I have published a number of note about new settings for primary care delivery such as walk-in clinics in retail drug stores and big-box stores (links here) and also on-the-road clinics for Schneider long-distance truckers (link here). Toyota, in a brand new truck plant deep in the heart of Texas, has decided to attack its healthcare costs, which have doubled in the last five years, while also increasing quality. Here is the link to the story and below is an excerpt from the it:
In designing its newest plant, in San Antonio, Toyota is trying to tackle the [soaring healthcare cost] problem by building a clinic at the factory to provide a wider array of treatments and services than a typical factory medical office. The workers at the San Antonio pickup plant can have their eyes checked and their teeth repaired at the $9 million clinic, which also offers pediatric services, laboratory tests and physical therapy. By offering better primary care and preventive medicine, Toyota expects to rein in its health-care expenses. Companies that have adopted this approach tend to spend more for primary care and drugs, but that increase is more than offset by a drop in costly hospitalization and specialty care expenses....Toyota will gauge the success of the clinic by monitoring employees' health-care indicators, such as smoking-cessation rates and blood-pressure levels, and by tracking expenses ....Toyota would not require San Antonio workers to go to the on-site clinic, but it encourages them to do so by charging higher co-pays and deductibles for workers who choose to go elsewhere.
The on-site health care center will be operated by CHD Meridian Health Care (link here). The center will be open to Toyota’s 2,000 employees working at the plant and their dependents as well as the 2,100 employees of companies manufacturing parts for Toyota Tundra pickups at the 1.5 million-square-foot, $1.28 billion facility (link here).
There are lots of interesting issues raised by this story -- I will comment on a few of them:
- Toyota, as everyone knows, believes and invests in continuous quality improvement. Wellness programs can result in higher quality employee health. The company obviously believes that it can achieve better healthcare outcomes by more directly managing this function.
- Also of interest is that the company anticipates higher primary care and drug costs in connection with this new facility but that they will be offset by lower costs for specialist referrals and hospitalization. This makes sense intuitively and should also result in fewer sick days because of the earlier intervention.
- Although healthcare cost containment is one of the primary goals of this program, it's interesting that the company is establishing quantitative monitoring measures such as smoking cessation and blood pressure control. I wonder how frequently large multi-physician clinics entertain the idea of measuring the quality and efficacy of their professional services.
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