the worksite medical clinic becomes a trusted resource for medical care to employees, and in turn, the employee engagement in the center’s cost containment tools is superior to those realized in the non worksite medical clinic environment. The investment in the worksite health clinic realizes a tangible and significant return on investment that is supported by aggregate patient outcomes and claims data.