Get ready for corporate on-site clinics


CHD Meridian Healthcare, an I-trax Inc. company, appears to have struck the right note with large corporations seeking to bring on-site clinics to their employees.

CHD Meridian offers on-site health centers, which deliver primary care, acute care, corporate health, occupational health, and pharmacy care management services as well as integrated disease management, wellness, and lifestyle management programs. The company serves about 100 clients at more than 215 locations nationwide. Clients include Goodyear, Vermeer Manufacturing, and Toyota. Thirteen of the facilities it serves have healthcare centers and pharmacy colocated on site.

Dixon Thayer, CEO of CHD Meridian, told Drug Topics, "We're not the McDonald's of clinics. We do very significant customization based on the employer and employee population needs. Sometimes we put the health centers right in the community, if that's where there's a concentration of employees and their dependents and retirees."

CHD Meridian has studied the impact of its services on cost and access for some clients, including a large mining company. "We studied the population that had chronic needs that came to our health center versus the population in that employee set that went to the community at large. They are not required to use the company's services." The study found the following about patients who went to the company's health center: the patient admission rate to hospitals was reduced by 50%, hospital outpatient visits were reduced by 42%, there was less need for referrals, the medical claims costs were reduced by 32%, and pharmacy claims were reduced by 17%.

"It's one of those unique situations where the employer wins and the employee wins. You get lower costs through getting better care because of prevention, access, and availability," boasted Thayer.

Asked whether retail pharmacists feel threatened by corporate pharmacies, Thayer said, "Some local pharmacists don't like our model because we provide only what the patient needs-drugs and counseling. Our model offers a more convenient and more focused option for the patient. Another benefit to our pharmacies is that the pharmacists work hand-in-hand with on-site physicians to further establish a trusted relationship between the patient and medical practitioner."

While Thayer did not disclose CHD Meridian's revenues, he said that according to Technomic International, a Chicago research firm, the industry is now estimated at $3 billion or $4 billion. "Over the next four to five years, depending on the combination of services, it will grow to $9 billion or $12 billion."

Emphasizing that CHD Meridian's model requires a company to have 1,000 employees or more, Thayer said, "We offer a completely transparent pass-through model. We work with employers who understand that we expect to get a reward, but it's an open book. They work with us to select and establish compensation for the clinicians we hire. We have a national support network that allows us to provide and continually update, train, benchmark, and manage those clinicians so the employer does not have to. All the rebates go back to the employer, and we get paid a certain value for the management of those employees."

In addition, Thayer revealed that CHD Meridian is getting ready to launch a new program called One Rx. "It's a completely integrated transparent pass-through model for integrating the pharmacy benefit manager, the on-site pharmacy, the clinician, and so on," he said. "It's an amazing leverage."

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